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Sample records for biliares totales elevados

  1. 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

  2. Íleo biliar

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

    2005-01-01

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

  3. Íleo biliar

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    Allan Pérez-Baltodano

    2005-01-01

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

  4. Íleo biliar

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    Allan Pérez-Baltodano

    2005-01-01

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

  5. El paso elevado de Dunton, Inglaterra

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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. Osteodistrofia de la cirrosis biliar primaria

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    Guañabens Gay, Nuria

    1987-01-01

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

  7. 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. 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

  9. Biliary atresia Atresia de las vías biliares.

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    Pastor Thomas Olivares

    Full Text Available Biliary atresia is an obstructive and progressive process of unknown etiology that affects intra and/or extrahepatics biliary tracts and cause neonatal jaundice by serious obstruction of the biliary flow. It is presented with a frequency of 1 by each 10 000 – 15000 born alive. Is not hereditary and the most probable etiology is the progressive inflammatory illness of the biliary tracts. We presented the Good Clinical Practices Guideline for Biliary atresia, approved by consensus in the 4th National Good Clinical Practices Workshop in Pediatric Surgery (Las Tunas, Cuba, March, 2005.
    La atresia de vías biliares es un proceso obstructivo y progresivo de etiología desconocida que afecta las vías biliares intra y/o extrahepáticas y causa ictericia neonatal por obstrucción grave del flujo biliar. Se presenta con una frecuencia de 1 por cada 10 000 – 15 000 nacidos vivos. No es hereditaria y la etiología más probable es la enfermedad inflamatoria progresiva de las vías biliares. Se presenta la Guía de Buenas Prácticas Clínicas para Atresia intestinal yeyunoileal, aprobada por consenso en el 4º Taller Nacional de Buenas Prácticas Clínicas en Cirugía Pediátrica (Las Tunas, marzo 2005.

  10. 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.

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

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    Alexandre Coutinho Teixeira de Freitas

    2000-12-01

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

  12. Tuberculosis peritoneal con niveles elevados de CA 125

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    Andrés José Gómez-Aldana

    2013-01-01

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

  13. Tuberculosis peritoneal con niveles elevados de CA 125

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    Andrés José Gómez-Aldana

    2013-09-01

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

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

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

    2006-01-01

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

  15. Carcinoma insospechado de la vesícula biliar.

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    Armando Cortés

    2009-11-01

    Full Text Available Introducción. El carcinoma de la vesícula es una malignidad poco frecuente en Colombia. Este artículo pretende establecer la proporción global de carcinoma de la vesícula y el carcinoma de la vesícula insospechado e identificar características comunes en este grupo particular de pacientes. Materiales y métodos. Se evaluaron retrospectivamente todas las colecistectomías consecutivas realizados en la Fundación Hospital San José de Buga durante dos años. Resultados. De las 376 colecistectomías realizados en este hospital durante los dos últimos años, el carcinoma de la vesícula se diagnosticó en seis pacientes; sólo en uno de ellos fue sospechado antes de la cirugía. De acuerdo con la literatura la ocurrencia en mujeres (83.3% es más alta que en hombres (16.7%. La edad promedio es 58.5 años (rango 41-71; el síntoma más común es el dolor abdominal; la mayoría (66.7% tenía colelitiasis y los informes patológicos confirman el diagnóstico de adenocarcinoma en todos los 6 pacientes. Conclusión. La incidencia global de carcinoma insospechado de la vesícula en la presente serie es de 1.6%. No existió alguna característica común para este grupo de pacientes cuando se comparó con las personas con patología no-maligna. El carcinoma de la vesícula biliar puede pasar desapercibido al examen macroscópico del especímen quirúrgico tanto por el médico como por el radiólogo, el cirujano y el patólogo.

  16. 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

  17. Estenoses biliares benignas: reparação e resultados com o uso de silastic transhepático transanastomótico Benign biliary strictures: repair and outcome with the use of silastic transhepatic transanastomotic stents

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    José Artur Sampaio

    2010-12-01

    Full Text Available RACIONAL: Os avanços da medicina nem sempre estão relacionados a bons resultados homogêneos para todos os pacientes. Este é o caso de colecistectomia laparoscópica, cujas vantagens são amplamente reconhecidos na literatura médica. No entanto, ela pode trazer consigo temida e grave complicação que é lesão iatrogênica da via biliar extra-hepática. Ela vem aumentando nos últimos anos, apesar da curva de aprendizagem já estar ultrapassada na maioria dos centros. Está estabilizada em nível mais elevado do que o registrado nas colecistectomias laparotômicas. Na reparação das grandes lesões bom resultado pode ser alcançado com a utilização de tubos transanastomóticos em associação à hepaticojejunostomias. OBJETIVOS: Relatar 20 anos de experiência na reconstrução das vias biliares por lesão ductal com o uso de tubos transanastomóticos. MÉTODOS: Foram analisados os dados de 338 pacientes que se submeteram à operação para as principais lesões do ducto biliar entre janeiro de 1988 e dezembro de 2009. RESULTADOS: Todos os 338 pacientes foram submetidos à hepaticojejunostomias com anastomoses em Y-de-Roux (Hepp-Couinaud ou colangiojejunostomias, todos com o uso de tubos de silastic transanastomóticos. A longo prazo, bom resultado foi obtido em 240 (92,9% dos 338 pacientes, incluindo aqueles que necessitaram de procedimentos subsequentes. CONCLUSÃO: Estenoses biliares benignas próximas à confluência dos ductos hepáticos permanece sendo desafio cirúrgico. O uso de tubos de silastic transhepáticos transanastomóticos na reconstrução biliar alta é opção que pode proporcionar boa reparação biliar com baixos índices de complicações.BACKGROUND: The medical advances is not always related to homogeneous good results for all the patients. This is the case of laparoscopic cholecystectomy, whose advantages are largely recognized in the medical literature. However, this operation most dreaded complication

  18. 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

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

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

    2008-01-01

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

  20. 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

  1. Cirugía laparoscópica biliar Laparoscopic biliary surgery

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    P. Martí-Cruchaga

    2005-01-01

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

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

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    D. Martínez Ramos

    2009-02-01

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

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

    Science.gov (United States)

    Viozzi, Gustavo P; Flores, Verónica R

    2003-09-01

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

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

    OpenAIRE

    Rohacova ., Jana

    2010-01-01

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

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

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    Payares-Salgado Manuel A

    2010-06-01

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

  6. 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

  7. 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.

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

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    Lenin Enríquez Domínguez

    2009-01-01

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

  9. 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.

  10. 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

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

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    Humberto Izquierdo Oviedo

    2012-01-01

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

  12. 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

  13. 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

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

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    Antônio César Marson

    2004-08-01

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

  15. DOBLE CONDUCTO CÍSTICO EN VESÍCULA BILIAR ÚNICA: HALLAZGO QUIRÚRGICO Double cystic duct in single gallbladder: surgical finding

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    Lenin Enríquez-Domínguez

    2010-07-01

    Full Text Available La presencia de anomalías en el tracto biliar es un hallazgo común, sin embargo un conducto cístico doble sin la presencia de duplicación de la vesícula biliar es muy rara; y existen pocos reportes en la literatura. Presentamos el hallazgo transoperatorio de un conducto cístico doble, sin la presentación clínica típica. No se hizo diagnóstico prequirúrgico adecuado, a pesar de que existen los métodos apropiados. Es prudente tener en mente las malformaciones, de la vía biliar, para una correcta identificación.The presence of anomalies in the biliary tract is a common finding, but a double cystic duct without gallbladder duplication is very rare, and there are few reports in the literature. We report the chirurgical discovery of a double cystic duct, without the typical clinical presentation. Preoperative diagnosis was not appropriated, although there are precise methods to do it. We must keep in mind the malformations of the biliary tract, for a proper identification

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

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    Alberto Hideki Kanamura

    2007-10-01

    Full Text Available OBJETIVO: Analisar os gastos e o perfil de beneficiários de um plano de saúde privado e o impacto desses gastos nas finanças do plano e dos beneficiários. MÉTODOS: Estudo descritivo, incluindo 64.219 clientes de um plano de saúde que opera no Estado de São Paulo, no ano de 2003. Foram analisadas as características dos clientes de gastos elevados segundo a distribuição etária, por sexo, natureza dos gastos e doenças relacionadas. RESULTADOS: Dentre todos os clientes, 642 beneficiários (1% produziram os maiores gastos no ano, responsáveis por 36% do total. Dentre esses beneficiários, 45% eram idosos acima de 60 anos. O maior gasto foi com material e medicamento. As doenças do aparelho circulatório, neoplasias malignas, do sistema osteomuscular, do aparelho respiratório e as causas externas foram as mais freqüentemente relacionadas a esses gastos. CONCLUSÕES: A idade é um importante fator associado aos gastos elevados, tendo estreita relação com as doenças crônico-degenerativas. Assim, o envelhecimento da população aponta a necessidade de mudanças estratégicas na gestão dos planos de saúde privados.OBJECTIVE: To assess expenditures and the profile of beneficiaries of a private health plan and the impact of these expenditures on the finances of both the plan and of beneficiaries. METHODS: Descriptive study including 64,219 costumers of a health insurance plan of the State of São Paulo in the year of 2003. The characteristics of high spenders were assessed according to age group, gender, type of expenditure, and related diseases. RESULTS: Among all customers, 642 beneficiaries (1% were the highest spender in the year, accounting for 36% of the total. Among these beneficiaries, 45% were elderly, over 60 years old. Greatest expenditure was with medical supplies and drugs. Circulatory diseases, cancer, musculoskeletal diseases, respiratory tract diseases and the external causes were most frequently associated with these

  17. AVALIAÇÃO DE CITOCINAS NA FIBROSE HEPÁTICA INDUZIDA EM RATOS PELA LIGADURA DO DUCTO BILIAR

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    Juliana Saraiva Freitas

    2015-01-01

    Full Text Available A fibrose hepática é uma doença causada por uma grande variedade de doenças crônicas que afetam o fígado após diferentes agressões, cujo único tratamento é o transplante de fígado. A patogênese da fibrose engloba uma complexa interação entre as células e a matriz extracelular do tecido hepático, interações estas mediadas por citocinas que modulam a progressão da fibrose. O objetivo do trabalho foi analisar quantitativamente o perfil de citocinas pró-inflamatórias (IL-6 e TNF-a e anti-inflamatória (IL-10 no fígado de ratos, com diferentes graus de fibrose, induzida pela ligadura do ducto biliar (LDB. Vinte ratos foram submetidos ao procedimento da LDB e eutanasiados após 2, 4 e 6 semanas da indução da fibrose para a remoção do fígado e quantificação das citocinas pró e anti-inflamatórias pelo método de ELISA sanduíche. Foi observado o aumento na concentração de todas as citocinas após 4 semanas da LDB e diminuição dessas concentrações na 6ª semana. Dentre as citocinas pró-inflamatórias, o TNF-a mostrou aumento e diminuição estatisticamente significantes, respectivamente, na 4ª e 6ª semana, quando comparado a IL-6, a qual não apresentou significância estatística em nenhuma semana após a LDB. A IL-10, mostrou-se, significativamente, elevada na 4ª semana, seguida de uma diminuição moderada na 6ª semana. Esses resultados indicam que o TNF é a principal citocina na progessão da fibrose biliar, principalmente, durante sua fase intermediária. Ao mesmo tempo, a IL-10 atua nessa fase, limitando a produção da citocina pró-inflamatória TNF-a, na tentativa de um controle endógeno da progressão da doença.

  18. Depósito elevado Mar de Plata República Argentina

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    Magaldi, Jorge W.

    1974-12-01

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

  19. 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

  20. 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

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

    OpenAIRE

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

    2005-01-01

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

  2. 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)

  3. 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

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

    OpenAIRE

    Lucio Costa, Olga

    2014-01-01

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

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

    OpenAIRE

    A. Mendoza Domínguez; M. Graniel Peralta

    2006-01-01

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

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

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    Moreno, Paloma

    2012-01-01

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

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

    OpenAIRE

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

    2006-01-01

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

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

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    José Carlos Menegoci

    1999-12-01

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

  9. Efeito perioperatório do índice de massa corporal elevado no bloqueio do nervo periférico: uma análise de 528 bloqueios interescalênicos guiados por ultrassom

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    Kristopher Schroeder

    2012-02-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Os pacientes obesos podem representar um desafio anestésico perioperatório único, tornando as técnicas anestésicas regionais um meio desafiador de oferecer analgesia para esta população. A orientação por ultrassom foi recentemente elogiada como sendo benéfica para esta população na qual os limites anatômicos de superfície podem ser obscurecidos. Neste estudo, é investigado o efeito do Índice de Massa Corporal (IMC elevado no bloqueio interescalênico do nervo periférico guiado por ultrassom. MATERIAL E MÉTODOS: Este estudo é uma análise retrospectiva de 528 pacientes consecutivos que receberam bloqueios nervosos interescalênicos pré-operatórios guiados por ultrassom no Hospital e Clínica da University of Wisconsin. Examinamos a associação entre IMC e os parâmetros: tempo exigido para localização do bloqueio; presença de náuseas e vômitos pós-operatórios (NVPO; pontuações de dor pós-operatória na sala de recuperação pós-anestésica (SRPA; volume de anestésico local injetado; complicações agudas; e administração de opioides antes, durante e depois da cirurgia. Foram utilizadas regressões univariada e multivariada com estimativa dos mínimos quadrados e logística. RESULTADOS: Um IMC elevado foi associado a maiores: tempo exigido para localização do bloqueio (p = 0,025, administração de fentanil durante a cirurgia (p < 0,001, pico de pontuações de dor em SRPA (p < 0,001, administração de opioide na SRPA (p < 0,001, administração oral de opioide na SRPA (p < 0,001, administração total de opioide na SRPA (p < 0,001 e incidência de náusea em SRPA (p = 0,025. CONCLUSÕES: Os bloqueios nervosos interescalênicos guiados por ultrassom para analgesia perioperatória podem ser executados de forma segura e efetiva em pacientes obesos, mas o procedimento pode ser mais difícil e a analgesia talvez não seja completa

  10. 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

  11. 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

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

    Directory of Open Access Journals (Sweden)

    José Gustavo Parreira

    2004-12-01

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

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

    OpenAIRE

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

    1989-01-01

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

  14. 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 Rats inoculated with the Ystrain of Trypanosoma cruzi and control rats of the same age and sex were submitted to examination of the gastric mucosa exposed in vivo to an acidified solution of a bile salt, sodium taurocholate (TC. Neuronal counts in the myenteric plexus of the stomach were also performed for several animals in both groups. The scores indicating the severity of the lesions produced by TC were significantly higher (P 0.10 was observed between chagasic (1683.6 ± 449.7, n = 10 and control (1732.8 ± 401.1, n = 10 animals. These results indicate that in experimental chronic Chagas' disease the gastric mucosa is more sensitive to the damaging action of TC, suggesting reduction of the natural cytoprotection of the stomach. This abnormality does not appear to be due to changes in intrinsic innervation that may imply a reduction of the number of intramural neurons of the stomach.

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

    Directory of Open Access Journals (Sweden)

    J. García-Cano

    2010-09-01

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

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

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    Jeany Borges e Silva Ribeiro

    2012-12-01

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

  17. Endoscopic laser lithotripsy for complicated bile duct stones: is cholangioscopic guidance necessary? Litotripsia endoscópica a laser para cálculos difíceis de via biliar: a colangioscopia é necessária?

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    Ralf Jakobs

    2007-06-01

    guiada por fluoroscopia somente ou por colangioscopia. MÉTODOS: Entre 1992 e 2002 foram tratados 89 pacientes com cálculos biliares de difícil extração pela colangiopancreatografia endoscópica retrógrada e litotripsia à laser. Litotripsia extracorpórea e eletro-hidráulica sem sucesso foram executados antes do laser em 35% e 26% dos casos, respectivamente. RESULTADOS: O laser foi efetivo em 79,2% dos 72 pacientes guiados por colangioscopia e, em 82,4% dos 17 casos guiados por fluoroscopia. A média de impulsos do último foi de 4 335 e da primeira técnica de 1 800. Dois parâmetros influenciaram o modo de orientação da litotripsia à laser. Nos casos de cálculos situados proximais a uma estenose, o controle colangioscópico foi mais efetivo (64,7% vs 31,9%. Quando os cálculos estavam na via biliar distal, o controle fluoroscópico era mais efetivo. CONCLUSÃO: Nos casos de cálculos biliares de difícil extração na via biliar distal, litotripsia à laser com controle fluoroscópico é muito efetiva e de fácil execução. A orientação colangioscópica deve ser recomendada somente nos casos de cálculos intra-hepáticos ou em pacientes com cálculos situados proximamente a uma estenose de via biliar. Nesses casos, colangioscopia pode ser executada tanto por via endoscópica quanto percutânea.

  18. 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

  19. 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.

  20. 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.

  1. Relationship between intraduodenal peri-ampullar y diver ticulum and biliar y disease in 178 patients undergoing ERCP

    Institute of Scientific and Technical Information of China (English)

    Shuo-Dong Wu; Yang Su; Ying Fan; Zhen-Hai Zhang; Hao-Lin Wang; Jing Kong; Yu Tian

    2007-01-01

    BACKGROUND:The presence of intraduodenal peri-ampullary diverticulum is often observed during upper digestive tract barium meal studies and endoscopic retrograde cholangiopancreatography (ERCP). A few papers in China and overseas reported that the diverticulum had something to do with the incidence of cholelithiasis. This study was undertaken to further test this notion and ascertain the relationship between intraduodenal peri-ampullary diverticulum and biliary disease, especially the formation of bile duct pigment stones. METHODS: A total of 178 patients who had undergone ERCP or endoscopic sphincterotomy (EST) were studied retrospectively. They were divided into 6 groups according to the category of biliary disease, and the incidence rates of intraduodenal peri-ampullary diverticulum were calculated. RESULTS:There were 44 patients with intraduodenal peri-ampullary diverticulum in 81 patients with primary bile duct pigment stones (54.32%), 4 in 8 patients with bile duct stones and gallbladder stones (50%), 7 in 33 patients with bile duct stones secondary to gallbladder stones (21.21%), 3 in 21 patients with inlfammation and stricture of the end of the bile duct and papilla (14.29%), 1 in 22 patients with carcinoma of the end of the bile duct and papilla (4.54%), and 5 in 13 patients with post-cholecystectomy syndrome or sphincter of Oddi dysfunction (38.46%). CONCLUSIONS:The incidence rate of intraduodenal peri-ampullary diverticulum in patients with primary bile duct pigment stones is higher than that in patients with bile duct stones secondary to gallbladder stones, patients with inlfammation and stricture of the end of the bile duct and papilla, and patients with carcinoma of the end of the bile duct and papilla. These ifndings indicate that the anatomical abnormalities and malfunction of the sphincter of Oddi play an important role in the formation of bile duct pigment stones.

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

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    F. Arévalo

    2007-12-01

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

  3. 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

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

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    E. Cortés

    2013-08-01

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

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

    OpenAIRE

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

    2001-01-01

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

  6. 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.

  7. 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

  8. 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 ...

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

    OpenAIRE

    Cynthia R Matos Silva Passoni; Cláudio Antônio Rabello Coelho

    2008-01-01

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

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

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    Everson L. A. Artifon

    2006-12-01

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

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

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    Duenas Zulma

    2012-04-01

    Full Text Available

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

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

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    Torroja, José Antonio

    1964-02-01

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

  13. Tratamento cirúrgico da atresia de vias biliares: a experiência do hospital municipal jesus, 1997-2000 Surgical treatment of biliary atresia: the hospital municipal jesus experience 1997-2000

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    Lisieux Eyer de Jesus

    2001-04-01

    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.BACKGROUND: Indications, results and limitations of portoenterostomy to treat biliary atresia in a referral pediatric hospital in Rio de Janeiro, Brazil, are discussed

  14. 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

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    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

  15. Total algorithms

    NARCIS (Netherlands)

    Tel, G.

    1993-01-01

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

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

    OpenAIRE

    Atiaga, Galo; Demoraes, Florent

    2003-01-01

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

  17. 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

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    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

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

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    Monica Novis

    2010-06-01

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

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

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    Diego Sánchez de Lozada

    2006-10-01

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

  20. 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...

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

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    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.

  2. 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

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    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.

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

    OpenAIRE

    Bonet Beltrán, Marta

    2009-01-01

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

  4. Meningeal carcinomatosis as the initial manifestation of a gallbladder adenocarcinoma associated with a Krukenberg tumor Carcinomatose meníngea como manifestação inicial de um adenocarcinoma de vesícula biliar com tumor de Krukenberg

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    Tizuko Miyagui

    2003-01-01

    Full Text Available A case of malignant neoplasm is described in which the initial manifestations were mental dysfunction and meningeal irritation, mimicking chronic or subacute meningitis. Physical examination showed cranial nerve involvement and a pelvic tumor. There was progressive deterioration, and death occurred in 2 weeks. The autopsy revealed a gallbladder adenocarcinoma, meningeal carcinomatosis, and ovarian metastasis presenting as a Krukenberg tumor. The authors emphasize the importance of including meningeal carcinomatosis as a possibility in the differential diagnosis of non-characteristic clinical pictures, as well as the importance of the cerebrospinal fluid cytologic examination, repeated as needed, in order to confirm this diagnosis.Descreve-se um caso de neoplasia maligna cuja manifestação inicial foi distúrbio de comportamento e quadro de irritação meníngea, simulando uma meningite subaguda ou crônica. Na investigação clínica foram detectados o comprometimento de pares cranianos e a presença de massa tumoral pélvica. Houve piora progressiva, com evolução para o óbito em duas semanas. No exame post-mortem foram diagnosticados adenocarcinoma de vesícula biliar com componente mucinoso, carcinomatose meníngea e metástase ovariana sob a forma de um tumor de Krukenberg. Os autores mostram a importância da inclusão da carcinomatose meníngea no diagnóstico diferencial de quadros neurológicos incaracterísticos, e a necessidade de exames citológicos do liquor, às vezes repetidos, para a confirmação desta hipótese diagnóstica.

  5. Total Thyroidectomy

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    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.

  6. 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.

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

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    V. G. Domiciano

    2006-09-01

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

  8. Hemoperitoneo masivo consecutivo a perforación espontánea de la vesícula biliar: A propósito de un caso de muerte súbita Massive haemoperitoneum as a complication of spontaneous rupture of the gallbladder: Report of a sudden death

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    P.M. Garamendi

    2002-04-01

    Full Text Available Se presenta un caso de hemoperitoneo masivo consecutivo a perforación espontánea de la vesícula biliar asociada con colelitiasis, obstrucción del conducto cístico y colecistitis aguda hemorrágica que produjo como primera manifestación la muerte súbita en un varón adulto. En la literatura médica este tipo de situación clínica y anatomopatológica es excepcional. Los casos descritos de perforaciones espontáneas de la vesícula biliar con hemoperitoneo asociado son menos de 50 desde 1858. Desde 1952 solo existe otra referencia de 1991 de un hallazgo similar, aunque no asociado a colelitiasis, como causa de muerte súbita.We report a case of sudden death due to massive haemoperitoneum as a complication of spontaneous rupture of the gallbladder associated with cholelithiasis, obstruction of the cystic duct and acute haemorrhagic cholecystitis. Death occurred in an adult male previously asymptomatic. This is an unusual circumstance in the medical literature. Since 1858, less than 50 cases of spontaneous rupture of the gallbladder associated with haemoperitoneum have been reported. Since 1952, there is only one other case of sudden death with this clinical condition, reported in 1991, but not associated with cholelithiasis.

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

    Directory of Open Access Journals (Sweden)

    Diane Jackson

    2012-08-01

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

  10. 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

  11. 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

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

    2011-01-01

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

  12. 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

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

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    Luiz Carlos Bertges

    1999-08-01

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

  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. 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

  16. 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

  17. 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.

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

    OpenAIRE

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

    2011-01-01

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

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

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    DIEGO ARMANDO LEÓN RODRÍGUEZ

    2012-04-01

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

  20. 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.

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

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    AV Abregú

    2012-09-01

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

  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

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    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. Restricted total stability and total attractivity

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    Giuseppe Zappala'

    2006-08-01

    Full Text Available In this paper the new concepts of restricted total stability and total attractivity is formulated. For this purpose the classical theory of Malkin with suitable changes and the theory of limiting equations, introduced by Sell developed by Artstein and Andreev, are used. Significant examples are presented.

  4. Níveis pressóricos elevados em mulheres com síndrome dos ovários policísticos: prevalência e fatores de risco associados Elevated blood pressure in women with polycystic ovary syndrome: prevalence and associated risk factors

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    Maria Fátima de Azevedo

    2011-01-01

    Full Text Available OBJETIVO: investigar a prevalência de níveis pressóricos elevados em pacientes com síndrome dos ovários policísticos (SOP e correlacionar os níveis de pressão arterial (PA com outros fatores de risco cardiovascular. MÉTODOS: por meio de estudo transversal, foram alocadas 113 mulheres com SOP (26,2±4,3 anos e um Grupo Controle com 242 mulheres saudáveis da população geral (26,8±5,0 anos. As variáveis consideradas foram: PA sistólica e diastólica, parâmetros antropométricos e concentrações séricas de glicose, colesterol total, HDL-colesterol e triglicerídeos. Os valores de PA foram classificados de acordo com as V Diretrizes Brasileiras de Hipertensão. A análise estatística constou da comparação intergrupos com os testes t de Student e do χ2 e análise de correlação com teste de correlação de Pearson. RESULTADOS: o Grupo SOP apresentou prevalência de PA alterada (>130/85 mmHg significativamente superior ao Grupo Controle (18,6 versus 9,9%, respectivamente; pPURPOSE: to investigate the prevalence of elevated blood pressure (BP in patients with polycystic ovary syndrome (PCOS and to correlate the BP levels with other cardiovascular risk factors. METHODS: a cross-sectional study was conducted on 113 PCOS women (26.2±4.3 years and on a Control Group of 242 healthy women from the general population (26.8±5.0 years. The variables considered were: systolic and diastolic BP, anthropometric parameters and plasma levels of glucose, total cholesterol, HDL-cholesterol, and triglycerides. The BP values were classified according to the V Brazilian Guidelines of Hypertension. Statistical analysis was performed by intergroup comparison with the Student's t-test and χ2 test, and correlation analysis was performed using Pearson's coefficient. RESULTS: the PCOS Group showed a significantly higher prevalence of altered BP (>130/85 mmHg than the Control Group (18.6 versus 9.9%, respectively; p<0.05. PCOS women had higher mean

  5. 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

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    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

  6. Laparoscopic cholecystectomy in the treatment of biliary lithiasis: outpatient surgery or short stay unit? Colecistectomía laparoscópica en el tratamiento de la litiasis biliar: ¿cirugía mayor ambulatoria o corta estancia?

    Directory of Open Access Journals (Sweden)

    A. Martínez Vieira

    2004-07-01

    ísticas clínicas, quirúrgicas y evolución postoperatoria de ambos grupos de pacientes Resultados: el grupo A estaba compuesto por 53 pacientes. El Grupo B por 28 pacientes. Los factores con significación estadística que determinaron que el alta se prolongara más de 24 horas fueron: las incidencias o complicaciones postquirúrgicas precoces (p=0,017, la no tolerancia oral de alimentos (p=0,002 y las dudas o inseguridad de los pacientes ante el alta determinada por la tradición cultural (62,3%; p=0,0003. Conclusiones: la colecistectomía laparoscópica ambulatoria es un procedimiento seguro y realizable, con un elevado porcentaje de aceptación y escasas complicaciones. Quizás se deba cambiar la tradición cultural para obtener mejores resultados.

  7. Qualidade total do produto Products total quality

    Directory of Open Access Journals (Sweden)

    Henrique Silveira de Almeida

    1992-06-01

    Full Text Available O texto aborda o conceito de qualidade total do produto, seus determinantes, bem como as dimensões que compõem essa qualidade. Parte-se do pressuposto de que a qualidade do produto deve ser avaliada pela satisfação total do consumidor. Para o consumidor a qualidade do produto envolve pelo menos as seguintes dimensões: a qualidade do produto em si; a qualidade do produto ao longo do tempo; a qualidade dos serviços associados ao uso do produto; e o custo do ciclo de vida do produto. O trabalho procura detalhar e discutir cada uma dessas dimensões da qualidade, tendo em vista a satisfação do consumidor.The paper concerns to the concept of product's total quality, its determinants, and the dimensions wich constitute this quality. We admit that product quality should be evaluated via consumer's total satisfaction. Product quality for consumers includes at least the following dimensions: the product quality per se; the performance of product quality over time; the quality of services related to the use of the product; and the product lifecycle costs. This study seeks to specify and to discuss each of these quality dimensions related to consumer's satisfaction.

  8. Total parenteral nutrition

    Science.gov (United States)

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

  9. Total Knee Replacement

    Science.gov (United States)

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

  10. 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 ...

  11. Anatomic Total Shoulder System

    Medline Plus

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

  12. 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....

  13. Controversy Total War

    OpenAIRE

    Segesser, Daniel Marc

    2014-01-01

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

  14. Totalization Data Exchange (TDEX)

    Data.gov (United States)

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

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

    Directory of Open Access Journals (Sweden)

    Mauren Lúcia de Araújo Bergmann

    2011-07-01

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

  16. 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...

  17. 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.

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

    OpenAIRE

    Matencio Hilla, Esther

    2013-01-01

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

  19. 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.

  20. 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

  1. Anatomic Total Shoulder System

    Medline Plus

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

  2. Total Water Management - slides

    Science.gov (United States)

    Total Water Management (TWM) examines urban water systems in an interconnected manner. It encompasses reducing water demands, increasing water recycling and reuse, creating water supply assets from stormwater management, matching water quality to end-use needs, and achieving envi...

  3. Anatomic Total Shoulder System

    Medline Plus

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

  4. Total parenteral nutrition

    Science.gov (United States)

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

  5. Anatomic Total Shoulder System

    Medline Plus

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

  6. Anatomic Total Shoulder System

    Medline Plus

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

  7. Total 2004 results

    International Nuclear Information System (INIS)

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

  8. Anatomic Total Shoulder System

    Medline Plus

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

  9. Anatomic Total Shoulder System

    Medline Plus

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

  10. Total Ecosystem Carbon Stock

    Data.gov (United States)

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

  11. Anatomic Total Shoulder System

    Medline Plus

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

  12. Anatomic Total Shoulder System

    Medline Plus

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

  13. Anatomic Total Shoulder System

    Medline Plus

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

  14. Anatomic Total Shoulder System

    Medline Plus

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

  15. 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.)

  16. Total lymphoid irradiation

    Energy Technology Data Exchange (ETDEWEB)

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

    1983-05-01

    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.

  17. Niveles de plomo elevados en sangre de niños que vivían en casas antiguas de Evansville, Indiana: asociación entre año de construcción de la casa, niveles de plomo en suelo y niveles de plomo en sangre de niños de 1-5 años, entre 1998-2006

    Directory of Open Access Journals (Sweden)

    Diane Jackson

    2012-08-01

    Full Text Available En este estudio se evaluaron los niveles de plomo en 18.218 muestras de sangre. Las muestras de 11.719 niños de Evansville, Indiana, de edades comprendidas entre 1 y 5 años se obtuvieron de manera voluntaria entre los años 1998 y 2006. Se evaluaron además los niveles de plomo en el suelo de 35 jardines residenciales correspondientes al domicilio de 81 niños.Durante el periodo de estudio, tanto los niveles de plomo en sangre como el porcentaje de valores elevados para dichos niveles fueron descendiendo. A pesar de ello, los valores de plomo en sangre en Evansville siguieron estando por encima de los nacionales (mediana de niveles de plomo en sangre 3,0 frente a 1,5 μg/dL, respectivamente. Nuestro análisis dio como resultado que vivir en casas antiguas (presumiblemente con pintura que contiene plomo estaba asociado con niveles más elevados de plomo en sangre en los niños. No se encontró una asociación clara de los niveles elevados de plomo en sangre ni con el género ni con los niveles de plomo en el suelo de los jardines.

  18. Algebraic totality, towards completeness

    CERN Document Server

    Tasson, Christine

    2009-01-01

    Finiteness spaces constitute a categorical model of Linear Logic (LL) whose objects can be seen as linearly topologised spaces, (a class of topological vector spaces introduced by Lefschetz in 1942) and morphisms as continuous linear maps. First, we recall definitions of finiteness spaces and describe their basic properties deduced from the general theory of linearly topologised spaces. Then we give an interpretation of LL based on linear algebra. Second, thanks to separation properties, we can introduce an algebraic notion of totality candidate in the framework of linearly topologised spaces: a totality candidate is a closed affine subspace which does not contain 0. We show that finiteness spaces with totality candidates constitute a model of classical LL. Finally, we give a barycentric simply typed lambda-calculus, with booleans ${\\mathcal{B}}$ and a conditional operator, which can be interpreted in this model. We prove completeness at type ${\\mathcal{B}}^n\\to{\\mathcal{B}}$ for every n by an algebraic metho...

  19. Total Energy Monitor

    Energy Technology Data Exchange (ETDEWEB)

    Friedrich, S

    2008-08-11

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

  20. 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...

  1. Strictness and Totality Analysis

    DEFF Research Database (Denmark)

    Solberg, K. L.; Nielson, Hanne Riis; Nielson, Flemming

    1998-01-01

    We define a novel inference system for strictness and totality analysis for the simply-typed lazy lambda-calculus with constants and fixpoints. Strictness information identifies those terms that definitely denote bottom (i.e. do not evaluate to WHNF) whereas totality information identifies those...... terms that definitely do not denote bottom (i.e. do evaluate to WHNF). The analysis is presented as an annotated type system allowing conjunctions at ?top-level? only. We give examples of its use and prove the correctness with respect to a natural-style operational semantics....

  2. Total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Slavković Nemanja

    2012-01-01

    Full Text Available Total hip arthroplasty is most common reconstructive hip procedure in adults. In this surgery we replace some parts of the upper femur and acetabulum with biocompatible materials. The main goal of this surgery is to eliminate pain and regain full extent of joint motion, maintaining hip stability. Surgical technique, biomaterials, design of the prosthesis and fixation techniques have evolved with time adjusting to each other. After total hip arthroplasty patients’ quality of life should be improved. There are many various postoperative complications. Some of them are fatal, and some are minor, which may become manifested years after surgery. Each next surgical procedure following previous hip surgery is associated with considerably lower chances to be successful. Therefore, in primary total hip arthroplasty, preoperative evaluation and preparation of patients are essential. Every orthopaedic surgeon needs to improve already adopted surgical skills applying them with precision and without compromise, with the main goal to achieve long-term durability of the selected implant. The number of total hip arthroplasties will also increase in future, and newer and higher quality materials will be used.

  3. Total Cost of Ownership

    DEFF Research Database (Denmark)

    Zachariassen, Frederik

    2007-01-01

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

  4. "Total Deposition (TDEP) Maps"

    Science.gov (United States)

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

  5. CSF total protein

    Science.gov (United States)

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

  6. Total Synthesis of Naloxone

    Institute of Scientific and Technical Information of China (English)

    HU Wen-Xiang; WANG Jian-Ying; XU Ming

    2003-01-01

    @@ Naloxone (1) is one of the 14-hydroxyl substituted opium antagonists which are valuable medications for treat ment of opiate abuse, opiate overdose, and alcohol addiction. Here, the total synthesis of naloxone was described. We selected 2,6-dihydroxynaphalene (2) as the starting material.

  7. Total 2004 annual report

    International Nuclear Information System (INIS)

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

  8. Anatomic Total Shoulder System

    Medline Plus

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

  9. 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…

  10. 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…

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

    OpenAIRE

    Hulya Ozturk; Akan Terzi; Hayrettin Ozturk; Aysel Kukner

    2010-01-01

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

  12. Total 2003 Results

    International Nuclear Information System (INIS)

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

  13. Total - annual report 2005

    International Nuclear Information System (INIS)

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

  14. Total Synthesis of Millingtonine.

    Science.gov (United States)

    Brown, Patrick D; Lawrence, Andrew L

    2016-07-11

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

  15. Total synthesis of teixobactin

    Science.gov (United States)

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

    2016-08-01

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

  16. Cervical Total Disc Arthroplasty

    OpenAIRE

    Basho, Rahul; Hood, Kenneth A.

    2012-01-01

    Symptomatic adjacent segment degeneration of the cervical spine remains problematic for patients and surgeons alike. Despite advances in surgical techniques and instrumentation, the solution remains elusive. Spurred by the success of total joint arthroplasty in hips and knees, surgeons and industry have turned to motion preservation devices in the cervical spine. By preserving motion at the diseased level, the hope is that adjacent segment degeneration can be prevented. Multiple cervical disc...

  17. Total synthesis of teixobactin.

    Science.gov (United States)

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

    2016-01-01

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

  18. Total synthesis of ochnaflavone

    OpenAIRE

    Monica M. Ndoile; van Heerden, Fanie R

    2013-01-01

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

  19. Total synthesis of ochnaflavone

    Directory of Open Access Journals (Sweden)

    Monica M. Ndoile

    2013-07-01

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

  20. Boosting Total Relationship Marketing

    OpenAIRE

    Aykut, Arslan

    2008-01-01

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

  1. Avaliação da lesão isquêmica normotérmica do fígado: papel da oclusão do ducto biliar principal e da N-acetilcisteína Evaluation of the normothermic ischemic liver injury: the role of main biliary duct occlusion and N-acetylcysteine

    Directory of Open Access Journals (Sweden)

    Susi Heliene Lauz Medeiros

    2005-08-01

    Full Text Available OBJETIVO: Estudar o efeito da N-acetilcisteína (NAC na isquemia hepática. MÉTODO: Trinta e oito ratos machos EPM-1 Wistar foram distribuídos em quatro grupos. Nos Grupos 1 e 2 foi realizado 30 min de clampeamento do hilo hepático, e nos Grupos 3 e 4 os animais foram submetidos a 30 minutos de isquemia sem clampleamento do ducto biliar. Os animais dos Grupos 2 e 4 receberam 150mg.Kg-1 de NAC, endovenoso, 15 minutos antes do procedimento. Colheu-se sangue antes do procedimento e após o clampeamento do pedículo para a dosagem enzimática. Amostras de fígado foram coletadas para dosagem de glutationa, microscopia óptica e eletrônica. No estudo estatístico aplicaram-se testes não paramétricos, p BACKGROUND: The aim of this study was to investigate the effect of N-Acetylcysteine (NAC on the hepatic ischemia injury. METHODS: Thirty eight male EPM-1 Wistar rats were divided in four groups: G1 and G2 with ischemia time of 30 min.; groups 3 and 4 were submitted to 30 min of ischemia and bile duct was not clamped. Animals from groups 2 and 4 received NAC, 150mg.Kg-1 bw, by IV injection, 15 min. before procedure. Blood samples were collected before and after ischemia and liver function was evaluated by enzymatic measurement. Hepatic samples were processed to GSH/GSSG, light and electronic microscopy evaluation. Non-parametric tests were applied to the statistical analysis (p < 0.05. RESULTS: Enzymatic increase were higher when NAC was absent. There was no protection by NAC when bile duct was absent nor when bile duct was not clamped. Under light microscopy there was significant difference in the groups S/NAC X C/NAC, showing that group C/NAC maintained better parenchyma architecture during ischemia time, independent on bile duct clamp. Under electronic microscopy, the groups C/NAC and those without bile duct clamping showed preserved cellular arquitecture. NAC did not alter the relationship between reduced glutathione / oxidated gluthatione

  2. 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

  3. 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

  4. TOTAL annual report 2003

    International Nuclear Information System (INIS)

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

  5. Supravaginal eller total hysterektomi?

    DEFF Research Database (Denmark)

    Edvardsen, L; Madsen, E M

    1994-01-01

    is examined. It is concluded that the risk of developing carcinoma of the cervical stump is low, and no longer a weighty indication for the total in preference to the supravaginal hysterectomy as long as subsequent screening of the cervix is performed. At the same time it is important to inform the women...... carefully after the supravaginal operation in order to secure that subsequent screening actually is taking place. One must have a normal smear and offer a colposcopic examination before the operation. In general the rate of complications after both kind of hysterectomies is low. However, a few new studies...

  6. 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.

  7. Total Factbook 2003

    International Nuclear Information System (INIS)

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

  8. Total 2004 fact book

    International Nuclear Information System (INIS)

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

  9. Total Synthesis of (-)-Daphenylline.

    Science.gov (United States)

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

    2016-05-10

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

  10. 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.

  11. [Total knee and hip prosthesis: variables associated with costs].

    Science.gov (United States)

    Herrera-Espiñeira, Carmen; Escobar, Antonio; Navarro-Espigares, José Luis; Castillo, Juan de Dios Lunadel; García-Pérez, Lidia; Godoy-Montijano, Amparo

    2013-01-01

    antecedentes: la alta prevalencia de artrosis en los países occidentales, el elevado costo de las intervenciones de artroplastia de cadera y rodilla y las amplias variaciones en la práctica médica generan gran interés por comparar los costos asociados antes y después de la cirugía. Objetivo: conocer el costo de las intervenciones de reemplazo total de cadera y rodilla durante la estancia hospitalaria y al año de seguimiento posterior al alta. material y métodos: estudio multicéntrico y prospectivo efectuado en 15 hospitales de tres comunidades autónomas. La relación entre las variables independientes con el costo de la estancia y costo post-alta, se analizó con modelos multinivel y para agrupar los casos se utilizó la variable "hospital." Las variables independientes fueron: edad, sexo, índice de masa corporal, calidad de vida prequirúrgica (cuestionarios ED-5D, SF-12 y Womac), intervención (cadera-rodilla), índice Charlson, complicaciones, número de camas y dependencia económico-institucional del hospital, comunidad autó-noma y presencia de cuidador. Resultados: el costo promedio por paciente, sin incluir el costo de la prótesis, fue de 4,734 Euros ± 2,136 y el costo del seguimiento post alta de 554 Euros ± 509. Si se incluye el costo de la prótesis, al final del año el costo total asciende a 7,645 Euros ± 2,248. Conclusiones: existe un margen considerable en la reducción de los costos de estancia; más de 44% de la variabilidad observada no está determinada por las condiciones clínicas de los pacientes sino por el comportamiento de los centros hospitalarios.

  12. 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

  13. Total synthesis of atropurpuran.

    Science.gov (United States)

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

    2016-01-01

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

  14. Total organic carbon analyzer

    Science.gov (United States)

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

    1991-01-01

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

  15. Identity and total institution

    Directory of Open Access Journals (Sweden)

    Ljubičić Milana

    2015-01-01

    Full Text Available This paper analyses a psychiatric institution resident’s identity (self- construction processes. Our quest was grounded on constructivist theoretical paradigm that sees identity as a manner a person defines oneself in accordance with offered social repertoire. In other words, the total institution milieu offers limited range of identities to its residents. On the other hand, the latter are not just passive subjects that identity is imposed upon. They are able to use a number of adjustment mechanisms to the knowledge about themselves - ranging from symbolic escape to open resistance against the imposed image about them; to obedience, and we were interested to understand the (supposed complex dynamic of identity (re-building in, so-called, special or forensic patients. In order to understand this process and attempting to discover, besides the manifest also the latent layer of the story about self, the local, or personal, identity understanding was examined.

  16. Total ankle joint replacement.

    Science.gov (United States)

    2016-02-01

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

  17. Total disc replacement.

    Science.gov (United States)

    Vital, J-M; Boissière, L

    2014-02-01

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

  18. Total Solar Eclipse 2001

    Science.gov (United States)

    Craig, Nahide; Hawkins, Isabel

    Evaluation and assessments of informal education programs small or large such as science museum traveling exhibits interpretive kiosks hands-on activities and very large public programs have been challenging due to the diverse nature of objectives setups and expected outcomes of these programs. Almost all institutions that develop and present such programs include in their staff evaluation specialists. However for very large public outreach efforts which include participation of multi institutions located across the country larger evaluation groups/institutions can contribute more objective and extensive evaluation and assessment instruments that will help to identify weather the program was successful and if the learning objectives were achieved. Total Solar Eclipse 2001 event was participated by approximately 42000 people at museums science centers and Planetaria all over the world. I will share with you the results of an evaluation of this event that was surveyed and reported by an independent evaluation company. I will expand further on the properties of this program that helps to determine weather the program was successful or not including the discussion on how personal interest in the content publicity connectivity to a group educational as well as entertainment value and the challenges of using high technology can define success.

  19. Total quality management

    OpenAIRE

    Цветкова, Наталья

    1993-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Marcos Gervasio Pereira

    2006-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Stepan Kutilek

    2012-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Luiz Henry Monken e Silva

    2005-01-01

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

  3. Total Process Surveillance (TOPS)

    International Nuclear Information System (INIS)

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

  4. 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

  5. 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

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

    Institute of Scientific and Technical Information of China (English)

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

    2010-01-01

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

  7. Iatrogenic bile duct injuries from biliar y tract surger y

    Institute of Scientific and Technical Information of China (English)

    Umar Ali; Zhen-Hua Ma; Cheng-En Pan; Qing-Yong Ma

    2007-01-01

    BACKGROUND:Cholecystectomy is the most commonly performed procedure in general surgery. However, bile duct injury is a rare but still one of the most common complications. These injuries sometimes present variably after primary surgery. Timely detection and appropriate management decrease the morbidity and mortality of the operation. METHODS:Five cases of iatrogenic bile duct injury (IBDI) were managed at the Department of Surgery, First Afifliated Hospital, Xi'an Jiaotong University. All the cases who underwent both open and laparoscopic cholecystectomy had persistent injury to the biliary tract and were treated accordingly. RESULTS: Recovery of the patients was uneventful. All patients were followed-up at the surgical outpatient department for six months to three years. So far the patients have shown good recovery. CONCLUSIONS:In cases of IBDI it is necessary to perform the operation under the supervision of an experienced surgeon who is specialized in the repair of bile duct injuries, and it is also necessary to detect and treat the injury as soon as possible to obtain a satisfactory outcome.

  8. Íleo biliar: enterolitotomia videoassistida Gallstone ileus: videoassisted enterolithotomy

    Directory of Open Access Journals (Sweden)

    Álvaro Queiroz de Godoy

    2000-12-01

    Full Text Available Treatment, morbidity and mortality of patients with gallstone ileus depend on an accurate diagnosis made in time, and also on a more adequate therapeutic option.A detailed clinical evaluation is fundamental for such diagnosis. Complementary exams like a simple radiological study of the abdomen, high and low endoscopies, an ultrasonography, and a tomography can also be performed. The therapeutic options include the removal of the obstructive factor separately, the performance of a treatment in two separate stages, or the performance of a complete treatment (removal of the calculus, cholecystectomy, and the closing of the fistula.This study aims to present a case report of an elderly man of high surgical risk, presenting gallstone ileus. He was submitted to an isolated videoassisted enterolithotomy through a minilaparotomy. Taking into consideration the patient’s advanced age and the lack of evidence as to other biliary associated pathologies, the chosen treatment seemed to be a good alternative. The evolution was good, and after an 8 month follow-up the patient was found well and with no biliary symptoms whatsoever.

  9. Rotational total skin and total nodal radiotherapy in mycosis fungoides

    Energy Technology Data Exchange (ETDEWEB)

    Bamberg, M.; Molls, M.; Langrock, J.; Muskalla, K.; Quast, U.

    1987-04-01

    The following report describes our technique of rotational total skin radiotherapy with electrons (TSER). We present stage related treatment results. Furthermore our first experiences with the combination of TSER and total nodal irradiation (TNI) are communicated.

  10. Total Knee Replacement for Women

    Medline Plus

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

  11. Total Restrained Bondage in Graphs

    Institute of Scientific and Technical Information of China (English)

    Nader JAFARI RAD; Roslan HASNI; Joanna RACZEK; Lutz VOLKMANN

    2013-01-01

    A subset S of vertices of a graph G with no isolated vertex is a total restrained dominating set if every vertex is adjacent to a vertex in S and every vertex in V(G)-S is also adjacent to a vertex in V(G)-S.The total restrained domination number of G is the minimum cardinality of a total restrained dominating set of G.In this paper we initiate the study of total restrained bondage in graphs.The total restrained bondage number in a graph G with no isolated vertex,is the minimum cardinality of a subset of edges E such that G-E has no isolated vertex and the total restrained domination number of G-E is greater than the total restrained domination number of G.We obtain several properties,exact values and bounds for the total restrained bondage number of a graph.

  12. 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

  13. Signed Total Domination in Graphs

    Institute of Scientific and Technical Information of China (English)

    邢化明; 孙良; 陈学刚

    2003-01-01

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

  14. The total charm cross section

    Energy Technology Data Exchange (ETDEWEB)

    Vogt, R

    2007-09-14

    We assess the theoretical uncertainties on the total charm cross section. We discuss the importance of the quark mass, the scale choice and the parton densities on the estimate of the uncertainty. We conclude that the uncertainty on the total charm cross section is difficult to quantify.

  15. Relación entre la concentración sérica de malondialdehido y el consumo de nutrientes antioxidantes, el estado nutricional y la concentración plasmática de vitamina E, en escolares con valores elevados de LDL. Medellín, 2000

    Directory of Open Access Journals (Sweden)

    Wilmer Soler Terranoya

    2000-02-01

    Full Text Available Introducción: Las especies reactivas del oxígeno(ERO producen daño en diferentes biomoléculas entre ellas los lípidos, en los cuales el radical hidroxilo induce peroxidación. La peroxidación de los lípidos altera la estructura y funcionalidad de las membranas de las células endoteliales de los vasos sanguíneos y origina la oxidación de las lipoproteinas de alta densidad (LDL, situación que se ha identificado como un riesgo potencial para el desarrollo de enfermedad cardiovascular, especialmente cuando se acompaña de la presencia de valores plasmáticos de LDL elevados. La peroxidación lipídica puede reducirse en la medida en que se interrumpa la reacción en cadena, que genera el radical hidroxilo sobre los ácidos grasos poliinsaturados. Este efecto antioxidante lo posee la vitamina E porque dispone, en su estructura química, de un grupo hidroxi que puede reducir y estabilizar la especie radical. El propósito de esta investigación es correlacionar la peroxidación lipídica con algunos indicadores alimentarios y nutricionales de defensa antioxidante. El objetivo general es comparar entre dos grupos de escolares con LDL elevadas, uno con alta concentración de malondialdehido en suero y otro con concentraciones bajas, los niveles plasmáticos de Vit. E, el estado nutricional y la ingestión dietética de grasa poliinsaturada, carotenos, vitamina C y cinc. Metodología: se realizará un estudio de tipo cross-sectional, con una muestra de 204 escolares entre 6 y 10 años, que tienen concentraciones plasmáticas de LDL superiores a 110 mg/dl. Los estudiantes se seleccionaron por muestreo estratificado según las 16 comunas que tiene la ciudad de Medellín y muestreo por conglomerado constituidos por las escuelas del sector público y las del sector privado. De cada conglomerado y en forma aleatoria se seleccionaron los establecimientos educativos, de los cuales se extrajo la población a estudiar por muestreo aleatorio simple. El

  16. Cogema acquires TOTAL's uranium assets

    International Nuclear Information System (INIS)

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

  17. 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...

  18. The first Polish total laryngectomies

    OpenAIRE

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

    2013-01-01

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

  19. Total anomalous pulmonary venous return

    Science.gov (United States)

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

  20. 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...

  1. Total Knee Replacement for Women

    Medline Plus

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

  2. Qualità totale e mobilità totale

    Directory of Open Access Journals (Sweden)

    Giuseppe Trieste

    2010-04-01

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

  3. The total charm cross section

    OpenAIRE

    R. Vogt

    2007-01-01

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

  4. Reduction of total ownership cost

    OpenAIRE

    Boudreau, Michael; Naegle, Brad R.

    2003-01-01

    Acquisition research (Graduate School of Business & Public Policy) Total Ownership Cost (TOC) is the current initiative to manage costs over the entire life cycle of a weapon system. There are several major categories of costs that contribute to Total Ownership Cost but the principal categories are (1) R&D, (2) Production, (3) Operating and Support, and (4) Disposal. System TOC is the same as Life Cycle Cost (LCC) and has implications for Cost As an Independent Variable (CAIV), cost-per...

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

    International Nuclear Information System (INIS)

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

  6. 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.)

  7. 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.

  8. Elective hemithyroidectomy during total laryngectomy

    Directory of Open Access Journals (Sweden)

    Soheyla Nikakhlagh

    2009-01-01

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

  9. TOTAL THYROIDECTOMY USING CAPSULAR DISSECTION

    Directory of Open Access Journals (Sweden)

    R. Moldovanu

    2008-01-01

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

  10. Stereoselective Total Synthesis of Mycalamides

    Institute of Scientific and Technical Information of China (English)

    Masahiro Toyota

    2005-01-01

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

  11. Total Knee Replacement for Women

    Medline Plus

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

  12. Minimally Invasive Total Knee Arthroplasty

    Medline Plus

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

  13. Minimally Invasive Total Knee Arthroplasty

    Medline Plus

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

  14. Total Knee Replacement for Women

    Medline Plus

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

  15. ARTHROFIBROSIS FOLLOWING TOTAL KNEE ARTHROPLASTY

    Directory of Open Access Journals (Sweden)

    Ravi B. Solanki

    2014-11-01

    Full Text Available Arthrofibrosis following total knee arthroplasty is an uncommon complication defined as less than 80 degrees of knee flexion 6-8 weeks post operatively. It is characterized by abnormal scarring of the joint in which the formation of dense fibrous tissue and tissue metaplasia prevent normal range of motion. Clinical features include limited knee Range of motion with extension deficit, pain with activities of daily living and unusual amount of pain and swelling post operatively in the absence of infection, bleeding or mechanical complications. We present case of 55 years old female who undergone for total knee replacement before 3 months and presented to our department with complain of knee pain and swelling with activities of daily living. She was diagnosed on the basis of clinical examination. Her detailed evaluation was carried out and Physiotherapy treatment was started.

  16. Subtotal versus total abdominal hysterectomy

    DEFF Research Database (Denmark)

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

    2015-01-01

    , constipation, pain, sexuality, quality of life (Short Form-36 questionnaire), hospital contacts, and vaginal bleeding. RESULTS: The questionnaire was answered by 197 of 304 women (64.8%) (subtotal hysterectomy [n = 97] [63.4%]; total hysterectomy [n = 100] [66.2%]). Mean follow-up time was 14 years and mean...... hysterectomy. All women enrolled in the trial from 1996 to 2000 who were still alive and living in Denmark (n = 304) were invited to answer the validated questionnaire used in prior 1 and 5 year follow-ups. Hospital contacts possibly related to hysterectomy from 5 to 14 years postoperatively were registered......, 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...

  17. Edge colouring by total labellings

    DEFF Research Database (Denmark)

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

    2010-01-01

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

  18. CYPRINIDS TOTAL BLOOD PROTEINS DETERMINATION

    Directory of Open Access Journals (Sweden)

    TANŢI PATRICHE

    2013-07-01

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

  19. Outcome after total elbow arthroplasty

    DEFF Research Database (Denmark)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2015-12-18

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

  1. Employees in Total Quality Management

    OpenAIRE

    M. G. Matlhape; N. Lessing

    2002-01-01

    Companies have become very disillusioned with Total Quality Management (TQM) as a solution to their quality related problems. Part of the problem has been that companies' expectations from TQM is as a solution to their existing problems rather than as a new philosophy towards creating value for shareholders, employees, and customers. Employee involvement is usually the element in the TQM philosophy that is most difficult to manage. Central to employee participation within the TQM philosophy ...

  2. TOTAL annual report 2003; TOTAL rapport annuel 2003

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2004-07-01

    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.)

  3. 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.

  4. Intrathoracic Hernia after Total Gastrectomy.

    Science.gov (United States)

    Tashiro, Yoshihiko; Murakami, Masahiko; Otsuka, Koji; Saito, Kazuhiko; Saito, Akira; Motegi, Kentaro; Date, Hiromi; Yamashita, Takeshi; Ariyoshi, Tomotake; Goto, Satoru; Yamazaki, Kimiyasu; Fujimori, Akira; Watanabe, Makoto; Aoki, Takeshi

    2016-01-01

    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. PMID:27403095

  5. Total light absorption in graphene

    CERN Document Server

    Thongrattanasiri, Sukosin; de Abajo, F Javier Garcia

    2011-01-01

    We demonstrate that 100% light absorption can take place in a single patterned sheet of doped graphene. General analysis shows that a planar array of small lossy particles exhibits full absorption under critical-coupling conditions provided the cross section of each individual particle is comparable to the area of the lattice unit-cell. Specifically, arrays of doped graphene nanodisks display full absorption when supported on a substrate under total internal reflection, and also when lying on a dielectric layer coating a metal. Our results are relevant for infrared light detectors and sources, which can be made tunable via electrostatic doping of graphene.

  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. Total filmless digital radiology service

    International Nuclear Information System (INIS)

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

  8. Radiology of total hip replacement

    Energy Technology Data Exchange (ETDEWEB)

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

    1984-06-01

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

  9. The total synthesis of (-)-nitidasin.

    Science.gov (United States)

    Hog, Daniel T; Huber, Florian M E; Mayer, Peter; Trauner, Dirk

    2014-08-01

    Nitidasin is a pentacyclic sesterterpenoid with a rare 5-8-6-5 carbon skeleton that was isolated from the Peruvian folk medicine "Hercampuri". It belongs to a small class of sesterterpenoids that feature an isopropyl trans-hydrindane moiety fused to a variety of other ring systems. As a first installment of our general approach toward these natural products, we report the total synthesis of the title compound. Our stereoselective, convergent route involves the addition of a complex alkenyl lithium compound to a trans-hydrindanone, followed by chemoselective epoxidation, ring-closing olefin metathesis, and redox adjustment.

  10. First total synthesis of Boehmenan

    Indian Academy of Sciences (India)

    Yamu Xia; Xiaoli Dai; Haixin Liu; Chen Chai

    2014-05-01

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

  11. Solar total energy project Shenandoah

    Energy Technology Data Exchange (ETDEWEB)

    None

    1980-01-10

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

  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

    2016-07-01

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

  13. Employees in Total Quality Management

    Directory of Open Access Journals (Sweden)

    M. G. Matlhape

    2002-12-01

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

  14. 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.

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

    OpenAIRE

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

    2015-01-01

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

  16. TOTAL LAPAROSCOPIC HYSTERECTOMY VERSUS TOTAL ABDOMINAL HYSTERECTOMY: A RETROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Virupaksha

    2015-10-01

    Full Text Available BACKGROUND: Hysterectomy is a common gynaecological surgery which can be done by abdominal, vaginal or laparoscopic routes or with robotic assistance. Although there were concerns regarding the safety of laparoscopic surgery, a newer technique when compared with abdominal hysterectomy, it is now being reco gnized as a safe procedure in the hands of an experienced surgeon. AIMS: This study was done to compare the intra - operative and post - operative parameters of abdominal and laparoscopic hysterectomy. SETTINGS AND DESIGN: This study was done at JSS Hospital, Mysore between June 2013 and September 2014. It is a retrospective study . MATERIALS AND METHOD S: Patients admitted in the Department of Obstetrics and Gynaecology at JSS Hospital, JSS University, Mysore, with an indication for total abdominal hysterectomy( TAH or total laparoscopic hysterectomy(TLH for benign pathology from June 2013 to September 2014 were included in the study. Exclusion criteria were suspicion of malignancy, vaginal prolapse higher than first degree and those undergoing laparoscopic assi sted vaginal hysterectomy. Baseline characteristics, intraoperative and postoperative parameters were compared between the two groups. STATISTICAL ANALYSIS : The data were analyzed using independent T test, Chi square test and Mann Whitney test. A p value o f <0 . 05 was accepted as significant. RESULTS: The mean time taken to perform TLH was significantly longer, i.e. 113.46 minutes compared with TAH, i.e. 70.44 minutes, with the p value being <0.0001. But the duration of stay in the hospital was shorter for t he women undergoing TLH, mean duration being 3.74 days as opposed to 7.65 days in women undergoing TAH. This difference was also statistically significant with p value being <0.0001. Also, women undergoing TAH required more analgesic doses (mean 3.29 than those undergoing TLH (mean 1.36 and this difference was also statistically significant. CONCLUSION: Although TLH took a

  17. Demand: a total nuclear disarmament

    International Nuclear Information System (INIS)

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

  18. TVD: Total Variation Diminishing code

    Science.gov (United States)

    Pen, Ue-Li; Arras, Phil; Wong, ShingKwong

    2013-04-01

    TVD solves the magnetohydrodynamic (MHD) equations by updating the fluid variables along each direction using the flux-conservative, second-order, total variation diminishing (TVD), upwind scheme of Jin & Xin. The magnetic field is updated separately in two-dimensional advection-constraint steps. The electromotive force (EMF) is computed in the advection step using the TVD scheme, and this same EMF is used immediately in the constraint step in order to preserve \\Downtriangle B=0 without the need to store intermediate fluxes. The code is extended to three dimensions using operator splitting, and Runge-Kutta is used to get second-order accuracy in time. TVD offers high-resolution per grid cell, second-order accuracy in space and time, and enforcement of the \\Downtriangle B=0 constraint to machine precision. Written in Fortran, It has no memory overhead and is fast. It is also available in a fully scalable message-passing parallel MPI implementation.

  19. Sociologist in the total institution

    Directory of Open Access Journals (Sweden)

    Krstić Željko

    2010-01-01

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

  20. 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.

  1. A total safety management model

    International Nuclear Information System (INIS)

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

  2. Dosimetry of total body irradiation

    International Nuclear Information System (INIS)

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

  3. Application Of Total Quality Management In Library

    OpenAIRE

    Vilas A. Kale

    2013-01-01

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

  4. Stiffness after total knee arthroplasty.

    Science.gov (United States)

    Manrique, Jorge; Gomez, Miguel M; Parvizi, Javad

    2015-04-01

    Stiffness after total knee arthroplasty (TKA) adversely affects outcome and impacts patient function. Various risk factors for stiffness after TKA have been identified, including reduced preoperative knee range of motion, history of prior knee surgery, etiology of arthritis, incorrect positioning or oversizing of components, and incorrect gap balancing. Mechanical and associated causes, such as infection, arthrofibrosis, complex regional pain syndrome, and heterotopic ossification, secondary gain issues have also been identified. Management of stiffness following TKA can be challenging. The condition needs to be assessed and treated in a staged manner. A nonsurgical approach is the first step. Manipulation under anesthesia may be considered within the first 3 months after the index TKA, if physical therapy fails to improve the range of motion. Beyond this point, consideration should be given to surgical intervention such as lysis of adhesions, either arthroscopically or by open arthrotomy. If the cause of stiffness is deemed to be surgical error, such as component malpositioning, revision arthroplasty is indicated. The purpose of this article is to evaluate the various aspects of management of stiffness after TKA.

  5. Stiffness after total knee arthroplasty.

    Science.gov (United States)

    Manrique, Jorge; Gomez, Miguel M; Parvizi, Javad

    2015-04-01

    Stiffness after total knee arthroplasty (TKA) adversely affects outcome and impacts patient function. Various risk factors for stiffness after TKA have been identified, including reduced preoperative knee range of motion, history of prior knee surgery, etiology of arthritis, incorrect positioning or oversizing of components, and incorrect gap balancing. Mechanical and associated causes, such as infection, arthrofibrosis, complex regional pain syndrome, and heterotopic ossification, secondary gain issues have also been identified. Management of stiffness following TKA can be challenging. The condition needs to be assessed and treated in a staged manner. A nonsurgical approach is the first step. Manipulation under anesthesia may be considered within the first 3 months after the index TKA, if physical therapy fails to improve the range of motion. Beyond this point, consideration should be given to surgical intervention such as lysis of adhesions, either arthroscopically or by open arthrotomy. If the cause of stiffness is deemed to be surgical error, such as component malpositioning, revision arthroplasty is indicated. The purpose of this article is to evaluate the various aspects of management of stiffness after TKA. PMID:25513992

  6. Asymmetric total synthesis of vindoline.

    Science.gov (United States)

    Kato, Daisuke; Sasaki, Yoshikazu; Boger, Dale L

    2010-03-24

    A concise asymmetric total synthesis of (-)-vindoline (1) is detailed based on a tandem intramolecular [4+2]/[3+2] cycloaddition cascade of a 1,3,4-oxadiazole inspired by the natural product structure, in which the tether linking the initiating dienophile and oxadiazole bears a chiral substituent that controls the facial selectivity of the initiating Diels-Alder reaction and sets absolute stereochemistry of the remaining six stereocenters in the cascade cycloadduct. This key reaction introduces three rings and four C-C bonds central to the pentacyclic ring system setting all six stereocenters and introducing essentially all the functionality found in the natural product in a single step. Implementation of the approach also required the development of a unique ring expansion reaction to provide a six-membered ring suitably functionalized for introduction of the Delta (6, 7)-double bond found in the core structure of vindoline and defined our use of a protected hydroxymethyl group as the substituent used to control the stereochemical course of the cycloaddition cascade.

  7. 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 ...

  8. Total joint replacement preadmission programs.

    Science.gov (United States)

    Messer, B

    1998-01-01

    Patients begin to formulate their expectations of the postoperative hospitalization during the preadmission program. The challenge is to better understand the factors patients consider when formulating judgments about the quality of preadmission education. For example, it may be that perceptions of the preadmission program are influenced by what patients believe about their postoperative pain and functional abilities. Specific attention needs to be given both preoperatively and postoperatively to instructing patients on realistic expectations for recovery. One other method of measuring patient outcomes is with the Health Status Profile (SF-36) (Response Healthcare Information Management, 1995). The SF-36 approach emphasizes the outcome of medical care as the patient sees it, in addition to a clinical evaluation of successful health care. This form is currently initiated in the physician's office and returned for scanning at the preadmission class. The patient then completes another SF-36 at 6 months and every year thereafter to compare measurable outcomes. Patients intending to have elective total joint replacements experience anxiety and require much support and education. An effective preadmission program is a major investment in a patient's recovery, as well as a unique marketing tool to customers. Preadmission programs can be viewed as an opportunity to enhance customer satisfaction. Preadmission clinics are an excellent means for nurses to improve the quality of patient care through patient education. the overall goal of preadmission testing programs is to ensure patient preparedness while increasing quality health care and overall customer satisfaction. To enhance program effectiveness, health care providers must lead collaborative efforts to improve the efficiency of systems. PMID:9601410

  9. Total joint replacement preadmission programs.

    Science.gov (United States)

    Messer, B

    1998-01-01

    Patients begin to formulate their expectations of the postoperative hospitalization during the preadmission program. The challenge is to better understand the factors patients consider when formulating judgments about the quality of preadmission education. For example, it may be that perceptions of the preadmission program are influenced by what patients believe about their postoperative pain and functional abilities. Specific attention needs to be given both preoperatively and postoperatively to instructing patients on realistic expectations for recovery. One other method of measuring patient outcomes is with the Health Status Profile (SF-36) (Response Healthcare Information Management, 1995). The SF-36 approach emphasizes the outcome of medical care as the patient sees it, in addition to a clinical evaluation of successful health care. This form is currently initiated in the physician's office and returned for scanning at the preadmission class. The patient then completes another SF-36 at 6 months and every year thereafter to compare measurable outcomes. Patients intending to have elective total joint replacements experience anxiety and require much support and education. An effective preadmission program is a major investment in a patient's recovery, as well as a unique marketing tool to customers. Preadmission programs can be viewed as an opportunity to enhance customer satisfaction. Preadmission clinics are an excellent means for nurses to improve the quality of patient care through patient education. the overall goal of preadmission testing programs is to ensure patient preparedness while increasing quality health care and overall customer satisfaction. To enhance program effectiveness, health care providers must lead collaborative efforts to improve the efficiency of systems.

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

    OpenAIRE

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

    2014-01-01

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

  11. Perfil demográfico e epidemiológico dos usuários de medicamentos de alto custo no Sistema Único de Saúde Perfil demográfico y epidemiológico de los usuarios de medicamentos de costo elevado en el Sistema Único de Salud Epidemiological profile of high cost medicines users in the Brazilian Health System

    Directory of Open Access Journals (Sweden)

    Francisco de Assis Acurcio

    2009-12-01

    Full Text Available O Programa de Medicamentos Excepcionais, do Ministério da Saúde, provê, ao tratamento de doenças, medicamentos de alto valor unitário, ou que, em caso de uso crônico ou prolongado, configurem um tratamento de custo elevado. Com o objetivo de descrever o perfil demográfico e epidemiológico dos pacientes atendidos pelo programa, realizou-se um relacionamento probabilístico-determinístico de dados provenientes de registros do Datasus: Autorizações de Procedimentos de Alta Complexidade/Alto Custo (Apac/SIA e Sistema de Informação sobre Mortalidade (SIM. A coorte formada pelo pareamento das bases de dados identificou 611.419 indivíduos que iniciaram o tratamento no período de 2000-2004. As análises foram desagregadas por sexo, região de residência, diagnósticos e medicamentos mais utilizados. A construção desta coorte histórica propiciou a descrição das características demográficas, epidemiológicas e de utilização de medicamentos dos usuários do programa. Além disso, o banco de dados gerado viabiliza uma série de análises específicas por doenças, que podem contribuir para avaliações de efetividade e eficiência de alternativas terapêuticas constantes nos protocolos clínicos, com o objetivo de fornecer subsídios aos tomadores de decisão no que tange ao planejamento das ações e oferta de medicamentos de alto custo pelo SUS.El Programa de Medicamentos Excepcionales del Ministerio de Salud tiene como objetivo satisfacer la demanda de medicamentos de alto valor unitario, o de aquellos empleados en enfermedades crónicas que impliquen un tratamiento de costo elevado. Con el objetivo de describir el perfil demográfico y epidemiológico de los pacientes incluidos en el programa, se realizó una vinculación probabilística-determinística de datos provenientes de registros del DATASUS (Banco de Datos del Sistema Único de Salud: Autorizaciones de Procedimientos de Alta Complejidad/Alto Costo (Apac/SIA y Sistema de

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

    Directory of Open Access Journals (Sweden)

    F. J. Sánchez-Muniz

    2009-06-01

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

  13. Evolution of the total logistics costs concept

    Directory of Open Access Journals (Sweden)

    2011-09-01

    Full Text Available The article considers the evolution stages of the total logistics cost concept; an interrelations of TLC and EOQ models has been analyzed. The author presented analytical approaches to determine a value of total cost, as well as an integral criterion for logistics systems' functioning, based upon package treatment of the total costs value and service level.

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

    Directory of Open Access Journals (Sweden)

    M. Planells Roig

    2004-07-01

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

  15. 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.

  16. Generalized gravitational entropy from total derivative action

    Science.gov (United States)

    Dong, Xi; Miao, Rong-Xin

    2015-12-01

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

  17. Generalized Gravitational Entropy from Total Derivative Action

    CERN Document Server

    Dong, Xi

    2015-01-01

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

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

    OpenAIRE

    Campos, Pedro Gabriel da Silva

    2012-01-01

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

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

    OpenAIRE

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

    2000-01-01

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

  20. 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.

  1. 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...

  2. 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....

  3. Comparison of Recent Total Irradiance Measurements

    Science.gov (United States)

    Helizon, R.; Pap, J.

    2002-12-01

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

  4. 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)

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

    OpenAIRE

    Havet, Frédéric; Yu, Min-Li

    2002-01-01

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

  6. The total bondage number of grid graphs

    CERN Document Server

    Hu, Fu-Tao; Xu, Jun-Ming

    2011-01-01

    The total domination number of a graph $G$ without isolated vertices is the minimum number of vertices that dominate all vertices in $G$. The total bondage number $b_t(G)$ of $G$ is the minimum number of edges whose removal enlarges the total domination number. This paper considers grid graphs. An $(n,m)$-grid graph $G_{n,m}$ is defined as the cartesian product of two paths $P_n$ and $P_m$. This paper determines the exact values of $b_t(G_{n,2})$ and $b_t(G_{n,3})$, and establishes some upper bounds of $b_t(G_{n,4})$.

  7. 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.

  8. Waardenburg's syndrome associated with total aganglionosis.

    OpenAIRE

    Farndon, P A; Bianchi, A.

    1983-01-01

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

  9. Patient Matched Instruments and Total Knee System

    Medline Plus

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

  10. Total Synthesis of (±)-Hibiscone C

    OpenAIRE

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

    2011-01-01

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

  11. Total lymphoid irradiation in alloimmunity and autoimmunity

    Energy Technology Data Exchange (ETDEWEB)

    Strober, S.

    1987-12-01

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

  12. ROE Total Nitrogen Deposition 1989-1991

    Data.gov (United States)

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

  13. ROE Total Sulfur Deposition 1989-1991

    Data.gov (United States)

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

  14. ROE Total Nitrogen Deposition 2011-2013

    Data.gov (United States)

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

  15. ROE Total Sulfur Deposition 2011-2013

    Data.gov (United States)

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

  16. 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.

  17. Non-blocking message total ordering protocol

    Institute of Scientific and Technical Information of China (English)

    WANG Yun; WANG JunLing

    2008-01-01

    Message total ordering is a critical part in active replication in order to maintain consistency among members in a fault tolerant group. The paper proposes a non-blocking message total ordering protocol (NBTOP) for distributed systems. Non-blocking property refers to that the members in a fault tolerant group keep on running independently without waiting for installing the same group view when a fault tolerant group evolves even when decision messages collide. NBTOP takes advantage of token ring as its logical control way. Members adopt re-requesting mechanism (RR) to obtain their lost decisions. Forward acknowledgement mechanism (FA) is put forth to solve decision collisions. The paper further proves that NBTOP satisfies the properties of total order, agreement, and termination. NBTOP is implemented, and its performance test is done. Comparing with the performance of Totem, the results show that NBTOP has a better total ordering delay. It manifests that non-blocking property helps to improve protocol efficiency.

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

    Science.gov (United States)

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

  20. 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...

  1. The total plasmatic estriol on normal gestation

    International Nuclear Information System (INIS)

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

  2. 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...

  3. Total ankle replacement - surgical treatment and rehabilitation.

    Science.gov (United States)

    Prusinowska, Agnieszka; Krogulec, Zbigniew; Turski, Piotr; Przepiórski, Emil; Małdyk, Paweł; Księżopolska-Orłowska, Krystyna

    2015-01-01

    Functions of the ankle joint are closely connected with the gait and ability to maintain an upright position. Degenerative lesions of the joint directly contribute to postural disorders and greatly restrict propulsion of the foot, thus leading to abnormal gait. Development of total ankle replacement is connected with the use of the method as an efficient treatment of joint injuries and continuation of achievements in hip and knee surgery. The total ankle replacement technique was introduced as an alternative to arthrodesis, i.e. surgical fixation, which made it possible to preserve joint mobility and to improve gait. Total ankle replacement is indicated in post-traumatic degenerative joint disease and joint destruction secondary to rheumatoid arthritis. In this paper, total ankle replacement and various types of currently used endoprostheses are discussed. The authors also describe principles of early postoperative rehabilitation as well as rehabilitation in the outpatient setting.

  4. Stereoselective Total Synthesis of (-)-Renieramycin T.

    Science.gov (United States)

    Yokoya, Masashi; Toyoshima, Ryoko; Suzuki, Toshihiro; Le, Vy H; Williams, Robert M; Saito, Naoki

    2016-05-20

    A stereoselective total synthesis of (-)-Renieramycin T (1t) from a key tetrahydroisoquinoline intermediate previously utilized in our formal total synthesis of Ecteinascidin 743 is described. The synthesis features a concise approach for construction of the pentacyclic framework using a Pictet-Spengler cyclization of bromo-substituted carbinolamine 17, which obviates the regioselectivity problem of the Pictet-Spengler cyclization. The results of cytotoxicity studies are also presented. PMID:27019081

  5. A scheme for total quantum teleportation

    OpenAIRE

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

    1999-01-01

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

  6. A strategic zone for Total's future

    International Nuclear Information System (INIS)

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

  7. The Error in Total Error Reduction

    OpenAIRE

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

    2013-01-01

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

  8. 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...

  9. Severe Heterotopic Ossification following Total Knee Replacement

    OpenAIRE

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

    2014-01-01

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

  10. Total Sleep Time Severely Drops during Adolescence

    OpenAIRE

    Damien Leger; François Beck; Jean-Baptiste Richard; Emmanuelle Godeau

    2012-01-01

    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 samp...

  11. Total Ownership Cost -- Tools and Discipline

    OpenAIRE

    Boudreau, Mike; Naegle, Brad

    2011-01-01

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

  12. Management of complications after total shoulder arthroplasty

    OpenAIRE

    Josef K Eichinger; Galvin, Joseph W.

    2015-01-01

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

  13. The Challenge of Total Factor Productivity

    OpenAIRE

    Erwin Diewert

    2000-01-01

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

  14. Brauer-Thrall for totally reflexive modules

    CERN Document Server

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

    2010-01-01

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

  15. Total OH reactivity emissions from Norway spruce

    Science.gov (United States)

    Nölscher, Anke; Bourtsoukidis, Efstratios; Bonn, Boris; Kesselmeier, Jürgen; Lelieveld, Jos; Williams, Jonathan

    2013-04-01

    Forest emissions represent a strong potential sink for the main tropospheric oxidant, the hydroxyl radical (OH). In forested environments, the comparison of the directly determined overall sink of OH radicals, the total OH reactivity, and the individually measured OH sink compounds often exposes a significant gap. This "missing" OH reactivity can be high and influenced by both direct biogenic emissions and secondary photo-oxidation products. To investigate the source of the missing OH sinks in forests, total OH reactivity emission rates were determined for the first time from a Norway spruce (Picea abies) throughout spring, summer and autumn 2011. The total OH reactivity was measured inside a branch enclosure using the Comparative Reactivity Method (CRM) with a Proton Transfer Reaction-Mass Spectrometer (PTR-MS) as the detector. In parallel, separate volatile organic compounds (VOC) emission rates were monitored by a second PTR-MS, including the signal of isoprene, acetaldehyde, total monoterpenes and total sesquiterpenes. The comparison of known and PTR-MS detected OH sink compounds and the directly measured total OH reactivity emitted from Norway spruce revealed unmeasured and possibly unknown primary biogenic emissions. These were found to be highest in late summer during daytime coincident with highest temperatures and ozone levels.

  16. Solution to causality paradox upon total reflection

    Institute of Scientific and Technical Information of China (English)

    LIU Xiang-min; CAO Zhuang-qi; ZHU Peng-fei; SHEN Qi-shun

    2006-01-01

    A dispute about the existence of an additional time (named as the Goos-H(a)nchen time) associated with the Goos-H(a)nchen shift in total reflection has recently arisen.At the same time,an inconsistency between the optical ray model and the electromagnetic theory also appears in the optical planar waveguide.By analyzing light propagation in an optical planar waveguide with both the zigzag-ray model and the electromagnetic theory,this paper shows that the Goos-H(a)nchen time really exists,and the total time delay upon total reflection upon an ideal nonabsorbing plasma mirror is the sum of the group-delay time and the Goos-H(a)nchen time.The causality paradox of total reflection of a TM wave upon an ideal nonabsorbing plasma mirror is also solved taking into consideration the negative Goos-H(a)nchen shift.Finally,the expression of the group velocity of the guided mode in optical planar waveguide was obtained,which clearly shows that the time delay upon total reflection is the sum of the group-delay time and the Goos-H(a)nchen time at given any time.

  17. Heterotopic bone formation following total shoulder arthroplasty

    DEFF Research Database (Denmark)

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

    1989-01-01

    the glenohumeral and/or the glenoacromial space. There was no correlation between shoulder pain and the development of ossification. Shoulders with grade III heterotopic bone formation had a limited range of active elevation compared with shoulders without or with only a milder lesion. Men and patients......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...... 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....

  18. Primary total hip arthroplasty for acetabular fracture

    Institute of Scientific and Technical Information of China (English)

    WANG Zi-ming; SUN Hong-zhen; WANG Ai-min; DU Quan-yin; WU Siyu; ZHAO Yu-feng; TANG Ying

    2006-01-01

    Objective: To explore the operative indications and operative methods of primary total hip arthroplasty for acetabular fracture and to observe the clinical curative effect.Methods: We retrospectively summarized and analyzed the traumatic conditions, fracture types, complications,operative time, operative techniques, and short-term curative effect of 11 patients( 10 males and 1 female, with a mean age of 42. 4 years ) with acetabular fracture who underwent primary total hip arthroplasty.Results: The patients were followed up for 6-45 months ( mean = 28 months). Their average Harris score of postoperative hip joint was 78.Conclusion: Under strict mastery of indications,patients with acetabular fracture may undergo primary total hip arthroplasty, but stable acetabular components should be made.

  19. Total reflection X-ray fluorescence analysis

    International Nuclear Information System (INIS)

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

  20. Totally Corrective Boosting for Regularized Risk Minimization

    CERN Document Server

    Shen, Chunhua; Barnes, Nick

    2010-01-01

    Consideration of the primal and dual problems together leads to important new insights into the characteristics of boosting algorithms. In this work, we propose a general framework that can be used to design new boosting algorithms. A wide variety of machine learning problems essentially minimize a regularized risk functional. We show that the proposed boosting framework, termed CGBoost, can accommodate various loss functions and different regularizers in a totally-corrective optimization fashion. We show that, by solving the primal rather than the dual, a large body of totally-corrective boosting algorithms can actually be efficiently solved and no sophisticated convex optimization solvers are needed. We also demonstrate that some boosting algorithms like AdaBoost can be interpreted in our framework--even their optimization is not totally corrective. We empirically show that various boosting algorithms based on the proposed framework perform similarly on the UCIrvine machine learning datasets [1] that we hav...

  1. 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.

  2. Effect of glutamine on the total antioxidant system of rats subjected to renal ischemia and reperfusion Efeito da glutamina no sistema antioxidante total de ratos submetidos a isquemia e reperfusão renal

    Directory of Open Access Journals (Sweden)

    Valter Torezan Gouvêa Junior

    2011-12-01

    Full Text Available PURPOSE: To evaluate the protective effects of glutamine administered before renal ischemia-reperfusion on plasma antioxidant protection, and lung and renal tissue injury. METHODS: 33 rats underwent right nephrectomy. On the eighth postoperative day, animals were randomized into three groups (n=11: glutamine, control and sham. Each group of animals received, by gavage, a particular diet for 7 days. On day 14 following nephrectomy, the animals were subjected to left renal ischemia-reperfusion. After this, blood samples were collected and the animals were killed. At necropsy the kidney and lung were removed for histology. RESULTS: The levels of total antioxidant capacity were higher in the glutamine group and control group compared with the sham group. The levels of glutathione peroxidase in both the sham and glutamine groups were higher when compared with the control group (pOBJETIVO: Avaliar os efeitos na proteção antioxidante plasmática e na lesão tecidual renal e pulmonar da glutamina oral administrada precedendo a isquemia/ reperfusão renal. MÉTODOS: Trinta e três ratos foram submetidos à nefrectomia à direita. No oitavo dia de pós-operatório, os animais foram randomizados em três grupos (n=11: glutamina, controle e sham. Cada grupo de animal recebeu por gavagem uma dieta distinta por sete dias. Ao final do 14º dia da nefrectomia procedeu-se a isquemia renal esquerda e posterior reperfusão. A seguir procedeu-se a coleta de sangue, eutanásia e retirada do rim e pulmões para análise histológica. RESULTADOS: Os níveis de capacidade antioxidante total foram maiores no grupo glutamina e grupo controle em relação ao grupo sham. Os níveis de glutationa peroxidase nos grupos sham e glutamina foram mais elevados quando comparados com o grupo controle (p<0,05. A dosagem de superóxido dismutase foi maior no grupo sham quando comparado com os grupos glutamina e controle. Não houve diferença na análise histológica do rim e pulm

  3. TOTAL 2003 activities report in brief

    International Nuclear Information System (INIS)

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

  4. Systematic Calculations of Total Atomic Binding Energies

    International Nuclear Information System (INIS)

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

  5. Total quantum Zeno effect beyond Zeno time

    International Nuclear Information System (INIS)

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

  6. TOTAL FINA ELF. Annual report 2002

    International Nuclear Information System (INIS)

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

  7. 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.

  8. Total positive curvature of circular DNA

    DEFF Research Database (Denmark)

    Bohr, Jakob; Olsen, Kasper Wibeck

    2013-01-01

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

  9. Distant set distinguishing total colourings of graphs

    OpenAIRE

    Przybyło, Jakub

    2015-01-01

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

  10. PRIVATE EQUITY INVESTING AND TOTAL QUALITY - UPDATED

    Directory of Open Access Journals (Sweden)

    Nikola Stefanovic

    2013-03-01

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

  11. Total Internal Reflection and the Related Effects

    CERN Document Server

    Kristoffel, Nikolai

    2014-01-01

    This submission presents the English translation of the early paper by N.Kristoffel appeared in Russian in the Proceedings 0f the Tartu State University No 42 p.94-112, 1956. It reflects the work done in Tartu State University (Estonia)1n 1950-s on the total internal reflection and associated effects. This paper can be of interest for the scientific community because it remained not well known during the long period. The conceptual paper of N.Kristoffel mentioned includes as the central result the prediction of the transversal shift of the totally reflected light beam.

  12. TECAB - Totally Endoscopic Coronary Artery Bypass

    Medline Plus

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

  13. [Open total dislocation of the talus].

    Science.gov (United States)

    Grabski, R S; Sosiński, R

    1992-01-01

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

  14. The technology behind Colgate Total Advanced Fresh.

    Science.gov (United States)

    Williams, Malcolm I; Cummins, Diane

    2003-09-01

    In the early 1990s, a breakthrough toothpaste, Colgate Total, was launched with documented long-lasting activity against plaque, gingivitis, calculus, tooth decay, and bad breath. The technology behind this toothpaste is the combination of triclosan, a polyvinylmethylether/maleic acid copolymer, and sodium fluoride. The copolymer ensures maximal oral retention and subsequent release of the antibacterial triclosan. Effective levels of triclosan have been observed in the oral cavity 12 hours after brushing the teeth, allowing prolonged control of oral bacteria that may cause the most common dental problems, including bad breath. Similarly, the enhanced retention of triclosan to oral surfaces after using this revolutionary toothpaste for up to 2 years has led to significantly reduced incremental coronal caries compared to an American Dental Association-Approved anticavity fluoride toothpaste. Furthermore, significantly less calcium remained in dental plaque after brushing the teeth with the triclosan/copolymer toothpaste, resulting in the formation of less tartar. In keeping with the multiple oral health benefits provided by Colgate Total, consumers are now offered a new dentifrice, Colgate Total Advanced Fresh, which provides the numerous therapeutic and esthetic benefits that are the hallmark of Colgate Total. The new dentifrice, which contains an impactful breath-freshening flavor, has been documented to provide sustained control of bad breath over 12 hours.

  15. Asymmetric Total Synthesis of (-)-Cladospolide B

    Institute of Scientific and Technical Information of China (English)

    WANG,Wen-Kuan; ZHANG,Ji-Yong; HE,Jin-Mei; TANG,Shi-Bing; WANG,Xiao-Lei; SHE,Xue-Gong; PAN,Xin-Fu

    2008-01-01

    An enantioselective total synthesis of (-)-cladospolide B was described.The key steps in this synthesis include (a) a Sharpless asymmetric dihydroxylation to elaborate syn diol at C-4 and C-5 positions;(b) a Mitsunobu esterification to reverse the configuration at C-11 from (S) to (R);and (c) a ring-closing metathesis to access the 12-membered macrocyclic ring.

  16. Dilemmas in Uncemented Total Hip Arthroplasty

    NARCIS (Netherlands)

    Goosen, J.H.M.

    2009-01-01

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

  17. 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-o...

  18. 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…

  19. Total internal reflection laser tools and methods

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-02-02

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

  20. Total synthesis: Towards artificial terpene cyclases

    Science.gov (United States)

    Willot, Matthieu; Christmann, Mathias

    2010-07-01

    The plant-derived sesquiterpene englerin A is a potent inhibitor of several renal cancer cell lines. Two recent total syntheses have utilized cationic gold(I)-complexes to coax readily available open-chain precursors into englerin's challenging oxotricyclic core with enzyme-like precision.

  1. Enantioselective Total Synthesis of Plectosphaeroic Acid B

    OpenAIRE

    Jabri, Salman Y.; Overman, Larry E.

    2013-01-01

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

  2. Learning Language through Total Physical Response.

    Science.gov (United States)

    Marlatt, Edward A.

    1995-01-01

    The Total Physical Response (TPR) method of language instruction is introduced, and guidelines for designing and implementing TPR lessons for students with hearing impairments are provided. In TPR instruction, students develop understanding before speech or signing, understanding is demonstrated through actions, and new vocabulary is developed…

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

    Science.gov (United States)

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

    2015-03-28

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

  4. Diagnosing total quality management - Part 2

    NARCIS (Netherlands)

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

    1993-01-01

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

  5. Diagnosing total quality management - Part 1

    NARCIS (Netherlands)

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

    1992-01-01

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

  6. 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.

  7. 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.

  8. 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 for

  9. Total Quality Management (TQM) in Higher Education.

    Science.gov (United States)

    Sullivan, Michael F.

    This document consists largely of paper versions of the transparencies used by the author to give his conference paper on Total Quality Management (TQM) in the college and university setting. An introduction lists a series of definitional phrases, a list of what TQM is not, and 11 fundamental principles describing what TQM is. The three major…

  10. PROCEDURE FOR ESTIMATING PERMANENT TOTAL ENCLOSURE COSTS

    Science.gov (United States)

    The paper discusses a procedure for estimating permanent total enclosure (PTE) costs. (NOTE: Industries that use add-on control devices must adequately capture emissions before delivering them to the control device. One way to capture emissions is to use PTEs, enclosures that mee...

  11. Sir John Charnley en de totale heuparthroplastiek

    NARCIS (Netherlands)

    P.T.P.W. Burgers (Paul T. P. W.); J. van Gijn (Jan)

    2011-01-01

    textabstractJohn Charnley, grondlegger van de moderne totale heuparthroplastiek, wordt in 1911 geboren in Bury (Lancashire). Zijn vader, Arthur, is chemicus in het nabijgelegen Manchester en zijn moeder, Lily, verpleegkundige in het Crumpsall Hospital. In 1929 start Charnley de opleiding geneeskunde

  12. Concepts of total quality management in radiology

    International Nuclear Information System (INIS)

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

  13. 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 …

  14. Total pressing Indonesian gas development, exports

    International Nuclear Information System (INIS)

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

  15. Favorable results after total wrist arthroplasty

    DEFF Research Database (Denmark)

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

    2013-01-01

    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-r...

  16. A modified total synthesis of cystothiazole A

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

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

  17. Applying Total Quality Management to Business Education.

    Science.gov (United States)

    Brown, Daniel J.; Koenig, Harold F.

    1993-01-01

    Responses from 390 business school alumni (60%) show that students want educators to consider their opinions about their overall educational experience and what happens after graduation. A total quality management approach can help discover customer/student needs, establish a focus on improvement, and implement a process orientation. (SK)

  18. Total Synthesis of (±)-Celaphanol A

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    The first total synthesis of (±)-Celaphanol A was accomplished starting from α-cyclocitral and 3,4-dimethoxy benzyl chloride via a six-step process, in which the intramolecular cyclization of ketone 4 with BF3@Et2O afforded an all-cis isomer intermediate for synthesis of aromatic tricyclic diterpenes.

  19. 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.

  20. Crossing Total Occlusions: Navigating Towards Recanalization

    NARCIS (Netherlands)

    A. Sakes (Aimée); E.S. Regar (Eveline); J. Dankelman (Jenny); P. Breedveld (Paul)

    2016-01-01

    textabstractChronic total occlusions (CTOs) represent the “last frontier” of percutaneous interventions. The main technical challenges lies in crossing the guidewire into the distal true lumen, which is primarily due to three problems: device buckling during initial puncture, inadequate visualizatio

  1. Crossing Total Occlusions: Navigating Towards Recanalization

    NARCIS (Netherlands)

    Sakes, A.; Regar, E.; Dankelman, J; Breedveld, P.

    2016-01-01

    Chronic total occlusions (CTOs) represent the “last frontier” of percutaneous interventions. The main technical challenges lies in crossing the guidewire into the distal true lumen, which is primarily due to three problems: device buckling during initial puncture, inadequate visualization, and the i

  2. The total synthesis of pantocin B.

    Science.gov (United States)

    Sutton, A E; Clardy, J

    2000-02-10

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

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

    Science.gov (United States)

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

  4. 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...

  5. Isolation of total RNA from pollens.

    Science.gov (United States)

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

    2001-05-01

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

  6. Total synthesis of insect antifeedant drimane sesquiterpenes.

    NARCIS (Netherlands)

    Jansen, B.J.M.

    1993-01-01

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

  7. Stereocontrolled total synthesis of hedyotol A.

    Science.gov (United States)

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

    2014-04-01

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

  8. 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

  9. Revision Total Hip Replacement: A Case Report

    Directory of Open Access Journals (Sweden)

    Md Hafizur Rahman

    2013-07-01

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

  10. Total synthesis of aeruginosin 98B.

    Science.gov (United States)

    Trost, Barry M; Kaneko, Toshiyuki; Andersen, Neil G; Tappertzhofen, Christoph; Fahr, Bruce

    2012-11-21

    The first total synthesis of aeruginosin 98B was accomplished. The key step is a highly diastereoselective Pd-catalyzed intramolecular asymmetric allylic alkylation reaction of a diastereomeric mixture of allylic carbonates that is enabled by the use of racemic phosphine ligand L1.

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

    Institute of Scientific and Technical Information of China (English)

    JIANG Zhankun; BAI Peng

    2011-01-01

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

  12. 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. ...

  13. 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.

  14. Temporal bone chondroblastoma totally invisible on MRI.

    Science.gov (United States)

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

    2016-08-01

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

  15. Total Immersion Program学习心得

    Institute of Scientific and Technical Information of China (English)

    郑喜花

    2014-01-01

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

  16. Implantation of total body irradiation in radiotherapy

    International Nuclear Information System (INIS)

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

  17. Overview of Total Group financial year

    International Nuclear Information System (INIS)

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

  18. Temporal bone chondroblastoma totally invisible on MRI.

    Science.gov (United States)

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

    2016-08-01

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

  19. Total Cellular RNA Modulates Protein Activity.

    Science.gov (United States)

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

    2016-08-16

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

  20. Scientific observations at total solar eclipses

    Institute of Scientific and Technical Information of China (English)

    Jay M.Pasachoff

    2009-01-01

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

  1. TOTAL ANTIOXIDANT ACTIVITY OF YEAST SACCHAROMYCES CEREVISIAE

    Directory of Open Access Journals (Sweden)

    Blažena Lavová

    2013-02-01

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

  2. Asymptotic Behaviour of Total Generalised Variation

    KAUST Repository

    Papafitsoros, Konstantinos

    2015-01-01

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

  3. Total Synthesis of (±)-Integrifolin.

    Science.gov (United States)

    Shimomaki, Katsuya; Kusama, Hiroyuki; Iwasawa, Nobuharu

    2016-07-11

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

  4. Totally Laparoscopic Gastrectomy for Gastric Cancer

    OpenAIRE

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

    2013-01-01

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

  5. Infected total knee arthroplasty treatment outcome analysis

    OpenAIRE

    Radoičić Dragan; Popović Zoran; Barjaktarović Radoslav; Marinković Jugoslav

    2012-01-01

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

  6. 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.

  7. Total fact-book 2000-2005

    International Nuclear Information System (INIS)

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

  8. Introduction of total knee arthroplasty in Lithuania

    OpenAIRE

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

    2009-01-01

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

  9. Fracture of femoral total hip replacement components

    International Nuclear Information System (INIS)

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

  10. 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.)

  11. Future Bearing Surfaces in Total Hip Arthroplasty

    OpenAIRE

    Chang, Jun-Dong

    2014-01-01

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

  12. 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

  13. NASA total quality management 1989 accomplishments report

    Science.gov (United States)

    1990-01-01

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

  14. Femoral Bone Plug in Total Knee Replacement.

    Science.gov (United States)

    Vulcano, Ettore; Regazzola, Gianmarco M V; Murena, Luigi; Ronga, Mario; Cherubino, Paolo; Surace, Michele F

    2015-10-01

    The intramedullary alignment guides used in total knee replacement disrupt the intramedullary vessels, resulting in greater postoperative blood loss. The use of an autologous bone plug to seal the intramedullary femoral canal has been shown to be effective in reducing postoperative bleeding. The authors present a simple technique to create a bone plug from the anterior chamfer femoral cut to perfectly seal the intramedullary canal of the femur. PMID:26488774

  15. Total workday control using Microsoft Outlook

    CERN Document Server

    Linenberger, Michael

    2008-01-01

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

  16. IFQs and total factor productivity changes

    OpenAIRE

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

    2015-01-01

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

  17. 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.)

  18. TOTAL ANTIOXIDANT ACTIVITY OF YEAST SACCHAROMYCES CEREVISIAE

    OpenAIRE

    Blažena Lavová; Dana Urminská

    2013-01-01

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

  19. Sign variation, the Grassmannian, and total positivity

    CERN Document Server

    Karp, Steven N

    2016-01-01

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

  20. Total synthesis of the indolizidine alkaloid tashiromine

    Directory of Open Access Journals (Sweden)

    McElhinney Alison D

    2008-01-01

    Full Text Available Abstract Background Tashiromine 1 is a naturally occurring indolizidine alkaloid. It has been the subject of thirteen successful total syntheses to date. Our own approach centres on the stereoselective construction of the indolizidine core by capture of an electrophilic acyliminium species by a pendant allylsilane. The key cyclisation precursor is constructed using olefin cross-metathesis chemistry, which has the potential to facilitate both racemic and asymmetric approaches, depending upon the choice of the allylsilane metathesis partner. Results The use of the allyltrimethylsilane cross-metathesis approach enables the rapid construction of the key cyclisation precursor 3 (3 steps from commercial materials, which undergoes acid-induced cyclisation to give the desired bicyclic indolizidine skeleton as a 96:4 mixture of diastereomers. Simple functional group interconversions allowed the completion of the total synthesis of racemic tashiromine in six steps (19% overall yield. Three chiral α-alkoxyallylsilanes (12,14 and 15 were prepared in enantioenriched form and their cross-metathesis reactions studied as part of a putative asymmetric approach to tashiromine. In the event, α-hydroxysilane 12 underwent isomerisation under the reaction conditions to acylsilane 17, while silanes 14 and 15 were unreactive towards metathesis. Conclusion A concise, stereoselective total synthesis of racemic tashiromine has been developed. Attempts to translate this into an asymmetric synthesis have thus far been unsuccessful.

  1. Total generating costs: coal and nuclear plants

    International Nuclear Information System (INIS)

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

  2. Salivary total protein and experimental Coriolis sickness.

    Science.gov (United States)

    Igarashi, M; Reschke, M F; Henley, C; MacDonald, S; Kohl, R; Mizukoshi, K

    1993-01-01

    Symptomatic reporting has been used in quantifying the severity of motion sickness including Coriolis sickness. This study was designed to objectively examine if the dynamic changes of salivary protein concentration relate to the severity of Coriolis sickness. Healthy adults with normal vestibular function underwent a modified Coriolis Sickness Susceptibility Index (CSSI) test, utilizing a staircase profile. Salivary samples were obtained prior to stimulation, 15, 30, and 45 min following stimulus onset, and/or upon reaching "nausea-II" endpoint. Total protein concentration tended to rise over the initial 30 min of stimulation, and then level off or decline. A statistically significant difference was found between the pre-stimulation and 30 min samples. Although some variability existed among the subjects, the general pattern of changes along the time course was similar. An inverse correlation approaching statistical significance was found between control (non-stimulus) total protein levels, and minutes of Coriolis stimulation required to reach the "nausea-II" endpoint. Thus, baseline salivary total protein levels can be of use in predicting susceptibility of Coriolis sickness and other forms of motion sickness.

  3. Total quantum coherence and its applications

    Science.gov (United States)

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

    2016-06-01

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

  4. Total Arterial Revascularisation in Left Ventricular Dysfunction

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    The feasibility and safety of total arterial coronary revascularization with 2 arterial conduits in patients with impaired left ventricular function was evaluated. Data were prospectively collected on all patients with multiple vessel disease and moderately or severely impaired left ventricular function, who underwent coronary surgery with the intention of total arterial revascularization with 2 conduits between March 1995 and August 2002. One hundred and seventy-nine patients were included in the study. Acute coronary insufficiency was present in 3 patients and 43 had unstable angina. Severe left ventricular impairment was present in 29 patients. There were 17 redo operations including 3 redo-redo procedures. Eighty-two percent of patients had a Y graft configuration from the left internal mammary artery (right internal mammary artery 40. 8 %, radial artery 33.5 %,other 7.8 % ). The perioperative mortality was 2.2 %, myocardial infarction 1.7 % and stroke 0. 6 %.Total arterial revascularization in patients with ischaemic left ventricular dysfunction can be safely performed with 2 arterial conduits. The radial artery provides conduit length greater than the right internal mammary artery and allows full revascularization despite left ventricular dilatation.

  5. Total Emissions from Flaring in Kuwait Oilfields

    Directory of Open Access Journals (Sweden)

    K. K. AL-Hamad

    2008-01-01

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

  6. Total quantum coherence and its applications

    Science.gov (United States)

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

    2016-09-01

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

  7. 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

  8. 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

  9. Íleo biliar: presentación en la urgencia quirúrgica

    Directory of Open Access Journals (Sweden)

    Reinaldo Jiménez Prendes

    2011-12-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2010-01-01

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

  11. 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.

  12. Introduction of total knee arthroplasty in Lithuania

    Science.gov (United States)

    Stucinskas, Justinas; Robertsson, Otto; Wingstrand, Hans

    2009-01-01

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

  13. 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.

  14. 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.

  15. Total-variation regularization with bound constraints

    Energy Technology Data Exchange (ETDEWEB)

    Chartrand, Rick [Los Alamos National Laboratory; Wohlberg, Brendt [Los Alamos National Laboratory

    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. Tikhonov Regularization and Total Least Squares

    DEFF Research Database (Denmark)

    Golub, G. H.; Hansen, Per Christian; O'Leary, D. P.

    2000-01-01

    Discretizations of inverse problems lead to systems of linear equations with a highly ill-conditioned coefficient matrix, and in order to compute stable solutions to these systems it is necessary to apply regularization methods. We show how Tikhonov's regularization method, which in its original...... formulation involves a least squares problem, can be recast in a total least squares formulation suited for problems in which both the coefficient matrix and the right-hand side are known only approximately. We analyze the regularizing properties of this method and demonstrate by a numerical example that......, in certain cases with large perturbations, the new method is superior to standard regularization methods....

  17. Total Pelvic Exenteration for Gynecologic Malignancies

    Directory of Open Access Journals (Sweden)

    Elisabeth J. Diver

    2012-01-01

    Full Text Available Total pelvic exenteration (PE is a radical operation, involving en bloc resection of pelvic organs, including reproductive structures, bladder, and rectosigmoid. In gynecologic oncology, it is most commonly indicated for the treatment of advanced primary or locally recurrent cancer. Careful patient selection and counseling are of paramount importance when considering someone for PE. Part of the evaluation process includes comprehensive assessment to exclude unresectable or metastatic disease. PE can be curative for carefully selected patients with gynecologic cancers. Major complications can be seen in as many as 50% of patients undergoing PE, underscoring the need to carefully discuss risks and benefits of this procedure with patients considering exenterative surgery.

  18. TotalFinaElf Factbook 2002

    International Nuclear Information System (INIS)

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

  19. 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.

  20. A journey into TQM (total quality management).

    Science.gov (United States)

    Jackson, M B

    1994-01-01

    Total quality management (TQM) which has been implemented for some time in industry and more recently in hospitals is just beginning to come to long term care organizations. Directors of Nursing can prepare themselves for such a program in their facility by learning from the experience of long term care facilities that have implemented TQM. This is part one of a two part series which describes the implementation process used and a discussion of problems encountered. The second article which will appear in a later issue describes the experience and findings of one project team-the nursing documentation team.

  1. ARE THERE LIMITS TO TOTAL QUALITY MANAGEMENT ?

    Directory of Open Access Journals (Sweden)

    Firdaus Firdaus

    2000-01-01

    Full Text Available Although TQM could solve every problems but it does not mean that TQM is unlimited. There are several limitations on TQM application, some examples from international cases is taken to show the failure of TQM implementation. The understanding of TQM philosophy is really necessary. Abstract in Bahasa Indonesia : Meskipun TQM dapat menyelesaikan semua masalah tetapi bukan berarti bahwa TQM tanpa batas. Ada beberapa keterbatasan penerapan TQM yang berujung pada beberapa kasus dunia yang dapat diambil sebagai contoh dari kegagalan penerapan TQM secara baik dan benar. Untuk itu diperlukan pemahaman filosophi TQM secara tepat. Kata kunci: total quality management, keterbatasan TQM

  2. Security Systems Consideration: A Total Security Approach

    Science.gov (United States)

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

    2007-12-01

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

  3. Total Variation and Tomographic Imaging from Projections

    DEFF Research Database (Denmark)

    Hansen, Per Christian; Jørgensen, Jakob Heide

    2011-01-01

    Total Variation (TV) regularization is a powerful technique for image reconstruction tasks such as denoising, in-painting, and deblurring, because of its ability to produce sharp edges in the images. In this talk we discuss the use of TV regularization for tomographic imaging, where we compute a 2D...... or 3D reconstruction from noisy projections. We demonstrate that for a small signal-to-noise ratio, this new approach allows us to compute better (i.e., more reliable) reconstructions than those obtained by classical methods. This is possible due to the use of the TV reconstruction model, which...

  4. Total Routhian surface calculation for 127I

    International Nuclear Information System (INIS)

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

  5. Total on-line purchasing system (TOPS)

    Energy Technology Data Exchange (ETDEWEB)

    Collins, N.

    1995-11-01

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

  6. 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

  7. Total internal reflection tomography of small objects

    International Nuclear Information System (INIS)

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

  8. Vaginal mass following uncemented total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Young-Soo Shin

    2014-01-01

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

  9. Total Syntheses of Periconiasins A-E.

    Science.gov (United States)

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

    2016-06-01

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

  10. Heterotopic ossification following lumbar total disc replacement

    OpenAIRE

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

    2010-01-01

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

  11. Total down to work for Chtokman's gas

    International Nuclear Information System (INIS)

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

  12. Total knee arthroplasty in vascular malformation

    Directory of Open Access Journals (Sweden)

    Harish Bhende

    2015-01-01

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

  13. Total synthesis of insect antifeedant drimane sesquiterpenes.

    OpenAIRE

    Jansen, B.J.M.

    1993-01-01

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

  14. 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.

  15. Total skin electron irradiation in mycosis fungoides

    Energy Technology Data Exchange (ETDEWEB)

    van Vloten, W.A.; Vermeij, J.; de Vroome, H.

    1977-01-01

    Total skin irradiation with fast electrons (4 MeV, 3500 rad) was applied in 10 cases of histologically proven mycosis fungoides without any signs of internal dissemination. The technique is described. Complete disappearance of both lesions and symptoms occurred in all patients after treatment. However, half of the patients relapsed after the initial irradiation and were subsequently treated with a booster dose of 1000 rad 4 MeV electrons or with topical nitrogen mustard. Irradiation with fast electrons seems to be of great importance in the treatment of mycosis fungoides.

  16. Scientific observations at total solar eclipses

    OpenAIRE

    Pasachoff, Jay M.

    2009-01-01

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

  17. 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...

  18. Total Ankle Arthroplasty: An Imaging Overview.

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    ZHANGWeijiang; QUHongmei; 等

    2002-01-01

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

  1. Methods development for total organic carbon accountability

    Science.gov (United States)

    Benson, Brian L.; Kilgore, Melvin V., Jr.

    1991-01-01

    This report describes the efforts completed during the contract period beginning November 1, 1990 and ending April 30, 1991. Samples of product hygiene and potable water from WRT 3A were supplied by NASA/MSFC prior to contract award on July 24, 1990. Humidity condensate samples were supplied on August 3, 1990. During the course of this contract chemical analyses were performed on these samples to qualitatively determine specific components comprising, the measured organic carbon concentration. In addition, these samples and known standard solutions were used to identify and develop methodology useful to future comprehensive characterization of similar samples. Standard analyses including pH, conductivity, and total organic carbon (TOC) were conducted. Colorimetric and enzyme linked assays for total protein, bile acid, B-hydroxybutyric acid, methylene blue active substances (MBAS), urea nitrogen, ammonia, and glucose were also performed. Gas chromatographic procedures for non-volatile fatty acids and EPA priority pollutants were also performed. Liquid chromatography was used to screen for non-volatile, water soluble compounds not amenable to GC techniques. Methods development efforts were initiated to separate and quantitate certain chemical classes not classically analyzed in water and wastewater samples. These included carbohydrates, organic acids, and amino acids. Finally, efforts were initiated to identify useful concentration techniques to enhance detection limits and recovery of non-volatile, water soluble compounds.

  2. Total quality drives nuclear plant improvements

    International Nuclear Information System (INIS)

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

  3. 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.

  4. Cortical bone total ossicular replacement prosthesis

    Directory of Open Access Journals (Sweden)

    Manu Malhotra

    2014-01-01

    Full Text Available Objectives: Evaluate an autologous cortical bone total ossicular replacement prosthesis (B TORP made of cortical bone for cost effective and sustainable hearing results. Materials and Methods: A prospective study was undertaken in the patients who underwent tympanoplasty with new B-TORP from January 2011 to December 2011. All patients had an absent superstructure of the stapes and long process of the incus due to chronic otitis media. Totally 40 patients were evaluated. Hearing results were evaluated using four-frequency average pure tone air conduction and air-bone gap (ABG measured at 0.5, 1, 2, and 3 kHz after a period of 12 months. Pre- and post-operative continuous variables were compared using a paired t-test and data from unequal groups were assessed for significant differences using unpaired t-test. Results: Successful rehabilitation of the ABG to 20 dB or less was achieved in 95% of patients. Overall mean improvement in ABG was 25.8 ± 5.6 dB, which was statistically significant (t = 26.8, P 0.5. Conclusion: The new autologous B-TORP provides sustainable hearing improvement and is bio-compatible, stable, and magnetic resonance imaging compatible.

  5. 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%.

  6. Surgical approaches for total knee arthroplasty.

    Science.gov (United States)

    Vaishya, Raju; Vijay, Vipul; Demesugh, Daniel Mue; Agarwal, Amit Kumar

    2016-01-01

    There are various surgical approaches to the knee joint and its surrounding structures and such approaches are generally designed to allow the best access to an area of pathology whilst safeguarding important surrounding structures. Controversy currently surrounds the optimal surgical approach for total knee arthroplasty (TKA). The medial parapatellar arthrotomy, or anteromedial approach, has been the most used and has been regarded as the standard approach for exposure of the knee joint. It provides extensive exposure and is useful for open anterior cruciate ligament reconstruction, total knee replacement, and fixation of intra-articular fractures. Because this approach has been implicated in compromise of the patellar circulation, some authors have advocated the subvastus, midvastus, and trivector approaches for exposure of the knee joint. While these approaches expose the knee from the medial side, the anterolateral approach exposes the knee joint from the lateral side. With careful planning and arthrotomy selection, the anterior aspect of the joint can be adequately exposed for TKA in different clinical scenarios. PMID:27182142

  7. Total hemispherical emissivity of Inconel 718

    International Nuclear Information System (INIS)

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

  8. 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

  9. Evaluation of salivary sialic acid, total protein, and total sugar in oral cancer: A preliminary report

    Directory of Open Access Journals (Sweden)

    Sanjay P

    2008-01-01

    Full Text Available Aim: Detection of cancer at the early stage is of utmost importance to decrease the morbidity and mortality of the disease. Apart from the conventional biopsy, noninvasive methods like analysis of saliva may provide a cost-effective approach for screening a large population. Thus, this study aimed to estimate salivary levels of sialic acid, total protein, and total sugar in the oral cancer patients and in healthy control group to evaluate their role in diagnosis and prognosis of oral cancer. Study Design: Unstimulated whole saliva samples were collected from 30 healthy controls (Group I and 30 squamous cell carcinoma patients (group II. Estimations of salivary levels of sialic acid, total protein, and total sugar were performed. This was correlated histopathologically with the grades of carcinoma. Statistical Analysis and Results: The Student′s ′ t ′ test and multivariate regression analysis were performed. The results showed that salivary levels of total protein, total sugar, protein-bound sialic acid, and free sialic acid were significantly higher in oral cancer patients compared to those of normal healthy controls ( P values in all the results were less than 0.001. The salivary free sialic acid levels were found to be significantly higher in well-differentiated squamous cell carcinoma than in moderately differentiated carcinoma ( P < 0.001. However, protein-bound sialic acid, total proteins, and total sugars did not show any statistical significance between well and moderately differentiated carcinomas. Conclusion: Biochemical analysis of saliva can be used in early detection of cancer and is best correlated with histopathological degree of squamous cell carcinoma.

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

    Energy Technology Data Exchange (ETDEWEB)

    Tattersall, Wade [Centre for Antimatter-Matter Studies, Research School of Physics and Engineering, The Australian National University, Canberra, ACT 0200 (Australia); Centre for Antimatter-Matter Studies, School of Engineering and Physical Sciences, James Cook University, Townsville, 4810 Queensland (Australia); Chiari, Luca [Centre for Antimatter-Matter Studies, School of Chemical and Physical Sciences, Flinders University, GPO Box 2100, Adelaide 5001, South Australia (Australia); Machacek, J. R.; Anderson, Emma; Sullivan, James P. [Centre for Antimatter-Matter Studies, Research School of Physics and Engineering, The Australian National University, Canberra, ACT 0200 (Australia); White, Ron D. [Centre for Antimatter-Matter Studies, School of Engineering and Physical Sciences, James Cook University, Townsville, 4810 Queensland (Australia); Brunger, M. J. [Centre for Antimatter-Matter Studies, School of Chemical and Physical Sciences, Flinders University, GPO Box 2100, Adelaide 5001, South Australia (Australia); Institute of Mathematical Sciences, University of Malaya, 50603 Kuala Lumpur (Malaysia); Buckman, Stephen J. [Centre for Antimatter-Matter Studies, Research School of Physics and Engineering, The Australian National University, Canberra, ACT 0200 (Australia); Institute of Mathematical Sciences, University of Malaya, 50603 Kuala Lumpur (Malaysia); Garcia, Gustavo [Instituto de Fısica Fundamental, Consejo Superior de Investigationes Cientıficas (CSIC), Serrano 113-bis, E-28006 Madrid (Spain); Blanco, Francisco [Departamento de Fısica Atomica, Molecular y Nuclear, Universidad Complutense de Madrid, E-28040 Madrid (Spain)

    2014-01-28

    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.

  11. Positron interactions with water-total elastic, total inelastic, and elastic differential cross section measurements.

    Science.gov (United States)

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

    2014-01-28

    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.

  12. 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.

  13. Potential Modulation on Total Internal Reflection Ellipsometry.

    Science.gov (United States)

    Liu, Wei; Niu, Yu; Viana, A S; Correia, Jorge P; Jin, Gang

    2016-03-15

    Electrochemical-total internal reflection ellipsometry (EC-TIRE) has been proposed as a technique to observe the redox reactions on the electrode surface due to its high phase sensitivity to the electrolyte/electrode interface. In this paper, we mainly focus on the influence of the potential modulation on the TIRE response. The analysis suggests that both dielectric constant variation of gold and the electric double layer transformation would modulate the reflection polarization of the surface. For a nonfaradaic process, the signal of TIRE would be proportional to the potential modulation. To testify the analysis, linear sweep voltammetry and open circuit measurement have been performed. The results strongly support the system analysis. PMID:26889871

  14. Aggregated Total Internal Reflection Optics for Solar

    Science.gov (United States)

    Schultz, David; Grimmer, Chris; Fine, Kevin; Evans, Matt; Ghosh, Shondip

    2010-10-01

    An agglomeration of factors has stifled the economic promise of CPV. Foremost among these factors are: insufficient optical efficiency, misfit with existing solar infrastructure, high costs, and inadequate reliability of the optic-receiver package. These difficulties are significantly driven by the choice of optic. The CPV industry is constrained in a paradigm of bulky reflective or refractive optics that operate best at either low concentration (2-5x) or high concentration (100x and above). Low concentration approaches are plagued by marginal economics, while high concentration approaches face technical risks and do not fit well with the existing solar infrastructure. Using total internal reflection as the primary optical mechanism, a cost effective, line-focus optic can be produced at scale to provide superior optical performance in a flat profile and operate at a mid level of concentration to optimize the tradeoff between economic benefit and adoptability.

  15. STUDY ON TOTAL SEDIMENT TRANSPORT BY FLOW

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

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

  16. THE MAIN PRINCIPLES OF TOTAL QUALITY MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Andrei DIAMANDESCU

    2016-06-01

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

  17. Segmental blood pressure after total hip replacement

    DEFF Research Database (Denmark)

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

    1992-01-01

    Twenty-nine patients due to have a total hip replacement had their systemic systolic and segmental blood pressures measured prior to operation and 1 and 6 weeks postoperatively. No patients had signs of ischemia. The segmental blood pressure was measured at the ankle and at the toes. A significant...... 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....... 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...

  18. Neck after total laryngectomy: CT study

    Energy Technology Data Exchange (ETDEWEB)

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

    1984-12-01

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

  19. Total Mercury in Six Antarctic Notothenioid Fishes.

    Science.gov (United States)

    Wintle, Nathan J P; Sleadd, Isaac M; Gundersen, Deke T; Kohl, Kristina; Buckley, Bradley A

    2015-11-01

    We analyzed white muscle samples from six species of Antarctic fish (suborder Notothenioidei) collected in 2011 from McMurdo Sound, Ross Sea, Antarctica, to assess levels of total mercury (THg). Gymnodraco acuticeps and Trematomus bernacchii exhibited the highest concentrations of THg followed by Trematomus pennellii, Trematomus nicolai, Trematomus newnesi and Pagothenia borchgrevinki, (71.3, 53.9±32.1, 45.8±27.3, 37.2±18.6, 35.7±23.6, and 21.9±2.8 ng/g wet weight, respectively). The results from this study suggest that THg has the potential to bioaccumulate from various marine Antarctic ecosystems into biota.

  20. Enantioselective Total Synthesis of (-)-Alstoscholarisine A.

    Science.gov (United States)

    Liang, Xiao; Jiang, Shi-Zhi; Wei, Kun; Yang, Yu-Rong

    2016-03-01

    We report a concise and highly enantioselective total synthesis of (-)-alstoscholarisine A (1), a recently isolated monoterpenoid indole alkaloid that has significant bioactivity in promoting adult neuronal stem cells proliferation. A highly enantioselective (99% ee), intramolecular Ir-catalyzed Friedel-Crafts alkylation of indole 9 with a secondary allylic alcohol was utilized to establish the first stereogenic center upon which the other three contiguous chiral centers were readily set by a highly stereoselective tandem 1,4-addition and aldol reaction. The key tetrahydropyran was constructed through a hemiacetal reduction, and the final aminal bridge was forged by a one-pot reductive amination/cyclization. The conciseness of this approach was highlighted by building core bonds in each step with a minimalist protecting group strategy. PMID:26882407

  1. Modeling total expenditure on warranty claims

    CERN Document Server

    Mitra, Abhimanyu

    2010-01-01

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

  2. Total synthesis of diterpenoid steenkrotin A.

    Science.gov (United States)

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

    2015-06-01

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

  3. The Total Synthesis of Inostamycin A.

    Science.gov (United States)

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

    2016-02-12

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

  4. Space orientation of total hip prosthesis

    International Nuclear Information System (INIS)

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

  5. Tissue air ratio in total body irradiation

    International Nuclear Information System (INIS)

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

  6. Total chemical management in photographic processing

    Science.gov (United States)

    Luden, Charles; Schultz, Ronald

    1985-01-01

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

  7. Implant survival after total elbow arthroplasty

    DEFF Research Database (Denmark)

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

    2014-01-01

    in 234 patients at a mean follow-up of 8.7 years (range, 0-27 years). The overall 5-year survival was 90% (95% confidence interval [CI], 88%-94%), and 10-year survival was 81% (95% CI, 76%-86%). TEAs performed with the unlinked design had a relative risk of revision of 1.9 (95% CI, 1.1-3.2) compared......BACKGROUND: Total elbow arthroplasty (TEA) is an established treatment for late-stage arthritis of the elbow. Indications have expanded to osteoarthritis and nonunion in distal humeral fractures. Information on implant survival and risk factors for revision is still sparse. The aim of this study...... was to evaluate implant survival and risk factors for revision of TEAs inserted in patients in the eastern part of Denmark in the period from 1980 until 2008. MATERIAL AND METHODS: The Danish National Patient Register provided personal identification numbers for patients who underwent TEA procedures from 1980...

  8. Pathology of Coronary Chronic Total Occlusion

    Directory of Open Access Journals (Sweden)

    Kenichi Sakakura

    2016-06-01

    Full Text Available There is an increasing need for percutaneous revascularization procedures of coronary Chronic Total Occlusion (CTO, because many patients with severe coronary artery disease have limited options for revascularization. Although the success rate of percutaneous revascularization of CTOs was unsatisfactory from the 1990s to the 2000s, recent technological advances in interventional strategies have improved the success rate to 85%. Detailed histological assessment of human autopsy studies of CTO has contributed significantly to the refinement in Percutaneous Coronary Intervention (PCI techniques and device development. We have recently reported the pathological findings and characteristics of CTOs that occur in different clinical scenarios. In this review, we discuss the pathology of CTOs to facilitate greater understanding of revascularization strategies for CTOs.

  9. 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...... patients) were included. Only low-quality evidence is available, and the literature consists of case reports and case series. Studies represent the initial experience of surgeons/centres. No precise indication for TaTME is yet specified other than the presence of mid and low rectal tumours, although...... 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...

  10. Fracture Blisters After Primary Total Knee Arthroplasty.

    Science.gov (United States)

    Halawi, Mohamad J

    2015-08-01

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

  11. 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.

  12. 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.

  13. Total body irradiation for bone marrow transplantation

    International Nuclear Information System (INIS)

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

  14. Infected total knee arthroplasty treatment outcome analysis

    Directory of Open Access Journals (Sweden)

    Radoičić Dragan

    2012-01-01

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

  15. Activation of Complement Following Total Hip Replacement.

    Science.gov (United States)

    Thordardottir, S; Vikingsdottir, T; Bjarnadottir, H; Jonsson, H; Gudbjornsson, B

    2016-03-01

    The aim of this study was to investigate whether complement activation, via the classical and alternative pathways, occurs following a cemented total hip replacement (THR) surgery due to osteoarthritis. Blood samples were collected systematically from 12 patients - six male and six women, with a median age of 75 (range: 59-90 years) - preoperatively, 6 h post-operatively and on the first, second and third post-operative day. Total function of classical (CH50) and alternative pathways (AH50) was evaluated, along with the determination of serum concentrations of the complement proteins C3, C4, C3d, the soluble terminal complement complex (sTCC) sC5b-9, as well as C-reactive protein (CRP) and albumin. Measurements of CRP and albumin levels elucidated a marked inflammatory response following the operation. The CH50, AH50 and C3 and C4 levels were significantly lower 6 h after the surgery compared with the preoperative levels, but elevated above the preoperative levels during the following 3 days. The complement activation product C3d levels increased continually during the whole observation period, from 13.5 AU/ml (range: 8-19 AU/ml) preoperative to 20 AU/ml (range: 12-34 AU/ml) on the third post-operative day. Furthermore, we observed an increase in the sC5b-9 levels between the preoperative and the third post-operative day. These results demonstrate a significant activation of the complement system following cemented THR. Further studies are needed to elucidate the time frame and the pathogenic role of this observed complement activation.

  16. 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.

  17. Total ankle prostheses in rheumatoid arthropathy

    Science.gov (United States)

    Schutte, Bernard; Louwerens, Jan Willem K; van den Hoogen, Frank H J; de Waal Malefijt, Maarten C

    2009-01-01

    Background and purpose The first generations of total ankle replacements (TARs) showed a high rate of early failure. In the last decades, much progress has been made in the development of TARs, with the newer generation showing better results. We evaluated TARs implanted with rheumatoid arthritis (RA) or juvenile inflammatory arthritis (JIA) as indication. Patients and methods 58 total ankle prostheses (Buechel-Pappas and STAR type) were implanted in patients with RA (n = 53) or JIA (n = 5) in 54 patients (4 bilateral). After a mean follow-up of 2.7 (1–9) years, all patients were reviewed by two orthopedic surgeons who were not the surgeons who performed the operation. Standard AP and lateral radiographs were taken and a Kofoed ankle score was obtained; this is a clinical score ranging from 0–100 and consists of sub-scores for pain, disability, and range of motion. Results 2 patients died of unrelated causes. Of the 52 patients who were alive (56 prostheses), 51 implants were still in place and showed no signs of loosening on the most recent radiographs. The mean Kofoed score at follow-up was 73 points (SD 16, range 21–92). 4 patients showed a poor result (score < 50) with persistent pain for which no obvious reason could be found. 5 implants were removed, 4 because of infection and 1 because of aseptic loosening. Interpretation Medium-term results of the STAR and BP types of TAR in RA were satisfactory. The main reason for failure of the implant was infection. PMID:19634020

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

    Directory of Open Access Journals (Sweden)

    Andréa Maria Furlanetti

    2003-12-01

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

  19. Coronal Dynamics at Recent Total Solar Eclipses

    Science.gov (United States)

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

    2014-12-01

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

  20. Radiologic analysis of total colonic aganglionosis

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Duk; Yeon, Kyung Mo [College of Medicine, Seoul National University, Seoul (Korea, Republic of)

    1985-08-15

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

  1. AN ASSESSMENT OF TOTAL FACTOR PRODUCTIVITY

    Directory of Open Access Journals (Sweden)

    Dana GÂRDU

    2011-10-01

    Full Text Available The high performing East Asian development model sparked controversies in the academia: its success was ascribed alternatively to nation-states, markets, and sociocultural factors. This paper undertakes a comparative assessment of the last two generations of submodels, i.e. ASEAN-4 and China, by quantifying and interpreting their total factor productivity (TFP using the Solow Model. Results show that capital accumulation was their major growth driver before the beginning of the millennium. Subsequently growth is led by technical change in ASEAN-32, and capital inputs respectively in late industrialising economies, i.e., China and the Philippines. The main differences between the two submodels consist in levels in growth rates and technical progress contributions, which are strongly sped up in China by transition and integration in global production networks. For ASEAN-4 average null or negligible TFP values in the 1990s point to structural vulnerabilities that surface during the Asian financial crisis. ASEAN-3’s recovery is led by technical change though.

  2. Total body irradiation with a sweeping beam

    Energy Technology Data Exchange (ETDEWEB)

    Pla, M.; Chenery, S.G.; Podgorsak, E.B.

    1983-01-01

    A technique for total body irradiation, in which the patient lies in the prone or supine position in the beam of a conventional column mounted 4 MV linear accelerator, is described. A sufficiently large radiation field is obtained by rotating the beam in a vertical plane about the source (i.e., sweeping beam) at a source-to-skin distance of 190 cm on the vertical axis. The variation of the midplane dose is less than +lt. slash-5% in parallel-opposed beams, when attenuators are placed over the region containing the lungs and bolus is employed around the head and legs. The percentage depth dose for the sweeping beam is identical to that of a stationary beam for the same collimator setting and source-to-skin distance. A method for monitoring the dose to the patient by means of a thimble ionization chamber located on the vertical beam axis is outlined. The average dose rates used are between 5 and 10 cGy/min. The design and placement of lung attenuators is simple. The treatment technique with the sweeping beam requires minimal modification of a treatment unit and can be applied on any unit which has a head swivel option.

  3. AIRS total precipitable water over high latitudes

    Science.gov (United States)

    Ye, H.; Fetzer, E. J.; Bromwich, D. H.; Fishbein, E.; Olsen, E. T.; Granger, S.; Lee, S.; Lambrigtsen, B.; Chen, L.

    2006-12-01

    Given the importance of atmospheric conditions over the Arctic and Antarctica to the global climate system, hydrological cycles, and cryopspheric dynamics, and the poor coverage of traditional data over these region, AIRS data will play a significant role in filling the information gaps. In this study, we examine the quality of AIRS total atmospheric precipitable water (PWV) and explore its potential applications over the Antarctica and Arctic. For Antarctica, both Level II matching files and Level III gridded products of AIRS are compared with radiosonde records at Dome C and ECMWF's analysis products during December 10, 2003 to January 26, 2004. Results will testify to the quality of AIRS moisture data over glacial surfaces. For the Arctic region, AIRS level III data are used to compare with AMSR-E data and ECMWF analysis product during September of 2004. Results will reveal the quality of AIRS data over high-latitude water, sea ice, and land surfaces. The potential of AIRS data to improve model simulation will be discussed.

  4. The femoral sulcus in total knee arthroplasty.

    Science.gov (United States)

    Lingaraj, Krishna; Bartlett, John

    2009-05-01

    The position of the femoral sulcus relative to the midline of the distal femoral resection in total knee arthroplasty (TKA) was studied to determine if centralized placement of the femoral component on the distal femur was justified in terms of aligning the prosthetic sulcus with the native femoral sulcus. The location of the femoral sulcus was studied in 112 consecutive patients undergoing TKA. The mean sulcus position was 0.7 mm lateral to the midline of the distal femoral resection (SD 1.4, 95% CI, 0.5-1.0 mm). However, the variation in sulcus positions ranged from 4 mm medial to 4 mm lateral to the midline. The mean sulcus position in valgus knees was 1.0 mm lateral to the midline (SD 1.8), and that in varus knees was 0.7 mm lateral to the midline (SD 1.2) (P = 0.501). It appears prudent to centre the femoral component on the native sulcus rather than the midline of the distal femoral resection, so as to ensure accurate alignment of the prosthetic sulcus with the native sulcus and to encourage normal patella tracking.

  5. Total least squares for anomalous change detection

    Energy Technology Data Exchange (ETDEWEB)

    Theiler, James P [Los Alamos National Laboratory; Matsekh, Anna M [Los Alamos National Laboratory

    2010-01-01

    A family of difference-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 TLSQ-based 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 furthermore it is shown to be equivalent to the optimized covariance equalization algorithm. What whitened TLSQ offers, in addition to connecting with a common language the derivations of two of the most popular anomalous change detection algorithms - chronochrome and covariance equalization - is a generalization of these algorithms with the potential for better performance.

  6. Total Knee Arthroplasty in the Combined Contracture

    Directory of Open Access Journals (Sweden)

    O.J. Voskresensky

    2009-09-01

    Full Text Available We have offered modified access to a knee to work out a method for restoration of extensive apparatus of the knee. 91 patients with degenerative damages of the knee were under out su-pervision. All patients were differentiated in groups according to the form of access and pa-thology of the knee. At all stages of studying the following method of investigation were made: goniometry — for estimation of the knee functional condition; electroneiromyography — for reveling deficiency of muscular activity and determination of its kind. Patient's satisfac-tion by operation was defined by means of WOMAC scale subjective indexes. The received digital material was subjected to statistical processing. Thus, it has been proved that applica-tion of the modified access to a knee offered by us in total knee arthroplasty in patients with combined contracture in comparison with traditionally applied technologies of extensive ap-paratus releasing allows in short terms to restore the volume and force of movements in a knee that reduces time of rehabilitation and improves quality of patient's life

  7. Muscular strength after total hip arthroplasty

    Science.gov (United States)

    Winther, Siri B; Husby, Vigdis S; Foss, Olav A; Wik, Tina S; Svenningsen, Svein; Engdal, Monika; Haugan, Kristin; Husby, Otto S

    2016-01-01

    Background and purpose Minimizing the decrease in muscular strength after total hip arthroplasty (THA) might allow patients to recover faster. We evaluated muscular strength in patients who were operated on using 3 surgical approaches. Patients and methods In a prospective cohort study, 60 patients scheduled for primary THA were allocated to the direct lateral, posterior, or anterior approach. Leg press and abduction strength were evaluated 2 weeks or less preoperatively, 2 and 8 days postoperatively, and at 6-week and 3-month follow-up. Results Differences in maximal strength change were greatest after 2 and 8 days. The posterior and anterior approaches produced less decrease in muscular strength than the direct lateral approach. 6 weeks postoperatively, the posterior approach produced greater increase in muscular strength than the direct lateral approach, and resulted in a greater increase in abduction strength than the anterior approach. At 3-month follow-up, no statistically significant differences between the groups were found. The operated legs were 18% weaker in leg press and 15% weaker in abduction than the unoperated legs, and the results were similar between groups. Interpretation The posterior and anterior approaches appeared to have the least negative effect on abduction and leg press muscular strength in the first postoperative week; the posterior approach had the least negative effect, even up to 6 weeks postoperatively. THA patients have reduced muscle strength in the operated leg (compared to the unoperated leg) 3 months after surgery. PMID:26141371

  8. Human pancreatic cell autotransplantation following total pancreatectomy.

    Science.gov (United States)

    Traverso, L W; Abou-Zamzam, A M; Longmire, W P

    1981-01-01

    During total pancreaticoduodenectomy for chronic pancreatitis, four patients received an intraportal pancreatic mixed-cell autograft prepared by collagenase digestion. The technique of this autotransplantation procedure was successfully developed using a normal canine pancreas, but has proved difficult to apply in the human chronic pancreatitis model. Our four patients became insulin-dependent, with proof of intrahepatic insulin production in only one patient. Three factors have contributed to the lack of graft success: 1) the preoperative endocrine status, 2) systemic hypotension and portal hypertension secondary to graft infusion, and 3) difficulty applying the successful technique in a normal dog pancreas to an extensively scarred human pancreas. The preoperative insulin response during a glucose tolerance test was blunted or delayed in the three patients tested. An immediate decrease in blood pressure and rise in portal pressure occurred in every patient and prevented infusion of the entire graft (30-50%) in three patients. Unfortunately, the patient with the most compromised insulin status was the only patient able to receive the entire graft. Our experience would indicate that further refinements in technique are necessary to prevent the vascular reaction and allow infusion of the entire graft. Furthermore, normal islet cell function is necessary before a successful graft can be expected. PMID:6781424

  9. The Road to Total Earthquake Safety

    Science.gov (United States)

    Frohlich, Cliff

    Cinna Lomnitz is possibly the most distinguished earthquake seismologist in all of Central and South America. Among many other credentials, Lomnitz has personally experienced the shaking and devastation that accompanied no fewer than five major earthquakes—Chile, 1939; Kern County, California, 1952; Chile, 1960; Caracas,Venezuela, 1967; and Mexico City, 1985. Thus he clearly has much to teach someone like myself, who has never even actually felt a real earthquake.What is this slim book? The Road to Total Earthquake Safety summarizes Lomnitz's May 1999 presentation at the Seventh Mallet-Milne Lecture, sponsored by the Society for Earthquake and Civil Engineering Dynamics. His arguments are motivated by the damage that occurred in three earthquakes—Mexico City, 1985; Loma Prieta, California, 1989; and Kobe, Japan, 1995. All three quakes occurred in regions where earthquakes are common. Yet in all three some of the worst damage occurred in structures located a significant distance from the epicenter and engineered specifically to resist earthquakes. Some of the damage also indicated that the structures failed because they had experienced considerable rotational or twisting motion. Clearly, Lomnitz argues, there must be fundamental flaws in the usually accepted models explaining how earthquakes generate strong motions, and how we should design resistant structures.

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

    Science.gov (United States)

    1978-01-01

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

  11. Total system performance assessment for Yucca Mountain

    International Nuclear Information System (INIS)

    As part of the U.S. Department of Energy's evaluation of site suitability for a potential high-level radioactive waste repository, the long-term behavior of the mined geologic disposal system must be determined. This determination requires a knowledge of the characteristics of the present natural system, waste-package and engineered-system designs, a description of the environment around the emplacement zone, and descriptions of possible perturbations that may affect the nature of the engineered and natural systems. In 1991, participants in the Yucca Mountain Site Characterization Project completed a preliminary assessment of the likely performance of a potential repository at Yucca Mountain, Nevada. This preliminary assessment evaluated aqueous and gaseous flow, future climatic conditions, and disturbances to the system by basaltic volcanism and inadvertent human intrusion. A second total system performance evaluation is currently in progress. This second iteration is building on the previous analyses in a number of ways. More recent site characterization information and a much more complex model representing the source term are being incorporated. Multiple waste package designs, emplacement modes, and areal power densities are being analyzed. (author)

  12. Total body irradiation in bone marrow transplantation

    International Nuclear Information System (INIS)

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

  13. Total quality management in blood transfusion.

    Science.gov (United States)

    Smit-Sibinga, C T

    2000-01-01

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

  14. Hiatal Hernia as a Total Gastrectomy Complication

    Directory of Open Access Journals (Sweden)

    Bruna do Nascimento Santos

    2016-02-01

    Full Text Available Introduction: According to the Brazilian National Institute of Cancer, gastric cancer is the third leading cause of death among men and the fifth among women in Brazil. Surgical resection is the only potentially curative treatment. The most serious complications associated with surgery are fistulas and dehiscence of the jejunal-esophageal anastomosis. Hiatal hernia refers to herniation of elements of the abdominal cavity through the esophageal hiatus of the diaphragm, though this occurrence is rarely reported as a complication in gastrectomy. Case Report: A 76-year-old man was diagnosed with intestinal-type gastric adenocarcinoma. He underwent a total laparoscopic-assisted gastrectomy and D2 lymphadenectomy on May 19, 2015. The pathology revealed a pT4pN3 gastric adenocarcinoma. The patient became clinically stable and was discharged 10 days after surgery. He was subsequently started on adjuvant FOLFOX chemotherapy; however, 9 days after the second cycle, he was brought to the emergency room with nausea and severe epigastric pain. A CT scan revealed a hiatal hernia with signs of strangulation. The patient underwent emergent repair of the hernia and suffered no postoperative complications. He was discharged from the hospital 9 days after surgery. Conclusion: Hiatal hernia is not well documented, and its occurrence in the context of gastrectomy is an infrequent complication.

  15. 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. PMID:27327919

  16. [Total transgastric highly selective vagotomy (author's transl)].

    Science.gov (United States)

    Petropoulos, P C

    1981-01-01

    By replacing the transection and excision of the hiatal cardioesophageal branches of the vagus nerve including the nerve branches accompanying those arteries entering the proximal gastric fundus and the gastric branches of the nerves of Laterjet by a seromuscular incision along the lesser curvature from the incisura to the cardia continuing in an arch below the oesophagogastric junction downwards along the greater curvature to a level between the estimated entrance of the short gastric and left gastroepiploic vessels, a total transgastric highly selective vagotomy is achieved. The danger of free exposure of the mucosa is prevented by interposing a free omental graft sutured into the gap in the gastric musculature. The graft protects against complications due to regeneration of the divided vagal branches. This operation is much less extensive, less invasive and significantly more simple than HSV. Completeness of vagotomy is less invasive and significantly more simple than HSV. Completeness of vagotomy is controlled intra-operatively both a gastric pH meter and by measuring the oxygen tension of the gastric mucosa. Twelve to twenty months after applying TTrHSV the mortality was nil in only a restricted number of patients with duodenal ulcers and the morbidity was insignificant. Previous ulcer symptoms disappeared. Dumping syndrome, recurrence of ulceration and other significant complications were not observed. Data of basal and stimulated acid secretion during the 12 to 20 month period after the operation are given.

  17. Nineteen-step total synthesis of (+)-phorbol.

    Science.gov (United States)

    Kawamura, Shuhei; Chu, Hang; Felding, Jakob; Baran, Phil S

    2016-04-01

    Phorbol, the flagship member of the tigliane diterpene family, has been known for over 80 years and has attracted attention from many chemists and biologists owing to its intriguing chemical structure and the medicinal potential of phorbol esters. Access to useful quantities of phorbol and related analogues has relied on isolation from natural sources and semisynthesis. Despite efforts spanning 40 years, chemical synthesis has been unable to compete with these strategies, owing to its complexity and unusual placement of oxygen atoms. Purely synthetic enantiopure phorbol has remained elusive, and biological synthesis has not led to even the simplest members of this terpene family. Recently, the chemical syntheses of eudesmanes, germacrenes, taxanes and ingenanes have all benefited from a strategy inspired by the logic of two-phase terpene biosynthesis in which powerful C-C bond constructions and C-H bond oxidations go hand in hand. Here we implement a two-phase terpene synthesis strategy to achieve enantiospecific total synthesis of (+)-phorbol in only 19 steps from the abundant monoterpene (+)-3-carene. The purpose of this synthesis route is not to displace isolation or semisynthesis as a means of generating the natural product per se, but rather to enable access to analogues containing unique placements of oxygen atoms that are otherwise inaccessible. PMID:27007853

  18. TOTAL ANKLE REPLACEMENT: WHY, WHEN AND HOW?

    Science.gov (United States)

    Bonasia, Davide Edoardo; Dettoni, Federico; Femino, John E; Phisitkul, Phinit; Germano, Margherita; Amendola, Annunziato

    2010-01-01

    Total ankle replacement (TAR) was first attempted in the 1970s, but poor results led to its being considered inferior to ankle fusion until the late 1980s and early 1990s. By that time, newer designs which more closely replicated the natural anatomy of the ankle, showed improved clinical outcomes.1 Currently, even though controversy still exists about the effectiveness of TAR compared to ankle fusion, TAR has shown promising mid-term results and should no longer be considered an experimental procedure. Factors related to improved TAR outcomes include: 1) better patient selection, 2) more precise knowledge and replication of ankle biomechanics, 3) the introduction of less-constrained designs with reduced bone resection and no need for cementation, and 4) greater awareness of soft-tissue balance and component alignment. When TAR is performed, a thorough knowledge of ankle anatomy, pathologic anatomy and biomechanics is needed along with a careful pre-operative plan. These are fundamental in obtaining durable and predictable outcomes. The aim of this paper is to outline these aspects through a literature review. PMID:21045984

  19. Total ankle replacement for posttraumatic arthritis

    Science.gov (United States)

    Weme, Rebecca A Nieuwe; van Solinge, Guido; N Doornberg, Job; Sierevelt, Inger; Haverkamp, Daniël; Doets, H Cornelis

    2015-01-01

    Background and purpose Most studies on total ankle replacement (TAR) have used a case mix of patients. We evaluated the outcome of TAR performed for end-stage arthritis either because of fracture or ligamentous injury. Patients and methods We prospectively followed 88 consecutive patients (50 postfracture ankles and 40 ankles with instability arthritis (2 bilateral)) who underwent TAR between 2001 and 2009. Mean follow-up for both groups was 5 years. Results Preoperative varus deformity of 10° or more was present in 23 ankles in the instability group. At 6 years, survival with revision or salvage fusion as an endpoint was 87% (95% CI: 74–99) in the postfracture group and 79% (95% CI: 63–94) in the instability group. Progressive periprosthetic osteolysis was seen in 23 ankles, and required salvage fusion in 6. The number of reoperations was similar in both groups. Clinical outcome, as assessed with 2 ankle scores and 2 questionnaires, showed good results and was similar at the latest follow-up. Interpretation The outcome was similar in the postfracture and instability groups and also similar to that reported in series including a case mix of patients. In contrast to earlier reports, preoperative frontal plane deformity in this series was not identified as a risk factor for failure. PMID:25772269

  20. Totally vegetarian diets and infant nutrition.

    Science.gov (United States)

    Shinwell, E D; Gorodischer, R

    1982-10-01

    Observations on the deleterious effects of a totally vegetarian diet in infancy are reported and the difficulties encountered in the prevention of nutritional deficiencies in a vegan religious community are discussed. Twenty-five infants of this community who were seen at the hospital showed evidence of protein-calorie malnutrition, iron- and vitamin B12-deficient anemia, rickets, zinc deficiency, and multiple recurrent infections. Evidence of growth retardation was also found in 47 infants seen at the local mother-child health (well-baby) clinic. Samples of breast milk showed low levels of carbohydrate (1.6 to 3.5 gm/100 ml), protein (0.8 to 1.4 gm/100 ml), and fat (2.4 to 4.1 gm/100 ml). The main constituent of the infants' diet after the age of 3 months (a "soya milk" prepared at the community's central kitchen) was extremely dilute with a very low calorific value (13.7 kcal/100 ml). Persistent attempts to find dietary modifications that would satisfy both the vegan philosophy and also the recommended dietary allowances failed. This problem represents a scientific and medicosocial challenge to pediatricians and nutritionists.

  1. Process optimized minimally invasive total hip replacement

    Directory of Open Access Journals (Sweden)

    Philipp Gebel

    2012-02-01

    Full Text Available The purpose of this study was to analyse a new concept of using the the minimally invasive direct anterior approach (DAA in total hip replacement (THR in combination with the leg positioner (Rotex- Table and a modified retractor system (Condor. We evaluated retrospectively the first 100 primary THR operated with the new concept between 2009 and 2010, regarding operation data, radiological and clinical outcome (HOOS. All surgeries were perfomed in a standardized operation technique including navigation. The average age of the patients was 68 years (37 to 92 years, with a mean BMI of 26.5 (17 to 43. The mean time of surgery was 80 min. (55 to 130 min. The blood loss showed an average of 511.5 mL (200 to 1000 mL. No intra-operative complications occurred. The postoperative complication rate was 6%. The HOOS increased from 43 points pre-operatively to 90 (max 100 points 3 months after surgery. The radiological analysis showed an average cup inclination of 43° and a leg length discrepancy in a range of +/- 5 mm in 99%. The presented technique led to excellent clinic results, showed low complication rates and allowed correct implant positions although manpower was saved.

  2. SORCE Level 3 Total Solar Irradiance Daily Average V016

    Data.gov (United States)

    National Aeronautics and Space Administration — The Total Solar Irradiance (TSI) data set SOR3TSID contains the total solar irradiance (a.k.a solar constant) data collected by the Total Irradiance Monitor (TIM)...

  3. 20 CFR 410.412 - “Total disability” defined.

    Science.gov (United States)

    2010-04-01

    ... 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Total Disability or Death Due to Pneumoconiosis § 410.412 “Total disability” defined. (a) A miner shall be considered totally disabled due to pneumoconiosis if:...

  4. [Total thyroidectomy treatment of bening multinodular goiter].

    Science.gov (United States)

    Palas, César; Álvarez, Facundo; Ferreira, Gastón; Gramática, Luis h

    2014-01-01

    Introducción. El tratamiento del bocio multinodular beningo (BMNB) es motivo de continuo debate en las últimas décadas pese a la evidencia de que la tiroidectomía total (TT) está relacionada a una reducción significativa en la recurrencia de la enfermedad y a una mínima morbilidad en manos entrenadas. Objetivo. Determinar la recurrencia del BMNB al cabo de 10 años en 100 pacientes tratados con TT y evaluar las complicaciones relacionadas a la técnica.Diseño. Prospectivo no randomizado.Material y métodos. Desde marzo del 1999 a marzo del 2001, cien pacientes, 95 del sexo femenino, con un promedio de edad de 42,4 años (rango: 23-67), fueron sometidos a una TT por padecer un BMNB, el cual fue confirmado por la ecografía cervical, la que además sirvió de guía para realizar la punción aspiración con aguja fina (PAAF). En todos los casos se realizó un laringoscopía inderecta pre y post postquirúrgica. Resultados. El tiempo operatorio promedio fue de 49 minutos (rango: 35-58). Registramos una parálisis recurrencial (1%) y cinco hipoparatiroidismos (5%), ambos transitorios y ningún caso definitivo. Todos los pacientes fueron dados de alta antes de las 24 horas de la cirugía. No objetivamos ninguna recurrencia del BMNB en un período de seguimiento de más de 10 años.Conclusión. La TT es el tratamiento elección del BMNB, por ser un procedimiento eficaz, seguro, con mínimas tasas de complicaciones y por evitar o reducir significativamente la recurrencia de esta enfermedad.

  5. Total lymphoid irradiation for multiple sclerosis

    International Nuclear Information System (INIS)

    Although chemical immunosuppression has been shown to benefit patients with chronic progressive multiple sclerosis (MS), it appears that chemotherapy has an appreciable oncogenic potential in patients with multiple sclerosis. Accordingly, we developed a modified total lymphoid irradiation (TLI) regimen designed to reduce toxicity and applied it to a randomized double blind trial of TLI or sham irradiation in MS. Standard TLI regimens were modified to reduce dose to 1,980 rad, lowering the superior mantle margin to midway between the thyroid cartilage and angle of the mandible (to avert xerostomia) and the lower margin of the mantle field to the inferior margin of L1 (to reduce gastrointestinal toxicity by dividing abdominal radiation between mantle and inverted Y), limiting spinal cord dose to 1,000 rad by custom-made spine blocks in the mantle and upper 2 cm of inverted Y fields, and also protecting the left kidney even if part of the spleen were shielded. Clinical efficacy was documented by the less frequent functional scale deterioration of 20 TLI treated patients with chronic progressive MS compared to to 20 sham-irradiated progressive MS patients after 12 months (16% versus 55%, p less than 0.03), 18 months (28% versus 63%, p less than 0.03), and 24 months (44% versus 74%, N.S.). Therapeutic benefit during 3 years follow-up was related to the reduction in lymphocyte count 3 months post-irradiation (p less than 0.02). Toxicity was generally mild and transient, with no instance of xerostomia, pericarditis, herpes zoster, or need to terminate treatment in TLI patients. However, menopause was induced in 2 patients and staphylococcal pneumonia in one

  6. Future bearing surfaces in total hip arthroplasty.

    Science.gov (United States)

    Chang, Jun-Dong

    2014-03-01

    One of the most important issues in the modern total hip arthroplasty (THA) is the bearing surface. Extensive research on bearing surfaces is being conducted to seek an ideal bearing surface for THA. The ideal bearing surface for THA should have superior wear characteristics and should be durable, bio-inert, cost-effective, and easy to implant. However, bearing surfaces that are currently being implemented do not completely fulfill these requirements, especially for young individuals for whom implant longevity is paramount. Even though various new bearing surfaces have been investigated, research is still ongoing, and only short-term results have been reported from clinical trials. Future bearing surfaces can be developed in the following ways: (1) change in design, (2) further improvement of polyethylene, (3) surface modification of the metal, (4) improvement in the ceramic, and (5) use of alternative, new materials. One way to reduce wear and impingement in THA is to make changes in its design by using a large femoral head, a monobloc metal shell with preassembled ceramic liner, dual mobility cups, a combination of different bearing surfaces, etc. Polyethylene has improved over time with the development of highly crosslinked polyethylene. Further improvements can be made by reinforcing it with vitamin E or multiwalled carbon nanotubes and by performing a surface modification with a biomembrane. Surface modifications with titanium nitride or titanium niobium nitride are implemented to try to improve the metal bearings. The advance to the fourth generation ceramics has shown relatively promising results, even in young patients. Nevertheless, further improvement is required to reduce fragility and squeaking. Alternative materials like diamond coatings on surfaces, carbon based composite materials, oxidized zirconium, silicon nitride, and sapphire are being sought. However, long-term studies are necessary to confirm the efficacy of these surfaces after enhancements

  7. Hypocupremia in patients receiving total parenteral nutrition.

    Science.gov (United States)

    Bozzetti, F; Inglese, M G; Terno, G; Pupa, A; Sequeira, C; Migliavacca, S

    1983-01-01

    Although hypocupremia is a well-known consequence of long-term total parenteral nutrition (TPN), its incidence as well as the duration of TPN necessary to induce it are still unsettled. The purpose of this study is to review the changes in serum copper level in 25 patients receiving TPN for a period longer than 2 wk (mean duration 6 wk) at the Istituto Nazionale Tumori of Milan and to evaluate the possible relationship of cupremia with the basic disease. Main indications for TPN included enterocutaneous fistulas (11 patients), cancer cachexia (10 patients), radiation enteropathy (two patients), and severe postoperative stricture following esophagogastric resection (two patients). Mean value of serum copper at the beginning of the study was 143 micrograms/100 ml (normal value 65-165 micrograms/100 ml), and the regression analysis showed a mean fall of 5.64 micrograms/100 ml/wk. Hypocupremia occurred in four patients (three with intestinal fistulas and one with radiation obstructive enteritis) at 5th, 6th, 9th, and 6th wk of TPN, respectively. No patient with cancer cachexia developed hypocupremia. No patient with hypocupremia had clinical evidence of a copper deficiency syndrome. We conclude that 1) hypocupremia does not occur within the first month of TPN; 2) its incidence is about 16% in patients intravenously fed for period longer than 2 wk; 3) it is more frequent in patients with enterocutaneous fistulas, whereas it never occurs in patients with cancer cachexia, and 4) it is not necessarily associated to a clinicometabolic syndrome of copper deficiency. Finally, the "nutritional" meaning of serum copper should be questioned in cancer patients since it could represent a "tumor marker."

  8. Nordic Seas total alkalinity data in CARINA

    Directory of Open Access Journals (Sweden)

    A. Olsen

    2009-08-01

    Full Text Available Water column data of carbon and carbon relevant hydrographic and hydrochemical parameters from 188 previously non-publicly available cruises in the Arctic, Atlantic, and Southern Ocean have been retrieved and merged into a new database: CARINA (CARbon IN the Atlantic. The data have been subject to rigorous quality control (QC in order to ensure highest possible quality and consistency. The data for most of the parameters included were examined in order to quantify systematic biases in the reported values, i.e. secondary quality control. Significant biases have been corrected for in the data products, i.e. the three merged files with measured, calculated and interpolated values for each of the three CARINA regions; the Arctic Mediterranean Seas (AMS, the Atlantic (ATL and the Southern Ocean (SO. With the adjustments the CARINA database is consistent both internally as well as with GLODAP (Key et al., 2004 and is suitable for accurate assessments of, for example, oceanic carbon inventories and uptake rates and for model validation. The Arctic Mediterranean Seas includes the Arctic Ocean and the Nordic Seas, and the quality control was carried out separately in these two areas. This contribution presents an account of the quality control of the total alkalinity (ALK data from the Nordic Seas in CARINA. Out of the 35 cruises from the Nordic Seas included in CARINA, 21 had ALK data. The data from 6 of these were found to be of low quality and should not be used. Of the others, 3 were found to be biased low and were subject to adjustment. Thus the final CARINA data product contains ALK data from 15 cruises from the Nordic Seas, and these data appear consistent to ±3 μmol kg−1.

  9. Salvage arthrodesis for failed total ankle arthroplasty

    Science.gov (United States)

    Zürcher, Arthur W

    2010-01-01

    Background and purpose Total ankle arthroplasty (TAA) has gained popularity in recent years. If it fails, however, salvage arthrodesis must be reliable as a rescue procedure. We therefore investigated the clinical, radiographic, and subjective outcome after salvage arthrodesis in a consecutive group of patients, and concentrated on the influence of the method of fixation on union rate and on salvage in inflammatory joint disease. Patients and methods Between 1994 and 2005, salvage arthrodesis was performed on 18 ankles (18 patients). Diagnosis was inflammatory joint disease (IJD) in 15 cases and osteoarthritis (OA) in 3. Tibio-talar fusion was performed in 7 ankles, and tibio-talocalcaneal fusion in 11. Serial radiographs were studied for time to union. Clinical outcome at latest follow-up was measured by the AOFAS score, the foot function index (FFI) and by VAS scores for pain, function, and satisfaction. Results Blade plates were used in 7 ankles (4 IJD, 3 OA); all united. Nonunion developed in 7 of the 11 rheumatic ankles stabilized by other methods. 11 patients (8 fused ankles, 3 nonunions) were available for clinical evaluation. Their mean AOFAS score was 62 and mean overall FFI was 70. VAS score for pain was 20, for function 64, and for satisfaction 74. The scores were similar in united and non-united ankles. Interpretation Blade plate fixation is successful in salvage arthrodesis for failed TAA. A high nonunion rate was found after salvage ankle arthrodesis in IJD with other methods of fixation. Clinical results were fair to good. PMID:20175648

  10. 10-year survival of total ankle arthroplasties

    Science.gov (United States)

    2011-01-01

    Background and purpose There is an ongoing need to review large series of total ankle replacements (TARs) for monitoring of changes in practice and their outcome. 4 national registries, including the Swedish Ankle Register, have previously reported their 5-year results. We now present an extended series with a longer follow-up, and with a 10-year survival analysis. Patients and methods Records of uncemented 3-component TARs were retrospectively reviewed, determining risk factors such as age, sex, and diagnosis. Prosthetic survival rates were calculated with exchange or removal of components as endpoint—excluding incidental exchange of the polyethylene meniscus. Results Of the 780 prostheses implanted since 1993, 168 (22%) had been revised by June 15, 2010. The overall survival rate fell from 0.81 (95% CI: 0.79–0.83) at 5 years to 0.69 (95% CI: 0.67–0.71) at 10 years. The survival rate was higher, although not statistically significantly so, during the latter part of the period investigated. Excluding the STAR prosthesis, the survival rate for all the remaining designs was 0.78 at 10 years. Women below the age of 60 with osteoarthritis were at a higher risk of revision, but age did not influence the outcome in men or women with rheumatoid arthritis. Revisions due to technical mistakes at the index surgery and instability were undertaken earlier than revisions for other reasons. Interpretation The results have slowly improved during the 18-year period investigated. However, we do not believe that the survival rates of ankle replacements in the near future will approach those of hip and knee replacements—even though improved instrumentation and design of the prostheses, together with better patient selection, will presumably give better results. PMID:22066551

  11. Total fertilization failure and idiopathic subfertility

    Directory of Open Access Journals (Sweden)

    Goverde Angelique J

    2009-01-01

    Full Text Available Abstract Background To gain more insight in whether failure of intrauterine insemination (IUI treatment in patients with idiopathic subfertility could be related to diminished fertilization, the aim of this study is to compare the fertilization of an initial IVF procedure after six cycles of IUI and the fertilization of an initial IVF procedure without preceding IUI cycles in couples with idiopathic subfertility. Methods We performed a complimentary analysis of a randomized controlled trial, in which the number of total fertilization failure (TFF in the first IVF procedure after unsuccessful IUI was compared to those of IVF without preceding IUI in patients with idiopathic subfertility. These patients participated in a previous study that assessed the cost effectiveness of IUI versus IVF in idiopathic subfertility and were randomized to either IUI or IVF treatment. Results 45 patients underwent IVF after 6 cycles of unsuccessful IUI and 58 patients underwent IVF immediately without preceding IUI. In 7 patients the IVF treatment was cancelled before ovum pick. In the IVF after unsuccessful IUI group TFF was seen in 2 of the 39 patients (5% versus 7 of the 56 patients (13% in the immediate IVF group. After correction for confounding factors the TFF rate was not significantly different between the two groups (p = 0.08, OR 7.4; 95% CI: 0.5–14.9. Conclusion Our data showed that TFF and the fertilization rate in the first IVF treatment were not significantly different between couples with idiopathic subfertility undergoing IVF after failure of IUI versus those couples undergoing IVF immediately without prior IUI treatment. Apparently, impaired fertilization does not play a significant role in the success rate of IUI in patients with idiopathic subfertility.

  12. Measurement of total body radioactivity in man

    International Nuclear Information System (INIS)

    Techniques for the determination of whole-body radioactivity in man using uncollimated NaI(Tl) detectors have been studied. Geometrical effects and photon attenuation effects due to the different shapes of humans as well as due to varying in-vivo radioactivity distributions have been evaluated particularly for scanning-bed geometries and the chair geometry. Theoretically it is shown that the attenuation effects are generally dominating, for full-energy-peak pulse-range methods. For the application in radiation protection a cheap and simple chair-geometry unit has been constructed and used at various places distantly from the home-laboratory, for studies of body activity of Cs-137 in northern Sweden. High body activities were found particularly in reindeer-breeding Lapps. The elimination rate of Cs-137 in man was studied in the stationary whole-body counter in Lund as well as with the field-system. For the study of the performances at low and high photon energies clinical applications of methods for gastro-intestinal absorption of vitamin B12 (Co-57; 122 keV) and total body potassium determination (K-40; 1.46 MeV, K-42; 1.52 MeV) have been evaluated. Theoretical and experimental results as well as experiences of applications in radiation protection and medicine show that the scanning-bed geometry effectively evens out redistributional effects. For optimum results, however, scatter-energy pulse-ranges rather than full-energy-peak ranges should be used. (Auth.)

  13. First Total Synthesis of Gliomasolide C and Formal Total Synthesis of Sch-725674.

    Science.gov (United States)

    Seetharamsingh, B; Khairnar, Pankaj V; Reddy, D Srinivasa

    2016-01-01

    Syntheses of two 14-membered macrolides Sch-725674 and Gliomasolide C are described here. The first total synthesis of Gliomasolide C, the short synthesis of Sch-725674, and regioselective Wacker oxidation of internal olefin are the highlights of this disclosure. In addition, a key macrocycle with orthogonal functionalities was designed and synthesized on a gram scale for the generation of analogues. PMID:26633579

  14. "Total Physical Response": Un apprentissage non conventionnel ("Total Physical Response": An Unconventional Way to Learn).

    Science.gov (United States)

    Lafayette, R. C.

    1991-01-01

    A discussion of the Total Physical Response method of second language instruction places the concept within the context of other unconventional language learning methods, reviews the rationale behind the approach, and outlines the classroom procedures used. A sampling of useful commands for classroom use is included. (19 references) (MSE)

  15. Evaluation of total phosphorus and total nitrogen methods in pulp mill effluents.

    Science.gov (United States)

    Cook, D L; Frum, N L

    2004-01-01

    Under the Clean Water Action Plan, the US Environmental Protection Agency is requiring states to establish numeric criteria for phosphorus and nitrogen. In preparation for the development of nutrient criteria NCASI undertook a research project to conduct a comparative study of methods for the determination of total phosphorus and total nitrogen in pulp and paper mill matrices. This paper presents results of a single laboratory method evaluation and comparative study of digestion techniques and analytical methods for the determination of total phosphorus (TP) and total nitrogen (TN) in pulp and paper mill secondary treated effluents. Analytical methods included EPA Methods 365.2 and 365.4 for TP. TN and total kjeldahl nitrogen (TKN) methods included EPA Methods 351.2, 351.4, and 353.2. Examinations of sample preservation and storage stability were conducted. Substitution of mercuric sulfate with copper sulfate during block digestion resulted in higher blank levels and method detection limits. TP measurements using EPA Method 365.4 (autoanalyzer) were found to be accurate with a positive bias as determined using matrix spike experiments. Sample digestion by acidic persulfate oxidation or mercuric sulfate block digestion in conjunction with EPA Method 365.4 yielded low blank levels (averages of 0.01 and 0.02 mg/L, respectively), precision of 2.1 and 2.4% relative standard deviations, respectively, and accuracy expressed as an average recovery (%R) of 117% for both. EPA Method 351.2 (autoanalyzer) was more precise than EPA Method 351.4 (ammonia probe). Accuracy (%R) for EPA Method 351.2 ranged from 81 to 95%, depending on the digestion technique applied, and was 55% when EPA Method 351.4 was utilized. Investigation of a method utilizing basic to acidic persulfate oxidation for the simultaneous determination of TN and TP using only two analytical techniques was found to be effective at concentrations above 1 mg/L in pulp mill effluents.

  16. The satellite total solar irradiance database

    Science.gov (United States)

    Willson, R. C.

    2009-12-01

    A precise knowledge of the total solar irradiance (TSI) over time is essential to understanding the physics of solar luminosity variation and its impact on the Earth in the form of climate change. A National Research Council study found that sustained trends as small as 0.25% per century were the most likely forcing for ‘little ice age’ climate minima during the 12th - 19th centuries. Recent phenomenological analyses of TSI observations and proxies indicate that TSI variation is an important climate change forcing on many timescales including the industrial era. The profound sociological and economic implications of understanding the relative climate change contributions of natural and anthropogenic forcings makes it essential that the satellite TSI database be precisely sustained into the foreseeable future. There are currently three satellite TSI monitoring experiments in operation: SOHO/VIRGO, ACRIMSAT/ACRIM3 and SORCE/TIM, in order of deployment (1996, 2000 and 2003, resp.). Results reported on their ‘native scales show the same basic variations in TSI over time, yet some smaller variations detected by ACRIM3 are less well defined or absent in the results of VIRGO and TIM. There is also a scale difference issue: TIM results are 0.35% lower than those of ACRIM3 and VIRGO, outside the ± 0.1% uncertainty bounds predicted for ACRIM3 and VIRGO, and well outside TIM’s ± 0.01% uncertainty design goal. TIM’s failure to achieve 0.01% uncertainty in flight demonstrates that the TSI monitoring paradigm shift of relying on measurement accuracy rather than a redundant/overlap strategy to provide long term traceability cannot be realized with current ‘ambient temperature’ technology. The only viable monitoring approach for the foreseeable future continues to be the redundant/overlap strategy that has provided the 31 year satellite TSI database to date with useful traceability. Intercomparisons of flight experiments at their levels of mutual precision can

  17. Total exploitation of an ornamental granite quarry

    Directory of Open Access Journals (Sweden)

    Taboada, J.

    2005-09-01

    Full Text Available In this paper we propose a methodology to estimate the recovery percentage for each of the products which can be obtained from the exploitation of an ornamental granite quarry: block, semiblock, masonry-transverse stone, and the smaller materials that can be used to obtain construction aggregates. This methodology ensures that quarry exploitation is exhaustive, thereby minimising the production of spoils and the consequent negative impact on the environment. The analysis is based on a detailed and exhaustive compilation of discontinuity data from the research fronts, which are then interpreted statistically and projected over the three weakness planes that are a particular feature of ornamental granite deposits. Using this information, and bearing in mind the minimum commercially viable sizes for each kind of granite, the corresponding recovery rates are calculated for each material in each plane. The results are then integrated using spatial techniques, and the result is an evaluation of quarry contents with a view to total exploitation. This methodology was applied to a quarry in the opening phase in order to carry out an a priori assessment of the economic feasibility of the quarry.

    En este trabajo se propone una metodología para estimar el porcentaje de recuperación de cada uno de los productos que se pueden obtener en la explotación de una cantera de granito ornamental: bloque, semibloque, manpostería y per piaños, y material restante destinado a la obtención de áridos. De esta manera se logra un aprovechamiento integral de la cantera, evitándose la generación de estériles y el subsiguiente impacto ambiental producido por éstos. La metodología de análisis se basa en la recopilación detallada y exhaustiva de datos de discontinuidades en los frentes de investigación, que se interpretan estadísticamente y se proyectan sobre los tres planos de debilidad propios del granito ornamental. Con esta información, y las

  18. Isolated Total Rupture of Extraocular Muscles.

    Science.gov (United States)

    Chen, Jingchang; Kang, Ying; Deng, Daming; Shen, Tao; Yan, Jianhua

    2015-09-01

    Total rupture of extraocular muscles is an infrequent clinical finding. Here we conducted this retrospective study to evaluate their causes of injury, clinical features, imaging, surgical management, and final outcomes in cases of isolated extraocular muscle rupture at a tertiary center in China. Thirty-six patients were identified (24 men and 12 women). Mean age was 34 years (range 2-60). The right eye was involved in 21 patients and the left 1 in 15. A sharp object or metal hook was the cause of this lesion in 16 patients, sinus surgery in 14 patients, traffic accident in 3 patients, orbital surgery in 2 patients, and conjunctive tumor surgery in 1 patient. The most commonly involved muscles were medial (18 patients) and inferior rectus muscles (13 patients). The function of the ruptured muscles revealed a scale of -3 to -4 defect of ocular motility and the amount of deviation in primary position varied from 10 to 140 PD (prism diopter). Computerized tomography (CT) confirmed the presence of ruptured muscles. An end-to-end muscle anastomosis was performed and 3 to 5 mm of muscle was resected in 23 patients. When the posterior border of the injured muscle could not be identified (13 patients), a partial tendon transposition was performed, together with recession of the antagonist in most patients, whereas a recession of the antagonist muscle plus a resection of the involved muscle with or without nasal periosteal fixation was performed in the remaining patients. After an average of 16.42 months of follow-up an excellent result was achieved in 23 patients and results of 13 patients were considered as a failure. In most patients, the posterior border of the ruptured muscle can be identified and an early surgery can be performed to restore function. Alternatively, a partial tendon transposition should be performed. When muscular rupture is suspected, an early orbital CT is required to confirm this possibility, which can then verify the necessity for an early surgical

  19. Computer-Navigated Total Knee Arthroplasty Utilization.

    Science.gov (United States)

    Bala, Abiram; Penrose, Colin Thomas; Seyler, Thorsten Markus; Mather, Richard Chad; Wellman, Samuel Secord; Bolognesi, Michael Paul

    2016-07-01

    Computer-navigated total knee arthroplasty (CN-TKA) has been used to improve component alignment, though the evidence is currently mixed on whether there are clinically significant differences in long-term outcomes. Given the established increased costs and operative time, we hypothesized that the utilization rate of CN-TKA would be decreasing relative to standard TKA in the Medicare population given the current health care economic environment. We queried 1,914,514 primary TKAs performed in the entire Medicare database from 2005 to 2012. Current Procedural Terminology (CPT) and International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes were used to identify and separate CN-TKAs. Utilization of TKA was compared by year, gender, and region. Average change in cases per year and compound annual growth rate (CAGR) were used to evaluate trends in utilization of the procedure. We identified 30,773 CN-TKAs performed over this time period. There was an increase in utilization of CN-TKA per year from 984 to 5,352 (average = 572/year, R (2) = 0.85, CAGR = 23.58%) from 2005 to 2012. In contrast, there was a slight decrease in overall TKA utilization from 264,345 to 230,654 (average = 4297/year, R (2) = 0.74, CAGR = - 1.69%). When comparing proportion of CN-TKA to all TKAs, there was an increase from 0.37 to 2.32% (average 0.26%/year, R (2) = 0.88, CAGR = 25.70%). CN-TKA growth in males and females was comparable at 24.42 and 23.11%, respectively. The South region had the highest growth rate at 28.76%, whereas the Midwest had the lowest growth rate at 15.51%. The Midwest was the only region that peaked (2008) with a slow decline in utilization until 2012. Despite increased costs with unclear clinical benefit, CN-TKA is increasing in utilization among Medicare patients. Reasons could include patient preference, advertising, proper of coding the procedure, and increased publicly available information about

  20. Development of meteorological parameters and total ozone during the total solar eclipse of August 11, 1999

    Directory of Open Access Journals (Sweden)

    Peter Winkler

    2001-05-01

    Full Text Available During the total eclipse of August 11, 1999 frequent showers occurred due to a unstable stratification of the air mass. At different observation sites, meteorological effects from the eclipse (99.4% coverage at Hohenpeißenberg and from showers were superimposed making it partly difficult to unambiguously interpret the observations. The weather radar at Hohenpeißenberg observatory provided a general overview of the distribution of clouds and precipitation in this area (200 km diameter. From the Garching site in the zone of totality (100% temperature and wind data taken on a 50 m mast were evaluated. By selecting periods with relatively low cloud cover it was possible to approximately follow the development of the vertical temperature and wind profiles during the eclipse. The minimum temperature at Hohenpeißenberg (about 450 m above the altitude of Garching during the eclipse was comparable to that during the previous night, the corresponding value measured at Garching remained about 2 K above the minimum observed during clear sky conditions in the previous night. Showers before, during or after the eclipse may have induced vertical exchange of air parcels. Temperatures during a shower change towards the same direction at all altitudes, thus no inversion forms. Additionally, air parcels with relatively lower concentrations of trace constituents were transported down from aloft for time periods of 10–15 minutes. These mixing processes significantly determined the temporal variations of various trace substances measured during the eclipse. Total ozone measurements at Hohenpeißenberg were performed with both DOBSON and BREWER spectrophotometers and at another site within the zone of totality by using a portable Microtops II filter instrument. Different results were obtained for both sites. These differences can be to a large extend, but not exclusively, attributed to eclipse induced shifts (limb darkening and straylight effects in the atmosphere