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Sample records for casing repair quarterly

  1. Design, build, develop, and test a fieldworthy spiral tool and packer for casing repair. Quarterly report, June 16, 1992--September 15, 1992

    Energy Technology Data Exchange (ETDEWEB)

    Koster, C.

    1992-10-01

    A new method for sealing casing is currently under development by Nu-Bore Systems. The method involves internally lining a section of the wellbore with a multi-layer spiral wrapping of a high strength, corrosion resistant metal interleaved with a high bond strength, resilient epoxy. The high strength metal is preferably a copper based alloy hardened to a very high strength in order to resist the internal and external pressures of downhole environments. The epoxy adhesive formulation is one that forms a bond between the steel inner wall of the casing and copper alloy strip. The copper alloy strip spiral wraps are interleaved with epoxy, and the whole system provides a high level of outward directed spring force and, thus, resists both internal and externally directed forces. This method has been assessed by the Department of Energy, and the magnitude of the oilfield need and the technology are described in a DoE report entitled, ``Downhole Casing Repair System`` (OERI Number 013152). In this report, the cost savings to the nation`s energy program was estimated to be in the range of hundreds of millions of dollars per year, and the method was judged technically feasible once certain well defined engineering obstacles are overcome.

  2. Arthroscopic Quadriceps Tendon Repair: Two Case Reports

    Directory of Open Access Journals (Sweden)

    Hidetomo Saito

    2015-01-01

    Full Text Available Recently, although some studies of open repair of the tendon of the quadriceps femoris have been published, there have been no reports in the literature on primary arthroscopic repair. In our present study, we present two cases of quadriceps tendon injury arthroscopically repaired with excellent results. Case 1 involved a 68-year-old man who was injured while shifting his weight to prevent a fall. MRI showed complete rupture at the insertion of the patella of the quadriceps tendon. The rupture was arthroscopically repaired using both suture anchor and pull-out suture fixation methods via bone tunnels (hereafter, pull-out fixation. Two years after surgery, retearing was not observed on MRI and both Japan Orthopedic Association (JOA Knee and Lysholm scores had recovered to 100. Case 2 involved a 50-year-old man who was also injured when shifting his weight to prevent a fall. MRI showed incomplete superficial rupture at the insertion of the patella of the quadriceps tendon. The rupture was arthroscopically repaired using pull-out fixation of six strand sutures. One year after surgery, MRI revealed a healed tendon and his JOA and Lysholm scores were 95 and 100, respectively. Thus, arthroscopic repair may be a useful surgical method for repairing quadriceps tendon injury.

  3. Arthroscopic quadriceps tendon repair: two case reports.

    Science.gov (United States)

    Saito, Hidetomo; Shimada, Yoichi; Yamamura, Toshiaki; Yamada, Shin; Sato, Takahiro; Nozaka, Koji; Kijima, Hiroaki; Saito, Kimio

    2015-01-01

    Recently, although some studies of open repair of the tendon of the quadriceps femoris have been published, there have been no reports in the literature on primary arthroscopic repair. In our present study, we present two cases of quadriceps tendon injury arthroscopically repaired with excellent results. Case 1 involved a 68-year-old man who was injured while shifting his weight to prevent a fall. MRI showed complete rupture at the insertion of the patella of the quadriceps tendon. The rupture was arthroscopically repaired using both suture anchor and pull-out suture fixation methods via bone tunnels (hereafter, pull-out fixation). Two years after surgery, retearing was not observed on MRI and both Japan Orthopedic Association (JOA) Knee and Lysholm scores had recovered to 100. Case 2 involved a 50-year-old man who was also injured when shifting his weight to prevent a fall. MRI showed incomplete superficial rupture at the insertion of the patella of the quadriceps tendon. The rupture was arthroscopically repaired using pull-out fixation of six strand sutures. One year after surgery, MRI revealed a healed tendon and his JOA and Lysholm scores were 95 and 100, respectively. Thus, arthroscopic repair may be a useful surgical method for repairing quadriceps tendon injury.

  4. Timing of traumatic lumbar hernia repair: is delayed repair safe? Report of two cases and review of the literature.

    Science.gov (United States)

    Bathla, L; Davies, E; Fitzgibbons, R J; Cemaj, S

    2011-04-01

    Fewer than 100 cases of traumatic lumbar hernias are described in the English literature. The herniation has been described as a consequence of a combination of local tangential shearing forces combined with an acute increase in intra-abdominal pressure secondary to sudden deceleration sustained during blunt abdominal trauma. Delayed diagnosis is not uncommon, as nearly a quarter of these are missed at initial presentation. These hernias are best managed by operative intervention; however, there is no well-defined treatment strategy regarding either the timing or the type of repair. Several approaches, including laparoscopy, have been described to repair these defects. Various techniques, including primary repair, musculoaponeurotic reconstruction, and prosthetic mesh repair, have been described. These repairs are usually complicated because of the lack of musculoaponeurotic tissue inferiorly near the iliac crest. We describe here two cases of traumatic lumbar hernia managed by initial watchful waiting and subsequent elective repair using a combined laparoscopic and open technique and one with and one without bone anchor fixation.

  5. Patellar ligament rupture in the dog: repair methods and patient outcomes in 43 cases.

    Science.gov (United States)

    Das, S; Thorne, R; Lorenz, N D; Clarke, S P; Madden, M; Langley-Hobbs, S J; Perry, K L; Burton, N J; Moores, A L; Mosley, J R

    2014-10-18

    The medical records of dogs receiving surgery for unilateral patellar ligament rupture between 1999 and 2012 at 12 multidisciplinary referral centres were reviewed. Forty-three cases were identified; 26 were traumatic in origin; almost one-third were iatrogenic, of which over three-quarters occurred as a complication following surgical stabilisation of patellar luxation. Treatment involved primary reapposition of the ligament (36 cases). The repair was protected by circumpatellar and/or transpatellar loop(s) of orthopaedic wire, nylon, polypropylene or polydioxanone suture (34 cases). Wire loops were more likely to require surgical removal compared with loops of other materials (P=0.0014). The stifle joint was immobilised postoperatively by the applications of a transarticular external skeletal fixator (taESF) in 17 cases and by external coaptation (EC) in 8 cases; in 18 cases, no postoperative joint immobilisation was provided. Complications specific to the method of immobilisation occurred in seven of the cases with taESF and six of the cases with EC. Revision surgery to address failure of repair was required in five cases. Outcome was classified as acceptable or good in over three-quarters of the cases (31/40) and poor in less than a quarter (9/40). These data highlight patellar ligament rupture as a complication of surgical stabilisation of patellar luxation. British Veterinary Association.

  6. Ceramic restoration repair: report of two cases

    Directory of Open Access Journals (Sweden)

    Luís Henrique Araújo Raposo

    2009-04-01

    Full Text Available The esthetic and functional rehabilitation of patients with multiple missing teeth can be performed with several techniques and materials. Ceramic restorations provide reliable masticatory function and good esthetics. However, fracture can occur in some cases due to their brittle behavior. In some cases, the replacement of an extensive prosthesis is a problem due to the high treatment cost. In this paper, two cases are presented, in which fractures occurred in extensive metal-ceramic fixed partial dentures, and their replacement was not possible. Ceramic repair was chosen and the sequences of treatment with and without presence of the ceramic fragment are also discussed. The cases illustrate that, in some situations, fractured metal-ceramic partial dentures can be successfully repaired when prosthetic replacement is not a choice. Prosthodontists must use alternatives that allow a reliable repair to extensive metal-ceramic fixed partial dentures. Surface preparation of the ceramic with hydrofluoric acid in conjunction with a silane coupling agent is essential for a predictable bonding of composite resin. The repair performed with composite resin is an esthetic and functional alternative when extensive fixed partial dentures cannot be replaced.

  7. Girls' Living Quarters: Success and Challenge, the Case of ...

    African Journals Online (AJOL)

    user

    in the hostel include administration, learning materials, vocational skill trainings, recreational center ..... Table I. The role of Girls' living quarters in providing access to education. Item ..... designed to improve student's speaking, reading and ...

  8. Combined epigastric hernia repair and mini-abdominoplasty. Case report.

    Science.gov (United States)

    Grella, Roberto; Razzano, Sergio; Lamberti, Rossella; Trojaniello, Biagio; D'Andrea, Francesco; Nicoletti, Giovanni Francesco

    2015-01-01

    The objectives of abdominal hernia repair are to restore the structural integrity of the abdominal wall. Current techniques include primary closure, staged repair and the use of prosthetic materials. Techniques for mini-abdominoplasty include the use of the transverse lower abdominal incision and the resection of excess skin. We report a case of epigastric hernia repair through a transverse lower abdominal incision with the resection of excess of skin. Our purpose is to evaluate the results of the procedure by incorporating these aspects into an epigastric hernia repair, we found out that the procedures are made safer and the results are improved. Proper indication and details of the technique are described.

  9. Laparoscopic mesh repair of parahiatal hernia: a case report.

    Science.gov (United States)

    Lew, Pei Shi; Wong, Andrew Siang Yih

    2013-08-01

    We report a case of a primary parahiatal hernia that was repaired laparoscopically with a composite mesh. A 51-year-old woman presented with vomiting and epigastric pain. CT scan showed a giant paraesophageal hernia with intrathoracic gastric volvulus. Intraoperatively, a diaphragmatic muscular defect was found lateral to an attenuated left crus of the diaphragm, distinct from the normal esophageal hiatus. The defect ring was fibrotic, making a tension-free primary repair difficult. A laparoscopic mesh repair was performed with a composite mesh, which was covered with the hernia sac to prevent potential erosion into the esophagus or stomach. Recovery was uneventful and the patient was discharged on the 5 days postoperatively. She remained asymptomatic at subsequent follow-up. Laparoscopic repair of parahiatal hernia can be safely performed. In circumstances where a large or fibrotic defect prevents a tension-free primary repair, the use of a composite mesh can provide effective repair of the hernia.

  10. ANAESTHESIA MANAGEMENT OF CSF RHINORRHEA REPAIR : A CASE REPORT

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    Kirti Arvind

    2015-09-01

    Full Text Available Anaesthesiologist plays a major role in Cerebrospinal Fluid (CSF rhinorrhea repair surgery as the prognosis of which is dependent on provision of clear bloodless surgical field and surgeons satisfaction. Anaesthesiologist also plays vital role in the management of CSF Lumbar drain. This case highlights the importance of hypotensive anaesthesia during endoscopic repair of a case of spontaneous CSF Rhinorrhea with successful perioperative management of Lumbar drainage of CSF

  11. Combined epigastric hernia repair and mini-abdominoplasty. Case report

    Directory of Open Access Journals (Sweden)

    Grella Roberto

    2015-01-01

    Full Text Available The objectives of abdominal hernia repair are to restore the structural integrity of the abdominal wall. Current techniques include primary closure, staged repair and the use of prosthetic materials. Techniques for mini-abdominoplasty include the use of the transverse lower abdominal incision and the resection of excess skin. We report a case of epigastric hernia repair through a transverse lower abdominal incision with the resection of excess of skin. Our purpose is to evaluate the results of the procedure by incorporating these aspects into an epigastric hernia repair, we found out that the procedures are made safer and the results are improved. Proper indication and details of the technique are described.

  12. FUNCTIONAL OUTCOMES AFTER DISTAL BICEPS BRACHII REPAIR: A CASE SERIES

    Science.gov (United States)

    Morris, Tim; Otto, Charissa; Zerella, Tanisha; Semmler, John G; Human, Taaibos; Phadnis, Joideep; Bain, Gregory I

    2016-01-01

    Objectives To investigate outcomes after surgical repair of distal biceps tendon rupture and the influence of arm dominance on isokinetic flexion and supination results. Background/Purpose While relatively uncommon, rupture of the distal biceps tendon can result in significant strength deficits, for which surgical repair is recommended. The purpose of this study was to assess patient reported functional outcomes and muscle performance following surgery. Methods A sample of 23 participants (22 males, 1 female), who had previously undergone surgical repair of the distal biceps tendon, were re-examined at a minimum of one year after surgery. Biodex isokinetic elbow flexion and supination testing was performed to assess strength (as measured by peak torque) and endurance (as measured by total work and work fatigue). The Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) and Mayo Elbow Performance Scale (MEPS) were used to assess participants' subjectively reported functional recovery. Results At a mean of 7.6 years after surgical repair, there were no differences between the repaired and uninvolved elbows in peak torque (p = 0.47) or total work (p = 0.60) for flexion or supination. There was also no difference in elbow flexion work fatigue (p = 0.22). However, there was significantly less work fatigue in supination, which was likely influenced by arm dominance, as most repairs were to the dominant arm, F(1,22)=5.67, p = 0.03. Conclusion The long-term strength of the repaired elbow was similar to the uninvolved elbow after surgery to the distal biceps tendon. Endurance of the repaired elbow was similar in flexion but greater in supination, probably influenced by arm dominance. Study design Retrospective case series Level of Evidence Level 4 PMID:27904798

  13. THORACOSCOPIC REPAIR OF ESOPHAGEAL ATRESIA WITH DISTAL FISTULA IN A NEW BORN: A TECHNICAL CASE REPORT

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    E. Brandigi

    2013-12-01

    Full Text Available Introduction. Esophageal atresia encompasses a group of congenital anomalies comprising of an interruption of the esophageal continuity with or without a persistent communication with the trachea. Esophageal atresia with tracheoesophageal fistula (type C accounts for 85% of all esophageal atresia. Minimally invasive approach to correct esophageal atresia with distal fistula is becoming more generally accepted. The outcome of these technique are critically analyzed and compared with results from open repair. We present one case of type IIIB esophageal atresia treated by a thoracoscopic approach. Case Report. The patient was a 2-days-old infant male, weight 3 kg with esophageal atresia and distal tracheoesophageal fistula without other associated disease. A polidramanios was detected in prenatal age by a prenatal ultrasound evaluation. He underwent to a thoracoscopic repair of the defect. The operation was approached through the right chest using a three-trocar technique (three 5-mm with the patient placed in a three-quarter prone position. The azygos vein was ligated by Ligature device. The fistula was ligated by two resorbable stiches suture and dissected, the proximal esophagus was opened and an anastomosis was made over a 6 Ch nasogastric tube with interrupted and resorbable stiches suture. On the postoperative day 7, gastrografin swallow was performed and oral feeding was started. The patient’s six month upper Gastrointestinal barium studies was normal. Discussion and conclusion. Thoracoscopic repair of esophageal atresia is considered to be one of the more advanced and most difficult pediatric surgical procedures and it undoubtely has necessary an elevated learning curve. The minimally invasive approach was larged accepted in the last ten years also for the well documented sequelae of traditional open repair of esophageal atresia. More experience is needed to determine the exact place of this approach.

  14. Laparoscopic repair of hiatal hernias: Experience after 200 consecutive cases

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    Bjelović Miloš

    2014-01-01

    Full Text Available Introduction. Repair of hiatal hernias has been performed traditionally via open laparotomy or thoracotomy. Since first laparoscopic hiatal hernia repair in 1992, this method had a growing popularity and today it is the standard approach in experienced centers specialized for minimally invasive surgery. Objective. In the current study we present our experience after 200 consecutive laparoscopic hiatal hernia repairs. Methods. A retrospective cohort study included 200 patients who underwent elective laparoscopic hiatal hernia repair at the Department for Minimally Invasive Upper Digestive Surgery, Clinic for Digestive Surgery, Clinical Center of Serbia in Belgrade from April 2004 to December 2013. Results. Hiatal hernia types included 108 (54% patients with type I, 30 (15% with type III, 62 (31% with giant paraesophageal hernia, while 27 (13.5% patients presented with a chronic gastric volvulus. There were a total of 154 (77% Nissen fundoplications. In 26 (13% cases Nissen procedure was combined with esophageal lengthening procedure (Collis-Nissen, and in 17 (8.5% Toupet fundoplications was performed. Primary retroesophageal crural repair was performed in 164 (82% cases, Cleveland Clinic Foundation suture modification in 27 (13.5%, 4 (2% patients underwent synthetic mesh hiatoplasty, 1 (0.5% primary repair reinforced with pledgets, and 4 (2% autologous fascia lata graft reinforcement. Poor result with anatomic and symptomatic recurrence (indication for revisional surgery was detected in 5 patients (2.7%. Conclusion. Based on the result analysis, we found that laparoscopic hiatal hernia repair was a technically challenging but feasible technique, associated with good to excellent postoperative outcomes comparable to the best open surgery series.

  15. Fatal musculoskeletal injuries of Quarter Horse racehorses: 314 cases (1990-2007).

    Science.gov (United States)

    Sarrafian, Tiffany L; Case, James T; Kinde, Hailu; Daft, Barbara M; Read, Deryck H; Moore, Janet D; Uzal, Francisco A; Stover, Susan M

    2012-10-01

    To determine major causes of death and the anatomic location of musculoskeletal injuries in Quarter Horse racehorses in California. Retrospective case series. 314 Quarter Horse racehorses with musculoskeletal injuries that were necropsied through the California Horse Racing Board Postmortem Program from 1990 to 2007. Postmortem pathology reports were retrospectively reviewed. Musculoskeletal injuries were categorized by anatomic region and described. The number of Quarter Horse starts and starters for the same period of time were obtained from a commercial database for determination of fatal injury incidence. Musculoskeletal injuries accounted for 314 of the 443 (71 %) Quarter Horse racehorses that died during the 18-year study period. Fatal musculoskeletal injuries occurred at a rate of 2.0 deaths/1,000 race starts and 18.6 deaths/1,000 horses that started a race. Musculoskeletal injuries occurred predominantly during racing (84%) and in the forelimbs (81%). The most common fatal musculoskeletal injuries were metacarpophalangeal and metatarsophalangeal joint (fetlock) support injuries (40%) and carpal (24%), vertebral (10%), and scapular (8%) fractures. Proximal interphalangeal (pastern) joint luxations resulted in death of 3% of horses. Fracture configurations of some bones were consistent with those of Thoroughbred racehorses. Evidence of preexisting stress remodeling of bone was reported for some fractures. Knowledge of common locations and types of fatal musculoskeletal injuries in racing Quarter Horses may enhance practitioners' ability to detect mild injuries early, rest horses, and help prevent catastrophic injuries.

  16. Percutaneous repair of inadvertent subclavian artery cannulation: a case report

    Institute of Scientific and Technical Information of China (English)

    SHI Hong-yu; QIU Xing-biao; CHEN Hui; LIU Zhi-gang; YE Ying; FANG Wei-yi

    2009-01-01

    @@ Although catheterization of the subclavian vein is a common procedure, it might be associated with life-threatening complications including accidental cannulation of subclavian artery.1-3 Rash sheath removal could result in fatal hemorrhage. We report a case of inadvertent 6F sheath cannulation of the right subclavian artery during a radiofrequency catheter ablation procedure and successful repair of the cannulation by Angio-Seal STS plus (St. Jude Medical, St. Paul, MN, US), a collagen-base vascular closure device.

  17. Laparoscopic repair of vaginal evisceration: a case report.

    Science.gov (United States)

    Lledó, Jose Bueno; Roig, Manuel Planells; Serra, Alfonso Serralta; Astaburuaga, Carmen Rodero; Giménez, Fernando Dobón

    2002-12-01

    Vaginal evisceration, although rare, is usually present in postmenopausal women with a history of vaginal surgery and high-grade pelvic floor dysfunction. Operative management is directed toward resecting any compromised bowel, repairing vaginal defect, and correcting the defect in the pelvic floor, which is associated with most cases, either in the same intervention or in a second procedure. Laparoscopy allows for assessment of the viability of the compromised bowel and the vaginal defect suture with advantages common to minimally invasive techniques. We report the first case in the international literature of vaginal evisceration managed by laparoscopy.

  18. [Horizontal root fracture repaired by cementum--a case report].

    Science.gov (United States)

    Lin, K R; Kuo, J S

    1989-09-20

    Horizontal root fractures are rare among dental trauma. According to Dr. Andreasen's report there are four types of repairs after root fractures. They are 1. healing with calcified tissue; 2. interposition of connective tissue; 3. interposition of connective and bony tissue; 4. interposition of granulation tissue. This report presented a case of horizontal root fracture in a 27 years old female patient. The patient had a trauma in the front teeth about 15 years ago. Spontaneous healing occurred without dental treatment at that moment. However, symptoms appeared recently as a dento-alveolar abscess. Radiograph revealed a horizontal fracture at the middle third of the root portion of the left upper central incisor, and irregular hard tissue over the fractured area. Histologically, the main component of repair tissue is cementum.

  19. Umbilical hernia in adults: day case local anaesthetic repair.

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    Menon V

    2003-01-01

    Full Text Available INTRODUCTION: The waiting times for elective surgery of Umbilical hernia (UH in adults are unacceptably long in some cases. During this period, irreducibility and strangulation are possible. We operate on adult patients under local anaesthesia (LA as day cases to avoid this delay and describe our experience in this paper. AIMS: The aims of our study were to look at the age and sex distribution, body weight, type and amount of local anaesthetic used, morbidity, admission and readmission rates, and waiting times of adult patients operated on for UH under LA. MATERIALS AND METHODS: It was a retrospective study covering a 4 year period from July 1996 to June 2000 including all adult patients undergoing the above procedure under the care of a single consultant general surgeon. A standard Mayo repair using non absorbable material was used without a mesh or a drain. RESULTS: 32 patients with UH were operated on under LA, 23 males and 9 females with a median age of 51 years (range 20 to 86 years. The body weight ranged from 63 to 120 (median 87 kg. The average duration of the procedure was 30 (range 22-40 minutes. Sedation was needed in 4 patients. Two patients developed wound infections, one superficial and one deep. There was no mortality. The median period of follow-up was 24 (range 4-48 months and there was no recurrence. The median waiting time for the operation was 6 weeks. CONCLUSIONS: Day case local anaesthetic repair of UH in adults seems to be safe and feasible with an acceptable morbidity. Suture repair in the right patient has excellent results and the waiting times are acceptable.

  20. Delayed diagnosis of hemoptysis in the case of prior aortic coarctation repair: A case report of aortobronchial fistula

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    Vinay Kansal

    2015-01-01

    Full Text Available We report a case of a 46-year old man who presented with spontaneous bright red blood per mouth for several months. The patient had history of aortic coarctation repair at age 17. Endoscopy and nasopharyngeoscopy revealed no source of bleeding. Computed tomography scan revealed the presence of thoracic aortic pseudoaneurysm with the formation of an aortobronchial fistula (ABF. This case illustrates the high index of suspicion for ABF in the case of hemoptysis or hematemesis with prior history of coarctation repair. Furthermore, we discuss the role of thoracic endovascular aneurysm repair (TEVAR as the standard of repair over open surgery.

  1. A Rare Case of Laparoscopic Repair of Simultaneously Occurring Morgagni and Paraesophageal Hernias.

    Science.gov (United States)

    Zhou, Zu-Li; Li, Hao; Li, Jian-Feng; Liu, Yan-Guo; Wang, Chong; Wang, Jun

    2016-01-01

    Simultaneously occurring Morgagni hernia and paraesophageal hernia is an extremely rare clinical condition with only six case reports in the English-language literature and only two laparoscopic repair reports. We report a 73-year-old woman with both Morgagni hernia and paraesophageal hernia who underwent successful laparoscopic repair of the hernia defects using transabdominal wall suturing. The laparoscopic operation can provide excellent exposure and repair the hernia defect easily with minimal invasiveness and fewer complications. This case report reported the concurring Morgagni and paraesophageal hernias and validated the feasibility of laparoscopic repair both hernias simultaneously.

  2. SUSTAINABILITY OF «FRAMEWORK» AND «FABRIC» OF HISTORIC QUARTERS IN THE CASE OF EKATERINBURG CITY

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    Арина Вениаминовна Лейзерова

    2016-11-01

    Full Text Available The article deals with the features of urban area sustainable development using the case of Ekaterinburg city. Preserving historical and cultural heritage is considered to be one of the main aspects towards the modernization of urban environment under the policy of sustainable urban development. The article analyzes urban fabric of the historic center, elements of “framework”, «fabric» and «plasma» of the quarters in question. Factors influencing the sustainability of architectural and planning structure of historic quarters of Ekaterinburg city are identified as well.

  3. Reconstruction of Posterior Interosseous Nerve Injury Following Biceps Tendon Repair: Case Report and Cadaveric Study

    OpenAIRE

    Mokhtee, David B.; Brown, Justin M.; Mackinnon, Susan E.; Tung, Thomas H.

    2008-01-01

    Surgical repair of distal biceps tendon rupture is a technically challenging procedure that has the potential for devastating and permanently disabling complications. We report two cases of posterior interosseous nerve (PIN) injury following successful biceps tendon repair utilizing both the single-incision and two-incision approaches. We also describe our technique of posterior interosseous nerve repair using a medial antebrachial cutaneous nerve graft (MABC) and a new approach to the termin...

  4. Robotic repair of retrocaval ureter: A case series

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    B. Nayak

    2012-09-01

    Conclusions: Robotic retrocaval ureter repair without excision of the retrocaval segment is feasible and an effective alternative to open or laparoscopic retrocaval ureter repair with good anatomical and functional outcome. It may become the procedure of choice along with laparoscopic surgery for retrocaval ureter.

  5. Hemolytic anemia following mitral valve repair: A case presentation and literature review

    OpenAIRE

    AbouRjaili, Georges; Torbey, Estelle; Alsaghir, Taher; Olkovski, Yefim; Costantino, Thomas

    2012-01-01

    Hemolytic anemia is a known complication after valve replacement, but the incidence of hemolysis following valve repair is unknown. A case involving mitral annuloplasty complicated by hemolytic anemia, which resolved after replacement of the valve, is presented. Only 70 cases of hemolysis after mitral valve repair have been reported in the literature. In nearly all of these cases, replacement or rerepair of the valve was the definitive treatment for hemolysis.

  6. A successful double-layer facial nerve repair: A case presentation

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    Mehmet Dadaci

    2015-04-01

    Full Text Available The best method to repair the facial nerve is to perform the primary repair soon after the injury, without any tension in the nerve ends. We present a case of patient who had a full-thickness facial nerve cut at two different levels. The patient underwent primary repair, recovered almost completely in the fourth postoperative month, and had full movement in mimic muscles. Despite lower success rates in double-level cuts, performing appropriate primary repair at an appropriate time can reverse functional losses at early stages, and lead to recovery without any complications. [Hand Microsurg 2015; 4(1.000: 24-27

  7. Muscle breakdown and repair in polymyositis: a case study.

    Science.gov (United States)

    Edwards, R H; Wiles, C M; Round, J M; Jackson, M J; Young, A

    1979-01-01

    Muscle breakdown and repair were measured by metabolic balance techniques in a patient with polymyositis who was being treated with prednisolone and azathioprine. Changes in body muscle mass that had been estimated from nitrogen and phosphorus balances correlated with antropometric assessments of thigh muscle mass and quadriceps strength. Decline in muscle strength was associated with a net rate of muscle breakdown of 148 g/day. Recovery was associated with a net rate of muscle repair of up to 100 g/day. Early reduction in corticosteroid treatment appeared to enhance the rate of repair. Changes in the isometric contraction force of the quadriceps muscle (but not in clinical symptoms, plasma creatine kinase [CK] or erythrocyte sedimentation rate [ESR] were found to reliably indicate whether the muscle was in a state of breakdown or repair. Treatment of the individual patient may be quantitatively monitored by metabolic balance studies or, more simply, by measurement of muscle strength.

  8. The case for a centralized repair depot for Space Shuttle

    Science.gov (United States)

    Enlow, R. D.

    1985-01-01

    The first priority of the NSTS program is to make the Space Shuttle system fully operational and cost effective in providing routine access to space. In support of this priority an integrated logistics support system was planned, structured and is being implemented to support a launch-on-time goal of 95 percent. In achieving a 95 percent spares 'fill rate' in an environment of small fleet size, highly unique and high cost assets, significant spares cost can be incurred. A major portion of these costs are for the additional spares required when repair or acquisition times are lengthy. This paper provides a fundamental analysis of the costs and other factors involved in the spare and repair process and provides an optimized cost and process solution for the Space Shuttle program - a centralized repair depot located at KSC.

  9. [A Case of Mitral Valvular Re-repair in a Patient with Hemolytic Anemia after Mitral Valvular Repair].

    Science.gov (United States)

    Tomino, Mikiko; Miyata, Kazuto; Takeshita, Yuji; Kaneko, Koki; Kanazawa, Hiroko; Uchino, Hiroyuki

    2015-07-01

    A 54-year-old woman was admitted for mitral valvular repair. After folding plasty to A3, a 30 mm Cosgrove-Edwards ring was placed. There was no mitral regurgitation jet observed by transesophageal echocardiography (TEE) during the operation. However, high blood pressure was monitored and treated in the intensive care unit, hemolytic anemia developed, and the serum lactate dehydrogenase level was elevated. Two weeks after the operation, serum lactate dehydrogenase was again elevated. TEE showed mild mitral regurgitation and the regurgitation jet colliding with the annuloplasty ring. Multiple transfusions of red blood cells were required. Repeat surgery was therefore undertaken. Lam and associates previously studying patients on hemolysis after mitral valvular repair noted high grade mitral regurgitation jets fragmented or accelerated. In the present case, mitral regurgitation was mild, but the high velocity and manner of regurgitation (collision with the annuloplasty ring) could cause hemolytic anemia. In the present case, high blood pressure might have caused chordae rupture. Furthermore, a flexible ring, such as the Cosgrove-Edwards ring, is likely to cause hemolytic anemia. As contributing factors to hemolysis after mitral valvular repair, perioperative blood pressure management and type of ring are significant.

  10. Laparoscopic morgagni hernia repair using single-site umbilical and full-thickness abdominal wall repair: Technical report of two cases

    Directory of Open Access Journals (Sweden)

    Martin L van Niekerk

    2013-01-01

    Full Text Available Single incision laparoscopic surgery is used in many centres for routine cases such as appendisectomy, splenectomy and cholecystectomy. Morgagni hernias are uncommon and account for 1-2% of all congenital diaphragmatic hernia. We report our first laparoscopic repair of two Morgagni hernias, using a single umbilical incision and full-thickness abdominal wall repair with standard straight laparoscopic instruments. Operative time was short and compared favourably with the laparoscopic repair.

  11. Laparoscopic Morgagni hernia repair using single-site umbilical and full-thickness abdominal wall repair: technical report of two cases.

    Science.gov (United States)

    van Niekerk, Martin L

    2013-01-01

    Single incision laparoscopic surgery is used in many centres for routine cases such as appendectomy, splenectomy and cholecystectomy. Morgagni hernias are uncommon and account for 1-2% of all congenital diaphragmatic hernia. We report our first laparoscopic repair of two Morgagni hernias, using a single umbilical incision and full-thickness abdominal wall repair with standard straight laparoscopic instruments. Operative time was short and compared favourably with the laparoscopic repair.

  12. Full incorporation of Strattice™ Reconstructive Tissue Matrix in a reinforced hiatal hernia repair: a case report

    Directory of Open Access Journals (Sweden)

    Freedman Bruce E

    2012-08-01

    Full Text Available Abstract Introduction A non-cross-linked porcine acellular dermal matrix was used to reinforce an esophageal hiatal hernia repair. A second surgery was required 11 months later to repair a slipped Nissen; this allowed for examination of the hiatal hernia repair and showed the graft to be well vascularized and fully incorporated. Case presentation A 71-year-old Caucasian woman presented with substernal burning and significant dysphagia. An upper gastrointestinal series revealed a type III complex paraesophageal hiatal hernia. She underwent laparoscopic surgery to repair a hiatal hernia that was reinforced with a xenograft (Strattice™ Reconstructive Tissue Matrix, LifeCell, Branchburg, NJ, USA along with a Nissen fundoplication. A second surgery was required to repair a slipped Nissen; this allowed for examination of the hiatal repair and graft incorporation 11 months after the initial surgery. Conclusion In this case, a porcine acellular dermal matrix was an effective tool to reinforce the crural hiatal hernia repair. The placement of the mesh and method of fixation are believed to be crucial to the success of the graft. It was found to be well vascularized 11 months after the original placement with no signs of erosion, stricture, or infection. Further studies and long-term follow-up are required to support the findings of this case report.

  13. EPA, Seattle truck repair firm settle water pollution case

    Science.gov (United States)

    (SEATTLE - May 13, 2015) Western Peterbilt, LLC, a Seattle truck sales and repair shop, has reached a settlement with the U.S. Environmental Protection Agency stemming from violations of the federal Clean Water Act. As part of the settlement, the company h

  14. Reconstruction of posterior interosseous nerve injury following biceps tendon repair: case report and cadaveric study.

    Science.gov (United States)

    Mokhtee, David B; Brown, Justin M; Mackinnon, Susan E; Tung, Thomas H

    2009-06-01

    Surgical repair of distal biceps tendon rupture is a technically challenging procedure that has the potential for devastating and permanently disabling complications. We report two cases of posterior interosseous nerve (PIN) injury following successful biceps tendon repair utilizing both the single-incision and two-incision approaches. We also describe our technique of posterior interosseous nerve repair using a medial antebrachial cutaneous nerve graft (MABC) and a new approach to the terminal branches of the posterior interosseous nerve that makes this reconstruction possible. Finally, we advocate consideration for identification of the posterior interosseous nerve prior to reattachment of the biceps tendon to the radial tuberosity.

  15. Emergent Laparoscopic Repair of a Spigelian Hernia: Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Reid Barker

    2013-01-01

    Full Text Available A spigelian hernia is a protrusion through an anterior abdominal wall defect along the linea semilunaris. The traditional method of repair consists of an open surgical technique requiring a lengthy abdominal incision to allow visualization of the defect. However, with the emergence and availability of laparoscopic techniques, a minimally invasive approach is feasible. Only eight prior case reports have documented emergent laparoscopic repair of a spigelian hernia. We describe the first successful laparoscopic repair of a spigelian hernia in an emergent setting at our institution.

  16. Perioperative Challenges in Repeat Bladder Exstrophy Repair - Case Report

    Directory of Open Access Journals (Sweden)

    Otu Enenyi Etta

    2015-07-01

    Full Text Available Bladder exstrophy is a rare congenital malformation. It presents as leakage of urine in the anterior abdominal wall following defects in midline anterior abdominal wall skin and bladder. We report the use of combined general anaesthesia and caudal epidural analgesia in a 4yr old boy for repeat bladder exstrophy repair. Problems of prolonged surgery and the challenges of pain and sedation management in the post operative period are discussed.

  17. Thoracoscopic Patch Repair of Congenital Diaphragmatic Hernia in a Neonate using Spiral Tacks: A Case Report

    Directory of Open Access Journals (Sweden)

    Mario A Riquelme

    2015-07-01

    Full Text Available We present a case of congenital diaphragmatic hernia that was successfully treated with spi-ral tacks using thoracoscopy. A newborn female was diagnosed with a diaphragmatic hernia at 20 weeks of gestation. The defect was surgically repaired by thoracoscopy and primary closure. On postoperative day 25, she developed respiratory distress. Chest x-ray showed a recurrence and was taken to the OR for surgical repair with spiral tacks.

  18. Sampson’s Artery Hemorrhage after Inguinal Hernia Repair: Second Case Reported

    Directory of Open Access Journals (Sweden)

    Joseph Adjei Boachie

    2016-01-01

    Full Text Available Sampson artery is normally obliterated in postembryonic development. In rare cases it can remain patent and complicate a routine outpatient herniorrhaphy when severed. This is the second reported case in the available English literature of hemoperitoneum due to bleeding from a patent Sampson’s artery following an open inguinal hernia repair.

  19. A case report on management of synergistic gangrene following an incisional abdominal hernia repair in an immunocompromised obese patient

    Directory of Open Access Journals (Sweden)

    N. Merali

    2015-01-01

    Conclusion: This case has demonstrated how a planned multidisciplinary action can produce prosperous results in a severely obese immunocompromised patient with an SSI, following an incisional hernia repair.

  20. Minimally invasive repair of Morgagni hernia - A multicenter case series.

    Science.gov (United States)

    Lamas-Pinheiro, R; Pereira, J; Carvalho, F; Horta, P; Ochoa, A; Knoblich, M; Henriques, J; Henriques-Coelho, T; Correia-Pinto, J; Casella, P; Estevão-Costa, J

    2016-01-01

    Children may benefit from minimally invasive surgery (MIS) in the correction of Morgagni hernia (MH). The present study aims to evaluate the outcome of MIS through a multicenter study. National institutions that use MIS in the treatment of MH were included. Demographic, clinical and operative data were analyzed. Thirteen patients with MH (6 males) were operated using similar MIS technique (percutaneous stitches) at a mean age of 22.2±18.3 months. Six patients had chromosomopathies (46%), five with Down syndrome (39%). Respiratory complaints were the most common presentation (54%). Surgery lasted 95±23min. In none of the patients was the hernia sac removed; prosthesis was never used. In the immediate post-operative period, 4 patients (36%) were admitted to intensive care unit (all with Down syndrome); all patients started enteral feeds within the first 24h. With a mean follow-up of 56±16.6 months, there were two recurrences (18%) at the same institution, one of which was repaired with an absorbable suture; both with Down syndrome. The application of MIS in the MH repair is effective even in the presence of comorbidities such as Down syndrome; the latter influences the immediate postoperative recovery and possibly the recurrence rate. Removal of hernia sac does not seem necessary. Non-absorbable sutures may be more appropriate.

  1. Biological Glue Application in Repair of Atrioventricular Groove Rupture: A Case Report

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    Ahmet Baris-Durukan

    2015-10-01

    Full Text Available Atrioventricular groove rupture is a rare, albeit mortal, complication following mitral valve surgery. Avoidance is the best strategy but it cannot fully prevent the occurrence of this complication. Several repair techniques have been described with varying success rates; however, the rarity of the complication precludes consensus about the safest technique.Here we report two cases of posterior atrioventricular groove rupture. Both cases were diagnosed immediately after the cessation of cardiopulmonary bypass. Repair was performed successfully with a technique involving the use of biological glue. The postoperative course was uneventful for both of them. Both cases are well with normally functioning mitral prostheses; one with a follow-up time of 5.5 years and the other 10 months. We believe that the glue provides additional hemostasis and support to the repaired area.

  2. Ultrasonographic Evaluation of Uterine Scar Niche before and after Laparoscopic Surgical Repair: A Case Report

    Directory of Open Access Journals (Sweden)

    Olivier Drouin

    2014-11-01

    Full Text Available Context - Uterine scar defects or scar niche are relatively common after cesarean delivery. An association has been observed between the severity of scar defect, also known as isthmocele, some gynecologic symptoms, and the risk of uterine scar dehiscence at the next delivery. It has been suggested that surgical repair of scar defect could improve the gynecological symptoms, but it remains unclear whether such surgery mends the uterine scar itself. Case Report - We report the case of a woman with uterine scar defect in whom laparoscopic repair significantly improved the gynecological symptoms without affecting the uterine scar, evaluated by hysterosonography. Conclusion - This case highlights the significant dearth of knowledge surrounding the diagnosis, consequences, and benefits of surgical repair of uterine scar defect after cesarean.

  3. Laparoscopic repair of a bilateral internal inguinal hernia with supravesical hernia – a case report

    Science.gov (United States)

    Kawaguchi, Tsutomu; Itoh, Tadao; Yoshii, Kazuhiro; Otsuji, Eigo

    2015-01-01

    Introduction Supravesical hernia is an exceptional subtype of internal inguinal hernia, and it is located between the median umbilical ligament and the medial umbilical ligament. The hernia is classified as two types: internal supravesical hernia and external supravesical hernia. Presentation of case Herein we report a rare case of external supravesical hernia successfully treated by laparoscopic procedure. The patient who complained right inguinal protrusion and mild frequent urination was diagnosed as right inguinal hernia and potential of left inguinal hernia using computed tomography. He underwent laparoscopic bilateral hernia repair, and intraoperative findings revealed right external supravesical hernia and left internal inguinal hernia. Discussion Laparoscopic hernia repair may make it possible to avoid overlooking of internal hernia such as supravesical hernia. Moreover it was possible to cover the hernia orifice and dissected layer of the dorsal site of urine bladder using bilateral approach in the current case. Conclusion In conclusions, laparoscopic hernia repair might be a surgical option for supravesical hernia. PMID:26263448

  4. An unusual case of cancer of the urachal remnant following repair of bladder exstrophy.

    LENUS (Irish Health Repository)

    Fanning, D M

    2009-03-18

    INTRODUCTION: We report the first case of cancer of the urachal remnant following repair of bladder exstrophy, in a renal transplant recipient. METHOD: A retrospective review of this clinical case and the associated literature were performed. CONCLUSION: This unusual case highlights two very rare entities. Bladder exstrophy has an incidence of 1 in 50,000 newborns, whereas urachal cancer accounts for less than 1% of all bladder tumours.

  5. An unusual case of cancer of the urachal remnant following repair of bladder exstrophy.

    LENUS (Irish Health Repository)

    Fanning, D M

    2012-02-01

    INTRODUCTION: We report the first case of cancer of the urachal remnant following repair of bladder exstrophy, in a renal transplant recipient. METHOD: A retrospective review of this clinical case and the associated literature were performed. CONCLUSION: This unusual case highlights two very rare entities. Bladder exstrophy has an incidence of 1 in 50,000 newborns, whereas urachal cancer accounts for less than 1% of all bladder tumours.

  6. Robotic repair of a large abdominal intercostal hernia: a case report and review of literature.

    Science.gov (United States)

    Wang, Stephani C; Singh, Tejinder P

    2017-06-01

    Abdominal intercostal hernia is an uncommon phenomenon, reported in few case reports and small case series. If left untreated, it can lead to strangulation and visceral ischemia. Prompt diagnosis and appropriate surgical intervention are thus critical to prevent resulting morbidity. We present a 50-year-old woman with a large abdominal intercostal hernia after an open nephrectomy. She underwent a successful robotic repair of the hernia with mesh placement. Through the presentation, we would like to raise awareness of intercostal hernia as a complication of open nephrectomy and significance of early diagnosis in avoiding potential morbidity. We also performed a review of literature especially focusing on acquired abdominal intercostal hernia secondary to prior surgery. Although intercostal hernias can be difficult to repair secondary to the size and location, adequate visualization and surgical planning are critical to successful repair.

  7. [Breast repaired by silicone implant. Case report of necrobiosis lipoidica].

    Science.gov (United States)

    Azoulay, B; Bosque, T; Burin des Roziers, B; Daoud, G; Cartier, S

    2012-02-01

    The authors report a very rare case of necrobiosis lipoidica, histopathologically confirmed, which happened in the breast a few months following the insertion of a silicone implant (post-mastectomy reconstruction). This case raises two problems: the physiopathology (role of the silicone implant) and the treatment of this accident, resistant to current therapy.

  8. Innominate vein repair after iatrogenic perforation with central venous catheter via mini-sternotomy—Case report

    Directory of Open Access Journals (Sweden)

    Juan A. Siordia

    2015-01-01

    Conclusion: The case presented in this report suggests a new approach to replace the traditional complete median sternotomy in attempts to repair the innominate vein. The mini-sternotomy approach provides sufficient visualization of the vessel and surrounding structures with minimal post-operative complications and healing time.

  9. Median Nerve Repair with Autologous Sciatic Nerve Graft: A Case Report

    OpenAIRE

    Ragel, Brian T.; Park, Gregory C.; Sid Brevard

    2011-01-01

    Background. Peripheral nerve injury treatment options are limited to primary nerve repair, nerve grafting, and tendon transfers. In this case, a large suitable donor site was easily accessible and delayed grafting was indicative of poor prognosis. Case Description. A 25-year-old soldier presented to a military hospital in Afghanistan following a roadside bomb attack. The patient had a medial shrapnel wound in the bicipital groove with a cool pulseless hand and catastrophic lower extremity inj...

  10. 2500 KW Ship Service Turbine Generator Casing Welded Inconel Plug Failure and Repair Analysis

    Science.gov (United States)

    2012-06-01

    was requested to be proven and validated. 15. SUBJECT TERMS Inconel x750 600 Chrome -moly Casting Inconel weld repair system Steam Turbine Generator...by reference (3): 1. Change the allowable minimum thickness of the remaining Inconel clad on the turbine casing from 3/32 inch to 3/16 inch. 2...Change the minimum radial distance between the new weld and the interface between the existing Inconel inlay and the chrome -moly turbine casing

  11. Laparoscopic mesh repair of a Morgagni hernia using the double-crown technique: A case study.

    Science.gov (United States)

    Kaida, Takeshi; Ikeda, Atsushi; Shimoda, Hirofumi; Sako, Hiroyuki; Uchida, Hiroshi; Wada, Masahiro; Ikeda, Ken; Okusawa, Seijiro; Watanabe, Masahiko

    2014-11-01

    We report a case of Morgagni hernia in which the patient underwent laparoscopic mesh repair. A 65-year-old woman presented with an abnormal shadow in the right lower lung field on a routine medical checkup. CT showed that the transverse colon passed between the liver and abdominal wall, and herniated into the thoracic cavity. Simple closure was precluded by the large hernial orifice. We therefore performed laparoscopic repair using a Parietex Optimized Composite Mesh. The double-crown technique was used to fix the margin of the mesh to the region around the hernial orifice. Our procedure for repair of a Morgagni hernia with a large hernial orifice is safe and minimally invasive, and it may effectively prevent recurrence.

  12. A case of acute ischemic colitis after endovascular abdominal aortic aneurysm repair

    Institute of Scientific and Technical Information of China (English)

    Grigorios Voulalas; Chrisostomos Maltezos

    2016-01-01

    Colonic ischemia is a recognized complication of either open or endovascular abdominal aortic aneurysm repair. The clinical difficulty in establishing the diagnosis, the severity of this complication and the patient's poor physiological status may lead to a fatal outcome. We presented a case of ischemic colitis in a patient with patent hypogastric arteries that occurred after an endovascular abdominal aortic aneurysm repair as well as a review of the available literature. The patient's preoperative, intraoperative and postoperative data were recorded. A thorough search through the Google data and Medline to review similar cases or any analyses that referred to ischemic colitis after endovascular abdominal aneurysm repair was conducted. A 76-year-old male was admitted to our department for an elective endovascular repair of an 8 cm in diameter abdominal aortic aneurysm. A Zenith bifurcation graft was implanted. The whole procedure was uneventful and the final angiogram showed an accurate deployment of the endograft without endoleaks and patency of both hypogastric arteries. During the 1st postoperative day, the patient developed symptoms of acute abdomen in combination with metabolic acidosis and oliguria. He underwent an exploratory laparotomy, which revealed necrosis of the sig-moid. A Hartmann's procedure was performed;the patient was transferred to the intensive care unit where he deceased after 24 h. Postoperative ischemic colitis has been described after open abdominal aneurysm repair. The description of this complication has been reported since the early phase of endovascular abdominal aneurysm repair development with a current incidence of 1.5%–3.0%. Possible mechanisms that may contribute to ischemic colitis in spite of the presence of patent hypogastric arteries include athe-roembolization, shock, vasopressive drugs and inferior mesenteric artery occlusion.

  13. Recurrence in a Laparoscopically Repaired Traumatic Diaphragmatic Hernia: Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Bhatt

    2016-02-01

    Full Text Available Introduction Traumatic diaphragmatic hernia (TDH develops infrequently following a traumatic diaphragmatic rupture (TDR. As TDR is frequently missed due to lack of sensitive and specific imaging modalities, a high index of suspicion for such injuries is essential, whether immediately posttraumatic, or even decades after the trauma. We describe a rare case of recurrence in a laparoscopically repaired TDH and review the current literature on the same. Case Presentation A 23-year-old male with a history of primary laparoscopic repair of left-sided TDR two years ago presented with symptoms of acute large bowel obstruction. His chest X-ray showed a left-sided pleural effusion and a loop of the bowel in the left hemithorax, but no signs of free gas. An abdominal X-ray (AXR demonstrated massively dilated large bowel with distension of the small bowel. At laparotomy, the obstructing lesion consisted of the large bowel with omentum herniated through the left hemidiaphragm, consistent with a left recurrent/chronic diaphragmatic hernia. The diaphragmatic defect was repaired with interrupted nylon. The patient made an uneventful recovery. Conclusions Recurrence after repair of TDH is a less reported condition (with only two published articles and little is known regarding the factors responsible for this. Laparoscopy is an excellent diagnostic tool, but currently management is probably best performed via an open technique using heavy non-absorbable suture material to prevent recurrence. Long term follow up of these patients should also be considered.

  14. LPV Control for a Semi-Active Suspension Quarter of Car-One Parameter Case

    Directory of Open Access Journals (Sweden)

    Lozoya SantosJorge de Jesús

    2016-01-01

    Full Text Available The actual semi-active suspension control systems with a balance between comfort and road holding goals are not optimal because in these solutions one goal or the other always dominates in the suspension performance. This paper is centered in a new proposal to control an automotive semi-active suspension to achieve the comfort and maintain the road holding.The output in the control strategy is the electric current. A nonlinear quarter of vehicle model simulation compares and validates the proposal versus different controllers. The controller is designed with the H∞ criteria and the Linear Varying Parameter (LPV considering the saturation and sigmoid shape of the F-V characteristic diagram. Unlike the solutions in literature, which use at least two scheduling parameters, the proposed LPV controller scheme for a semi-active suspension uses only one scheduling parameter.

  15. A Case of Microangiopathic Hemolytic Anemia after Myxoma Excision and Mitral Valve Repair Presenting as Hemolytic Uremic Syndrome

    OpenAIRE

    Park, Young Joo; Kim, Sang Pil; Shin, Ho-Jin; Choi, Jung Hyun

    2016-01-01

    Microangiopathic hemolytic anemia occurs in a diverse group of disorders, including thrombotic thrombocytopenic purpura, hemolytic uremic syndrome, and prosthetic cardiac valves. Hemolytic anemia also occurs as a rare complication after mitral valve repair. In this report, we describe a case of microangiopathic hemolytic anemia following myxoma excision and mitral valve repair, which was presented as hemolytic uremic syndrome.

  16. GAINT INGUINOSCROTAL HERNIA – LICHTENSTEIN’S TENSION FREE REPAIR WITHOUT LOSS OF DOMAIN: CASE REPORT

    Directory of Open Access Journals (Sweden)

    Sreekant

    2015-03-01

    Full Text Available Inguinal hernia is one of the most surgical common diseases in clinical practice. The history of inguinal hernia repair originated in the ancient times and the treatment has evolved, developed and changed since. [1] The most recent one is the concept of tension - free repair which remains popular among surgeons today. It is interesting to note, though, that numerous literatures have been published on this disease in the small anatomical space despite its simplicity. In the past couple of years, most publications focused on laparoscopic surgery and the different types of prosthetic mesh. Giant inguinal hernia, however, is more unusual and significantly challenging in terms of surgical management. It is defined as an ingu inal hernia that extends below the midpoint of inner thigh when the patient is in standing position. [2] No treatment has been adopted as standard procedure for this uncommon disease and several repair techniques are suggested by published articles and case reports. Further, the absence of large scale comparative study is expected to continue due to the relatively low number of cases. As a result, choosing a surgical procedure is made difficult and the decision must be made intraoperatively. A 55 - year - old ma le patient presented with Left Giant inguinal hernia and compromised quality of life due to pain and sexual discomfort. Lichtenstein’s polypropylene mesh repair was done after reducing the sac contents (omentum and ileum with partial omentectomy. There wa s no loss of intra - abdominal domain. Postoperative period was uneventful. In literature many techniques are available to increase the intra - abdominal cavity (a Creating progressive preoperative pneumoperitoneum (b Creation of ventral wall defect (c surg ical debulking of hernia contents. Recurrence is prevented by reconstruction of the abdominal wall using Marlex mesh and a Tensor fasciae lata flap. Laparoscopic repair is associated with more recurrence

  17. Repair, Evaluation, Maintenance, and Rehabilitation Research Program. Rehabilitation of Navigation Lock Walls: Case Histories.

    Science.gov (United States)

    1987-12-01

    construction contract for the repairs was awarded to the low bidder, Premier Waterproofing Company, .- Denver, Colorado. 258. There was no device or test...sound condition except for surface deterioration. Total resurfacing of the lock chamber would be for cosmetic reasons only and was not considered...may only be cosmetic and in many cases the appearance may not be satisfac- . ’ tory either. Damage from freezing and thawing may only be a % few

  18. Simple facet joint repair with dynamic pedicular system: Technical note and case series

    OpenAIRE

    Ali Fahir Ozer; Tuncer Suzer; Mehdi Sasani; Tunc Oktenoglu; Phillip Cezayirli; Hosein Jafari Marandi; Deniz Ufuk Erbulut

    2015-01-01

    Simple facet joint repair with dynamic pedicular system: Technical note and case series Ali Ozer, Tuncer Suzer, Mehdi Sasani, Tunc Oktenoglu, Phillip Cezayirli and Hosein Marandi Journal of Craniovertebral Junction and Spine. 6.2 (April-June 2015): p65. Copyright: COPYRIGHT 2015 Medknow Publications and Media Pvt. Ltd. http://www.jcvjs.com/ Full Text: Byline: Ali. Ozer, Tuncer. Suzer, Mehdi. Sasani, Tunc. Oktenoglu, Phillip. Cezayirli, Hosein. Marandi, Deniz. Erbulut Purpose: Facet joints are...

  19. A surgical case for severe hemolytic anemia after mitral valve repair.

    Science.gov (United States)

    Shingu, Yasushige; Aoki, Hidetoshi; Ebuoka, Noriyoshi; Eya, Kazuhiro; Takigami, Ko; Oba, Junichi; Fukuhara, Takashi

    2005-06-01

    We report a rare case of severe hemolytic anemia accompanied by moderate renal insufficiency after mitral valve repair. Although the degree of the residual mitral regurgitation was less than 1+ during the first three weeks after the operation, the maximum lactate dehydrogenase (LDH) was up to 7,430 U/l and the minimum hemoglobin was 4.9 g/dl. The mitral valve replacement successfully resolved the hemolysis, but the renal function did not completely recover.

  20. Arthroscopic Bony Bankart Repair Using Double-Threaded Headless Screw: A Case Report

    OpenAIRE

    Takeshi Kokubu; Issei Nagura; Yutaka Mifune; Masahiro Kurosaka

    2012-01-01

    We present a case of arthroscopic fixation for bony Bankart lesion using a double-threaded cannulated screw. A 39-year-old man sustained a left shoulder injury from a motorcycle accident. Radiographs showed bony Bankart lesion and CT revealed 40% defect of glenoid articular surface. Arthroscopic fixation was performed using double-threaded cannulated screw after the bony fragment was reduced by suturing the labrum at the edge with a suture anchor. Arthroscopic bony Bankart repair using double...

  1. Identification of the DNA repair defects in a case of Dubowitz syndrome.

    Directory of Open Access Journals (Sweden)

    Jingyin Yue

    Full Text Available Dubowitz Syndrome is an autosomal recessive disorder with a unique set of clinical features including microcephaly and susceptibility to tumor formation. Although more than 140 cases of Dubowitz syndrome have been reported since 1965, the genetic defects of this disease has not been identified. In this study, we systematically analyzed the DNA damage response and repair capability of fibroblasts established from a Dubowitz Syndrome patient. Dubowitz syndrome fibroblasts are hypersensitive to ionizing radiation, bleomycin, and doxorubicin. However, they have relatively normal sensitivities to mitomycin-C, cisplatin, and camptothecin. Dubowitz syndrome fibroblasts also have normal DNA damage signaling and cell cycle checkpoint activations after DNA damage. These data implicate a defect in repair of DNA double strand break (DSB likely due to defective non-homologous end joining (NHEJ. We further sequenced several genes involved in NHEJ, and identified a pair of novel compound mutations in the DNA Ligase IV gene. Furthermore, expression of wild type DNA ligase IV completely complement the DNA repair defects in Dubowitz syndrome fibroblasts, suggesting that the DNA ligase IV mutation is solely responsible for the DNA repair defects. These data suggests that at least subset of Dubowitz syndrome can be attributed to DNA ligase IV mutations.

  2. Endovascular repair of early rupture of Dacron aortic graft--two case reports.

    LENUS (Irish Health Repository)

    Sultan, Sherif

    2005-01-01

    Complications after open aortic surgery pose a challenge both to the vascular surgeon and the patient because of aging population, widespread use of cardiac revascularization, and improved survival after aortic surgery. The perioperative mortality rate for redo elective aortic surgery ranges from 5% to 29% and increases to 70-100% in emergency situation. Endovascular treatment of the postaortic open surgery (PAOS) patient has fewer complications and a lower mortality rate in comparison with redo open surgical repair. Two cases of ruptured abdominal aortic aneurysm (AAA) were managed with the conventional open surgical repair. Subsequently, spiral contrast computer tomography scans showed reperfusion of the AAA sac remnant mimicking a type III endoleak. These graft-related complications presented as vascular emergencies, and in both cases endovascular aneurysm repair (EVAR) procedure was performed successfully by aortouniiliac (AUI) stent graft and femorofemoral crossover bypass. These 2 patients add further merit to the cases reported in the English literature. This highlights the crucial importance of endovascular grafts in the management of such complex vascular problems.

  3. Rejection of Permacol(R) mesh used in abdominal wall repair: A case report

    Institute of Scientific and Technical Information of China (English)

    Franchesca T Wotton; Jacob A Akoh

    2009-01-01

    Permacol(R) mesh has shown promise when used in abdominal wall repair, especially in the presence of a contaminated surgical field. This biomaterial, derived from porcine dermis collagen, has proposed advantages over synthetic materials due to increased biocompatibility and reduced foreign body reaction within human tissues. However, we present a case report describing a patient who displayed rejection to a Permacol(R) mesh when used in the repair of abdominal wound dehiscence following an emergency laparotomy. Review of the English language literature using PubMed and Medline, showed only two previously published cases of explantation of Permacol(R) due to sepsis or wound breakdown. The authors believe this is the first case of severe foreign body reaction leading to rejection of Permacol(R). Both animal and human studies show conflicting evidence of biocompatibility. There are several reports of successful use of Permacol(R) to repair complex incisional herniae or abdominal walls in the presence of significant contamination. It appears from the literature that Permacol(R) is a promising material, but as we have demonstrated, it has the potential to evoke a foreign body reaction and rejection in certain subjects.

  4. Rejection of Permacol mesh used in abdominal wall repair: a case report.

    Science.gov (United States)

    Wotton, Franchesca T; Akoh, Jacob A

    2009-09-14

    Permacol mesh has shown promise when used in abdominal wall repair, especially in the presence of a contaminated surgical field. This biomaterial, derived from porcine dermis collagen, has proposed advantages over synthetic materials due to increased biocompatibility and reduced foreign body reaction within human tissues. However, we present a case report describing a patient who displayed rejection to a Permacol mesh when used in the repair of abdominal wound dehiscence following an emergency laparotomy. Review of the English language literature using PubMed and Medline, showed only two previously published cases of explantation of Permacol due to sepsis or wound breakdown. The authors believe this is the first case of severe foreign body reaction leading to rejection of Permacol. Both animal and human studies show conflicting evidence of biocompatibility. There are several reports of successful use of Permacol to repair complex incisional herniae or abdominal walls in the presence of significant contamination. It appears from the literature that Permacol is a promising material, but as we have demonstrated, it has the potential to evoke a foreign body reaction and rejection in certain subjects.

  5. Clinical and Demographic Profile of Cases Requiring Ear Lobe Repair in North Gujarat

    Directory of Open Access Journals (Sweden)

    Ajeet K. Khilani

    2013-04-01

    Full Text Available Introduction: Wearing various types of earrings is not only an age old custom but a fashion symbol also. This demographic and clinical profile study was done on ear lobe cleft cases attending ENT OPD of a tertiary care center of North Gujarat. Methodology: The size, number of ears involved, factors leading to ear lobe cleft such as weight of earring, duration of wearing heavy rings, pull leading to tear were noted in all cases. Surgical repair was done by scar excision and suturing. The procedure was completed in 15-20 minutes and minimal post surgical complications in the form of depressed linear scar and lower border notching are seen in 2 cases. Results: Prevalence of ear lobe cleft was 2.4% of all OPD cases. 192 cases (328 ears included 187 (97.3% females and 5 males. Both ears were involved in 136 (70.8% cases while 56 cases had unilateral involvement. A partial cleft of 6 to 10 mm size (range from 3-25 mm was most common reason in females to visit for repair and total cleft was observed in 122 (37.1% ears. 42% females (age 15-45 years had bilateral clefts whereas unilateral involvement was common at young age (1-15 years. Factors leading to cleft formation were earrings weight and prolonged use (44.4% tears were due to weight 15 grams or more. Conclusion: Ear lobe cleft can be repaired by simple surgical approximation. Prevention of recurrence can be done by simple advice of avoiding the scar site for re-piercing and use of light weight earrings. [Natl J Med Res 2013; 3(2.000: 140-142

  6. Role of tongue flap in palatal fistula repair: A series of 41 cases

    Directory of Open Access Journals (Sweden)

    Ravi Kumar Mahajan

    2014-01-01

    Full Text Available Introduction: Despite the improved techniques of repair of cleft palate, fistula occurrence is still a possibility either due to an error in the surgical technique or due to the poor tissue quality of the patient. Though commonly the fistula closure is established by use of local flaps but at times the site and the size of the fistula make use of local flaps for its repair a remote possibility. The use of tongue flaps because of the central position in the floor of the mouth, mobility and the diversity of positioning the flaps make it a method of choice for closure of anterior palatal fistulae than any other tissues. The aim of this study was to analyse the utility of tongue flap in anterior palatal fistula repair. Materials and Methods: We had 41 patients admitted to our hospital during the period 2006-2012 for repair of palatal fistula and were enrolled into the study. In the entire 41 cases, fistula was placed anteriorly. The size of the fistulae varied from 2 cm × 1.5 cm to 5.5 cm × 3 cm. The flaps were divided after 3-week and final inset of the flap was done. Observation and Result: None of the patients developed flap necrosis, in one case there was the dehiscence of the flap, which was reinset and in one patient there was bleeding. None of our patients developed functional deformity of the tongue. Speech was improved in 75% cases. Conclusion: Leaving apart its only drawback of two-staged procedure and transient patient discomfort, tongue flap remains the flap of choice for managing very difficult and challenging anterior palatal fistulae.

  7. Laparoscopic umbilical hernia repair in the presence of extensive paraumbilical collateral veins: a case report.

    Science.gov (United States)

    Lases, Seilenna S; Eker, Hasan H; Pierik, Engelbertus G J M; Klitsie, Pieter J; de Goede, Barry; Peeters, Mark P F M Vrancken; Kazemier, Geert; Lange, Johan F

    2011-12-01

    A patient with an umbilical hernia presenting with collateral veins in the abdominal wall and umbilicus is a case that every hernia surgeon has to deal with occasionally. Several underlying diseases have been described to provoke collateral veins in the abdominal wall. However, the treatment strategy should be uniform. We herein report a case of a successful laparoscopic umbilical hernia repair in a patient with collateral veins in the abdominal wall and umbilicus. A 63-year-old man was referred to the surgical outpatient clinic with a large symptomatic umbilical hernia and collateral veins in the abdominal wall, secondary to an occlusion of both common iliac veins. Because of collateral veins in the umbilicus and the size of the hernial defect, he was offered laparoscopic hernia repair without compromising these veins. Because of the extensive abdominal wall collaterals, duplex sonography vein mapping was performed preoperatively to mark a safe collateral-free area for trocar introduction. The defect was repaired by mesh prosthesis.

  8. Functional evaluation of repairs to circumferential labral lesions of the glenoid - Case series

    Directory of Open Access Journals (Sweden)

    Alexandre Tadeu do Nascimento

    Full Text Available ABSTRACT OBJECTIVE: To evaluate the clinical results among patients undergoing arthroscopic repair of circumferential labral lesions. METHODS: This was a retrospective study on 10 patients who underwent arthroscopic repair to circumferential labral lesions of the shoulder, between September 2012 and September 2015. The patients were evaluated by means of the Carter-Rowe score, DASH score, UCLA score, visual analog scale (VAS for pain and Short-Form 36 (SF36. The average age at surgery was 29.6 years. The mean follow-up was 27.44 months (range: 12-41.3. RESULTS: The mean score was 16 points for DASH; 32 points for UCLA, among which six patients (60% had excellent results, three (30% good and one (10% poor; 1.8 points for VAS, among which nine patients (90% had minor pain and one (10% moderate pain; 79.47 for SF-36; and 92.5 for Carter-Rowe, among which nine patients (90% had excellent results and one (10% good. Joint degeneration was present in one case (10%, of grade 1. We did not observe any significant complications, except for grade 1 glenohumeral arthrosis, which one patient developed after the operation. CONCLUSION: Arthroscopic repair of circumferential labral lesions of the shoulder through use of absorbable anchors is effective, with improvements in all scores applied, and it presents low complication rates. Cases associated with glenohumeral dislocation have lower long-term residual pain.

  9. Laparoscopic repair of a symptomatic post-cesarean section isthmocele: a video case report.

    Science.gov (United States)

    Aimi, Giorgio; Buggio, Laura; Berlanda, Nicola; Vercellini, Paolo

    2017-06-01

    To describe our technique for laparoscopic management of post-cesarean section isthmocele. Surgical video article. Local Institutional Review Board approval for the video reproduction has been obtained. University hospital. A 36-year-old patient with a history of two previous cesarean deliveries. She complained of persistent postmenstrual spotting and chronic pelvic pain. At transvaginal ultrasound examination, a cesarean scar defect of 20.0 × 15.6 mm was identified, with a residual myometrial thickness over the defect of 2.6 mm. Repair of isthmocele and relief of pain. Isthmocele excision and myometrial repair was performed laparoscopically. The first step of the procedure was the cautious mobilization of the bladder from its adhesions with the site of the previous cesarean scar. Subsequently, the isthmocele site was identified with the aid of intraoperative transrectal ultrasonography. Transrectal ultrasonographic assistance is particularly important when a bulge of the cesarean scar is not laparoscopically visible. Once identified, the isthmocele pouch was incised and its pitchy content drained. Then the cesarean scar was excised with cold scissors, avoiding cauterization to reduce the risk of tissue necrosis. This step is considered completed when the whitish scar tissue of the isthmocele site margins are no longer present and reddish healthy myometrium is visualized. Before suturing the defect, a Hegar dilator was placed into the cervix with the aim of maintaining the continuity between the cervical canal and the uterine cavity. Then, the myometrial repair was performed with the use of a single layer of interrupted 2-0 Vycril sutures. To limit tissue ischemia, we prefer not to add a second layer of sutures. Finally, the visceral peritoneum defect was closed, with the aim of restoring the physiologic uterine anatomy. In this case, multiple peritoneal endometriotic implants were also identified and excised. Operating time was 70 minutes. The postoperative

  10. Congenital superior sternal cleft repair using our modified Sally technique: A case report

    Directory of Open Access Journals (Sweden)

    Tomoyuki Kuwata

    2014-12-01

    Full Text Available We report the case of an 8-month-old male neonate who underwent reconstructive surgery for a congenital superior sternal cleft to decrease the risk of commotio cordis. With regard to use of the Sally technique for the repair of a relatively wide cleft (4 × 4 cm, we were concerned about respiratory problems caused by compression following closure of the sternal halves. By closing the sternal halves imperfectly, elevation of intrapleural pressure can be avoided to some extent. By bridging the surplus resected cartilage from the lower sternum over the gap of the upper sternum, the heart is protected by more rigid material. We recommend our modified Sally technique because it is both flexible and effective for sternal cleft repair.

  11. [Repair of a root perforation by using MTA: a case report].

    Science.gov (United States)

    Riccitiello, Francesco; Di Caprio, Maria Patrizia; D'Amora, Marilina; Pizza, Nunzia Luisa; Vallone, Gianfranco; D'Ambrosio, Colomba; Amato, Massimo

    2013-01-01

    Root perforations are accidental events that may occur during the treatment, causing tissue inflammation and alveolar bone loss of integrity of the periodontium. In such cases, the radiological evidence is fundamental in the formulation of the diagnosis, in the choice of therapy (surgical or non-surgical) and finally for the assessment of prognosis of the dental element. In non-surgical treatment of endodontic lesions, the material used for the repair of the defect root should have biocompatibility, antibacterial activity, ability to induce healing of periodontal tissues and radiopacity. The Mineral Trioxide Aggregate (MTA) is a silicate-based cement introduced in dental clinical practice with good radiopacity, biocompatibility and bone induction. This article describes the use of MTA in endodontic repair of a perforation of the middle third root and the success of non-surgical treatment was dimonstrated radiographicaly.

  12. Arthroscopic Bony Bankart Repair Using Double-Threaded Headless Screw: A Case Report

    Directory of Open Access Journals (Sweden)

    Takeshi Kokubu

    2012-01-01

    Full Text Available We present a case of arthroscopic fixation for bony Bankart lesion using a double-threaded cannulated screw. A 39-year-old man sustained a left shoulder injury from a motorcycle accident. Radiographs showed bony Bankart lesion and CT revealed 40% defect of glenoid articular surface. Arthroscopic fixation was performed using double-threaded cannulated screw after the bony fragment was reduced by suturing the labrum at the edge with a suture anchor. Arthroscopic bony Bankart repair using double-threaded cannulated screw fixation is effective because compression force could be applied between bony fragments and the screw head is not exposed in the glenohumeral joint.

  13. Suture less 3D mesh repair of sliding inguinal hernia: a case report

    Directory of Open Access Journals (Sweden)

    Abhijit Bagul

    2016-07-01

    Full Text Available Sliding hernias involving the urinary bladder are rare, almost exclusively seen in men. As a result of slipping of the posterior parietal peritoneum on the underlying retroperitoneal structures, the posterior wall of the sac is not formed of the peritoneum alone, but by a portion of the bladder on either side. This case report presents the case of a 54 year old male patient with Right groin swelling since two years, gradually increasing in size with complaints of pain at the site of the swelling prior to voiding and also, an increase in the size of the swelling on retaining urine for a long duration. Based on clinical and radiological findings patient was diagnosed with Sliding inguinal hernia with bladder component, and underwent Open suture less 3D Mesh repair, with replacement of the bladder in the retroperitoneal space. The aim of this case report is to highlight the successful surgical management of a rare sliding hernia involving the urinary bladder using suture less 3D mesh repair. [Int J Res Med Sci 2016; 4(7.000: 3068-3070

  14. Medicinal Leech Therapy for Glans Penis Congestion After Primary Bladder Exstrophy-Epispadias Repair in an Infant: A Case Report.

    Science.gov (United States)

    Wagenheim, Gavin N; Au, Jason; Gargollo, Patricio C

    2016-01-01

    Many postoperative complications have been reported after repair of classic bladder exstrophy. We present a case of medicinal leech therapy for glans penis congestion following exstrophy repair in an infant. A 2-week-old male with classic bladder exstrophy underwent complete primary repair. On postoperative day 1, he developed rapidly worsening glans penis venous congestion. Medicinal leech therapy was instituted with antibiotics and blood transfusions to maintain a hematocrit >30%. After 24 hours, venous congestion improved and therapy was discontinued. The patient's remaining hospital course was uncomplicated. Medicinal leeches are an effective therapy to relieve glans penis venous congestion.

  15. Exploring a Third Confirmed Case of Hemoperitoneum following Open Inguinal Hernia Repair Caused by Sampson Artery Hemorrhage

    Science.gov (United States)

    Hebert, Jordan; Jagtiani, Manoj; Schmelzer, David; Wolodiger, Fred

    2017-01-01

    Hemoperitoneum is a rare complication of open inguinal hernia repair. This is the third reported case of this complication attributed to the same bleeding source: Sampson's artery. Sampson's artery courses along the round ligament of the uterus in the inguinal canal of females, originating from the arcade formed between the uterine and ovarian arteries. Usually obliterated in postembryonic development, this artery can persist in some adult female patients. Disruption of Sampson's artery can lead to hemoperitoneum following ligation of the uterine round ligament during open inguinal hernia repair in females. This case report describes a third confirmed case of hemoperitoneum complicating an open inguinal hernia repair. We review all three reported cases to date and discuss the recurring signs, symptoms, epidemiologic factors, and diagnostic findings associated. Our review suggests that females of childbearing age, particularly those in the peripartum period, are most at risk of developing this rare complication. PMID:28487804

  16. Exploring a Third Confirmed Case of Hemoperitoneum following Open Inguinal Hernia Repair Caused by Sampson Artery Hemorrhage

    Directory of Open Access Journals (Sweden)

    Jordan Hebert

    2017-01-01

    Full Text Available Hemoperitoneum is a rare complication of open inguinal hernia repair. This is the third reported case of this complication attributed to the same bleeding source: Sampson’s artery. Sampson’s artery courses along the round ligament of the uterus in the inguinal canal of females, originating from the arcade formed between the uterine and ovarian arteries. Usually obliterated in postembryonic development, this artery can persist in some adult female patients. Disruption of Sampson’s artery can lead to hemoperitoneum following ligation of the uterine round ligament during open inguinal hernia repair in females. This case report describes a third confirmed case of hemoperitoneum complicating an open inguinal hernia repair. We review all three reported cases to date and discuss the recurring signs, symptoms, epidemiologic factors, and diagnostic findings associated. Our review suggests that females of childbearing age, particularly those in the peripartum period, are most at risk of developing this rare complication.

  17. Herpes simplex 1 stomatitis after cleft palate repair: a case report and guidelines for management.

    Science.gov (United States)

    Evangelista, Maristella S; Tracy, Lauren; Wells, James H

    2015-05-01

    Herpes simplex virus (HSV) primary infection and reactivation has been associated with the inflammation and transient decrease in immunocompetence after surgery and local trauma. In addition, HSV infection is known to impair wound healing, increase risk of scarring, and impede connective tissue graft transplantation. To our knowledge, this is the first case of HSV infection complicating cleft palate repair presented in literature. In this report, we present a case of primary HSV infection occurring in a healthy 26-month-old patient after repair of the secondary cleft palate with mucoperichondrial flaps and V-Y pushback. The patient developed high fever on postoperative day 1, which was followed by perioral vesicular lesions and multiple intraoral ulcerations involving the lips, palate, and posterior pharynx. Unknown to the surgeons, the patient was exposed to HSV before surgery by a sibling with orolabial HSV infection. The infective cause was ascertained via polymerase chain reaction for HSV-1 DNA, and the infection was treated with topical and intravenous acyclovir for 1 week. The patient recovered well with adequate flap healing, good aesthetic outcome, and no complications on 1-month follow-up. This report underscores the importance of prompt recognition of herpetic infections in the patient with craniofacial surgery and reviews the association and complications of HSV infection in surgical healing. Early identification with prompt antiviral therapy and meticulous wound care are essential to ameliorate the scarring and delayed wound healing associated with HSV infection.

  18. Tuberculous aneurysm of the abdominal aorta: endovascular repair using stent grafts in two cases

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Wei Chiang; Kwak, Byung Kook; Kim, Kyo Nam [Sung Ae General Hospital, Seoul (Korea, Republic of); And Others

    2000-12-01

    Tuberculous aneurysm of the aorta is exceedingly rare. To date, the standard therapy for mycotic aneurysm of the abdominal aorta has been surgery involving in-situ graft placement or extra-anatomic bypass surgery followed by effective anti-tuberculous medication. Only recently has the use of a stent graft in the treatment of tuberculous aortic aneurysm been described in the literature. We report two cases in which a tuberculous aneurysm of the abdominal aorta was successfully repaired using endovascular stent grafts. One case involved is a 42-year-old woman with a large suprarenal abdominal aortic aneurysm and a right psoas abscess, and the other, a 41-year-old man in whom an abdominal aortic aneurysm ruptured during surgical drainage of a psoas abscess. (author)

  19. Vascular Rupture Caused by a Molding Balloon during Endovascular Aneurysm Repair: Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hee Young; Do, Young Soo; Park, Hong Suk; Park, Kwang Bo [Dept. of Radiology, Samsugn Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kim, Young Wook; Kim, Dong Ik [Dept. of Surgery, Samsugn Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2011-08-15

    Endovascular aneurysm repair (EVAR) has been accepted as an alternative to traditional open surgery in selected patients. Despite the minimally invasiveness of this treatment, several complications may occur during or after EVAR. Complications include endoleak, aortic dissection, distal embolism, or iatrogenic injury to the access artery. However, there are few reports on the vascular rupture caused by a molding balloon during EVAR. We report two cases of infrarenal abdominal aortic aneurysms complicated by procedure-related aortic or iliac artery rupture by the molding balloon during EVAR. In our cases, we observed suddenly abrupt increase of the diameter of the endograft during balloon inflation, because we inflated the balloon rapidly. In conclusion, careful attention must be paid during inflation of the molding balloon to prevent vascular rupture.

  20. REPAIR OF LARGE SKULL BASE DEFECT FOLLOWING EXCISION OF BASALOID SQUAMOUS CELL CARCINOMA OF MAXILLO - ETHMOID REGION : A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Monoj Mukherjee

    2015-02-01

    Full Text Available AIM: To present a case of basaloid squamous cell carcinoma of maxillo - ethmoid region with intracranial extradural extention and its surgical management including repair of the skull base defect. MATERIAL : A 30 year female presented with progressive bilateral nasal obstruction, facial deformity for 5 years duration. She developed blindness in last 6 months. Recent CT s can showed large heterogeneous enhancing soft tissue mass in right maxillary sinus, nasal cavity and right ethmoid sinus invading the skull base . INTERVENTION : She underwent excision of the mass by modified weber ferguson incision and repair of skull base defect with temporalis muscle flap. Skin defect over the face and nose was repaired by median forehead flap. RESULT : There was total tumor clearance and no CSF leakage following surgery. CONCLUSION : Sinonasal malignancy with intracranial extradural extenti on is not a contraindication for successful surgical management. Resultant skull base defect can be repaired by a temporalis muscle flap to prevent CSF leak and intracranial infection

  1. Preserved urethral plate urethroplasty for failed hypospadias repair: report of 249 cases

    Institute of Scientific and Technical Information of China (English)

    ZHANG Wei-ping; TIAN Jun; LI Ming-lei; SONG Hong-cheng; BAI Ji-wu; HUANG Cheng-ru; SUN Ning

    2008-01-01

    @@ Hypospadias is one of the most common abnormalities of the external male genitalia but is very difficult to repair. Hypospadias reoperation is also a common practice for pediatric urologists, though repair of hypospadias at reoperation is much more difficult.

  2. Surgical repair of femoral fractures in New World camelids: five cases (1996-2003).

    Science.gov (United States)

    Shoemaker, R W; Wilson, D G

    2007-04-01

    Five New World camelids were admitted to the Western College of Veterinary Medicine between 1996 and 2003 for evaluation of femoral fractures. There were three alpacas and two llamas. Four of the animals were female and three were less than 3 months of age. Fracture configurations consisted of distal physeal fractures (three), a comminuted diaphyseal/metaphyseal fracture, and a transverse diaphyseal fracture. Fractures were diagnosed with a combination of physical examination and radiographs in all cases. All five fractures were repaired with internal fixation and three animals were discharged from the hospital with fractures that healed. One cria underwent successful internal fixation but died from pulmonary oedema during recovery from anaesthesia. Postoperative complications were rare and limited to inadequate fracture stability in one alpaca and prolonged recovery to weight bearing in another. One llama with a comminuted metaphyseal fracture, repaired with a 4.5 mm dynamic compression plate, subsequently had catastrophic failure of the bone 17 days after surgery. Overall the clients were pleased with the outcome of discharged animals. Although femoral fractures are considered rare, they pose a unique opportunity for the large animal veterinarian to successfully achieve fracture union with the aid of internal fixation.

  3. Frequency of and risk factors associated with catastrophic musculoskeletal injuries in Quarter Horses at two Midwestern racetracks: 67 cases (2000-2011).

    Science.gov (United States)

    Beisser, Andrea; McClure, Scott; Rezabek, Grant; Soring, Keith H; Wang, Chong

    2014-11-15

    To determine the incidence and anatomic location of and potential risk factors for catastrophic musculoskeletal injuries (CMIs) in racing Quarter Horses. Retrospective matched case-control study. 67 racing Quarter Horse racehorses euthanized because of CMIs and 134 matched controls. Data for Quarter Horses that sustained CMIs and the total number of race starts for each year were obtained from 2 Midwestern racing jurisdictions from 2000 through 2011. Information for each horse with a CMI and for 2 randomly selected control horses that ran in the same race but did not incur a CMI were obtained from race records, past performance reports, and video analysis. There were 61,797 race starts and 82 CMIs from 2000 through 2011 at the 2 racetracks studied, for an overall CMI incidence of 1.33 CMIs/1,000 starts. Sixty-seven horses with CMIs for which complete data were available and 134 matched control horses were included in the study. There was no difference in the incidence of CMIs between the 2 racetracks or over the years studied. The right forelimb was injured in 38 of the 67 (56.7%) horses. Injures to the carpus (24/67 [35.8%]) and metacarpophalangeal joint (fetlock joint; 23/67 [34.3%]) occurred most frequently. Case-control data indicated that the horses with a CMI had fewer starts, were more likely to have stumbled at the break, had a more erratic stride, were fatigued, and trailed in the race, compared with matched controls from the same races. Irrespective of race distance, most of the horses (47/67 [70.1%]) were injured after or within 10 yards before the finish line. The results of the present study may aid in the identification of racing Quarter Horses at risk for CMIs. The cluster of injuries near the finish line provides a specific focus for future research into methods of injury prevention in this population of racehorses.

  4. Isolated superior mesenteric artery dissection: case for conservative treatment and endovascular repair

    Institute of Scientific and Technical Information of China (English)

    WU Bin; ZHANG Jian; YIN Ming-di; WANG Lei; SONG Jin-qiu; LI Xuan; YANG Dong; DUAN Zhi-quan; XIN Shi-jie

    2009-01-01

    @@ Dissection of the superior mesenteric artery (SMA) not associated aortic dissection is an uncommon event. The pathogenesis remains unclear. Diagnosis has become more efficient due to recent advances in imaging techniques and increased awareness of mesenteric vessel diseases. Early recognition has led to early interventions. Although there is still no consensus on the best option of management for this disease, an increasing number of patients in recent years have been reported to be treated successfully by non-operative approaches (medical therapy and/or percutaneous endovascular repair) rather than operations. We report the diagnosis and non-operative managements of isolated dissection of SMA in the acute stage in two cases at the First Hospital of China Medical University from October to December in 2006.

  5. Laparoscopic repair of a lumbar hernia: report of a case and extensive review of the literature.

    Science.gov (United States)

    Suarez, Sebastian; Hernandez, Juan D

    2013-09-01

    Lumbar hernias are a protrusion of intra-abdominal contents through a weakness or rupture in the posterior abdominal wall. They are considered to be a rare entity with approximately 300 cases reported in the literature since it was first described by Barbette in 1672. Petit described the inferior lumbar triangle in 1783 and Grynfeltt described the superior lumbar triangle in 1866; both are anatomical boundaries where 95% of lumbar hernias occur, whereas the other 5% are considered to be diffuse. Twenty percent of lumbar hernias are congenital and the other 80% are acquired; the acquired lumbar hernias can be further classified into either primary (spontaneous) or secondary. The typical presentation of lumbar hernias is a patient with a protruding semispherical bulge in the back with a slow growth. However, they may present with an incarcerated or strangulated bowel, so it is recommended that all lumbar hernias must be repaired as soon as they are diagnosed. The "gold standard" for diagnosing a lumbar hernia is a CT scan, because it is able to delineate muscular and fascial layers, detect a defect in one or more of these layers, evaluate the presence of herniated contents, differentiate muscle atrophy from a real hernia, and serve as a useful tool in the differential diagnosis, such as tumors. Recent studies have demonstrated the advantages of a laparoscopic repair instead of the classic open approach as the ideal treatment option for lumbar hernias. We report a case of a spontaneous lumbar hernia initially diagnosed as a lipoma and corrected with the open approach, but after relapsing 2 years later it was corrected using a laparoscopic approach. It is followed by an extensive review of lumbar hernias literature regarding history, anatomy, and surgical techniques.

  6. Quadratus lumborum block in chronic pain after abdominal hernia repair: case report

    Directory of Open Access Journals (Sweden)

    Rita Carvalho

    Full Text Available Abstract Background and objectives: The quadratus lumborum blockade was described by R. Blanco in its two approaches (I and II. The local anesthetic deposition in this location can provide blockade to T6-L1 dermatomes. We performed this fascia blockade guided by ultrasound for treating a chronic neuropathic pain in the abdominal wall. Case report: Male patient, 61 years old, 83 kg, with a history of thrombocytopenia due to alcoholic cirrhosis, among others; had chronic pain in the abdominal wall after multiple abdominal hernia repairs in the last year and a half, with poor response to treatment with neuromodulators and opioids. On clinical examination, he revealed a neuropathic pain, with prevalence of allodynia to touch, covering the entire anterior abdominal wall, from T7 to T12 dermatomes. We opted for a quadratus lumborum block type II, guided by ultrasound, with administration of 0.2% ropivacaine (25 mL and depot (vial methylprednisolone (20 mg on each side. The procedure gave immediate relief of symptoms and, after six months, the patient still had a significant reduction in allodynia without compromising the quality of life. Conclusions: We consider that performing the quadratus lumborum block type II was an important analgesic option in the treatment of a patient with chronic pain after abdominal hernia repair, emphasizing the effects of local anesthetic spread to the thoracic paravertebral space. The technique has proven to be safe and well tolerated. The publication of more clinical cases reporting the effectiveness of this blockade for chronic pain is desirable.

  7. Case-control study of high-speed exercise history of Thoroughbred and Quarter Horse racehorses that died related to a complete scapular fracture.

    Science.gov (United States)

    Vallance, S A; Entwistle, R C; Hitchens, P L; Gardner, I A; Stover, S M

    2013-05-01

    Identification of exercise history patterns that are related to catastrophic scapular fracture will facilitate prevention of racehorse fatalities. To determine if exercise patterns are associated with scapular fracture in Thoroughbred (TB) and Quarter Horse (QH) racehorses. High-speed exercise histories for 65 TB and 26 QH racehorses that had a complete scapular fracture (cases) and 2 matched control racehorses were retrospectively studied. Exercise variables were created from lifetime race and official timed workout reports. Associations between exercise variables and scapular fracture were investigated using conditional logistic regression. Thoroughbreds with a scapular fracture had a greater number of workouts, events (combined works and races), and mean event distances than QHs with a scapular fracture. Quarter Horses worked less frequently and accumulated distance at a lower rate than TBs. Breed differences were not found for career race number or length, time between races or lay-up variables for horses with ≥1 lay-up. For both breeds, cases had fewer events, lower recent accumulated distance and fewer active days in training than controls; however, a subset of TB cases with >10 events since lay-up had a longer active career than controls. For QHs that had a lay-up, total and mean lay-up times were greater for cases than controls. Multivariable models revealed that odds ratios (OR) of scapular fracture were greater for TBs that had not yet raced (OR = 23.19; 95% confidence interval (CI) 3.03-177.38) and lower for QHs with more events (OR = 0.71; 95% CI 0.54-0.94). Racehorses that are in early high-speed training but behind that of their training cohort should be examined for signs of scapular stress remodelling. Quarter Horses that had a prolonged lay-up and TBs that have endured high-speed training for a longer duration than that of their training cohort also were at greater risk. © 2012 EVJ Ltd.

  8. Design, build, develop, and test a fieldworthy spiral tool and packer for casing repair

    Energy Technology Data Exchange (ETDEWEB)

    Koster, C.

    1992-01-01

    A new method for sealing casing is currently under development by Nu-Bore Systems. The method involves internally lining a section of the wellbore with a multi-layer spiral wrapping of a high strength, corrosion resistant metal interleaved with a high bond strength, resilient epoxy. The high strength metal is preferably a copper based alloy hardened to a very high strength in order to resist the internal and external pressures of downhole environments. The epoxy adhesive formulation is one that forms a bond between the steel inner wall of the casing and copper alloy strip. The copper alloy strip spiral wraps are interleaved with epoxy, and the whole system provides a high level of outward directed spring force and, thus, resists both internal and externally directed forces. This method has been assessed by the Department of Energy, and the magnitude of the oilfield need and the technology are described in a DoE report entitled, Downhole Casing Repair System'' (OERI Number 013152). In this report, the cost savings to the nation's energy program was estimated to be in the range of hundreds of millions of dollars per year, and the method was judged technically feasible once certain well defined engineering obstacles are overcome.

  9. A 30-Year-Old Man with Three Primary Malignancies: A Case of Constitutional Mismatch Repair Deficiency.

    Science.gov (United States)

    Rengifo-Cam, William; Jasperson, Kory; Garrido-Laguna, Ignacio; Colman, Howard; Scaife, Courtney; Samowitz, Wade; Samadder, N Jewel

    2017-01-01

    Constitutional mismatch repair deficiency (CMMRD) is a devastating cancer predisposition syndrome for which clinical manifestations, genetic screening, and cancer prevention strategies are limited. We report a case of CMMRD presenting with metachronous colorectal cancer and brain cancer. Oncologists and gastroenterologists should be aware of the CMMRD syndrome as a rare cause of very early-onset colorectal cancer.

  10. Unusual perigraft abscess formation associated with stent graft infection after endovascular aortic repair of abdominal aortic aneurysm: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hyo Jin; Kim, Song Soo; Ahn, Moon Sang; Lee, Jae Hwan; Shin, Byung Seok; KIm, Jin Hwan [Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon (Korea, Republic of)

    2014-03-15

    Although a stent graft infection after endovascular aortic repair (EVAR) of abdominal aortic aneurysm (AAA) is a rare complication, it carries a high mortality and morbidity rate. We report a rare case of stent graft infection that led to an unusual perigraft abscess formation without any associated aortoenteric fistula two years after the EVAR of AAA.

  11. Hybrid repair of a very late, post-aortic coarctation surgery thoracic aneurysm: a case report

    Directory of Open Access Journals (Sweden)

    Tilea Ioan

    2012-08-01

    Full Text Available Abstract Introduction Local aneurysms after surgical repair of coarctation of the aorta occur mainly in patients surgically treated by Dacron patch plasty during adulthood. The management of these patients is always problematic, with frequent complications and increased mortality rates. Percutaneous stent-graft implantation avoids the need for surgical reintervention. Case presentation We report a case involving the hybrid treatment by stent-graft implantation and transposition of the left subclavian artery to the left common carotid artery of an aneurysmal dilatation of the thoracic aorta that occurred in a 64-year-old Caucasian man, operated on almost 40 years earlier with a Dacron patch plasty for aortic coarctation. Our patient presented to our facility for evaluation with back pain and shortness of breath after minimal physical effort. A physical examination revealed stony dullness to percussion of the left posterior thorax, with no other abnormalities. The results of chest radiography, followed by contrast-enhanced computed tomography and aortography, led to a diagnosis of giant aortic thoracic aneurysm. Successful treatment of the aneurysm was achieved by percutaneous stent-graft implantation combined with transposition of the left subclavian artery to the left common carotid artery. His post-procedural recovery was uneventful. Three months after the procedure, computed tomography showed complete thrombosis of the excluded aneurysm, without any clinical signs of left lower limb ischemia or new onset neurological abnormalities. Conclusions Our patient’s case illustrates the clinical outcomes of surgical interventions for aortic coarctation. However, the very late appearance of a local aneurysm is rather unusual. Management of such cases is always difficult. The decision-making should be multidisciplinary. A hybrid approach was considered the best solution for our patient.

  12. Cesarean scar ectopic pregnancy. Laparoscopic resection and total scar dehiscence repair. A case report.

    Science.gov (United States)

    Mahgoub, Sara; Gabriele, Victor; Faller, Emilie; Langer, Bruno; Wattiez, Arnaud; Lecointre, Lise; Akladios, Cherif

    2017-02-04

    Illustrate laparoscopic technique for resection of cesarean scar ectopic pregnancy, associated with isthmocele repair. Case report SETTING: Tertiary referral centre in Strasbourg, France. The study was approved by the local IRB. Cesarean scar pregnancy is a rare form of ectopic pregnancy. The major risk of this type of pregnancy is the early uterine rupture with massive bleeding and maternal life-threatening. It is therefore crucial to manage actively these pregnancies as soon as they are diagnosed. Therapeutic options can be medical, surgical, or a combination of both. Many case reports or case series are found in the literature, but only few clinical studies, too difficult to carry out because of cases rarity and inconclusiveness. "Systematic review: What is the best first-line approach for cesarean section ectopic pregnancy?" is a meta-analysis that was published in 2016, and includes 194 studies between 1978 and 2014 (126 case reports, 45 cases series and 23 clinical studies). According to this systematic review, hysteroscopy or laparoscopic hysterotomy seems to be the best first-line approach to treat cesarean scar ectopic pregnancy. Uterine artery embolization seems to be reserved for significant bleeding and/or a high suspicion index for arteriovenous malformation. There is however no consensus on treatment of reference. The case concerns a 38-year-old primiparous women with cesarean section in 2010, who was diagnosed by US scan at 7 WG as cesarean scar ectopic pregnancy, confirmed by pelvic MRI. The patient has initially received medical treatment with two intramuscular injections of Methotrexate and one local intra-gestational injection of KCl. Initial rate of HCG was 82000 IU/L. Through a rigorous weekly biological and US scan monitoring, it has been observed an involution of the ectopic pregnancy at ultrasonography associated to HCG decreasing. No bleeding or infectious complications occurred during this period. After 10 weeks of monitoring, because of a

  13. Laparoscopic Hernia Repair With 3-Millimeter Instruments: A Point of Technique and Illustrative Case Video.

    Science.gov (United States)

    Kassir, Radwan; Tiffet, Olivier; Bourbon, Michel; Meyer, Alberto; Gugenheim, Jean; Debs, Tarek; Amor, Imed Ben; Blanc, Pierre

    2015-08-01

    The repair of inguinal hernia has been a controversial issue in surgical practice since its conception. The article demonstrates that use of 3 mm instruments can be incorporated in Laparoscopic hernia repair. The second aim of this article is that use of TAP block (Transverse abdominal plane block) without curare is efficient, safe and reproducible.

  14. Open Surgical Repair After Endovascular Treatment with Endologix Stent Graft: A Case Report

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    Ižsa Coskun

    2016-01-01

    Full Text Available Endovascular treatment of abdominal aortic aneurysm repair is increasingly being used today. We report a 72-year-old male patient who underwent open surgical repair due to separation of IntuTrak Powerlink XL (Endologix endovascular stent graft four months after endovascular intervention for abdominal aortic aneurysm with 9.5 cm diameter.

  15. Acute liver failure following cleft palate repair: a case of therapeutic acetaminophen toxicity.

    Science.gov (United States)

    Iorio, Matthew L; Cheerharan, Meera; Kaufman, Stuart S; Reece-Stremtan, Sarah; Boyajian, Michael

    2013-11-01

    Background : Acetaminophen is a widely used analgesic and antipyretic agent in the pediatric population. While the hepatotoxic effects of the drug have been well recognized in cases of acute overdose and chronic supratherapeutic doses, the toxic effects of acetaminophen are rarely documented in cases where therapeutic guidelines are followed. Case : An 8-month-old boy underwent cleft palate repair and placement of bilateral myringotomy tubes. His anesthetic course was uneventful, consisting of maintenance with desflurane and fentanyl. He received acetaminophen for routine postoperative pain management and was tolerating liquids and discharged home on postoperative day 1. On day 3, the child was profoundly lethargic with multiple episodes of emesis and was taken to the emergency department. He suffered a 45-second tonic-clonic seizure in transport to the regional children's medical center, and initial laboratory results demonstrated acute hepatitis with AST 24,424 U/L, ALT 12,885 U/L, total bilirubin 3.1 mg/dL, and a serum acetaminophen level of 83 μg/mL. Aggressive supportive measures including blood products and periprocedural fresh frozen plasma, piperacillin/tazobactam, and intravenous infusions of N-acetylcysteine, sodium phenylacetate and sodium benzoate, carnitine, and citrulline were administered. His metabolic acidosis and acute hepatitis began to correct by day 4, and he was discharged home without further surgical intervention on day 15. Conclusion : Although acetaminophen is an effective and commonly used analgesic in pediatric practice, hepatotoxicity is a potentially devastating complication. This report challenges the appropriateness of existing guidelines for acetaminophen administration and emphasizes the importance of close follow-up and hydration after even relatively minor surgery.

  16. Local Circles in a Circular Economy – the Case of Smartphone Repair in Denmark

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    Henrik Riisgaard

    2016-02-01

    Full Text Available Abstract Circular economy has gained increasing attention the last decade, and more often the main focus is on the large  global circles addressing recycling of materials rather than the “inner circles” that address maintenance/repair and reuse. In this article we investigate one such inner circle ofthe circular economy namely repair of smartphones which extends the lifetime of products and adds to a local economy. Local repair of smartphones has increased in the resent years in Denmark. These loop-closing businesses not only extend the useful lifetime of smartphones; they also entail both environmental benefits and economic value creation. We map the extent ofthe repair sector and investigate the drivers and barriers for its emergence. The study builds on desk studies for identification of repair companiesand telephone interviews with 33 out of 90 identified companies. The mapping of the businessesshows that the repair of smartphones constitute viable business opportunities, and that the main driversarerelated to the economic business potentials as well as motivated entrepreneurs who spot a market potential.The study concludes that the local circular economy within smartphone repair is due to large consumer willingness-to-pay for repair and maintenance services, and this can extend the lifetime of the smartphones. There are some special characteristics that limit the possibility to apply the results directly to other product groups, but further analysis of how to facilitate repair shops within other product groups are interesting in order to facilitate the development of local circles in a circular economy not only in Denmark but also in other countries.   Keywords: Circular economy; Smartphone;Repair; Remanufacturing. 

  17. Early Incorporation of an Evidence-Based Aquatic-Assisted Approach to Arthroscopic Rotator Cuff Repair Rehabilitation: Prospective Case Study.

    Science.gov (United States)

    Burmaster, Chris; Eckenrode, Brian J; Stiebel, Matthew

    2016-01-01

    Both traditional and progressive rotator cuff repair rehabilitation protocols often delay active motion of the shoulder for 6 weeks or more. The early inclusion of a comprehensive aquatic-assisted exercise program presents a unique approach to postoperative management. The purpose of this case study is to describe a comprehensive evidence-based, aquatic-assisted rehabilitation program following arthroscopic rotator cuff repair. A 73-year-old woman with a nonretracted, medium-size, full-thickness tear (2.5 cm) of the supraspinatus tendon underwent arthroscopic rotator cuff repair and was referred for postoperative physical therapy. The rehabilitation program was initiated at 2 weeks postoperatively and consisted of concurrent land- and aquatic-based interventions over 6 weeks for a total of 18 physical therapy visits. Improvements were made in all 5 patient-reported outcome measures that were recorded weekly over the course of care. Improvements reached or exceeded minimal detectable change levels for the Shoulder Pain and Disability Index and the Penn Shoulder Score. Her numeric pain rating scale score at rest decreased from 4/10 at the initial evaluation to 2/10 at 8 weeks postoperatively and with activity decreased from 9/10 to 6/10. Shoulder strength and range of motion values also exhibited improvement over the course of care. No adverse events occurred during the case study. This case study illustrates the safe inclusion of low-stress aquatic exercises as an early adjunct to traditional land-based rotator cuff repair rehabilitation programs in small- to medium-size repairs. Further studies are needed to determine the long-term effectiveness of adding aquatic therapy to traditional postoperative programs. © 2016 American Physical Therapy Association.

  18. Rare coexistence of gouty and septic arthritis after arthroscopic rotator cuff repair: a case report.

    Science.gov (United States)

    Ichiseki, Toru; Ueda, Shusuke; Matsumoto, Tadami

    2015-01-01

    Coexistence of septic arthritis and gouty arthritis is rare. In particular, no reports have described the development of both gouty and septic arthritis after arthroscopic shoulder surgery. The patient was an 83-year-old man who underwent arthroscopic rotator cuff repair. He had a history of diabetes mellitus (HbA1c: 7.4%), but not of gout, and the GFR was decreased (GFR=46). During the postoperative course fever suddenly developed and joint fluid retention was found. Uric acid crystals were detected when the joint fluid was aspirated, after which when the culture results became available sepsis due to methicillin sensitive Staphylococcus aureus (MSSA) was diagnosed. On the 2(nd) day after fever onset, lavage and debridement were performed under arthroscopy, with the subsequent course uneventful with no recurrence of the infection or gouty arthritis and no joint destruction. When uric acid crystals are found in aspirated joint fluid, gouty arthritis tends to be diagnosed, but like in the present case if infection also supervenes, joint destruction and a poor general state may result if appropriate intervention is not initiated swiftly. Accordingly, even if uric acid crystals are found, the possibility of coexistence of septic arthritis and gouty arthritis should be kept in mind.

  19. The association of noise and surgical-site infection in day-case hernia repairs.

    Science.gov (United States)

    Dholakia, Shamik; Jeans, John Paul; Khalid, Usman; Dholakia, Shruti; D'Souza, Charlotte; Nemeth, Kristof

    2015-06-01

    Surgical-site infections (SSIs) are associated with an increased duration of hospital stay, poorer quality of life, and an marked increase in cost to the hospital. Lapses in compliance with aseptic principles are a substantial risk factor for SSI, which may be attributable to distractions such as noise during the operation. The aims of this study were to assess whether noise levels in the operating room are associated with the development of SSI and to elucidate the extent to which these levels affect the financial burden of surgery. Prospective data collection from elective, day-case male patients undergoing elective hernia repairs was undertaken. Patients were included if they were fit and at low risk for SSI. Sound levels during procedures was measured via a decibel meter and correlated with the incidence of SSI. Data analysis was performed with IBM SPSS (IBM, Armonk, NY). Noise levels were substantially greater in patients with SSI from time point of 50 minutes onwards, which correlated to when wound closure was occurring. Additional hospital costs for these patients were £243 per patient based on the National Health Service 2013 reference costing. Decreasing ambient noise levels in the operating room may aid in reducing the incidence of SSIs, particularly during closure, and decrease the associated financial costs of this complication. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Chemotherapy-induced enterocutaneous fistula after perineal hernia repair using a biological mesh: a case report

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    Eriksen MH

    2014-01-01

    Full Text Available MH Eriksen, O Bulut Department of Surgical Gastroenterology, Hvidovre University Hospital, University of Copenhagen, Copenhagen, Denmark Abstract: This is the first reported case of an enterocutaneous fistula as a late complication to reconstruction of the pelvic floor with a Permacol™ mesh after a perineal hernia. A 70-year-old man had a reconstruction of the pelvic floor with a biological mesh because of a perineal hernia after laparoscopic abdominoperineal resection. Nine months after the perineal hernia operation, the patient had multiple metastases in both lungs and liver. The patient underwent chemotherapy, including bevacizumab, irinotecan, calcium folinate, and fluorouracil. Six weeks into chemotherapy, the patient developed signs of sepsis and complained of pain from the right buttock. Ultrasound examination revealed an abscess, which was drained, guided by ultrasound. A computed tomography scan showed a subcutaneous abscess cavity located in the right buttock with communication to the small bowel. Operative findings confirmed a perineal fistula from the distal ileum to perineum. A resection of the small bowel with primary anastomosis was performed. The postoperative course was complicated by fluid and electrolyte disturbances, but the patient was stabilized and finally discharged to a hospice for terminal care after 28 days of hospital stay. It seems that hernia repairs with biological meshes have lower erosion and infection rates compared with synthetic meshes, and so far, evidence suggests that biological grafts are safe and effective in the treatment of pelvic floor reconstruction. There have been no reports of enteric fistulas after pelvic reconstruction with biological meshes. However, the development of intestinal fistulas after chemotherapy with bevacizumab has been described in the literature. Our case report supports this association between bevacizumab and fistula formation among rectal cancer patients, as symptoms of a

  1. Delayed repair in a case of forearm fascial muscle herniation using non-cross-linked acellular porcine dermal matrix.

    Science.gov (United States)

    Hartmann, Christoph E A; Branford, Olivier A; Floyd, David

    2012-09-01

    The options for treatment of symptomatic muscle herniation in the limbs traditionally include fasciotomy, direct repair, tendon weave graft (palmaris longus), fascial graft (tensor fascia lata), and synthetic mesh (prolene). A recent case report has described the use of acellular cadaveric dermal matrix to reconstruct fascial defects in 2 cases. We describe the use of Strattice, a non-cross-linked acellular porcine dermal matrix, as a fascial underlay graft in a case of symptomatic upper limb muscle herniation. We propose that Strattice has the advantages over cadaveric dermal matrices in terms of avoiding the use of human donor tissue. It has suitable tensile properties to be used for reconstructing fascial defects.

  2. Laparoscopic repair of giant paraesophageal hernia with synthetic mesh: 45 consecutive cases.

    Science.gov (United States)

    Stavropoulos, George; Flessas, Ioannis I; Mariolis-Sapsakos, Theodoros; Zagouri, Flora; Theodoropoulos, George; Toutouzas, Konstantinos; Michalopoulos, Nikolaos V; Triantafyllopoulou, Ioanna; Tsamis, Dimitrios; Spyropoulos, Basilios G; Zografos, George C

    2012-04-01

    Giant paraesophageal hernias (PEHs) are associated with progression of symptoms in up to 45 per cent of patients. Recently, many series have reported that laparoscopic repair of PEH is technically feasible, effective, and safe. A retrospective review of the University of Athens tertiary care hospitals patient database and the patient medical records identified 45 patients who underwent elective repair of a giant PEH between 2002 and 2009. Elective laparoscopic repair of a giant PEH was attempted in 45 patients who were treated with Gore-Tex dual mesh with or without Nissen fundoplication. They all had a mesh repair. Intraoperative complications included one pulmonary embolism and one recurrent hernia. The use of a mesh seems to be effective in the treatment of large hernias. It appears to offer the benefit of a shorter hospital stay and a quicker recovery.

  3. Repair, Evaluation, Maintenance, and Rehabilitation Research Program Overlays on Horizontal Concrete Surfaces: Case Histories

    Science.gov (United States)

    1994-02-01

    thermal expansion and contraction and autogenous shrinkage. No attempt was made to repair the cracks. During an inspection in August of 1984, it was...LATEX- ’ * """* 9 MODIFIED CONCRETE SLOPE PATCH IF NECESSARY EXOSTING CRACK TO MAINTAIN DRAINAGE Figure 27. Typical surface repair, Mississippi River...102-mm) deep densely graded aggregate base. The sand base extended to the ditch foreslopes to provide drainage of subbase. The average daily

  4. [Previously expanded full-thickness skin grafts. Technical principles. Indications in the repair of sequelae of burns. Apropos of 22 cases].

    Science.gov (United States)

    Foyatier, J L; Gounot, N; Comparin, J P; Delay, E; Masson, C L; Latarjet, J

    1995-06-01

    Burns raise difficult repair problems. Previously expanded full-thickness skin grafts represent a good solution in many situations. Based on their experience of 22 cases, the authors present a review of the various indications for this technique.

  5. Teflon-buttressed sutures plus pericardium patch repair left ventricular rupture caused by radiofrequency catheter ablation: A case report.

    Science.gov (United States)

    Cao, Hao; Zhang, Qi; He, Yanzhong; Feng, Xiaodong; Liu, Zhongmin

    2016-09-01

    Cardiac rupture often occurs after myocardial infarction or chest trauma with a high mortality rate. However, left ventricular rupture caused by radiofrequency catheter ablation (RFCA) is extremely rare. We describe a case of a 61-year-old male who survived from left ventricular rupture caused by a RFCA procedure for frequent ventricular premature contractions. Surgical exploration with cardiopulmonary bypass (CPB) was performed when the signs of cardiac tamponade developed 7 hours after the ablation surgery. Teflon-buttressed sutures of the tear in the left ventricular posterolateral wall and pericardium patch applied to the contusion region on the wall repaired the rupture safely and effectively. Timely surgical intervention under CPB facilitated the survival of the patient. Teflon-buttressed sutures plus pericardium patch achieved the successful repair of the rupture.

  6. Laparoscopic repair of Morgagni hernia with composite mesh in an elderly woman: Report of a case.

    Science.gov (United States)

    Ikarashi, Masahito; Matsuda, Minoru; Murayama, Isao; Fujii, Masashi; Takayama, Tadatoshi

    2015-05-01

    A 78-year-old woman was admitted to another hospital with vomiting. Chest X-ray showed an abnormal shadow in the lower right lung field, and CT indicated a Morgagni hernia containing the stomach and transverse colon. The patient was transferred to our hospital and underwent laparoscopic surgery. After the hernia contents were repositioned into the abdominal cavity, we repaired the hernia orifice with a prosthetic mesh to achieve a tension-free repair. There were no complications after the surgery, and there has been no recurrence. The patient has remained free of clinical symptoms since 10 months after the surgery. Laparoscopic repair with a prosthetic mesh for Morgagni hernia is a simple and safety procedure for elderly patients.

  7. Ergonomic assessment for the task of repairing computers in a manufacturing company: A case study.

    Science.gov (United States)

    Maldonado-Macías, Aidé; Realyvásquez, Arturo; Hernández, Juan Luis; García-Alcaraz, Jorge

    2015-01-01

    Manufacturing industry workers who repair computers may be exposed to ergonomic risk factors. This project analyzes the tasks involved in the computer repair process to (1) find the risk level for musculoskeletal disorders (MSDs) and (2) propose ergonomic interventions to address any ergonomic issues. Work procedures and main body postures were video recorded and analyzed using task analysis, the Rapid Entire Body Assessment (REBA) postural method, and biomechanical analysis. High risk for MSDs was found on every subtask using REBA. Although biomechanical analysis found an acceptable mass center displacement during tasks, a hazardous level of compression on the lower back during computer's transportation was detected. This assessment found ergonomic risks mainly in the trunk, arm/forearm, and legs; the neck and hand/wrist were also compromised. Opportunities for ergonomic analyses and interventions in the design and execution of computer repair tasks are discussed.

  8. Tunica vaginalis: An aid in hypospadias fistula repair: Our experience of 14 cases

    Directory of Open Access Journals (Sweden)

    Yogender Singh Kadian

    2011-01-01

    Full Text Available Background: Urethrocutaneous fistula is the most common complication of hypospadias surgery. The correction of such fistula is associated with a failure rate of 10 to 40%. The step in successful repair of a fistula is separation of the suture lines in the urethra and skin using well vascularized elastic tissue. We report our experience of using the tunica vaginalis flap as a layer between the neourethra and skin suture line in repair of recurrent urethrocutaneous fistula. Patients and Methods: We have used the tunica vaginalis flap for the repair of recurrent urethrocutaneous fistula in 14 children with a mean age of 6.5 years (range 3-14 years. All patients had undergone previous hypospadias repair and at least one previous attempt to close the fistula had failed. Surgery was initiated by injecting a povidone solution via urethral meatus to identify all fistulae. The fistulae were closed primarily and urethral suture line was covered with a flap of tunica vaginalis which was harvested either through a small scrotal incision and mobilized via a subcutaneous tunnel into the penile shaft (8/14 or by the same incision as for fistula closure (6/14. The testis was fixed to the scrotum. A urethral catheter was kept for urinary diversion for 10 days. Results: The repair was successful in all but one patient in whom there was leak from the fistula site. One patient in whom tunica vaginalis fascia was tunnelled into neourethra developed scrotal haematoma which needed drainage. Penile cosmesis was acceptable without any significant postoperative testicular complication in 13/14 patients. Conclusion: Repair of recurrent urethrocutaneous fistula with a tunica vaginalis flap is highly effective regardless of fistula location. This flap is easy to mobilize and provide effective coverage of urethral suture line. Putting a glove drain should be considered into scrotal wound if perfect haemostasis is doubtful.

  9. Predictors of adverse events after endovascular abdominal aortic aneurysm repair: A meta-analysis of case reports

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    Schlösser Felix JV

    2008-09-01

    Full Text Available Abstract Introduction Endovascular abdominal aortic aneurysm repair is a life-saving intervention. Nevertheless, complications have a major impact. We review the evidence from case reports for risk factors of complications after endovascular abdominal aortic aneurysm repair. Case presentation We selected case reports from PubMed reporting original data on adverse events after endovascular abdominal aortic aneurysm repair. Extracted risk factors were: age, sex, aneurysm diameter, comorbidities, re-interventions, at least one follow-up visit being missed or refusal of a re-intervention by the patient. Extracted outcomes were: death, rupture and (non-device-related complications. In total 113 relevant articles were selected. These reported on 173 patients. A fatal outcome was reported in 15% (N = 26 of which 50% came after an aneurysm rupture (N = 13. Non-fatal aneurysm rupture occurred in 15% (N = 25. Endoleaks were reported in 52% of the patients (N = 90. In half of the patients with a rupture no prior endoleak was discovered during follow-up. In 83% of the patients one or more re-interventions were performed (N = 143. Mortality was higher among women (risk ratio 2.9; 95% confidence interval 1.4 to 6.0, while the presence of comorbidities was strongly associated with both ruptures (risk ratio 1.6; 95% confidence interval 0.9 to 2.9 and mortality (risk ratio 2.1; 95% confidence interval 1.0 to 4.7. Missing one or more follow-up visits (≥1 or refusal of a re-intervention by the patient was strongly related to both ruptures (risk ratio 4.7; 95% confidence interval 3.1 to 7.0 and mortality (risk ratio 3.8; 95% confidence interval 1.7 to 8.3. Conclusion Female gender, the presence of comorbidities and at least one follow-up visit being missed or refusal of a re-intervention by the patient appear to increase the risk for mortality after endovascular abdominal aortic aneurysm repair. Larger aneurysm diameter, higher age and multimorbidity at the time

  10. Infraorbital Nerve Block for Isolated Orbital Floor Fractures Repair: Review of 135 Consecutive Cases

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    Giuseppe Spinelli, MD

    2014-01-01

    Conclusions: There are several advantages to surgically repairing isolated orbital floor fractures under regional and local anesthesia that include the following: surgeons can check the surgical outcome (enophthalmos and extrinsic ocular muscles function intraoperatively, thereby reducing the reoperation rate; patient discomfort due to general anesthesia is eliminated; and the hospital stay is reduced, thus decreasing overall healthcare costs.

  11. A case of de Garengeot hernia: the feasibility of laparoscopic transabdominal preperitoneal hernia repair

    Directory of Open Access Journals (Sweden)

    Saud Al-Subaie

    2015-01-01

    Conclusion: We were able to obtain an accurate diagnosis of an appendix within a long-standing irreducible femoral hernia through diagnostic laparoscopy followed by transabdominal preperitoneal (TAPP approach for hernia repair. We would like to underline the usefulness of laparoscopy as a valuable tool in the diagnosis and treatment of this unusual presentation of groin hernias.

  12. DNA repair deficiency as a susceptibility marker for spontaneous lymphoma in golden retriever dogs: a case-control study.

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    Douglas H Thamm

    Full Text Available There is accumulating evidence that an individual's inability to accurately repair DNA damage in a timely fashion may in part dictate a predisposition to cancer. Dogs spontaneously develop lymphoproliferative diseases such as lymphoma, with the golden retriever (GR breed being at especially high risk. Mechanisms underlying such breed susceptibility are largely unknown; however, studies of heritable cancer predisposition in dogs may be much more straightforward than similar studies in humans, owing to a high degree of inbreeding and more limited genetic heterogeneity. Here, we conducted a pilot study with 21 GR with lymphoma, 20 age-matched healthy GR and 20 age-matched healthy mixed-breed dogs (MBD to evaluate DNA repair capability following exposure to either ionizing radiation (IR or the chemical mutagen bleomycin. Inter-individual variation in DNA repair capacity was evaluated in stimulated canine lymphoctyes exposed in vitro utilizing the G2 chromosomal radiosensitivity assay to quantify clastogen-induced chromatid-type aberrations (gaps and breaks. Golden retrievers with lymphoma demonstrated elevated sensitivity to induction of chromosome damage following either challenge compared to either healthy GR or MBD at multiple doses and time points. Using the 75(th percentile of chromatid breaks per 1,000 chromosomes in the MBD population at 4 hours post 1.0 Gy IR exposure as a benchmark to compare cases and controls, GR with lymphoma were more likely than healthy GR to be classified as "sensitive" (odds ratio = 21.2, 95% confidence interval 2.3-195.8. Furthermore, our preliminary findings imply individual (rather than breed susceptibility, and suggest that deficiencies in heritable factors related to DNA repair capabilities may be involved in the development of canine lymphoma. These studies set the stage for larger confirmatory studies, as well as candidate-based approaches to probe specific genetic susceptibility factors.

  13. 74 cases of preperitoneal inguinal hernia repair%腹膜前腹股沟疝修补术74例

    Institute of Scientific and Technical Information of China (English)

    张润生

    2014-01-01

    Objective To investigate the curative effect of Modified Kugel mesh for inguinal hernia repair.Methods A total of 74 cases of inguinal hernia who underwent preperitoneal repair in Beijing Likang Hospital were retrospectively analyzed.Results The mean operation time was 55 minutes (rang from 30 to 90 minutes),the mean length of hospital stay was 6.3 days (rang from 3 to 8 days).Few postoperative complications and light discomfort were observed,and all incisions were primary healing.After follow-up for 6 to 24 months,no recurrence was found.Conclusion Preperitoneal inguinal hernia repair with Modified Kugel mesh has the characteristics of whole inguinal repair,which is safe,effective,lower recurrence and faster postoperative recovery.%目的:探讨应用Modified Kugel补片行腹股沟疝修补术的治疗效果。方法回顾性分析2010年8月至2012年7月,北京市利康医院采用腹膜前修补腹股沟疝74例患者的临床资料。结果手术时间30~90 min,平均55 min;住院时间3~8 d,平均6.3 d。术后并发症少,不适症状较轻,切口全部一期愈合,手术后随访6~24个月,无复发。结论采用Modified Kugel 补片行腹膜前腹股沟疝修补术具有全腹股沟修补的特点,安全有效、降低复发,术后恢复快。

  14. First laparoscopic totally extraperitoneal repair of Laugier's hernia: a case report.

    Science.gov (United States)

    Ates, M; Dirican, A; Kose, E; Isik, B; Yilmaz, S

    2013-02-01

    An atypical femoral hernia developing through the lacunar ligament is called Laugier's hernia. Preoperative diagnosis of these atypical hernias is very difficult because of their rarity and similar clinical appearance to conventional femoral hernias. A 52-year-old female presented with right groin swelling. During laparoscopic totally extraperitoneal (TEP) inguinal hernia repair, a hernia sac through an opening in the lacunar ligament was diagnosed and repaired with mesh covering the inguinal floor. The surgeon should be alert to the possibility of an atypical femoral hernia when examining patients with inguinal hernias. A laparoscopic approach should be chosen instead of a conventional approach for the treatment of femoral hernias because of its high diagnostic and therapeutic capacity for all types of femoral hernia, including Laugier's.

  15. METHODOLOGICAL HURDLES IN CAPTURING CMC DATA: THE CASE OF THE MISSING SELF-REPAIR

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    Bryan Smith

    2008-02-01

    Full Text Available This paper reports on a study of the use of self-repair among learners of German in a task-based CMC environment. The purpose of the study was two-fold. The first goal sought to establish how potential interpretations of CMC data may be very different depending on the method of data collection and evaluation employed. The second goal was to explicitly examine the nature of CMC self-repair in the task-based foreign language CALL classroom. Paired participants (n=46 engaged in six jigsaw tasks over the course of one university semester via the chat function in Blackboard. Chat data were evaluated first by using only the chat log file and second by examining a video file of the screen capture of the entire interaction. Results show a fundamental difference in the interpretation of the chat interaction which varies as a function of the data collection and evaluation methods employed. The findings also suggest a possible difference in the nature of self-repair across face-to-face and SCMC environments. In view of the results, this paper calls for CALL researchers to abandon the reliance on printed chat log files when attempting to interpret SCMC interactional data.

  16. Guidelines to develop interactive tutorials on 3D biomolecules: the case of DNA repair by photolyase

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    Larissa Assis Barony Valadares Fonseca

    2016-11-01

    Full Text Available INTRODUCTION: This work presents the following guidelines for developing interactive learning objects on the 3D biomolecules: i- identify a relevant educational need; ii-select an appropriate subject; iii- employ interactive 3D molecular structures; iv- simultaneously display animation with related textual information or 2D diagrams; v- integrating different modes of representation of chemical phenomena. Based on these, was constructed the "Photolyase Tutorial". Photolyase is an enzyme that repairs DNA. It recognizes the cyclobutane pyrimidine dimer lesion (CPD caused by exposure to ultraviolet light. Understanding the repair mechanism requires understanding the structure-activity relationships of the molecules involved. Therefore, this topic is a convenient subject for teaching key aspects of the structure of protein and nucleic acids. There are few interactive 3D DNA repair tutorials available and most of these are in english, therefore not acessible for students that do not domain this language. Besides, these tutorials generally focus only on displaying structural features without make foster correlations between the structure and chemical aspects of repair mechanisms. OBJECTIVES: In order to construct a interactive tutorial that fills these gaps, the 3D structures of a DNA molecule, a DNA with CPD lesion and the photolyase enzyme were manipulated focusing on structural and chemical explanation. MATERIALS AND METHODS: These structures were obtained from PDB (http://www.rcsb.org/pdb/home/home.do and manipulated to show biochemical and chemical concepts by using the resources from the LABIQ Platform (http://labiq.is.usp.br. DISCUSSION AND RESULTS: Several concepts are covered, i.e., H-bonding, active site, co-factors etc. The tutorial is organized in small conceptual blocks presenting, in a stepwise fashion, how the enzyme recognizes the DNA lesion and proceeds to repair. Each block comprises a trigger button that controls the interactive

  17. Ventral incisional hernia (VIH) repair after liver transplantation (OLT) with a biological mesh: experience in 3 cases.

    Science.gov (United States)

    Schaffellner, S; Sereinigg, M; Wagner, D; Jakoby, E; Kniepeiss, D; Stiegler, P; Haybäck, J; Müller, H

    2016-05-01

    Hernias after orthotopic liver transplant (OLT) occur in about 30 % of cases. Predisposing factors in liver cirrhotic patients of cases are ascites, low abdominal muscle mass and cachexia before and immunosuppression after OLT. Standard operative transplant-technique even in small hernias is to implant a mesh. For patients after liver transplantation a porcine non-cross linked biological patch being less immunogenic than synthetic and cross-linked meshes is chosen for ventral incisional hernia repair. 3 patients (1 female, 2 male), OLT indications Hepatitis C, exogenous- toxic cirrhosis, median-age 53 (51 - 56) and median time to hernia occurrence after OLT were 10 month (6 - 18 m) are documented. 2 patients suffered from diabetes, 2 from chronic-obstructive lung disease. Maintenance immunosuppressions were Everolimus in 1 patient, Everolimus + MMF in the second and Everolimus +Tacrolimus in the third patient. The biological was chosen for hernia repair due to the preexisting risk- factors. Meshes, 10 × 16 cm were placed, in IPOM (Intra-Peritonel-Onlay-Mesh) -position by relaparatomy. Insolvable, monofile, interrupted sutures were used. All patients recovered primarily, and were dismissed within 10 d post OP. No wound healing disorders or signs of postoperative infections occurred. All are free of hernia recurrence in a mean observation time of 22 month (10 - 36). The usage of porcine non-cross-linked biological patches seems feasible for incisional hernia repair after OLT. Wound infections in these patients have been observed with other meshes. Further investigation is needed to prove potential superiority of this biological to the other meshes. © Georg Thieme Verlag KG Stuttgart · New York.

  18. Percutaneous mitral valve repair.

    Science.gov (United States)

    Gillinov, A Marc; Liddicoat, John R

    2006-01-01

    Surgical mitral valve repair is the procedure of choice to treat mitral regurgitation of all etiologies. Whereas annuloplasty is the cornerstone of mitral valve repair, a variety of other surgical techniques are utilized to correct dysfunction of the leaflets and subvalvular apparatus; in most cases, surgical repair entails application of multiple repair techniques in each patient. Preclinical studies and early human experience have demonstrated that some of these surgical repair techniques can be performed using percutaneous approaches. Specifically, there has been great progress in the development of novel technology to facilitate percutaneous annuloplasty and percutaneous edge-to-edge repair. The objectives of this report were to (1) discuss the surgical foundations for these percutaneous approaches; (2) review device design and experimental and clinical results of percutaneous valve repair; and (3) address future directions, including the key challenges of patient selection and clinical trial design.

  19. Short-term energy outlook, quarterly projections, first quarter 1998

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-01-01

    The forecast period for this issue of the Outlook extends from the first quarter of 1998 through the fourth quarter of 1999. Values for the fourth quarter of 1997, however, are preliminary EIA estimates (for example, some monthly values for petroleum supply and disposition are derived in part from weekly data reported in EIA`s Weekly Petroleum Status Report) or are calculated from model simulations that use the latest exogenous information available (for example, electricity sales and generation are simulated by using actual weather data). The historical energy data, compiled in the first quarter 1998 version of the Short-Term Integrated Forecasting System (STIFS) database, are mostly EIA data regularly published in the Monthly Energy Review, Petroleum Supply Monthly, and other EIA publications. Minor discrepancies between the data in these publications and the historical data in this Outlook are due to independent rounding. The STIFS model is driven principally by three sets of assumptions or inputs: estimates of key macroeconomic variables, world oil price assumptions, and assumptions about the severity of weather. Macroeconomic estimates are adjusted by EIA to reflect EIA assumptions which may affect the macroeconomic outlook. By varying the assumptions, alternative cases are produced by using the STIFS model. 24 figs., 19 tabs.

  20. Short-Term Energy Outlook: Quarterly projections. Fourth quarter 1993

    Energy Technology Data Exchange (ETDEWEB)

    1993-11-05

    The Energy Information Administration (EIA) prepares quarterly, short-term energy supply, demand, and price projections for publication in February, May, August, and November in the Short-Term Energy Outlook (Outlook). An annual supplement analyzes the performance of previous forecasts, compares recent cases with those of other forecasting services, and discusses current topics related to the short-term energy markets. (See Short-Term Energy Outlook Annual Supplement, DOE/EIA-0202.) The forecast period for this issue of the Outlook extends from the fourth quarter of 1993 through the fourth quarter of 1994. Values for the third quarter of 1993, however, are preliminary EIA estimates (for example, some monthly values for petroleum supply and disposition are derived in part from weekly data reported in the Weekly Petroleum Status Report) or are calculated from model simulations using the latest exogenous information available (for example, electricity sales and generation are simulated using actual weather data). The historical energy data are EIA data published in the Monthly Energy Review, Petroleum Supply Monthly, and other EIA publications.

  1. PCA-induced respiratory depression simulating stroke following endoluminal repair of abdominal aortic aneurysm: a case report

    Directory of Open Access Journals (Sweden)

    Ahmad Javed

    2007-07-01

    Full Text Available Abstract Aim To report a case of severe respiratory depression with PCA fentanyl use simulating stroke in a patient who underwent routine elective endoluminal graft repair for abdominal aortic aneurysm (AAA Case presentation A 78-year-old obese lady underwent routine endoluminal graft repair for AAA that was progressively increasing in size. Following an uneventful operation postoperative analgesia was managed with a patient-controlled analgesia (PCA device with fentanyl. On the morning following operation the patient was found to be unusually drowsy and unresponsive to stimuli. Her GCS level was 11 with plantars upgoing bilaterally. A provisional diagnosis of stroke was made. Urgent transfer to a high-dependency unit (HDU was arranged and she was given ventilatory support with a BiPap device. CT was performed and found to be normal. Arterial blood gas (ABG analysis showed respiratory acidosis with PaCO2 81 mmHg, PaO2 140 mmHg, pH 7.17 and base excess -2 mmol/l. A total dose of 600 mcg of fentanyl was self-administered in the 16 hours following emergence from general anaesthesia. Naloxone was given with good effect. There was an increase in the creatinine level from 90 μmol/L preoperatively to 167 μmol/L on the first postoperative day. The patient remained on BiPap for two days that resulted in marked improvement in gas exchange. Recovery was complete.

  2. Comparison between major repair and replacement options for a bridge deck life cycle assessment: A case study

    Directory of Open Access Journals (Sweden)

    Abu Dabous Saleh

    2017-01-01

    Full Text Available Material production, manufacturing, transportation, usage, and end of lifeprocessing are usually the main contributors defining the life cycle assessment (LCA. Bridge infrastructure is important to the economy and the society. Over their life cycle, highway bridges experience several stressors that can significantly affect their structural performance and therefore require rehabilitation. This paper discusses the life cycle analysis of bridge rehabilitation decisions and demonstrates the analysis with a case study of a bridge located in Ontario, Canada. The LCA of the bridge deck is analyzed for two rehabilitation strategies: major repair and replacement. The study focuses on evaluating the different life cycle phases of the bridge deck by assessing their carbon dioxide emission, energy consumption and cost. Also, the paper presents the impact of the different elements within each phase to identify the most contributing elements. The LCA of the bridge deck is analyzed and estimated with the aid of CES EduPack 2016 software that includes a database of more than 4000 different materials and more than 200 manufacturing processes. Analysis of the case study shows that material phase causes significant life cycle impact. The study concluded that the deck replacement yields higher environmental impact and life cycle cost compared to repairing and strengthening the deck.

  3. Laparoscopic repair for recurrent parastomal hernia of an end stoma using the sandwich technique while preserving an ileal conduit: A case report

    Directory of Open Access Journals (Sweden)

    Toshiaki Wada

    2016-01-01

    Conclusion: We herein report a case of recurrent parastomal hernia treated laparoscopically while preserving an ileal conduit using the sandwich technique which combines the keyhole and Sugarbaker techniques. This is a quite rare case report of laparoscopic repair for recurrent parastomal hernia in a patient with an ileal conduit.

  4. The Neglected Achilles Tendon Rupture Repaired With Allograft: A Review of 14 Cases.

    Science.gov (United States)

    Ofili, Kene P; Pollard, Jason D; Schuberth, John M

    Various surgical techniques have been reported for the repair of neglected Achilles tendon ruptures, including V-Y advancements, synthetic augmentations, and collagen implants. The use of an Achilles tendon allograft allows bridging of large defects without donor site morbidity, with a relative ease of technique and adequate graft availability. The present retrospective report focused on the outcomes of a series of 14 patients with neglected ruptures treated with an Achilles tendon allograft. Patients were included in the present series if they had ≥12 months of postoperative follow-up data available and the allograft had been used without any adjunctive procedures. Of the 14 patients, 6 were female (43%) and 8 were male (57%), with a mean follow-up period of 16.1 ± 3 (range 12 to 27) months. The mean interval from the initial injury to surgery was 6.9 ± 5 (range 1 to 28) months. The mean intraoperative defect size was 7.0 ± 3 (range 4 to 15) cm. A calcaneal block was used in 2 patients (14%). All patients were able to perform a single heel rise at a mean of 27 ± 11 (range 12 to 37) weeks postoperatively. Weightbearing in normal shoe gear was achieved at a mean of 13.5 ± 3 (range 12 to 17) weeks. Complications included 1 delayed union (7%) of the calcaneal bone block. Repair of the neglected Achilles tendon rupture with an allograft appears to be an acceptable approach, with good overall outcomes and low risk. These results suggest that this method of repair compares favorably with established alternatives. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  5. Endovascular repair of an abdominal aortic aneurysm in a patient with horseshoe kidney: report of a case.

    Science.gov (United States)

    Volpe, Piero; Nano, Giovanni; Dalainas, Ilias; Palazzo, Vincenzo; Casana, Renato; Paroni, Giovanni

    2006-01-01

    A horseshoe kidney poses special problems during treatment of an abdominal aortic aneurysm (AAA), and there is much controversy about the most suitable method of repair. We report the case of a 65-year-old man with a horseshoe kidney, in whom an AAA was treated with a unibody bifurcated endograft. During the procedure, the two anomalous renal arteries were sacrificed. Although there was transient elevation of the creatinine levels, the patient was discharged with normal renal function and no endoleak from the accessory renal arteries. Thus, when two normal and two accessory renal arteries arise from the non-aneurysmatic proximal aortic neck, providing that preoperative kidney function is normal, it seems that the treatment can be safely carried out using an endovascular technique and excluding the accessory renal arteries. This case supports the feasibility of endovascular surgery for the treatment of AAA in the presence of a horseshoe kidney.

  6. Sarns centrifugal pump for repair of thoracic aortic injury: case reports.

    Science.gov (United States)

    Walls, J T; Curtis, J J; Boley, T

    1989-09-01

    A new centrifugal pump (Sarns), originally designed for ventricular assist, was successfully used in two patients during repair of traumatic pseudoaneurysm of the descending thoracic aorta. The distal thoracic aorta was perfused without heparinization to avoid spinal cord and visceral ischemia, reduce afterload on the heart, and avoid clamp injury to the aorta. Distal mean aortic pressure was maintained above 50 mm Hg with a mean pump flow of 1.75 liter/minute. Proposed structural advantages of the Sarns centrifugal pump for perfusion of the distal thoracic aorta without heparin are resistance to thrombus formation, air embolus, and hemolysis.

  7. First World Report of Internal Power Cable Repair in Left Ventricular Assist Device Jarvik 2000: Case Report.

    Science.gov (United States)

    Sassi, C G; Cameli, M; Dokollari, A; Diciolla, F; Scolletta, S; Ricci, C; Lucatelli, P; Mondillo, S; Maccherini, M

    2017-05-01

    There are limited clinical reports concerning internal power cable fixing in left ventricular assist device (L-VAD) patients. Actually there are no reports in the literature about Jarvik 2000 internal cable repair. We show the first description of a technique for surgical reparation of such a fatal complication. The patient was a 62-year-old woman who had L-VAD implantation (Jarvik 2000) with outflow graft apposition in descending thoracic aorta through left thoracotomy access, in 2009. She arrived urgently on January 25, 2014 for Jarvik 2000 dysfunction correlated with head movements. The neck X-rays revealed the rupture of one of the nine power cables located inside the neck and the damaging of two more cables nearby to be ruptured. On the same day she got pump failure due to the final interruption of the remaining two cables, we were obliged to install femoro-femoral extracorporeal membrane oxygenation (ECMO) assistance, to repair the power cables, approaching them through a pacemaker extension cable. The L-VAD outflow was occluded with vascular ball occluder inserted via right axillary artery under fluoroscopy before ECMO installation. At the end the ECMO assistance was interrupted and the Jarvik 2000 was turned back on. The patient was dismissed from the hospital 12 days after the procedure. At the moment the international literature is poor regarding this issue. This case provides evidence that in emergency conditions ECMO assistance is mandatory and a hybrid surgical and radiological approach could help to repair the damage in safe conditions. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Polymorphisms in genes controlling inflammation and tissue repair in rheumatoid arthritis: a case control study

    Directory of Open Access Journals (Sweden)

    de Vogel Lisette

    2011-03-01

    Full Text Available Abstract Background Various cytokines and inflammatory mediators are known to be involved in the pathogenesis of rheumatoid arthritis (RA. We hypothesized that polymorphisms in selected inflammatory response and tissue repair genes contribute to the susceptibility to and severity of RA. Methods Polymorphisms in TNFA, IL1B, IL4, IL6, IL8, IL10, PAI1, NOS2a, C1INH, PARP, TLR2 and TLR4 were genotyped in 376 Caucasian RA patients and 463 healthy Caucasian controls using single base extension. Genotype distributions in patients were compared with those in controls. In addition, the association of polymorphisms with the need for anti-TNF-α treatment as a marker of RA severity was assessed. Results The IL8 781 CC genotype was associated with early onset of disease. The TNFA -238 G/A polymorphism was differentially distributed between RA patients and controls, but only when not corrected for age and gender. None of the polymorphisms was associated with disease severity. Conclusions We here report an association between IL8 781 C/T polymorphism and age of onset of RA. Our findings indicate that there might be a role for variations in genes involved in the immune response and in tissue repair in RA pathogenesis. Nevertheless, additional larger genomic and functional studies are required to further define their role in RA.

  9. Duodenal Obstruction after Elective Abdominal Aortic Aneurysm Repair: A Case Report

    Directory of Open Access Journals (Sweden)

    Chun-Yao Lin

    2004-10-01

    Full Text Available Gastrointestinal tract complications after abdominal aortic aneurysm (AAA repair are well known. The reported frequency ranges from 6.6% to 21%. However, the incidence of duodenal obstruction following AAA has probably been underestimated. This report concerns a 78-year-old male who was admitted for elective repair of an infrarenal AAA. On the ninth postoperative day, the patient presented with large quantities of bile-stained vomitus despite passing flatus per rectum. Metoclopramide and ranitidine were given under the initial impression of paralytic ileus. However, the upper gastrointestinal obstruction persisted, and on day 12, computerized tomography (CT revealed marked distension of the gastric tube and duodenum, down to the level of the third portion, with abrupt change of caliber at the point of the superior mesenteric artery (SMA. SMA syndrome was diagnosed. After nasogastric tube aspiration, parenteral nutrition, and 11 days of conservative treatment, abdominal CT and upper gastrointestinal series showed no apparent duodenal obstruction. The patient was discharged on the 29th postoperative day; follow-up abdominal CT 4 months later was unremarkable.

  10. Surgical physiology of inguinal hernia repair - a study of 200 cases

    Science.gov (United States)

    Desarda, Mohan P

    2003-01-01

    Background Current inguinal hernia operations are generally based on anatomical considerations. Failures of such operations are due to lack of consideration of physiological aspects. Many patients with inguinal hernia are cured as a result of current techniques of operation, though factors that are said to prevent hernia formation are not restored. Therefore, the surgical physiology of inguinal canal needs to be reconsidered. Methods A retrospective study is describer of 200 patients operated on for inguinal hernia under local anaesthesia by the author's technique of inguinal hernia repair. Results The posterior wall of the inguinal canal was weak and without dynamic movement in all patients. Strong aponeurotic extensions were absent in the posterior wall. The muscle arch movement was lost or diminished in all patients. The movement of the muscle arch improved after it was sutured to the upper border of a strip of the external oblique aponeurosis (EOA). The newly formed posterior wall was kept physiologically dynamic by the additional muscle strength provided by external oblique muscle to the weakened muscles of the muscle arch. Conclusions A physiologically dynamic and strong posterior inguinal wall, and the shielding and compression action of the muscles and aponeuroses around the inguinal canal are important factors that prevent hernia formation or hernia recurrence after repair. In addition, the squeezing and plugging action of the cremasteric muscle and binding effect of the strong cremasteric fascia, also play an important role in the prevention of hernia. PMID:12697071

  11. Surgical physiology of inguinal hernia repair - a study of 200 cases

    Directory of Open Access Journals (Sweden)

    Desarda Mohan P

    2003-04-01

    Full Text Available Abstract Background Current inguinal hernia operations are generally based on anatomical considerations. Failures of such operations are due to lack of consideration of physiological aspects. Many patients with inguinal hernia are cured as a result of current techniques of operation, though factors that are said to prevent hernia formation are not restored. Therefore, the surgical physiology of inguinal canal needs to be reconsidered. Methods A retrospective study is describer of 200 patients operated on for inguinal hernia under local anaesthesia by the author's technique of inguinal hernia repair. Results The posterior wall of the inguinal canal was weak and without dynamic movement in all patients. Strong aponeurotic extensions were absent in the posterior wall. The muscle arch movement was lost or diminished in all patients. The movement of the muscle arch improved after it was sutured to the upper border of a strip of the external oblique aponeurosis (EOA. The newly formed posterior wall was kept physiologically dynamic by the additional muscle strength provided by external oblique muscle to the weakened muscles of the muscle arch. Conclusions A physiologically dynamic and strong posterior inguinal wall, and the shielding and compression action of the muscles and aponeuroses around the inguinal canal are important factors that prevent hernia formation or hernia recurrence after repair. In addition, the squeezing and plugging action of the cremasteric muscle and binding effect of the strong cremasteric fascia, also play an important role in the prevention of hernia.

  12. Laparoscopic Repair of Morgagni Hernia: Three-Case Presentation and the Literature

    Directory of Open Access Journals (Sweden)

    Gholamali Godazandeh

    2016-01-01

    Full Text Available Introduction. Morgagni hernia is a rare form of congenital diaphragmatic hernia. Case Presentation. We present three cases of Morgagni hernia with GI symptoms treated by laparoscopic surgery. Discussion. Hernial sac was excised in two cases and left in situ in one case. There was no recurrence in symptoms after 30 months from surgery.

  13. Repair of diaphragmatic hernia following spinal surgery by laparoscopic mesh application: a case report and review of the literature.

    Science.gov (United States)

    Bini, Roberto; Fontana, Diego; Longo, Alessandro; Manconi, Paolo; Leli, Renzo

    2014-01-01

    We describe the laparoscopic management of diaphragmatic hernia (DH) caused by vertebral pedicle screw displacement. A 58-year-old woman underwent surgery for scoliosis and underwent posterior pedicle screw fixation. In the first postoperative (PO)day, she developed mild dyspnea. An anteroposterior chest radiograph revealed bilateral pleural effusion, which was more pronounced on the left side. A thoracoabdominal computed tomography (CT) scan, performed in the second PO day, revealed a solid mass in the pleural cavity that was associated with screw displacement, which had also entered into the peritoneal cavity without apparent other lesion of hollow and solid viscous. In the third PO day, after the screw was removed, explorative laparoscopy was carried out. We observed herniation of the omentum through a small diaphragmatic tear. Once the absence of visceral injury was confirmed, we reduced the omentum into the abdomen. Then, we repaired the hernia by applying a dual layer polypropylene mesh over the defect with a 3-cm overlap. The remainder of the postoperative period was uneventful. Iatrogenic DH due to a pedicle screw displacement has never been described before. In cases of pleural effusion following spinal surgery, rapid assessment and treatment are crucial. We conclude that a laparoscopic approach to iatrogenic DH could be feasible and effective in a hemodynamically stable patient with negative CT findings because it enables the completion of the diagnostic cascade and the repair of the tear, providing excellent visualization of the abdominal viscera and diaphragmatic tears.

  14. Surgical repair of the gluteal tendons: a report of 72 cases.

    Science.gov (United States)

    Walsh, Michael J; Walton, Judie R; Walsh, Nichola A

    2011-12-01

    Lateral hip pain is a common problem in middle-aged women. This pain is usually attributed to trochanteric bursitis and treated as such. This study reports the results of investigation, the findings at surgery, the operative technique, the histopathologic findings, and the results of gluteal tendon repair in 72 patients with long-standing trochanteric pain and reports a classification of the operative findings. Six patients (7%) in the original study cohort of 89 patients were lost to follow-up, but of the remaining patients, 65 of 72, or 90%, were pain-free or had minimal pain (P gluteal tendons causing chronic lateral hip pain addresses the problem directly and reliably relieves the symptoms of so-called "trochanteric bursitis."

  15. Outcome of arthroscopic subscapularis tendon repair: Are the results improving with improved techniques and equipment?: A retrospective case series

    Directory of Open Access Journals (Sweden)

    G R Arun

    2016-01-01

    Conclusion: At a median followup of 2 years, 95% of patients had a good to excellent result after an arthroscopic subscapularis tendon repair. We conclude that the midterm results show that arthroscopic subscapularis repair remains a good option for the treatment of patients with subscapularis tendon repair.

  16. Discrete-Event Simulation Modeling of the Repairable Inventory Process to Enhance the ARGCS Business Case Analysis

    Science.gov (United States)

    2006-12-01

    NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA MBA PROFESSIONAL REPORT Discrete-Event Simulation Modeling of the Repairable...TYPE AND DATES COVERED MBA Professional Report 4. TITLE AND SUBTITLE: Discrete-Event Simulation Modeling of the Repairable Inventory Process to...Advanced Concept Technology Demonstration; Agile Rapid Global Combat Support; Discrete- Event Simulation Modeling of the Repairable Inventory Process to

  17. Percutaneous, Minimally Invasive Repair of Traumatic and Simultaneous Rupture of Both Achilles Tendons: A Case Report.

    Science.gov (United States)

    Zietek, Pawel; Karaczun, Maciej; Kruk, Bartosz; Szczypior, Karina

    2016-01-01

    Achilles injury is a common musculoskeletal disorder. Bilateral rupture of the Achilles tendon, however, is much less common and usually occurs spontaneously. Complete, traumatic, and bilateral ruptures are rare and typically require long periods of immobilization before the patient can return to full weightbearing. A 52-year-old male was hospitalized for bilateral traumatic rupture to both Achilles tendons. No risk factors for tendon rupture were found. Blood samples revealed no peripheral blood pathologic features. Both tendons were repaired with percutaneous, minimally invasive surgery using the Achillon(®) tendon suture system. Rehabilitation was begun 4 weeks later. An ankle-foot orthosis was prescribed to provide ankle support with an adjustable range of movement, and active plantar flexion was set at 0° to 30°. The patient remained non-weightbearing with the ankle-foot orthosis device and performed active range-of-motion exercises. At 8 weeks after surgery, we recommended that he begin walking with partial weightbearing using a foot-tibial orthosis with the range of motion set to 45° plantar flexion and 15° dorsiflexion. At 10 weeks postoperatively, he was encouraged to return to full weightbearing on both feet. Beginning rehabilitation as soon as possible after minimally invasive surgery, compared with 6 weeks of immobilization after surgery, provided a rapid resumption to full weightbearing. We emphasize the clinical importance of a safe, simple treatment program that can be followed for a patient with damage to the Achilles tendons. To our knowledge, ours is the first report of minimally invasive repair of bilateral simultaneous traumatic rupture of the Achilles tendon. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  18. Sebaceous neoplasms and the immunoprofile of mismatch-repair proteins as a screening target for syndromic cases

    DEFF Research Database (Denmark)

    Boennelycke, Marie; Thomsen, Birthe M; Holck, Susanne

    2015-01-01

    16-negativity in MLH1-deficient cases may denote methylation rather than mutation. The prime aim of this study was to evaluate the mismatch-repair (MMR)-protein deficiency and the p16 status among sebaceous neoplasms. MATERIAL AND METHOD: From January 1990 through October 2012, 26 sebaceous adenomas...... (SAs) and 6 sebaceous carcinomas (SCs) were accrued. The expression of MLH1, MSH2, MSH6, and PMS2 was recorded. MLH1-deficient cases were tested for p16 status. RESULTS: Eighteen (56%) of the 32 specimens with SA or SC displayed MMR-protein deficiency, comprising 17 (65.4%) SAs (MSH2/MSH6 loss in 12......, MLH1/PMS2 loss in 3, MSH6 loss only in 2 cases) and 1 (16.7%) SC (MLH1/PMS2 loss). All 4 MLH1 deficient cases were p16-positive. CONCLUSION: A substantial proportion of sebaceous neoplasms were MMR-protein deficient and thus likely MTS candidates. Given the low prevalence of sebaceous neoplasms...

  19. Orchiectomy as a result of ischemic orchitis after laparoscopic inguinal hernia repair: case report of a rare complication

    Directory of Open Access Journals (Sweden)

    Moore John B

    2007-11-01

    Full Text Available Abstract Background Ischemic orchitis is an established complication after open inguinal hernia repair, but ischemic orchitis resulting in orchiectomy after the laparoscopic approach has not been reported. Case presentation The patient was a thirty-three year-old man who presented with bilateral direct inguinal hernias, right larger than left. He was a thin, muscular male with a narrow pelvis who underwent bilateral extraperitoneal mesh laparoscopic inguinal hernia repair. The case was complicated by pneumoperitoneum which limited the visibility of the pelvic anatomy; however, the mesh was successfully deployed bilaterally. Cautery was used to resect the direct sac on the right. The patient was discharged the same day and doing well with minimal pain and swelling until the fourth day after surgery. That night he presented with sudden-onset pain and swelling of his right testicle and denied both trauma to the area and any sexual activity. Ultrasound of the testicle revealed no blood flow to the testicle which required exploration and subsequent orchiectomy. Conclusion Ischemic orchitis typically presents 2–3 days after inguinal hernia surgery and can progress to infarction. This ischemic injury is likely due to thrombosis of the venous plexus, rather than iatrogenic arterial injury or inappropriate closure of the inguinal canal. Ultrasound/duplex scanning of the postoperative acute scrotum can help differentiate ischemic orchitis from infarction. Unfortunately, testicular torsion cannot be ruled out and scrotal exploration may be necessary. Although ischemic orchitis, atrophy, and orhiectomy are uncommon complications, all patients should be warned of these potential complications and operative consent should include these risks irrespective of the type of hernia or the surgical approach.

  20. A composite medial plantar flap for the repair of an achilles' tendon defect: a case report.

    Science.gov (United States)

    Dumont, C E; Kessler, J

    2001-12-01

    The surgical management of infected necrosis of the Achilles' tendon and overlying skin is very demanding, and reconstruction with vascularized tendon and skin flaps is considered the benchmark procedure. The authors report a 65-year-old man who sustained a chronic wound after operative repair of a chronic rupture of the Achilles' tendon. A pedicled medial plantar flap including the surrounding vascularized plantar aponeurosis was elevated. The plantar aponeurosis was split and used to bridge the 4-cm-long tendon defect. The flap donor site was covered with a thin skin graft. The flap survived completely without recurrence of the infection. At the 7-month follow-up, the reconstructed Achilles' tendon showed a good functional result and a normal range of dorsi- and plantar flexion of the foot. This technique is of great interest in comparison with free flaps because it does not require vascular anastomosis in a septic environment or a secondary debulking operation, yet it still provides both vascularized tendon and skin graft.

  1. Evaluating indoor exposure modeling alternatives for LCA: A case study in the vehicle repair industry

    Energy Technology Data Exchange (ETDEWEB)

    Demou, Evangelia; Hellweg, Stefanie; Wilson, Michael P.; Hammond, S. Katharine; McKone, Thomas E.

    2009-05-01

    We evaluated three exposure models with data obtained from measurements among workers who use"aerosol" solvent products in the vehicle repair industry and with field experiments using these products to simulate the same exposure conditions. The three exposure models were the: 1) homogeneously-mixed-one-box model, 2) multi-zone model, and 3) eddy-diffusion model. Temporally differentiated real-time breathing zone volatile organic compound (VOC) concentration measurements, integrated far-field area samples, and simulated experiments were used in estimating parameters, such as emission rates, diffusivity, and near-field dimensions. We assessed differences in model input requirements and their efficacy for predictive modeling. The One-box model was not able to resemble the temporal profile of exposure concentrations, but it performed well concerning time-weighted exposure over extended time periods. However, this model required an adjustment for spatial concentration gradients. Multi-zone models and diffusion-models may solve this problem. However, we found that the reliable use of both these models requires extensive field data to appropriately define pivotal parameters such as diffusivity or near-field dimensions. We conclude that it is difficult to apply these models for predicting VOC exposures in the workplace. However, for comparative exposure scenarios in life-cycle assessment they may be useful.

  2. Percutaneous coronary intervention following repair of type B aortic dissection: a report of 8 cases

    Institute of Scientific and Technical Information of China (English)

    Quanmin Jing; Xiaozeng Wang; Yaling Han; Bo Luan; Geng Wang; Xiaojiang Liu; Hongxu Jin

    2008-01-01

    Objective Patients with aortic dissection have a significant incidence of coronary artery disease.The purpose of this study is to evaluate the safety and feasibility of percutaneous coronary stent in patients who have undergone endovascular stent,and to assess the effect of anti-coagulant and anti-platelet treatment on patients' thrombosis process.Methods From January 2005 to July 2007,8 patients who had undergone endovascular stent-graft during the past 1 to 7 months for type B aortic dissection repair,underwent percutaneous coronary intervention (PCI) because of coexisting coronary artery disease.Anti-coagulant and anti-platelet treatments were administrated after PCI according to the standard protocol.Patients were followed up for a mean period of 23 months.Clinical and false lumen status data were collected during the follow-up.Results PCI were technically successful in all 8 patients and no severe complications such as death,paraplegia,renal failure occurred during hospitalization.Complete false lumen thrombosis was observed in 5 patients and incomplete false lumen thrombosis in the remained 3 patients at the end of follow up.There were no major complications such as death,dissection rupture or aneurysm development occurred during the follow-up period.Conclusion Our data implied that PCI can be safely performed in patients with type B aortic dissection who have undergone endovascular stent-graft,without interrupting the thrombosis process.

  3. Cyanoacrylate tissue glue for wound repair in early posttrabeculectomy conjunctival bleb leak: a case series

    Directory of Open Access Journals (Sweden)

    Haslinda AR

    2015-07-01

    Full Text Available Abdul-Rahim Haslinda, Yaakub Azhany, Rasid Noor-Khairul, Embong Zunaina, Ahmad-Tajudin Liza-Sharmini Department of Ophthalmology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia Abstract: We demonstrated a noninvasive management of early bleb leak following trabeculectomy using cyanoacrylate tissue glue (CATG. Three patients who underwent augmented trabeculectomy with mitomycin C with early bleb leak between January 2009 and June 2010 were reviewed. Case 1 and Case 2 exhibited bleb leak on postoperative Day 1 and Case 3 showed leak on follow-up at postoperative Day 7. Case 1 was successfully sealed with CATG at postoperative Day 3, after failed pressure padding and bandage contact lens. Case 2 was successfully sealed with CATG at postoperative Day 3, after failed pressure padding and conjunctiva flap resuturing. In Case 3, the leaking conjunctival flap was managed with combined techniques of resuturing and applying CATG at postoperative Day 9, after failed pressure padding. During leakage, the intraocular pressure was low (6–8 mmHg in all three cases, with shallow anterior chamber depth and absence of other complications such as choroidal detachment, hypotony maculopathy, or endophthalmitis. Foreign body sensation was the main complaint following the procedure. No clinical allergy reaction was documented. CATG may serve as a potential adjunctive and effective method in the management of posttrabeculectomy early bleb leak. Keywords: cyanoacrylate tissue glue, bleb leak, trabeculectomy, mitomycin C

  4. Totally percutaneous thoracic endovascular aortic repair with the preclosing technique: a case-control study

    Institute of Scientific and Technical Information of China (English)

    NI Zhong-han; LUO Jian-fang; HUANG Wen-hui; LIU Yuan; XUE Ling; FAN Rui-xin; CHEN Ji-yan

    2011-01-01

    Background The conventional thoracic endovascular aortic repair (TEVAR) involves groin incisions under general or epidural anesthesia. As technology moves towards less invasive procedures, a total percutaneous approach is desirable.In this study, we describe a Preclosing technique and investigate its safety and efficacy for femoral access sites management, and evaluate its advantages as compared to those of traditional surgical cutdown approaches.Methods The Preclosing technique involves two or multiple 6 F Perclose Proglide devices deployed in the femoral artery before upsizing to a 20-25 F sheath. The sutures were secured to close the arteriotomy at the end of the procedure. The medical records of patients who underwent thoracic endovascular aortic repairs using the Preclosing technique between December 2009 and November 2010 (group A) were compared with those using surgical femoral cutdown from January 2008 to November 2009 (group B). Outcome measures included rates of technical success, early complications, anesthesia method, procedure time, cardiac care unit (CCU) stay, time from procedure to discharge,hospital stay, procedure expense, hospital cost.Results Between the two groups, there were no significant differences in baseline characteristics, in the endograft models or profiles. The technical success rate was 100.0% (85/85) in group A vs. 97.4% (147/151) in group B (P <0.05).There was no access-related mortality in both groups. Compared with group B, the incidence of early complications were fewer in group A, 9.4% (8/85) vs. 22.5% (34/151) (P <0.01). Local anesthesia with conscious sedation was used more often in group A, 68.2% (58/85) vs. 51.7% (78/151) in group B (P<0.01). The procedure duration was shorter, (96±33)minutes in group Avs. (127±41) minutes in group B (P<0.01). The length of the CCU stay, the duration from procedure to discharge, and the hospital stay were both reduced in group A, (117.3±88.3) hours, (7.5±5.3) days and (15.3±6

  5. Case study. Health hazards of automotive repair mechanics: thermal and lighting comfort, particulate matter and noise.

    Science.gov (United States)

    Loupa, G

    2013-01-01

    An indoor environmental quality survey was conducted in a small private automotive repair shop during May 2009 (hot season) and February 2010 (cold season). It was established that the detached building, which is naturally ventilated and lit, had all the advantages of the temperate local climate. It provided a satisfactory microclimatic working environment, concerning the thermal and the lighting comfort, without excessive energy consumption for air-conditioning or lighting. Indoor number concentrations of particulate matter (PM) were monitored during both seasons. Their size distributions were strongly affected by the indoor activities and the air exchange rate of the building. During working hours, the average indoor/outdoor (I/O) number concentration ratio was 31 for PM0.3-1 in the hot season and 69 for the cold season. However I/O PM1-10 number concentration ratios were similar, 33 and 32 respectively, between the two seasons. The estimated indoor mass concentration of PM10 for the two seasons was on average 0.68 mg m(-3) and 1.19 mg m(-3), i.e., 22 and 36 times higher than outdoors, during the hot and the cold seasons, respectively. This is indicative that indoor air pollution may adversely affect mechanics' health. Noise levels were highly variable and the average LEX, 8 h of 69.3 dB(A) was below the European Union exposure limit value 87db (A). Noise originated from the use of manual hammers, the revving up of engines, and the closing of car doors or hoods. Octave band analysis indicated that the prevailing noise frequencies were in the area of the maximum ear sensitivity.

  6. Biodegradable polymer nanofiber membrane for the repair of cutaneous wounds in dogs - two case reports

    Directory of Open Access Journals (Sweden)

    Lívia Gomes Amaral

    2016-12-01

    Full Text Available The study of wound healing and its treatment is extremely important in veterinary medicine due to the high frequency of wounds and the difficulty in treating wounds by second intention. Thus, the objective of this study was to evaluate the use of a nanofiber membrane made of biodegradable polymers as a method of wound treatment in dogs. This study comprised two dogs with bite wounds. Debridement and cleaning was performed followed by the application of the membrane. In one dog, the wound was in the left proximal calcaneal region with clinical signs of infection, necrotic tissue, and muscle and the gastrocnemius tendon were exposed. The wound displayed rapid formation of granulation tissue which became excessive, so it was necessary to debride several times. However, with the suspension of the use of the membrane, formation of this tissue was not observed, and the wound evolved to epithelialization and fast contraction. In the second dog, there was a deep wound on the medial aspect of the proximal right hind limb, with clinical signs of infection, with muscle exposure. Once the membrane was placed, granulation tissue formed, and the membrane was used until the level of this tissue reached the skin. The wound underwent rapid epithelialization and contraction, without developing exuberant granulation tissue. Efficient wound repair was observed and the dogs exhibited greater comfort during application and use of the membrane. More studies should be conducted in dogs focusing on the application of this membrane until the appearance of healthy granulation tissue, as continued use seems to stimulate the formation of exuberant granulation tissue.

  7. Successful Use of Targeted Temperature Management After Repair of Myocardial Rupture from Blunt Chest Trauma: A Case Report.

    Science.gov (United States)

    Choi, Wook-Jin; Kim, Yun Seok; Hong, Jung Seok; Kim, Jeong Won

    2017-03-01

    Targeted temperature management (TTM) improves survival and neurological outcome after nontraumatic cardiac arrest. However, TTM is not used widely after traumatic cardiac arrest because of concerns that it might exacerbate bleeding. We report the use of postarrest TTM after repair of blunt myocardial rupture. A 48-year-old man was admitted after being rescued from a major traffic accident by the local emergency service. Focused sonography showed pericardial fluid without cardiac tamponade. Computed tomography showed a large hematoma in the anterior mediastinum associated with hemopericardium. The patient developed cardiac arrest during the operative preparations. Repeat bedside sonography revealed a large pericardial effusion and signs of cardiac tamponade. Spontaneous circulation was restored after ultrasound-guided pericardiocentesis. His Glasgow Coma Scale score was 3. The patient was transported promptly to the operating room and underwent median sternotomy without cardiopulmonary bypass. A rupture of the junction of the superior vena cava/right atrium and left atrial appendage was detected and was closed by direct suturing. Immediately after return to the intensive care unit, we performed TTM (target body temperature 34.5°C) using a surface-cooling device at 4 hours postarrest. TTM was maintained for 24 hours and controlled gradual rewarming was then initiated. He regained consciousness 36 hours postrewarming with limited speech ability. The patient recovered with no further cardiac events and was discharged 3 weeks after admission, with no other serious complications. The patient was neurologically intact (cerebral performance category 1) at 6 months of follow-up. This case demonstrates the potential benefit and applicability of postarrest TTM in patients after repair of blunt myocardial rupture.

  8. Laparoscopic repair of a bilateral internal inguinal hernia with supravesical hernia – a case report

    OpenAIRE

    2015-01-01

    Introduction: Supravesical hernia is an exceptional subtype of internal inguinal hernia, and it is located between the median umbilical ligament and the medial umbilical ligament. The hernia is classified as two types: internal supravesical hernia and external supravesical hernia. Presentation of case: Herein we report a rare case of external supravesical hernia successfully treated by laparoscopic procedure. The patient who complained right inguinal protrusion and mild frequent urination ...

  9. Surgical repair of an aberrant splenic artery aneurysm: report of a case.

    Science.gov (United States)

    Illuminati, Giulio; LaMuraglia, Glenn; Nigri, Giuseppe; Vietri, Francesco

    2007-03-01

    Aneurysms of the splenic artery are the most common splanchnic aneurysms. Aneurysms of a splenic artery with an anomalous origin from the superior mesenteric artery are however rare, with eight previously reported cases. Their indications for treatment are superposable to those of aneurysms affecting an orthotopic artery. Methods of treatment of this condition include endovascular, minimally invasive techniques and surgical resection. We report one more case of aneurysm of an aberrant splenic artery, treated with surgical resection, and preservation of the spleen.

  10. Surgical repair of tricuspid valve leaflet tear following percutaneous closure of perimembranous ventricular septal defect using Amplatzer duct occluder I: Report of two cases

    Directory of Open Access Journals (Sweden)

    Saatchi Mahesh Kuwelker

    2017-01-01

    Full Text Available Tricuspid valve (TV injury following transcatheter closure of perimembranous ventricular septal defect (PMVSD with Amplatzer ductal occluder I (ADO I, requiring surgical repair, is rare. We report two cases of TV tear involving the anterior and septal leaflets following PMVSD closure using ADO I. In both the patients, the subvalvular apparatus remained unaffected. The patients presented with severe tricuspid regurgitation (TR 6 weeks and 3 months following the device closure. They underwent surgical repair with patch augmentation of the TV leaflets. Postoperatively, both are asymptomatic with a mild residual TR.

  11. Surgical repair of tricuspid valve leaflet tear following percutaneous closure of perimembranous ventricular septal defect using Amplatzer duct occluder I: Report of two cases

    Science.gov (United States)

    Kuwelker, Saatchi Mahesh; Shetty, Devi Prasad; Dalvi, Bharat

    2017-01-01

    Tricuspid valve (TV) injury following transcatheter closure of perimembranous ventricular septal defect (PMVSD) with Amplatzer ductal occluder I (ADO I), requiring surgical repair, is rare. We report two cases of TV tear involving the anterior and septal leaflets following PMVSD closure using ADO I. In both the patients, the subvalvular apparatus remained unaffected. The patients presented with severe tricuspid regurgitation (TR) 6 weeks and 3 months following the device closure. They underwent surgical repair with patch augmentation of the TV leaflets. Postoperatively, both are asymptomatic with a mild residual TR. PMID:28163430

  12. Esthetic result of rhomboid flap repair after breast-conserving surgery for lower quadrant breast cancer lesion with skin invasion: report of two cases.

    Science.gov (United States)

    Tanaka, Satoru; Nohara, Takehiro; Nakatani, Shuichi; Iwamoto, Mitsuhiko; Sumiyoshi, Kazuhiro; Kimura, Kosei; Takahashi, Yuko; Sato, Nayuko; Tanigawa, Nobuhiko

    2011-06-01

    Breast-conserving surgery (BCS) has been increasingly performed as a standard operative strategy for patients with breast cancer. The primary purpose of BCS is to acquire both local control and good cosmetic results. An insignificant difference in cancer treatment results has been shown between BCS and total mastectomy. However, achieving sufficiently cosmetic results can be difficult, particularly in patients with tumors that are large or localized to the lower quadrant. To avoid breast deformities and asymmetries after BCS, immediate reconstruction using autologous tissue has been accepted as the standard option. Rhomboid skin and adipose flap repair is a simple, less invasive procedure than the myocutaneous flap, which has primarily been performed in patients with upper quadrant lesions. We herein report the cases of two patients with lower quadrant breast cancer with skin invasion, who underwent BCS with immediate breast repair using a rhomboid flap. This procedure is therefore worth considering as one of the first options for immediate repair after BCS.

  13. Tendon repair

    Science.gov (United States)

    Repair of tendon ... Tendon repair can be performed using: Local anesthesia (the immediate area of the surgery is pain-free) ... a cut on the skin over the injured tendon. The damaged or torn ends of the tendon ...

  14. First human experience with autologous Schwann cells to supplement sciatic nerve repair: report of 2 cases with long-term follow-up.

    Science.gov (United States)

    Gersey, Zachary C; Burks, S Shelby; Anderson, Kim D; Dididze, Marine; Khan, Aisha; Dietrich, W Dalton; Levi, Allan D

    2017-03-01

    OBJECTIVE Long-segment injuries to large peripheral nerves present a challenge to surgeons because insufficient donor tissue limits repair. Multiple supplemental approaches have been investigated, including the use of Schwann cells (SCs). The authors present the first 2 cases using autologous SCs to supplement a peripheral nerve graft repair in humans with long-term follow-up data. METHODS Two patients were enrolled in an FDA-approved trial to assess the safety of using expanded populations of autologous SCs to supplement the repair of long-segment injuries to the sciatic nerve. The mechanism of injury included a boat propeller and a gunshot wound. The SCs were obtained from both the sural nerve and damaged sciatic nerve stump. The SCs were expanded and purified in culture by using heregulin β1 and forskolin. Repair was performed with sural nerve grafts, SCs in suspension, and a Duragen graft to house the construct. Follow-up was 36 and 12 months for the patients in Cases 1 and 2, respectively. RESULTS The patient in Case 1 had a boat propeller injury with complete transection of both sciatic divisions at midthigh. The graft length was approximately 7.5 cm. In the postoperative period the patient regained motor function (Medical Research Council [MRC] Grade 5/5) in the tibial distribution, with partial function in peroneal distribution (MRC Grade 2/5 on dorsiflexion). Partial return of sensory function was also achieved, and neuropathic pain was completely resolved. The patient in Case 2 sustained a gunshot wound to the leg, with partial disruption of the tibial division of the sciatic nerve at the midthigh. The graft length was 5 cm. Postoperatively the patient regained complete motor function of the tibial nerve, with partial return of sensation. Long-term follow-up with both MRI and ultrasound demonstrated nerve graft continuity and the absence of tumor formation at the repair site. CONCLUSIONS Presented here are the first 2 cases in which autologous SCs were

  15. Laparoscopic umbilical hernia repair in the presence of extensive paraumbilical collateral veins: A case report

    NARCIS (Netherlands)

    S.S. Lases (Seilenna); H.H. Eker (Hasan); E.G.J.M. Pierik; P. Klitsie (Pieter); B. de Goede (Barry); M.P.F.V. Peeters; G. Kazemier (Geert); J.F. Lange (Johan)

    2011-01-01

    textabstractA patient with an umbilical hernia presenting with collateral veins in the abdominal wall and umbilicus is a case that every hernia surgeon has to deal with occasionally. Several underlying diseases have been described to provoke collateral veins in the abdominal wall. However, the treat

  16. A study on the effects of quarterly financial reports on systematic risk and return on assets: A case study of Tehran Stock Exchange

    Directory of Open Access Journals (Sweden)

    Roozbeh Hedayat Mazhari

    2013-06-01

    Full Text Available Financial statements are considered as primary sources of information for most investors to make investment decisions. A crystal clear and comprehensive annual report helps many interested parties about the performance of any business unit. However, many rules and regulations ask management teams of organizations to provide quarterly financial results. In this paper, we perform an empirical investigation to study the effects of quarterly financial reports on three ratios including systematic risk, return on assets and firm size. The proposed study gathers the necessary data from 72 firms listed on Tehran Stock Exchange over the period of 2000-2006. The study determined the performances of these 72 firms before and after the releases of three quarterly reports and using Freedman test determined whether there were any meaningful differences between two groups of data or not. The results of Freedman test indicate that there were not any meaningful differences between stock performance and systematic risk before and after quarterly results. The survey also examines the relationship between systematic risk and size of firms using Pearson correlation test and the results indicate there were some meaningful differences size and systematic risk.

  17. Endoscopic repair of transsellar transsphenoidal meningoencephalocele; case report and review of approaches

    Directory of Open Access Journals (Sweden)

    Maryam Jalessi, M.D.

    2015-06-01

    Full Text Available We present an extremely rare case of transsellar transsphenoidal meningoencephalocele in a 36-year-old woman with pituitary dwarfism complaining of nasal obstruction. Imaging studies showed a bony defect in the sellar floor and sphenoid sinus with huge nasopharyngeal mass and 3rd ventricle involvement. Using endoscopic endonasal approach the sac was partially removed and the defect was reconstructed with fat and fascial graft, and buttressed with titanium mesh and septal flap. Visual field improvement was noticed post-operatively and no complication was encountered during follow-up. So, endoscopic endonasal approach with partial resection of the sac is a safe and effective treatment for this disease

  18. "Open" repair of ruptured thoracoabdominal aortic aneurysm (experience of 51 cases).

    Science.gov (United States)

    Zanetti, Piero Paolo; Krasoń, Marcin; Walas, Ryszard; Cebotaru, Theodor; Popa, Calin; Vintila, Bogdan; Steiu, Flaviu

    2015-06-01

    Surgical treatment of toracoabdominal aortic aneurysms (TAAA) represents a difficult problem for the vascular surgeon and may become a formidable challenge in an emergency procedure. In patient with hemodynamic instability, protective measures as cerebral spinal fluid drainage and bio-pump against spinal cord, visceral and renal ischemia, may be ineffective or impracticable. We report our experience of 51 emergency-operated patients with TAAA out of 660 treated between 1994 and 2014; 48 patients (94%) were hemodynamically unstable, 3 (6%) were hemodynamically stable. The TAAA patients were evaluated, according to Crawford classification, as: 18 type I, 13 type II, 15 type III, 5 type IV. Overall mortality was 23 cases out of 51 (43.1%); 8 deaths occurred during the surgical procedure and 14 in the postoperative period. Early deaths, subdivided by Crawford TAAA classification, were: type I 9/18 (50%), type II 9/13 (69.2%), type III 7/15 (46.6%), type IV 3/5 (60%). Paraplegia-paraparesis developed in 6 cases out of 43 (16.2%), excluding 8 deaths during the operative procedure. Acute renal failure was observed in 8 out of 43 patients (18.6%). Dialysis was found to be a risk factor for hospital mortality (p = 0.03). Pulmonary insufficiency was diagnosed in 15 patients out of 43 (34.8%), and 5 patients (15.5%) needed tracheostomy, out of whom 3 died (p = 0.04%). Postoperative bleeding was present in 8 cases out of 43 (18.6%). Inferior laryngeal nerve palsy was present in 6 cases out of 43 (13.5%). The follow-up period comprised 1-3-5-10 years postoperative follow-up. The actuarial survival rate of patients discharged from hospital was respectively 75%, 63%, 48%, 35%. In the literature there are very few studies published on emergency treatment for TAAA. Having usually low numbers of patients in the groups wider experiences are still needed to give more light on the pathophysiology and surgical treatment of this type of TAAA, which are still being treated according to

  19. “Open” repair of ruptured thoracoabdominal aortic aneurysm (experience of 51 cases)

    Science.gov (United States)

    Zanetti, Piero Paolo; Walas, Ryszard; Cebotaru, Theodor; Popa, Calin; Vintila, Bogdan; Steiu, Flaviu

    2015-01-01

    Introduction Surgical treatment of toracoabdominal aortic aneurysms (TAAA) represents a difficult problem for the vascular surgeon and may become a formidable challenge in an emergency procedure. In patient with hemodynamic instability, protective measures as cerebral spinal fluid drainage and bio-pump against spinal cord, visceral and renal ischemia, may be ineffective or impracticable. Material and methods We report our experience of 51 emergency-operated patients with TAAA out of 660 treated between 1994 and 2014; 48 patients (94%) were hemodynamically unstable, 3 (6%) were hemodynamically stable. The TAAA patients were evaluated, according to Crawford classification, as: 18 type I, 13 type II, 15 type III, 5 type IV. Results Overall mortality was 23 cases out of 51 (43.1%); 8 deaths occurred during the surgical procedure and 14 in the postoperative period. Early deaths, subdivided by Crawford TAAA classification, were: type I 9/18 (50%), type II 9/13 (69.2%), type III 7/15 (46.6%), type IV 3/5 (60%). Paraplegia-paraparesis developed in 6 cases out of 43 (16.2%), excluding 8 deaths during the operative procedure. Acute renal failure was observed in 8 out of 43 patients (18.6%). Dialysis was found to be a risk factor for hospital mortality (p = 0.03). Pulmonary insufficiency was diagnosed in 15 patients out of 43 (34.8%), and 5 patients (15.5%) needed tracheostomy, out of whom 3 died (p = 0.04%). Postoperative bleeding was present in 8 cases out of 43 (18.6%). Inferior laryngeal nerve palsy was present in 6 cases out of 43 (13.5%). The follow-up period comprised 1-3-5-10 years postoperative follow-up. The actuarial survival rate of patients discharged from hospital was respectively 75%, 63%, 48%, 35%. Conclusions In the literature there are very few studies published on emergency treatment for TAAA. Having usually low numbers of patients in the groups wider experiences are still needed to give more light on the pathophysiology and surgical treatment of this type

  20. Fatal Pulmonary Embolism following Achilles Tendon Repair: A Case Report and a Review of the Literature

    Directory of Open Access Journals (Sweden)

    Asim M. Makhdom

    2013-01-01

    Full Text Available Deep venous thrombosis (DVT is a significant source of morbidity in orthopaedic surgery. It can progress to a pulmonary embolism, a significant source of mortality. Up to date, patients with Achilles tendon rupture routinely do not receive DVT chemical prophylaxis. We are presenting a case of fatal pulmonary embolism after a surgically treated Achilles tendon rupture in a forty-two-year-old male healthy patient. In the current body of the literature, the reported incidence of DVT after Achilles tendon rupture is highly variable ranging from less than 1% to 34%, and there is a disagreement in the international guidelines regarding the need of chemical DVT prophylaxis with this type of injury. Further research needs to be conducted to investigate the risks and benefits of chemical DVT prophylaxis following Achilles tendon rupture. For low-risk patients, the use of milder forms of prophylaxis such as aspirin should also be explored.

  1. Abdominal aortic aneurysm repair in patient with a renal allograft: a case report.

    Science.gov (United States)

    Kim, Hyung-Kee; Ryuk, Jong-Pil; Choi, Hyang Hee; Kwon, Sang-Hwy; Huh, Seung

    2009-02-01

    Renal transplant recipients requiring aortic reconstruction due to abdominal aortic aneurysm (AAA) pose a unique clinical problem. The concern during surgery is causing ischemic injury to the renal allograft. A variety of strategies for protection of the renal allograft during AAA intervention have been described including a temporary shunt, cold renal perfusion, extracorporeal bypass, general hypothermia, and endovascular stent-grafting. In addition, some investigators have reported no remarkable complications of the renal allograft without any specific measures. We treated a case of AAA in a patient with a renal allograft using a temporary aortofemoral shunt with good result. Since this technique is safe and effective, it should be considered in similar patients with AAA and previously placed renal allografts.

  2. Repair of Chronic Aneurysmal Aortic Dissection Using a Stent Graft and an Amplatzer(®) Vascular Plug: A Case Study.

    Science.gov (United States)

    Kanaoka, Yuji; Ohki, Takao; Ozawa, Hirotsugu

    2017-02-01

    We report a case in which a stent graft and an Amplatzer(®) vascular plug (AVP) were effective for the treatment of chronic aneurysmal aortic dissection. The patient was a 52-year-old man. At 45 years of age, he developed acute aortic dissection, for which he underwent surgery 4 times with prosthetic graft replacement in the abdominal aorta, descending thoracic, ascending aorta (without neck branch reconstruction), and thoracoabdominal aorta with the reconstruction of the celiac, superior mesenteric, and bilateral renal arteries. At the time of thoracoabdominal aortic surgery, strong adhesion was evident, particularly in the thoracoabdominal area. The adhesion was dissected in a part of the chest, and prosthetic graft replacement was performed the following day. Subsequently, the dissection of the residual distal aortic arch enlarged, and the patient was examined at our hospital. Computed tomography (CT) revealed a small intimal tear at the site of anastomosis distal to the graft in the ascending aorta and a large intimal tear in the descending thoracic aorta with a maximum diameter of 67 mm. Furthermore, open repair by prosthetic graft replacement seemed difficult; therefore, treatment with stent grafting was considered. Because the prosthetic graft in the abdomen was extremely tortuous, stent-graft insertion via the femoral artery seemed to be impossible. The planned treatment involved the placement of a thoracic stent graft using the chimney technique which included reconstruction of the brachiocephalic artery and left common carotid arteries using chimney stent graft and coverage of the left subclavian artery. The thoracic stent graft was planned to be inserted via the abdominal prosthetic graft site because the abdominal prosthetic graft was crooked and was located close to the body surface. However, a small intimal tear distal to the graft in the ascending aorta which had not been revealed by intraoperative aortography was detected by the selective

  3. 腹腔镜食管裂孔疝修补术12例报告%Laparoscopic hiatal hernia repair:a clinical analysis of 12 cases

    Institute of Scientific and Technical Information of China (English)

    李青; 渠时学; 谢光伟

    2012-01-01

    Objective:To explore the feasibility and clinical value of laparoscopic surgery in treating patients with hiatal herni-a. Methods:Twelve patients with hiatal hernia underwent laparoscopic hiatal hernia repair,including 9 cases of Nissen operation,3 cases of Toupet operation. 8 cases of hernia repaired with suture,4 cases repaired with Bard CruraSoftMesh. Results; 12 cases of laparoscopic hiatal hernia repair was successful in all. No conversions were needed. Mean operation time was (116 ±23) min (range :62-215 min). Mean intraoperative blood lose was ( 12 ± 2. 4) ml(range: 10-20 ml). Mean postoperative hospital stay was (5. 1 ±1.3) d ( range :3-19 d). Clinical symptoms were relieved in all cases. No mortality and severe complications were occurred. Symptoms completely disappeared in 9 cases (75% ) , improved in 3 cases (25% ). Conclusions: Laparoscopic repair of esophageal hiatal hernia with efficacy, safety and the advantages of minimally invasive, should be further applied clinically.%目的:探讨腹腔镜手术治疗食管裂孔疝的可行性及临床价值.方法:为12例食管裂孔疝患者行腹腔镜食管裂孔疝修补术,其中9例行胃底360度折叠术(Nissen术),3例行胃底270度部分折叠术(Toupet术).8例使用7号丝线缝合修补疝缺口,4例应用补片修补.结果:12例手术均获成功,无一例中转开腹.手术时间62 ~ 215 min,平均(116±23) min;术中出血量10 ~20 ml,平均(12±2.4)ml;术后住院3~19 d,平均(5.1±1.3)d;无严重并发症发生及死亡病例.术后症状完全消失9例(75%),好转3例(25%).结论:腹腔镜食管裂孔疝修补术安全,疗效确定,患者创伤小,值得临床应用.

  4. Percutaneous suturing technique and single-site umbilical laparoscopic repair of a Morgagni hernia: Review of three cases.

    Science.gov (United States)

    Zouari, M; Jallouli, M; Bendhaou, M; Zitouni, H; Mhiri, R

    2015-12-01

    Morgagni hernias are uncommon, accounting for only 1-2% of all congenital diaphragmatic hernia. Minimally invasive surgery is today the gold standard treatment. We present a technique using percutaneous suturing and single-site umbilical laparoscopic repair of Morgagni hernia in three children. Recovery was uneventful in all three patients. There was no recurrence and the chest radiograph remained normal during the postoperative follow-up. The percutaneous suturing technique and single-site umbilical laparoscopic repair of a Morgagni hernia is an easy and effective alternative to standard laparoscopic repair.

  5. Transanal Repair of Colonic Perforation due to Ventriculoperitoneal Shunt—Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Li-Lan Chiang

    2010-06-01

    Full Text Available Colonic perforation is an extremely rare complication following ventriculoperitoneal (VP shunting. Laparotomy to repair the perforation site is usually required for patients with peritonitis. Here we report colonic perforation due to VP shunt in a 4-year-old girl, presenting with a distal catheter protruding out of the anus as well as symptoms and signs of peritonitis. The distal catheter was removed and the perforation site was repaired successfully via the anus. Postoperative course was uneventful. Trans-anal repair of the colonic perforation after removal of the distal shunt may be considered an alternative choice for managing this kind of complication.

  6. EMSL Quarterly Highlights Report: 1st Quarter, Fiscal Year 2009

    Energy Technology Data Exchange (ETDEWEB)

    Showalter, Mary Ann; Kathmann, Loel E.; Manke, Kristin L.

    2009-02-02

    The EMSL Quarterly Highlights Report covers the science, staff and user recognition, and publication activities that occurred during the 1st quarter (October 2008 - December 2008) of Fiscal Year 2009.

  7. EMSL Quarterly Highlights Report: 1st Quarter, FY08

    Energy Technology Data Exchange (ETDEWEB)

    Showalter, Mary Ann

    2008-01-28

    The EMSL Quarterly Highlights Report covers the science, staff and user recognition, and publication activities that occurred during the 1st quarter (October 2007 - December 2007) of Fiscal Year 2008.

  8. EMSL Quarterly Highlights Report: FY 2008, 3rd Quarter

    Energy Technology Data Exchange (ETDEWEB)

    Showalter, Mary Ann

    2008-09-16

    The EMSL Quarterly Highlights Report covers the science, staff and user recognition, and publication activities that occurred during the 1st quarter (October 2007 - December 2007) of Fiscal Year 2008.

  9. Repair of olecranon fractures using fiberWire without metallic implants: report of two cases

    Directory of Open Access Journals (Sweden)

    Okawa Atsushi

    2010-10-01

    Full Text Available Abstract Olecranon fractures are a common injury in fractures. The tension band technique for olecranon fractures yields good clinical outcomes; however, it is associated with significant complications. In many patients, implants irritate overlying soft tissues and cause pain. This is mostly due to protrusion of the proximal ends of the K-wires or by the twisted knots of the metal wire tension band. Below we described 2 cases of olecranon fractures treated with a unique technique using FiberWire without any metallic implants. Technically, the fragment was reduced, and two K-wires were inserted from the dorsal cortex of the distal segment to the tip of the olecranon. K-wire was exchanged for a suture retriever, and 2 strands of FiberWire were retrieved twice. Each of the two FiberWires was manually tensioned and knotted on the posterior surface of the olecranon. Bony unions could be achieved, and patients had no complaint of pain and skin irritation. There was only a small loss of flexion and extension in comparison with that of the contralateral side, and the patient did not feel inconvenienced in his daily life. Using the method described, difficulty due to K-wire or other metallic implants was avoided.

  10. Repair of olecranon fractures using fiberWire without metallic implants: report of two cases

    Science.gov (United States)

    2010-01-01

    Olecranon fractures are a common injury in fractures. The tension band technique for olecranon fractures yields good clinical outcomes; however, it is associated with significant complications. In many patients, implants irritate overlying soft tissues and cause pain. This is mostly due to protrusion of the proximal ends of the K-wires or by the twisted knots of the metal wire tension band. Below we described 2 cases of olecranon fractures treated with a unique technique using FiberWire without any metallic implants. Technically, the fragment was reduced, and two K-wires were inserted from the dorsal cortex of the distal segment to the tip of the olecranon. K-wire was exchanged for a suture retriever, and 2 strands of FiberWire were retrieved twice. Each of the two FiberWires was manually tensioned and knotted on the posterior surface of the olecranon. Bony unions could be achieved, and patients had no complaint of pain and skin irritation. There was only a small loss of flexion and extension in comparison with that of the contralateral side, and the patient did not feel inconvenienced in his daily life. Using the method described, difficulty due to K-wire or other metallic implants was avoided. PMID:20937160

  11. 地下车库对住区景观建设的影响及防控对策——以郑州市紫荆尚都小区为例%Study on Impact of Building Underground Parking Lot upon Landscape in Residential Quarter and Corresponding Countermeasures -A Case Study of Zijingshangdu Residential Quarter in Zhengzhou

    Institute of Scientific and Technical Information of China (English)

    杨芳绒; 何知秋

    2011-01-01

    城市住宅区中的地下车库常给地面的景观建设带来困难.以郑州市紫荆尚都小区为例,探讨地下车库对硬质景观、水景、种植、通风口、人行出口等景观工程建设的影响及其防控途径,得出建设良好地上景观的关键是满足地下车库的使用功能,同时尽量体现景观设计意图.%Most underground parking lots in the urban residential quarters usually cause some trouble for land scape building on the ground. With the case study of Zijingshangdu Residential Quarter in Zhengzhou City, the im pact of underground parking lots on the above ground landscape construction such as solid landscape scenery , water feature, tree sapling planting, air vent, pedestrian entrance and exit was discussed and the solutions were pro posed. It was pointed out that the crux of constructing the appropriate ground landscape should be to ensure the use function of underground parking lots , as well as to reflect the intention of landscape design.

  12. Genetic variants in DNA double-strand break repair genes and risk of salivary gland carcinoma: a case-control study.

    Directory of Open Access Journals (Sweden)

    Li Xu

    Full Text Available DNA double strand break (DSB repair is the primary defense mechanism against ionizing radiation-induced DNA damage. Ionizing radiation is the only established risk factor for salivary gland carcinoma (SGC. We hypothesized that genetic variants in DSB repair genes contribute to individual variation in susceptibility to SGC. To test this hypothesis, we conducted a case-control study in which we analyzed 415 single nucleotide polymorphisms (SNPs in 45 DSB repair genes in 352 SGC cases and 598 controls. Multivariate logistic regression analysis was performed to calculate odds ratios (ORs and 95% confidence intervals (CIs. Rs3748522 in RAD52 and rs13180356 in XRCC4 were significantly associated with SGC after Bonferroni adjustment; ORs (95% CIs for the variant alleles of these SNPs were 1.71 (1.40-2.09, P = 1.70 × 10(-7 and 0.58 (0.45-0.74, P = 2.00 × 10(-5 respectively. The genetic effects were modulated by histological subtype. The association of RAD52-rs3748522 with SGC was strongest for mucoepidermoid carcinoma (OR = 2.21, 95% CI: 1.55-3.15, P = 1.25 × 10(-5, n = 74, and the association of XRCC4-rs13180356 with SGC was strongest for adenoid cystic carcinoma (OR = 0.60, 95% CI: 0.42-0.87, P = 6.91 × 10(-3, n = 123. Gene-level association analysis revealed one gene, PRKDC, with a marginally significant association with SGC risk in non-Hispanic whites. To our knowledge, this study is the first to comprehensively evaluate the genetic effect of DSB repair genes on SGC risk. Our results indicate that genetic variants in the DSB repair pathways contribute to inter-individual differences in susceptibility to SGC and show that the impact of genetic variants differs by histological subtype. Independent studies are warranted to confirm these findings.

  13. Clinical problems of colorectal cancer and endometrial cancer cases with unknown cause of tumor mismatch repair deficiency (suspected Lynch syndrome

    Directory of Open Access Journals (Sweden)

    Buchanan DD

    2014-10-01

    Full Text Available Daniel D Buchanan,1,2 Christophe Rosty,1,3,4 Mark Clendenning,1 Amanda B Spurdle,5 Aung Ko Win2 1Oncogenomics Group, Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Parkville, VIC, Australia; 2Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia; 3Envoi Specialist Pathologists, Herston, QLD, Australia; 4School of Medicine, University of Queensland, Herston, QLD, Australia; 5Molecular Cancer Epidemiology Laboratory, Genetics and Computational Biology Division, QIMR Berghofer Medical Research Institute, Herston, QLD, AustraliaAbstract: Carriers of a germline mutation in one of the DNA mismatch repair (MMR genes have a high risk of developing numerous different cancers, predominantly colorectal cancer and endometrial cancer (known as Lynch syndrome. MMR gene mutation carriers develop tumors with MMR deficiency identified by tumor microsatellite instability or immunohistochemical loss of MMR protein expression. Tumor MMR deficiency is used to identify individuals most likely to carry an MMR gene mutation. However, MMR deficiency can also result from somatic inactivation, most commonly methylation of the MLH1 gene promoter. As tumor MMR testing of all incident colorectal and endometrial cancers (universal screening is becoming increasingly adopted, a growing clinical problem is emerging for individuals who have tumors that show MMR deficiency who are subsequently found not to carry an MMR gene mutation after genetic testing using the current diagnostic approaches (Sanger sequencing and multiplex ligation-dependent probe amplification and who also show no evidence of MLH1 methylation. The inability to determine the underlying cause of tumor MMR deficiency in these "Lynch-like" or "suspected Lynch syndrome" cases has significant implications on the clinical management of these individuals and their relatives. When the

  14. Bladder exstrophy repair

    Science.gov (United States)

    Bladder birth defect repair; Everted bladder repair; Exposed bladder repair; Repair of bladder exstrophy ... Bladder exstrophy repair involves two surgeries. The first surgery is to repair the bladder and the second one is to attach ...

  15. Prosthetic repair of umbilical hernias in adults with local anesthesia in a day-case setting: a comprehensive report from a specialized hernia center.

    Science.gov (United States)

    Kulacoglu, H; Yazicioglu, D; Ozyaylali, I

    2012-04-01

    Umbilical hernia is a common surgical problem. However, there seems to be a certain discrepancy between its importance and the attention it has received in the literature to date. This prospective study aimed to report a detailed analysis of prosthetic umbilical hernia repairs with local anesthesia in a day-case setting. It was planned to enroll 100 consecutive patients who underwent an elective umbilical hernia repair with local anesthesia. Patients who required general anesthesia and simultaneous hernia repairs were excluded. The procedure including local anesthesia and intravenous sedation was explained to the patients in detail by the operating surgeons and the anesthesiologist. The following parameters were strictly recorded: gender, age, body mass index (BMI), concomitant diseases, history of hernia (primary/recurrent), size of fascial defect, duration of operation, level of intravenous sedation (light/moderate), discharge time, and complications. There were 54 male and 46 female patients. The mean age was 48.6 years (24-78 years). Four patients were older than 70 years of age. Forty-one patients had 84 concomitant diseases. Eleven patients had a recurrent hernia. Female patients more frequently presented with a recurrent hernia than male patients (19.6 vs. 3.7%, P = 0.009). A standard polypropylene mesh was used in the onlay position in 91 cases. In nine cases, a light mesh was placed in the preperitoneal space. A closed vacuum drain was left in situ in 37 cases. Light sedation was set in 86 cases, whereas 12 patients received a moderate sedation. Monitored anesthesia care was used in two cases. When moderate sedation was needed, a concurrent increase in lidocaine dose and total volume was recorded. There was a positive correlation between increased lidocaine use and high midazolam dose and additional propofol requirement. The mean total local anesthetic volume was 33 ml (10-63 ml). Lidocaine doses displayed a large range between the cases (70-600 mg). The

  16. 80 cases of laparoscopic inguinal hernia repair%腹腔镜腹股沟疝修补术80例

    Institute of Scientific and Technical Information of China (English)

    夏云; 王震

    2015-01-01

    Objective To summarize the clinical effect and value of laparoscopic inguinal hernia repair. Methods From January 2011 to October 2011, 80 cases of inguinal hernia patients who were admitted to People's Hospital of Xishuangbanna were performed with laparoscopic inguinal hernia repair, including 40 cases of transabdominal preperitoneal (TAPP) and 40 cases of totally extraperitoneal (TEP). The clinical data, such as operation time, length of hospital stay and complications, were retrospectively analyzed. Results All operations were successful without any conversion. Operation time was (45. 0 ± 5. 0) minutes for TAPP group and 45. 0±3. 0 min for TEP group. The difference was not statistically (t =11. 14, P=0. 153). There were also no differences in length of hospital stay (t = 15. 25, P = 0. 128) and scrotal hematoma (χ2 = 6. 85, P=0. 087). While, two and five cases of urinary retention occurred in TAPP and TEP group with significant difference (χ2 = 13. 10, P=0. 000), respectively. TAPP group had 2 cases of groin pain (none in TEP group, χ2 = 8. 15, P=0. 000), which were reliefed in 2 weeks. With following up for 3 to 18 months, there was no recurrence. Conclusion Laparoscopic inguinal hernia repair surgery has short operation time, less hospital stay, fewer complications and lower recurrence and pain, and can also find occult hernias in the procedure at the same time, to avoid the secondary surgery. It is suitable for the treatment of inguinal hernia.%目的:总结腹腔镜腹股沟疝修补术的临床效果与价值。方法采集2011年1月至2014年10月,云南省西双版纳州医院收治的腹股沟疝患者80例,随机分为经腹腹膜前疝修补术(TAPP)组和完全腹膜外疝修补术(TEP)组,每组患者40例。对二组患者的手术时间、住院时间、并发症等临床资料进行回顾性分析。结果本组80例患者手术顺利,无中转开放手术。 TAPP 组平均手术时间(45.0±5.0)min,TEP 组平均手术时间(45.0±3.0) min

  17. Operation of Finnish nuclear power plants. Quarterly report, 3rd quarter 1996

    Energy Technology Data Exchange (ETDEWEB)

    Sillanpaeae, T. [ed.

    1997-02-01

    Quarterly Reports on the operation of Finnish nuclear power plants describe events and observations relating to nuclear and radiation safety which the Finnish Centre for Radiation and Nuclear Safety (STUK) considers safety significant. Safety improvements at the plants are also described. The Report also includes a summary of the radiation safety of plant personnel and of the environment and tabulated data on the plants` production and load factors. In the third quarter of 1996, the Finnish nuclear power plant units were in power operation except for the annual maintenance outages of Loviisa plant units and a shutdown at Olkiluoto 1 to identify and repair malfunctions of a high pressure turbine control valve. The load factor average of all plant units was 77.2%. Events in the third quarter of 1996 were classified level 0 on the International Nuclear Event Scale. Occupational doses and radioactive releases off-site were below authorised limits. Radioactive substances were measurable in samples collected around the plants in such quantities only as have no bearing on the radiation exposure of the population. The names of Teollisuuden Voima Oy`s plant units have changed. Olkiluoto 1 and Olkiluoto 2 now replace the names TVO I and TVO II previously used in quarterly reports. (orig.).

  18. Rapid bone repair in a patient with lung cancer metastases to the spine using a novel herbal medicine: A case report

    OpenAIRE

    2016-01-01

    The prognosis of lung carcinoma with metastasis to the bone, particularly to the spine, is poor. Chemotherapy and radiotherapy are established treatments for metastatic bone disease, but their effectiveness is unsatisfactory and bone repair following their use is slow and difficult. Medicine prepared from herbal extracts may be an alternative treatment option. The present study discusses the case of a 59-year-old patient diagnosed with squamous cell lung cancer (T2N3M1) in which first-line ch...

  19. Laparoscopic repair of postoperative perineal hernia.

    LENUS (Irish Health Repository)

    Ryan, Stephen

    2010-01-01

    Perineal hernias are infrequent complications following abdominoperineal operations. Various approaches have been described for repair of perineal hernias including open transabdominal, transperineal or combined abdominoperineal repairs. The use of laparoscopic transabdominal repair of perineal hernias is not well-described. We present a case report demonstrating the benefits of laparoscopic repair of perineal hernia following previous laparoscopic abdominoperineal resection (APR) using a nonabsorbable mesh to repair the defect. We have demonstrated that the use of laparoscopy with repair of the pelvic floor defect using a non absorbable synthetic mesh offers an excellent alternative with many potential advantages over open transabdominal and transperineal repairs.

  20. When is mesh fixation in TAPP-repair of primary inguinal hernia repair necessary? The register-based analysis of 11,230 cases.

    Science.gov (United States)

    Mayer, F; Niebuhr, H; Lechner, M; Dinnewitzer, A; Köhler, G; Hukauf, M; Fortelny, R H; Bittner, R; Köckerling, F

    2016-10-01

    Whereas for TEP the guidelines do not recommend mesh fixation on the basis of meta-analyses regardless of the defect size, for TAPP mesh fixation can be omitted only up to a defect size of 3 cm because of the paucity of studies on this topic. Hence, this study now seeks to explore this subject on the basis of prospective data from the Herniamed Hernia Registry. In the period September 01, 2009, to January 31, 2014, 11,228 male patients were operated on with the TAPP technique for a primary unilateral inguinal hernia and were followed up for 1 year. Mesh fixation was used for 7422 (66.1 %) of these patients and no mesh fixation for 3806 patients (33.9 %). Unadjusted analysis did not find any significant difference in the recurrence rate (0.88 % with fixation vs. 1.1 % without fixation; p = 0.259). Multivariable analysis of all potential influence factors (age, ASA, BMI, risk factors, defect size, mesh fixation, localization of defect, mesh size) did not identify any factor that impacted recurrence on 1-year follow-up. Only for medial and combined defect localization versus lateral localization was a highly significant effect identified (p < 0.001). With mesh fixation and larger mesh size, it was possible to significantly reduce the recurrence rate for larger medial hernias in this series (p = 0.046). For TAPP repair of an inguinal hernia, mesh fixation is not necessary in a significant number of patients. Patients with a medial and combined hernia are at higher risk of recurrence. In the patient series analyzed, it was possible to significantly reduce the recurrence rate with mesh fixation and larger mesh size for medial defects.

  1. Quarterly environmental data summary for first quarter 1999

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-06-01

    In support of the Weldon Spring Site Remedial Action Project Federal Facilities Agreement, a copy of the Quarterly Environmental Data Summary (QEDS) for the first quarter of 1999 is enclosed. The data presented in this constitute the QEDS. The data, except for air monitoring data and site KPA generated data (uranium analyses), were received from the contract laboratories, verified by the Weldon Spring Site verification group and merged into the database during the first quarter of 1999. KPA results for on-site total uranium analyses performed during first quarter 1999 are included. Air monitoring data presented are the most recent complete sets of quarterly data.

  2. Quarterly fiscal policy

    NARCIS (Netherlands)

    Kendrick, D.A.; Amman, H.M.

    2014-01-01

    Monetary policy is altered once a month. Fiscal policy is altered once a year. As a potential improvement this article examines the use of feedback control rules for fiscal policy that is altered quarterly. Following the work of Blinder and Orszag, modifications are discussed in Congressional

  3. Quarterly Technical Progress Report

    Energy Technology Data Exchange (ETDEWEB)

    Ayman I. Hawari

    2002-12-30

    This report presents the progress made during the first quarter of phase 2 for the project entitled ''Development and Validation of Thermal Neutron Scattering Laws from Applications and Safety Implications in Generation IV Reactor Designs.'' (B204) THIS IS NOT A FINAL REPORT

  4. Salvage hypospadias repairs

    Directory of Open Access Journals (Sweden)

    Sripathi V

    2008-01-01

    Full Text Available Aim: Review of our experience and to develop an algorithm for salvage procedures in the management of hypospadias cripples and treatment of urethral strictures following hypospadias repair. Methods: This is a retrospective review of hypospadias surgeries over a 41-month period. Out of a total 168 surgeries, 20 were salvage/re-operative repairs. In three children a Duplay repair was feasible, while in four others a variety of single-stage repairs could be done. The repair was staged in seven children - buccal mucosal grafts (BMGs in five, buccal mucosal tube in one, and skin graft in one. Five children with dense strictures were managed by dorsal BMG inlay grafting in one, vascularized tunical onlay grafting on the ventrum in one, and a free tunical patch in one. Three children were treated by internal urethrotomy and stenting for four weeks with a poor outcome. Results: The age of children ranged from 1.5-15 years (mean 4.5. Follow-up ranged from 3 months to 3.5 years. Excellent results were obtained in 10 children (50% with a well-surfaced erect penis and a slit-like meatus. Glans closure could not be achieved and meatus was coronal in three. Two children developed fistulae following a Duplay repair and following a staged BMG. Three repairs failed completely - a composite repair broke down, a BMG tube stenosed with a proximal leak, and a stricture recurred with loss of a ventral free tunical graft. Conclusions: In salvage procedures performed on hypospadias cripples, a staged repair with buccal mucosa as an inlay in the first stage followed by tubularization 4-6 months later provides good results. A simple algorithm to plan corrective surgery in failed hypospadias cases and obtain satisfactory results is devised.

  5. Transvaginal early fistula debridement and repair plus continuous vacuum aspiration via anal tube for rectovaginal fistula following rectal cancer surgery: report of four cases.

    Science.gov (United States)

    Luo, Guo-De; Cao, Yong-Kuan; Wang, Yong-Hua; Zhang, Guo-Hu; Wang, Pei-Hong; Gong, Jia-Qing

    2014-01-01

    To investigate the feasibility and superiority of transvaginal early fistula debridement and repair plus continuous vacuum aspiration via anal tube for rectovaginal fistula following rectal cancer surgery. The clinical data of four cases of rectovaginal fistula following rectal cancer surgery were retrospectively analyzed in our center. After adequate preoperative preparation, the patients underwent transvaginal fistula debridement and repair plus continuous vacuum aspiration via anal tube under continuous epidural anesthesia. After surgery and before discharge, anti-infection and nutritional support was administered for 2 d, and fluid diet and anal tube vacuum aspiration continued for 7 d. All the four cases healed. Three of them healed after one operation, and the other patient had obvious shrinkage of the fistular orifice after the first operation and underwent the same operation for a second time before complete healing. The duration of postoperative follow-up was 2, 7, 8 and 9 months respectively. No recurrence or abnormal sex life was reported. Early transvaginal fistula debridement and repair plus continuous vacuum aspiration via anal tube are feasible for rectovaginal fistula following rectal cancer surgery. This operation has many advantages, such as minimal invasiveness, short durations of operation, short treatment cycles, and easy acceptance by the patient. In addition, it does not necessitate colostomy for feces shunt and a secondary colostomy and reduction.

  6. The role of repair in the survival of mammalian cells from heavy ion irradiation - Approximation to the ideal case of target theory

    Science.gov (United States)

    Lett, J. T.; Cox, A. B.; Story, M. D.

    1989-01-01

    Experiments are discussed in which the cell-cycle dependency of the repair deficiency of the S/S variant of the L5178Y murine leukemic lymphoblast was examined by treatment with the heavy ions, Ne-20, Si-28, Ar-40, Fe-56, and Nb-93. Evidence from those studies provide support for the notion that as the linear energy transfer of the incident radiation increases the ability of the S/S cell to repair radiation damage decreases until it is eliminated around 500 keV/micron. In the region of the latter linear energy transfer value, the behavior of the S/S cell approximates the ideal case of target theory where post-irradiation metabolism does not influence cell survival.

  7. Surgical repair of central slip avulsion injuries with Mitek bone anchor--retrospective analysis of a case series.

    LENUS (Irish Health Repository)

    Chan, Jeffrey C Y

    2007-01-01

    The purpose of this study is to describe our technique of central slip repair using the Mitek bone anchor and to evaluate the treatment outcome. Eight digits in eight patients were reconstructed using the bone anchor: three little fingers, two middle fingers, two index fingers and one ring finger. There were two immediate and six delayed repairs (range from one day to eight months). Four patients had pre-operative intensive splinting and physiotherapy to restore passive extension of the proximal interphalangeal joint prior to central slip reconstruction. All patients have made good progress since surgery. No patient requires a second procedure and none of the bone anchors have dislodged or loosened. We conclude that the Mitek bone anchor is a reliable technique to achieve soft tissue to bone fixation in central slip avulsion injuries. We recommend that this technique be considered as a treatment option for patients requiring surgical repair.

  8. 26 CFR 40.6071(a)-3 - Time for an eligible air carrier to file a return for the third calendar quarter of 2001.

    Science.gov (United States)

    2010-04-01

    ... return for the third calendar quarter of 2001. 40.6071(a)-3 Section 40.6071(a)-3 Internal Revenue... calendar quarter of 2001. (a) In general. If, in the case of an eligible air carrier, the quarterly return required under § 40.6011(a)-1(a) for the third calendar quarter of 2001 includes tax imposed by...

  9. Using RFID Tagging in a Mining Industry Maintenance, Repair, and Operating (MRO) Supply Warehouse: A Case Study

    Science.gov (United States)

    Smith, George D.

    2008-01-01

    The use of Radio Frequency Identification (RFID) technology has been shown to be successful by reducing operating costs in the retail and manufacturing industries, but has never been considered in the literature for a mining industry maintenance, repair, and operating (MRO) supply chain. This field study was conducted to determine whether or not…

  10. A case of single atrium and single ventricle physiology with bilateral cleft lip and palate for lip repair surgery

    Directory of Open Access Journals (Sweden)

    Rakhee Goyal

    2012-01-01

    Full Text Available Bilateral cleft lip and palate may occasionally be associated with complex congenital cyanotic heart disease. An infant with common atrium and single ventricle with infundibular pulmonary stenosis (Blalock-Taussig shunt done recently presented for lip repair surgery. Balanced general anesthesia was administered using sevoflurane along with a regional nerve block to maintain optimal pulmonary and systemic vascular resistance.

  11. Using RFID Tagging in a Mining Industry Maintenance, Repair, and Operating (MRO) Supply Warehouse: A Case Study

    Science.gov (United States)

    Smith, George D.

    2008-01-01

    The use of Radio Frequency Identification (RFID) technology has been shown to be successful by reducing operating costs in the retail and manufacturing industries, but has never been considered in the literature for a mining industry maintenance, repair, and operating (MRO) supply chain. This field study was conducted to determine whether or not…

  12. Physiotherapeutic attendance after repairing surgeries of lesions by brown spider: a case report - doi:10.5020/18061230.2007.p133

    Directory of Open Access Journals (Sweden)

    Ricardo Marques Frezza

    2012-01-01

    Full Text Available The loxoscelism is the most serious form of arachnidism in Brazil. The genus Loxosceles comprises more than 100 species of spiders in African and American continents. In Brazil, they are known as brown spiders. Nevertheless the great incidence of occurrence, few are the reports about repairing procedures, specially related to Physiotherapy after surgeries due to dermonecrosis. The aim of this case report was to register the Physiotherapeutic attendance of a female patient, 29 years old, victim of loxoscelism and who underwent debridement and skin transplantation for repairing right forearm lesions while she was interned at a hospital. Afterwards, data were confronted with the literature about loxoscelism, burns and Physiotherapy after skin transplantation. It is concluded that the patients with lesions caused by loxoscelism, who need repairing surgeries, may benefit a lot from Physiotherapeutic attendance while still at hospital. Although, factors such as: the lesion’s location, the cicatrization period, the number and complexity of surgeries, may be decisive for this indication.

  13. Hypospadias repair

    Science.gov (United States)

    ... the problem. If the repair is not done, problems may occur later on such as: Difficulty controlling and directing urine stream A curve in the penis during erection Decreased fertility Embarrassment about appearance of penis Surgery ...

  14. Gracilis muscle interposition with primary rectal without urethral repair for moderate sized rectourethral fistula caused by brachytherapy for prostate cancer: a case report

    Directory of Open Access Journals (Sweden)

    Samalavicius Narimantas

    2012-09-01

    Full Text Available Abstract Introduction There is a 0.16% chance of a rectourethral fistula after prostate brachytherapy monotherapy using Palladium-103 or Iodine-125 implants. We present an unusual case report of a rectourethral fistula following brachyradiotherapy monotherapy for prostate adenocarcinoma. It was also associated with unusual management of the fistula. Case presentation A 58-year-old Caucasian man underwent brachyradiotherapy monotherapy as definitive treatment for verified intracapsular prostate adenocarcinoma receiving 56 Iodine-125 implants using a transrectal ultrasound-guided technique. The patient started to complain of severe perineal pain and mild rectal bleeding 15Â months after brachyradiotherapy. A biopsy of mucosa of his anterior rectal wall was performed. A moderate sized rectourethral fistula was confirmed 23Â months after implantation of Iodine-125 seeds. Laparoscopic sigmoidostomy and suprapubic cystostomy were then performed. Long-term cortisone applications in combination with 30 sessions of hyperbaric oxygen therapy, and antibacterial therapies were initiated due to necrotic infection. A gracilis muscle interposition to create a partition between the patient's rectum and urethra in conjunction with primary rectal repair but without urethral repair were performed 6 months later. The 3cm rectal defect was repaired via a 3cm-long horizontal perineal incision. The 1.5cm urethral defect just below the prostate was not repaired. The patient underwent an optic internal urethrotomy 3Â months later for a 1.5cm-long urethral stricture. Several planned preventive urethral buginages were performed to avoid urethral stricture recurrence. At 12Â months postoperatively, there were no signs of a fistula and cancer recurrence. He now has a normal voiding and anal continence. Conclusion Severe rectal pain, bleeding, and local anterior necrotic proctitis are predictors of a rectourethral fistula. Urinary and fecal diversion is the first

  15. Feasibility and safety of on table extubation after corrective surgical repair of tetralogy of Fallot in a developing country: A case series

    Directory of Open Access Journals (Sweden)

    Mohammad Irfan Akhtar

    2015-01-01

    Full Text Available Fast-track extubation is an established safe practice in pediatric congenital heart disease (CHD surgical patients. On table extubation (OTE in acyanotic CHD surgical patients is well established with validated safety profile. This practice is not yet reported in tetralogy of Fallot (TOF cardiac surgical repair patients in developing countries. Evidence suggests that TOF total correction patients should be extubated early, as positive pressure ventilation has a negative impact on right ventricular function and the overall increase in post-TOF repair complications such as low cardiac output state and arrhythmias. The objective of the case series was to determine the safety and feasibility of OTE in elective TOF total correction cardiac surgical patients with an integrated team approach. To the best of our knowledge, this is the first reported case series. A total of 8 elective male and female TOF patients were included. Standard anesthetic, surgical and perfusion techniques were used in these procedures. All patients were extubated in the operating room safely without any complications with the exception of one patient who continued to bleed for 3 h of postextubation at 2-3 ml/kg/h which was managed with transfusion of fresh frozen plasma at 15 mL/kg, packed red blood cells 10 mL/kg and bolus of transamine at 20 mg/kg. Apart from better surgical and bypass techniques, the most important factor leading to successful OTE was an excellent analgesia. On the basis of the case series, it is suggested to extubate selected TOF cardiac surgery repair patients on table safely with integrated multidisciplinary approach.

  16. Feasibility and safety of on table extubation after corrective surgical repair of tetralogy of Fallot in a developing country: a case series.

    Science.gov (United States)

    Akhtar, Mohammad Irfan; Hamid, Mohammad; Minai, Fauzia; Rehman, Naveed

    2015-01-01

    Fast-track extubation is an established safe practice in pediatric congenital heart disease (CHD) surgical patients. On table extubation (OTE) in acyanotic CHD surgical patients is well established with validated safety profile. This practice is not yet reported in tetralogy of Fallot (TOF) cardiac surgical repair patients in developing countries. Evidence suggests that TOF total correction patients should be extubated early, as positive pressure ventilation has a negative impact on right ventricular function and the overall increase in post-TOF repair complications such as low cardiac output state and arrhythmias. The objective of the case series was to determine the safety and feasibility of OTE in elective TOF total correction cardiac surgical patients with an integrated team approach. To the best of our knowledge, this is the first reported case series. A total of 8 elective male and female TOF patients were included. Standard anesthetic, surgical and perfusion techniques were used in these procedures. All patients were extubated in the operating room safely without any complications with the exception of one patient who continued to bleed for 3 h of postextubation at 2-3 ml/kg/h which was managed with transfusion of fresh frozen plasma at 15 mL/kg, packed red blood cells 10 mL/kg and bolus of transamine at 20 mg/kg. Apart from better surgical and bypass techniques, the most important factor leading to successful OTE was an excellent analgesia. On the basis of the case series, it is suggested to extubate selected TOF cardiac surgery repair patients on table safely with integrated multidisciplinary approach.

  17. Simultaneous endovascular repair of an iatrogenic carotid-jugular fistula and a large iliocaval fistula presenting with multiorgan failure: a case report

    Directory of Open Access Journals (Sweden)

    Yuminaga Yuigi

    2012-01-01

    Full Text Available Abstract Introduction Iliocaval fistulas can complicate an iliac artery aneurysm. The clinical presentation is classically a triad of hypotension, a pulsatile mass and heart failure. In this instance, following presentation with multiorgan failure, management included the immediate use of an endovascular stent graft on discovery of the fistula. Case presentation A 62-year-old Caucasian man presented to our tertiary hospital for management of iatrogenic trauma due to the insertion of a central venous line into his right common carotid artery, causing transient ischemic attack. Our patient presented to a peripheral hospital with fever, nausea, vomiting, acute renal failure, acute hepatic dysfunction and congestive heart failure. A provisional diagnosis of sepsis of unknown origin was made. There was a 6.5 cm×6.5 cm right iliac artery aneurysm present on a non-contrast computed tomography scan. An unexpected intra-operative diagnosis of an iliocaval fistula was made following the successful angiographic removal of the central line to his right common carotid artery. Closure of the iliocaval fistula and repair of the iliac aneurysm using a three-piece endovascular aortic stent graft was then undertaken as part of the same procedure. This was an unexpected presentation of an iliocaval fistula. Conclusion Our case demonstrates that endovascular repair of a large iliac artery aneurysm associated with a caval fistula is safe and effective and can be performed at the time of the diagnostic angiography. The presentation of an iliocaval fistula in this case was unusual which made the diagnosis difficult and unexpected at the time of surgery. The benefit of immediate repair, despite hemodynamic instability during anesthesia, is clear. Our patient had two coronary angiograms through his right femoral artery decades ago. Unusual iatrogenic causes of iliocaval fistulas secondary to previous coronary angiograms with wire and/or catheter manipulation should be

  18. Sankt Jørgenbjerg in Roskilde - A gentified quarter?

    OpenAIRE

    Ball, Melanie; Dominguez Blanco, Benito Jesus; Rochau, Maike; Sabatino, Virginie

    2005-01-01

    The project analyses if gentrification is also taking place in, or has been taken place in other cities' quarters than the ones of the metropolises (New York, London, etc.) who often are the basis for hypothesis and theories on gentrification. After a discussion of approaches, Roskilde as a medium sized city and here especially the quarter Skt. Jørgensbjerg are taken into focus for the case study. A questionnaire and its analyse help to draw a picture of the quarter and its inhabitants. I...

  19. A Case of Heel Cord Pain After Repair of Acute Achilles Tendon Rupture: Treated by Endoscopic Adhesiolysis of the Achilles Tendon.

    Science.gov (United States)

    Lui, Tun Hing

    2016-10-01

    The causes of heel cord pain after repair of acute rupture of the Achilles tendon are unclear. The proposed etiologies include nonabsorbable suture granuloma formation, alteration of the pain receptors threshold in the tendon, and distension of the paratenon by the hypertrophied tendon, underlying tendinopathy, postrepair neovascularization, and peritendinous fibrous adhesion. We present an endoscopic technique of adhesiolysis of the Achilles tendon to deal with the various possible causes of postrepair heel cord pain. Therapeutic, Level 4: Case report. © 2015 The Author(s).

  20. A Rare Complication of Spinal Cord Ischemia Following Endovascular Aneurysm Repair of an Infrarenal Abdominal Aortic Aneurysm with Arteriosclerosis Obliterans: Report of a Case

    Science.gov (United States)

    Matsumoto, Takuya; Matsubara, Yutaka; Inoue, Kentaro; Aoyagi, Yukihiko; Matsuda, Daisuke; Tanaka, Shinichi; Okadome, Jun; Maehara, Yoshihiko

    2016-01-01

    We herein report a case of a rare complication of spinal cord ischemia (SCI) following endovascular aneurysm repair (EVAR). Computed tomography showed stenosis and calcification of bilateral iliac arteries and a saccular aneurysm of the terminal aorta. Paraplegia occurred soon after balloon angioplasty of iliac arteries and EVAR. Cerebrospinal fluid drainage was not performed because the patient was on dual antiplatelet drugs. The patient was treated with intravenous methylpredonisolone and naloxone; however, this did not improve his paraplegia. SCI after EVAR is extremely rare and unpredictable complication, however, physicians should be aware of SCI after EVAR in patients with atherosclerosis. PMID:27738476

  1. Endovascular treatment of type II endoleak following thoracic endovascular aortic repair for thoracic aortic aneurysm: Case report of squeeze technique to reach the aneurysmal sac

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Hyun Jung; Kim, Chang Won; Lee, Tae Hong; Song, Seung Hwan; Lee, Chung Won; Chung, Sung Woon [Pusan National University Hospital, School of Medicine, Pusan National University, Busan (Korea, Republic of)

    2014-12-15

    Type II endoleaks are common after thoracic endovascular aortic repair (TEVAR). Various strategies are introduced to manage type II endoleaks, such as the use of coils, plugs, or liquid embolic agents (histoacryl, thrombin, onyx, etc.) through a transarterial approach or a direct puncture of the aneurysmal sac. We herein report a case of a type II endoleak caused by reverse blood flow through intercostal artery after TEVAR which was successfully treated with n-butyl cyanoacrylate (histoacryl)-lipiodol mixture by a squeeze technique to reach the aneurismal sac using a microcatheter.

  2. Anaesthesia for a Rare Case of Down’s Syndrome with Morgagni’s Hernia Undergoing Laparoscopic Repair

    Science.gov (United States)

    Marulasiddappa, Vinay

    2015-01-01

    Morgagni’s hernia is a type of congenital diaphragmatic hernia and it is rare in children. The association between Down’s syndrome and Morgagni’s hernia in children is also rare. Laparoscopic repair is a preferred surgical approach than open surgical procedures as laparoscopy offers a bilateral view of Morgagni’s hernia, minimal tissue damage and a faster recovery. When children with Down’s syndrome and associated Morgagni’s hernia present for laparoscopic repair, they pose several complex challenges to the anaesthetist due to the involvement of multiple organ systems, difficulties in airway management and effects of laparoscopic surgery on the organ systems. Therefore, such children need a very careful anaesthetic plan, including a thorough preoperative assessment and preparation for a successful perioperative outcome. PMID:26155537

  3. Repairing skull defects in children with nano-hap/collagen composites:A clinical report of thirteen cases

    Institute of Scientific and Technical Information of China (English)

    Tuoyu Chen; Fuzhai Cui; Yuqi Zhang; Huancong Zuo; Yapeng Zhao; Chaoqiang Xue; Bin Luo; Qinglin Zhang; Jin Zhu; Xiumei Wang

    2016-01-01

    Objective: To evaluate the clinical results of repairing skull defects with biomimetic bone (nano-hap/collagen composites, NHACs) in children. Methods:Thirteen children with skull defects were treated with NHACs in our hospital. The NHACs molded with the help of a 3D printer were used in the operations. Results: All 13 operations were successful, and patients recovered without infection. Only one patient suffered from subcutaneous hydrops post-operation. The implanted NHACs remained fixed well after 1 year, and their CT HU values raised gradually. Skull shapes of children developed normally. Recovery of neurological and cognitive function was significant. Conclusions:NHAC, chosen to repair skull defects in children, can coexist with normal skull and reduce the negative effects on growth and development. NHAC could be a good choice for children with skull defects.

  4. [A Case of General Anesthesia for a Cardiac Transplanted Patient Undergoing Inguinal Hernia Repair under Laparoscopic Surgery].

    Science.gov (United States)

    Inoue, Mitsuko; Hayashi, Yasue; Fujita, Yuki; Shimizu, Motoko; Hotta, Arisa; Nakamoto, Ai; Yoshikawa, Noriko; Ohira, Naoko; Tatekawa, Shigeki

    2016-04-01

    A 52-year-old man was scheduled for the repair of inguinal hernia recurrence. When he was 48 years of age, he received a heart transplantation due to severe heart failure resulting from ischemic heart disease. When he was 50 years old, he suffered from inguinal hernia, and it was repaired under spinal anesthesia. During this surgery, he experienced pain because of the inadequate effect of anesthesia, but his blood pressure and heart rate were stable. We suspected that this was because of denervation of the heart. On hernia repair for inguinal hernia recurrence, general anesthesia was chosen, induced with midazolam, rocuronium, and fentanyl and maintained with sevoflurane, rocuronium, fentanyl, and remifentanil. The blood pressure was mostly stable during anesthesia, but we noted an increase in the heart rate when the trachea was intubated and extubated and when surgical incision started. This phenomenon may indicate reinnervation of the transplanted heart. We could safely manage anesthesia without invasive monitoring because the transplanted heart functioned favorably and surgery was minimally invasive.

  5. 20 CFR 404.146 - When a calendar quarter cannot be a quarter of coverage.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false When a calendar quarter cannot be a quarter...-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Insured Status and Quarters of Coverage Quarters of Coverage § 404.146 When a calendar quarter cannot be a quarter of coverage. This section applies when...

  6. Femoral hernia repair

    Science.gov (United States)

    Femorocele repair; Herniorrhaphy; Hernioplasty - femoral ... During surgery to repair the hernia, the bulging tissue is pushed back in. The weakened area is sewn closed or strengthened. This repair ...

  7. Undescended testicle repair

    Science.gov (United States)

    Orchidopexy; Inguinal orchidopexy; Orchiopexy; Repair of undescended testicle; Cryptorchidism repair ... first year of life without treatment. Undescended testicle repair surgery is recommended for patients whose testicles do ...

  8. Minimally disruptive schedule repair for MCM missions

    Science.gov (United States)

    Molineaux, Matthew; Auslander, Bryan; Moore, Philip G.; Gupta, Kalyan M.

    2015-05-01

    Mine countermeasures (MCM) missions entail planning and operations in very dynamic and uncertain operating environments, which pose considerable risk to personnel and equipment. Frequent schedule repairs are needed that consider the latest operating conditions to keep mission on target. Presently no decision support tools are available for the challenging task of MCM mission rescheduling. To address this capability gap, we have developed the CARPE system to assist operation planners. CARPE constantly monitors the operational environment for changes and recommends alternative repaired schedules in response. It includes a novel schedule repair algorithm called Case-Based Local Schedule Repair (CLOSR) that automatically repairs broken schedules while satisfying the requirement of minimal operational disruption. It uses a case-based approach to represent repair strategies and apply them to new situations. Evaluation of CLOSR on simulated MCM operations demonstrates the effectiveness of case-based strategy. Schedule repairs are generated rapidly, ensure the elimination of all mines, and achieve required levels of clearance.

  9. 腹横筋膜与腹膜前疝修补术103例分析%Transverse fascia and extraperitoneal inguinal hernia repair in 103 cases

    Institute of Scientific and Technical Information of China (English)

    陈若飞; 蒲建元; 陈伟

    2013-01-01

    目的 重新认识腹横筋膜的解剖特点,从解剖学角度探讨腹膜前疝修补术的合理性.方法 对术中腹横筋膜以及腹膜前间隙的解剖观察,回顾性分析腹膜前修补腹股沟疝103例的临床资料.结果 耻骨肌孔由腹横筋膜的前层覆盖,腹横筋膜由两层构成,腹壁下血管位于两层之间.3种方法放置的补片在不同的腹膜前间隙覆盖耻骨肌孔.103例均成功,无切口感染、髂腹股沟神经痛病例.术后随访1~6年无复发.结论 从解剖学特点看,覆盖耻骨肌孔的腹膜前疝修补具有合理性.前后入路腹膜前疝修补补片放置的间隙不同.%Objective To investigate the clinical rationality and characteristics of extraperitoneal inguinal hernia repair,and the anatomical features of transverse fascia was defined accurately.Methods The clinical data of 103 cases with extraperitoneal inguinal hernia repair were retrospectively analyzed,the transverse fascia and the preperitoneal space were observed.Results The preperitoneal space and inferior epigastric vessels are between the anterior and posterior laminae of the transversus fascia.The mesh was placed in the preperitoneal space and covered myopectineal office.All 103 cases recieved extraperitoneal inguinal hernia repair were successful,no complications occurred.There was no recurrence during the follow-up of 1 ~6 years.Conclusion From the view of preperitoneal groin anatomy,extraperitoneal inguinal hernia repair is an effective method in performing herniorrhaphy.

  10. [Mitral valve repair for mitral regurgitation induced by infective endocarditis complicated with ulcerative colitis; report of a case].

    Science.gov (United States)

    Shiraishi, Shoichiro; Koike, Masato; Aoshima, Minoru; Asai, Tohru

    2014-05-01

    Infective endocarditis is a rare complication of ulcerative colitis. We report on a 22-year-old man, who had been treated of ulcerative colitis for 5 years. He presented with dyspnea on effort. In spite of medical treatment, he developed congestive heart failure. Transthoracic echocardiography showed a large perforation on the anterior leaflet of the mitral valve, and prolapses of the posterior leaflet of the mitral valve with rupture of the chordae. The patient underwent mitral valve repair with an autologous pericardial patch on the anterior leaflet combined with butterfly resection and suture of the posterior leaflet. The postoperative course was uneventful.

  11. Laparoscopic repair of Morgagni hernia and cholecystectomy in a 40-year-old male with Down's sindrome. Report of a case.

    Science.gov (United States)

    De Paolis, P; Mazza, L; Maglione, V; Fronda, G R

    2007-06-01

    Morgagni-Larrey hernia (MH) is an unusual diaphragmatic hernia of the retrosternal region. Few cases of MH, treated laparoscopically, associated with Down's syndrome (DS) have been reported in literature. On October 2004, a DS 40-year-old male was admitted to our Department with mild abdominal pain and nausea. Hematochemical tests were within the normal range. Ultrasonography showed biliary sludge and multiple gallstones. Chest X-ray revealed a right-sided paracardiac mass that appeared as MH after a thoraco-abdominal computed tomography (CT). Four trocars were placed as a routinary cholecystectomy. Abdominal exploration confirmed the presence of a voluminous hernia through a wide diaphragmatic defect (12 cm) on the left side of the falciform ligament, containing the last 20 cm ileal loops and right colon with the third lateral of transverse. After retrograde cholecystectomy and reduction of the herniated ileo-colonic tract from multiple adherences, the defect was repaired with an interrupted 2/0 silk suture and then a running 2/0 polypropylene suture. Postoperative course was complicated by pulmonary edema but subsequently the patient was discharged without further complications and has no recurrence after 2 years. In conclusion, surgery is necessary for symptomatic MH and to prevent possible severe complications. We preferred laparoscopy for the reduced morbidity compared to laparotomy, even if in our case the postoperative course was not uneventful. There are still few comparative data about the modality of closure of the defect between primary repair with nonabsorbable suture material, in case of small defects, or continuous monofilament suture or prosthesis in case of large defects.

  12. Endovascular repair of bilateral common iliac artery aneurysms using GORE Excluder iliac branch endoprosthesis without aortobi-iliac stent graft conjunction: A case report.

    Science.gov (United States)

    Ardita, Vincenzo; Giaquinta, Alessia; Veroux, Massimiliano; Sanfiorenzo, Angelo; Virgilio, Carla; D'Arrigo, Giuseppe; Veroux, Pierfrancesco

    2017-02-01

    Bilateral common iliac artery (CIA) aneurysm (CIAA) is a rare entity. In the past decade, different endovascular approaches have been adopted for patients with several comorbidities or unfit for open repair (OR). Recently, the use of iliac branch stent graft has been proposed, resulting in satisfactory patency rates and decrease in morbidity. Currently, according to instruction for use, the iliac branch stent graft is to be used with aortobi-iliac stent graft conjunction. We describe a case of a successful endovascular repair of bilateral CIAAs using the GORE Excluder iliac branch endoprosthesis (IBEs) without aortobi-iliac stent graft conjunction. An 83-year-old man was admitted with abdominal pain and presence of pulsatile mass in the right and left iliac fossa. Computed tomographic (CT) angiography showed the presence of large bilateral CIAAs (right CIA = 66 mm; left CIA = 38 mm), without concomitant thoracic or abdominal aorta aneurysm. Moreover, CT scan demonstrated the presence of bilateral lower accessory renal artery close to the aortic bifurcation. Due to the high operative risk, the patient was scheduled for endovascular repair with bilateral IBEs, without the aortobi-iliac stent graft conjunction to avoid the renal ischemia as a consequence of renal arteries covering. The procedure was completed without complications and duplex ultrasound demonstrated the complete exclusion of both aneurysms without any type of endoleaks at 1 month of follow-up. GORE IBEs without aortobi-iliac stent graft conjunction seem to be a feasible and effective procedure for the treatment of isolated CIAAs in patients with highly selected anatomical conditions.

  13. Laparoscopic Repair of Vaginal Evisceration after Abdominal Hysterectomy for Uterine Corpus Cancer: A Case Report and Literature Review.

    Science.gov (United States)

    Matsuhashi, Tomohiko; Nakanishi, Kazuho; Hamano, Eri; Kamoi, Seiryu; Takeshita, Toshiyuki

    2017-01-01

    Vaginal cuff dehiscence is a rare but serious complication that can develop after hysterectomy. Emergent surgical intervention is required for vaginal cuff dehiscence due to the potential subsequent vaginal evisceration, which may lead to necrosis of the small bowel. A 62-year-old nulliparous woman with a 30-year history of smoking, diabetes mellitus, and rheumatoid arthritis (treated with oral steroids) presented with a vaginal cuff dehiscence. Thirty-eight days before the admission, she had undergone a radical operation including total abdominal hysterectomy for uterine corpus cancer at another hospital. We performed emergent laparoscopic surgery to reduce the prolapsed small bowel into the abdominal cavity and repaired the vaginal cuff with a two-layer continuous closure using absorbable barbed sutures. The patient experienced no postoperative complications, and no recurrence of the vaginal cuff dehiscence occurred. Vaginal cuff dehiscence and evisceration can be surgically managed using an abdominal, vaginal, or laparoscopic approach, and the choice of method should be based on patient characteristics and the surgeon's skills. Laparoscopic vaginal cuff repair with a two-layer continuous closure using absorbable barbed sutures is a minimally invasive technique that is safe and effective for medically stable patients with no small bowel injury or vascular compromise and no pelvic abscess.

  14. Intestinal obstruction repair

    Science.gov (United States)

    Repair of volvulus; Intestinal volvulus - repair; Bowel obstruction - repair ... Intestinal obstruction repair is done while you are under general anesthesia . This means you are asleep and DO NOT feel pain. ...

  15. Aortic aneurysm repair - endovascular

    Science.gov (United States)

    EVAR; Endovascular aneurysm repair - aorta; AAA repair - endovascular; Repair - aortic aneurysm - endovascular ... Endovascular aortic repair is done because your aneurysm is very large, growing quickly, or is leaking or bleeding. You may have ...

  16. Motorcycle Repair.

    Science.gov (United States)

    Hein, Jim; Bundy, Mike

    This motorcycle repair curriculum guide contains the following ten areas of study: brake systems, clutches, constant mesh transmissions, final drives, suspension, mechanical starting mechanisms, electrical systems, fuel systems, lubrication systems, and overhead camshafts. Each area consists of one or more units of instruction. Each instructional…

  17. MTBF evaluation for 2-out-of-3 redundant repairable systems with common cause and cascade failures considering fuzzy rates for failures and repair: a case study of a centrifugal water pumping system

    Science.gov (United States)

    Mortazavi, Seyed Mohammad; Mohamadi, Maryam; Jouzdani, Javid

    2017-08-01

    In many cases, redundant systems are beset by both independent and dependent failures. Ignoring dependent variables in MTBF evaluation of redundant systems hastens the occurrence of failure, causing it to take place before the expected time, hence decreasing safety and creating irreversible damages. Common cause failure (CCF) and cascading failure are two varieties of dependent failures, both leading to a considerable decrease in the MTBF of redundant systems. In this paper, the alpha-factor model and the capacity flow model are combined so as to incorporate CCF and cascading failure in the evaluation of MTBF of a 2-out-of-3 repairable redundant system. Then, using a transposed matrix, the MTBF function of the system is determined. Due to the fact that it is difficult to estimate the independent and dependent failure rates, industries are interested in considering uncertain failure rates. Therefore, fuzzy theory is used to incorporate uncertainty into the model presented in this study, and a nonlinear programming model is used to determine system's MTBF. Finally, in order to validate the proposed model, evaluation of MTBF of the redundant system of a centrifugal water pumping system is presented as a practical example.

  18. Turbine repair process, repaired coating, and repaired turbine component

    Energy Technology Data Exchange (ETDEWEB)

    Das, Rupak; Delvaux, John McConnell; Garcia-Crespo, Andres Jose

    2015-11-03

    A turbine repair process, a repaired coating, and a repaired turbine component are disclosed. The turbine repair process includes providing a turbine component having a higher-pressure region and a lower-pressure region, introducing particles into the higher-pressure region, and at least partially repairing an opening between the higher-pressure region and the lower-pressure region with at least one of the particles to form a repaired turbine component. The repaired coating includes a silicon material, a ceramic matrix composite material, and a repaired region having the silicon material deposited on and surrounded by the ceramic matrix composite material. The repaired turbine component a ceramic matrix composite layer and a repaired region having silicon material deposited on and surrounded by the ceramic matrix composite material.

  19. Recent trends in repair and refurbishing of steam turbine components

    Indian Academy of Sciences (India)

    A K Bhaduri; S K Albert; S K Ray; P Rodriguez

    2003-06-01

    The repair and refurbishing of steam generator components is discussed from the perspective of repair welding philosophy including applicable codes and regulations. Some case histories of repair welding of steam generator components are discussed with special emphasis on details of repair welding of cracked steam turbine blades and shrouds in some of the commercial nuclear power plants using procedures developed.

  20. Crack repair welding by CMT brazing using low melting point filler wire for long-term used steam turbine cases of Cr-Mo-V cast steels

    Energy Technology Data Exchange (ETDEWEB)

    Kadoi, Kota, E-mail: kadoi@hiroshima-u.ac.jp [Graduate School of Engineering, Hiroshima University, 1-4-1 Kagamiyama, Higashi-Hiroshima 739-8527 (Japan); Murakami, Aoi; Shinozaki, Kenji; Yamamoto, Motomichi [Graduate School of Engineering, Hiroshima University, 1-4-1 Kagamiyama, Higashi-Hiroshima 739-8527 (Japan); Matsumura, Hideo [Chugoku Electric Power Co., 3-9-1 Kagamiyama, Higashi-Hiroshima 739-0046 (Japan)

    2016-06-01

    Surface melting by gas tungsten arc (GTA) welding and overlaying by cold metal transfer (CMT) brazing using low melting point filler wire were investigated to develop a repair process for cracks in worn cast steel of steam turbine cases. Cr-Mo-V cast steel, operated for 188,500 h at 566 °C, was used as the base material. Silver and gold brazing filler wires were used as overlaying materials to decrease the heat input into the base metal and the peak temperature during the welding thermal cycle. Microstructural analysis revealed that the worn cast steel test samples contained ferrite phases with intragranular precipitates of Cr{sub 7}C{sub 3}, Mo{sub 2}C, and CrSi{sub 2} and grain boundary precipitates of Cr{sub 23}C{sub 6} and Mo{sub 2}C. CMT brazing using low melting point filler wire was found to decrease the heat input and peak temperature during the thermal cycle of the process compared with those during GTA surface melting. Thus, the process helped to inhibit the formation of hardened phases such as intermetallics and martensite in the heat affected zone (HAZ). Additionally, in the case of CMT brazing using BAg-8, the change in the hardness of the HAZ was negligible even though other processes such as GTA surface melting cause significant changes. The creep-fatigue properties of weldments produced by CMT brazing with BAg-8 were the highest, and nearly the same as those of the base metal owing to the prevention of hardened phase formation. The number of fracture cycles using GTA surface melting and CMT brazing with BAu-4 was also quite small. Therefore, CMT brazing using low melting point filler wire such as BAg-8 is a promising candidate method for repairing steam turbine cases. However, it is necessary to take alloy segregation during turbine operation into account to design a suitable filler wire for practical use.

  1. Treatment of knee arthrofibrosis and quadriceps insufficiency after patellar tendon repair: a case report including use of the graston technique.

    Science.gov (United States)

    Black, Douglass W

    2010-06-23

    Arthrofibrosis of the knee is a surgical complication that can limit range of motion, inhibit muscle activity, and decrease patient function. Optimal conservative treatment has not been well established in the literature, leaving a clinician with limited evidence for treatment planning. Described here is part of the rehabilitative course of care for a patient with arthrofibrotic limitations after a mid-substance patellar tendon repair with augmentation. Marked limitations in knee flexion range of motion and quadriceps activity were addressed using the Graston Technique to deal with soft-tissue adhesions; traditional physical therapy care was also provided. Clear improvement in range of motion and quadriceps activity and function was noted over the course of 5 treatments during 1 month. Treatment process and clinical reasoning are offered to promote understanding and to facilitate future inquiry.

  2. Laparoscopic Repair and Percutaneous Endoscopic Gastrostomy to Treat Giant Esophageal Hiatal Hernia with Gastric Obstruction: A Case Report.

    Science.gov (United States)

    Hamai, Yoichi; Hihara, Jun; Tanabe, Kazuaki; Furukawa, Takaoki; Yamakita, Ichiko; Ibuki, Yuta; Okada, Morihito

    2015-06-01

    We describe a 74-year-old man with repeated aspiration pneumonia who developed gastric obstruction due to giant esophageal hiatal hernia (EHH). We repaired the giant EHH by laparoscopic surgery and subsequently anchored the stomach to the abdominal wall by percutaneous endoscopic gastrostomy (PEG) using gastrofiberscopy. Thereafter, the patient resumed oral intake and was discharged on postoperative day 21. At two years after these procedures, the patient has adequate oral intake and lives at home. Because this condition occurs more frequently in the elderly with comorbidities, laparoscopic surgery contributes to minimally invasive treatment. Furthermore, the procedure combined with concurrent gastropexy via PEG is useful for treating patients who have difficulty swallowing and for preventing recurrent hernia.

  3. Repair of large frontal temporal parietal skull defect with digitally reconstructed titanium mesh: a report of 20 cases

    Directory of Open Access Journals (Sweden)

    Gang-ge CHENG

    2013-09-01

    Full Text Available Objective To explore the clinical effect and surgical technique of the repair of large defect involving frontal, temporal, and parietal regions using digitally reconstructed titanium mesh. Methods Twenty patients with large frontal, temporal, and parietal skull defect hospitalized in Air Force General Hospital from November 2006 to May 2012 were involved in this study. In these 20 patients, there were 13 males and 7 females, aged 18-58 years (mean 39 years, and the defect size measured from 7.0cm×9.0cm to 11.5cm×14.0cm (mean 8.5cm×12.0cm. Spiral CT head scan and digital three-dimensional reconstruction of skull were performed in all the patients. The shape and geometric size of skull defect was traced based on the symmetry principle, and then the data were transferred into digital precision lathe to reconstruct a titanium mesh slightly larger (1.0-1.5cm than the skull defect, and the finally the prosthesis was perfected after pruning the border. Cranioplasty was performed 6-12 months after craniotomy using the digitally reconstructed titanium mesh. Results The digitally reconstructed titanium mesh was used in 20 patients with large frontal, temporal, parietal skull defect. The surgical technique was relatively simple, and the surgical duration was shorter than before. The titanium mesh fit to the defect of skull accurately with satisfactory molding effect, good appearance and symmetrical in shape. No related complication was found in all the patients. Conclusion Repair of large frontal, temporal, parietal skull defect with digitally reconstructed titanium mesh is more advantageous than traditional manual reconstruction, and it can improve the life quality of patients.

  4. Rehabilitation and Return to Sport Following Surgical Repair of the Rectus Abdominis and Adductor Longus in a Professional Basketball Player: A Case Report.

    Science.gov (United States)

    Short, Steven M; Anloague, Philip A; Strack, Donald S

    2016-08-01

    Study Design Case report. Background Acute traumatic avulsion of the rectus abdominis and adductor longus is rare. Chronic groin injuries, often falling under the athletic pubalgia spectrum, have been reported to be more common. There is limited evidence detailing the comprehensive rehabilitation and return to sport of an athlete following surgical or conservative treatment of avulsion injuries of the pubis or other sports-related groin pathologies. Case Description A 29-year-old National Basketball Association player sustained a contact injury during a professional basketball game. This case report describes a unique clinical situation specific to professional sport, in which a surgical repair of an avulsed rectus abdominis and adductor longus was combined with a multimodal impairment- and outcomes-based rehabilitation program. Outcomes The patient returned to in-season competition at 5 weeks postoperation. Objective measures were tracked throughout rehabilitation and compared to baseline assessments. Measures such as the Copenhagen Hip and Groin Outcome Score and numeric pain-rating scale revealed progress beyond the minimal important difference. Discussion This case report details the clinical reasoning and evidence-informed interventions involved in the return to elite sport. Detailed programming and objective assessment may assist in achieving desired outcomes ahead of previously established timelines. Level of Evidence Therapy, level 4. J Orthop Sports Phys Ther 2016;46(8):697-706. Epub 3 Jul 2016. doi:10.2519/jospt.2016.6352.

  5. Laparoscopic repair of incisional hernia.

    Science.gov (United States)

    Lau, H; Lee, F; Patil, N G

    2001-09-01

    A 75-year-old man developed an incisional hernia over the upper abdomen following a wedge resection of a gastric stromal tumour in 1996. This is the first published report of a successful repair of an incisional hernia via a laparoscopic intraperitoneal on-lay technique using GORE-TEX DualMesh material in Hong Kong. Compared with conventional open repair of incisional hernia, long incisions and wound tension are avoided using the laparoscopic approach. This translates into a reduced risk of wound-related complications and facilitates recovery. In selected cases, minimally invasive surgery is a safe technique for the repair of incisional hernias.

  6. [Inguinal and femoral hernia repair].

    Science.gov (United States)

    Geissler, B; Anthuber, M

    2011-05-01

    With an incidence of 200,000 new cases per year in Germany, inguinal hernia has a significant socioeconomic impact. The 2009 guidelines from the European Hernia Society established treatment recommendations. Hernia repair is based on reinforcing the posterior wall of the inguinal canal by suture or mesh repair by an anterior or posterior approach. Lightweight mesh reduces recurrence rates and is the treatment of choice even in primary hernias. Laparoscopic hernia repair is associated with specific risks but is superior in postoperative pain and earlier return to work.

  7. Electronic Service Statistics - Quarterly Report

    Data.gov (United States)

    Social Security Administration — This is a quarterly report that compares electronic data vs non-electronic data for electronic services. Report contains six main sections namely, electronic access,...

  8. Quarterly coal report, July--September 1997

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-02-01

    The Quarterly Coal Report (QCR) provides comprehensive information about US coal production, distribution, exports, imports, receipts, prices, consumption, and stocks. Coke production consumption, distribution, imports, and exports data are also provided. This report presents detailed quarterly data for July through September 1997 and aggregated quarterly historical data for 1991 through the second quarter of 1997. Appendix A displays, from 1991 on, detailed quarterly historical coal imports data. 72 tabs.

  9. Mismatch repair protein deficient endometrioid adenocarcinomas, metastasizing to adrenal gland and lymph nodes: Unusual cases with diagnostic implications

    Directory of Open Access Journals (Sweden)

    Bharat Rekhi

    2015-01-01

    Full Text Available Recently, certain endometrial carcinomas have been found to be associated with mismatch repair (MMR protein defects/deficiency. A 39-year-old female presented with cough, decreased appetite and significant weight loss since 2 months. Earlier, she had undergone total abdominal hysterectomy with bilateral salpingo-oophorectomy (TAH-BSO for endometrioid adenocarcinoma. Imaging disclosed an 8 cm-sized adrenal mass that was surgically excised. Histopathology of the adrenal tumor, endocervical tumor, and endometrial biopsy revealed Federation of Gynecology and Obstetrics (FIGO Grade II to III endometrioid adenocarcinoma. By immunohistochemistry, tumor cells were positive for cytokeratin 7, epithelial membrane antigen, PAX8, MLH1 and PMS2 while negative for estrogen receptor (ER, progesterone receptor (PR, MSH2 and MSH6. She underwent adjuvant radiotherapy and chemotherapy. A 34-year-old lady presented with vaginal bleeding since 9 months. She underwent TAH-BSO, reported as FIGO Grade III endometrioid adenocarcinoma. By immunohistochemistry, tumor cells were negative for ER, PR, MLH1, and PMS2 while positive for MSH2 and MSH6. She underwent adjuvant radiotherapy and chemotherapy. However, she developed multiple nodal and pericardial metastases and succumbed to the disease within a year post-diagnosis. Certain high-grade endometrioid adenocarcinomas occurring in younger women are MMR protein deficient and display an aggressive clinical course. Adrenal metastasis in endometrial carcinomas is rare.

  10. Environmental impact of highway construction and repair materials on surface and ground waters. Case study: crumb rubber asphalt concrete.

    Science.gov (United States)

    Azizian, Mohammad F; Nelson, Peter O; Thayumanavan, Pugazhendhi; Williamson, Kenneth J

    2003-01-01

    The practice of incorporating certain waste products into highway construction and repair materials (CRMs) has become more popular. These practices have prompted the National Academy of Science, National Cooperative Highway Research Program (NCHRP) to research the possible impacts of these CRMs on the quality of surface and ground waters. State department of transportations (DOTs) are currently experimenting with use of ground tire rubber ( crumb rubber) in bituminous construction and as a crack sealer. Crumb rubber asphalt concrete (CR-AC) leachates contain a mixture of organic and metallic contaminants. Benzothiazole and 2(3H)-benzothiazolone (organic compounds used in tire rubber manufacturing) and the metals mercury and aluminum were leached in potentially harmful concentrations (exceeding toxic concentrations for aquatic toxicity tests). CR-AC leachate exhibited moderate to high toxicity for algae ( Selenastrum capriconutum) and moderate toxicity for water fleas ( Daphnia magna). Benzothiazole was readily removed from CR-AC leachate by the environmental processes of soil sorption, volatilization, and biodegradation. Metals, which do not volatilize or photochemically or biologically degrade, were removed from the leachate by soil sorption. Contaminants from CR-AC leachates are thus degraded or retarded in their transport through nearby soils and ground waters.

  11. Quarterly environmental data summary for first quarter 1998

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-05-01

    In support of the Weldon Spring Site Remedial Action Project Federal Facilities Agreement, a copy of the Quarterly Environmental Data Summary (QEDS) for the first quarter of 1998 is enclosed. The data presented in this letter and attachment constitute the QEDS. The data were received from the contract laboratories, verified by the Weldon Spring Site verification group and, except for air monitoring data and site KPA generated data (uranium analyses), merged into the data base during the first quarter of 1998. Air monitoring data presented are the most recent complete sets of quarterly data. Air data are not stored in the data base, and KPA data are not merged into the regular data base. Significant data, defined as data values that have exceeded defined {open_quotes}above normal{close_quotes} Level 2 values, are discussed in this letter for Environmental Monitoring Plan (EMP) generated data only. Above normal Level 2 values are based, in ES&H procedures, on historical high values, DOE Derived Concentration Guides (DCGs), NPDES limits and other guidelines. The procedures also establish actions to be taken in the event that {open_quotes}above normal{close_quotes} data occur. All data received and verified during the first quarter were within a permissible range of variability except for those detailed below. Above normal occurrences are cited for groundwater, air, and NPDES data. There were none for springs or surface water. The following discussion offers a brief summary of the data merged during the first quarter that exceeded the above normal criteria and updates on past reported above normal data. The attached tables present the most recent data for air and the data merged into the data base during the first quarter 1998 for groundwater, NPDES, surface water, and springs. Graphs showing concentrations of selected contaminants of concern at some of the critical locations have also been included in this QEDS. The graphs are discussed in the separate sections.

  12. Inventory and case studies of Louisiana, non-electric industrial applications of geopressured geothermal resources. Quarterly progress report, March 1-May 31, 1977

    Energy Technology Data Exchange (ETDEWEB)

    Schnadelbach, T.W. Jr.

    1977-06-01

    An inventory is provided of geopressured geothermal resources in Louisiana. The Louisiana industries; classified as Food and Kindred Products were cataloged and inventoried to determine potential and specific uses of the known energy resources. The possibility of relocating industries to the available resources is explored. Individual case studies are presented for near term industrial conversion for resource application. (MHR)

  13. 皮能快愈敷料应用于瘢痕整形21例%Pelnac applied in 21 scar repair cases

    Institute of Scientific and Technical Information of China (English)

    彭炳生

    2015-01-01

    目的 探讨皮能快愈敷料治疗瘢痕整形的临床疗效.方法 42例瘢痕整形患者, 根据随机数字法分为对照组(自体中厚皮片移植修复治疗, 21例)和观察组(皮能快愈敷料及自体刃厚皮覆盖治疗, 21例).对两组皮片成活时间, 受区皮肤弹性、色泽等情况以及供区愈合时间、供区色素沉着及瘢痕形成情况, 创面疼痛评分(VAS)及瘢痕挛缩畸形率进行观察和比较.结果 与对照组相比, 观察组供区愈合时间明显缩短, 创面疼痛评分和瘢痕挛缩畸形率均显著降低, 供区色素沉着相对较轻, 瘢痕形成不明显, 差异有统计学意义(P<0.05), 并且受区皮肤弹性和外观均恢复良好状态, 但是皮片成活时间相对较长.结论 皮能快愈敷料能够明显改善瘢痕区域的外观和功能, 是目前较为理想的瘢痕修复方式.%Objective To investigate the clinical effect of Pelnac in the treatment of scar repair. Methods A total of 42 scar repair patients were divided by random number table into control group (autologous split-thickness skin flap transplantation repair, 21 cases) and observation group (Pelnac and autologous epidermal skin flap coverage, 21 cases). Observation and comparison were made on skin flap survival time, skin elasticity and color in operation area, healing time, chromatosis and scar in donor area, visual analogue scale (VAS) and scar contracture malformation rate.Results Compared with the control group, the observation group had much shorter healing time in donor area, lower VAS score and scar contracture malformation rate, and slighter chromatosis in donor area and scar appearance. Their difference had statistical significance (P<0.05). Skin elasticity and appearance in operation area had good recovery in the observation group, while it had longer skin flap survival time. Conclusion Pelnac can remarkably improve appearance and function of scar area, and it is the ideal method for scar repair.

  14. Short-term energy outlook: Quarterly projections, fourth quarter 1997

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-10-14

    The Energy Information Administration (EIA) prepares quarterly short-term energy supply, demand, and price projections for printed publication in January, April, July, and October in the Short-Term Energy Outlook. The details of these projections, as well as monthly updates on or about the 6th of each interim month, are available on the internet at: www.eia.doe.gov/emeu/steo/pub/contents.html. The forecast period for this issue of the Outlook extends from the fourth quarter of 1997 through the fourth quarter of 1998. Values for the fourth quarter of 1997, however, are preliminary EIA estimates (for example, some monthly values for petroleum supply and disposition are derived in part from weekly data reported in EIA`s Weekly Petroleum Status Report) or are calculated from model simulations that use the latest exogenous information available (for example, electricity sales and generation are simulated by using actual weather data). The historical energy data, compiled in the fourth quarter 1997 version of the Short-Term Integrated Forecasting System (STIFS) database, are mostly EIA data regularly published in the Monthly Energy Review, Petroleum Supply Monthly, and other EIA publications. Minor discrepancies between the data in these publications and the historical data in this Outlook are due to independent rounding. The STIFS model is driven principally by three sets of assumptions or inputs: estimates of key macroeconomic variables, world oil price assumptions, and assumptions about the severity of weather. 19 tabs.

  15. Quarterly environmental data summary for fourth quarter 1997

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-12-31

    The Quarterly Environmental Data Summary (QEDS) for the fourth quarter of 1997 is prepared in support of the Weldon Spring Site Remedial Action Project Federal Facilities Agreement. The data presented constitute the QEDS. The data were received from the contract laboratories, verified by the Weldon Spring Site verification group and, except for air monitoring data and site KPA generated data (uranium analyses), merged into the data base during the fourth quarter of 1997. Air monitoring data presented are the most recent complete sets of quarterly data. Air data are not stored in the data base and KPA data are not merged into the regular data base. Significant data, defined as data values that have exceeded defined ``above normal`` level 2 values, are discussed in this letter for Environmental Monitoring Plan (EMP) generated data only. Above normal level 2 values are based, in ES and H procedures, on historical high values, DOE Derived Concentration Guides (DCGs), NPDES limits and other guidelines. The procedures also establish actions to be taken in response to such data. Data received and verified during the fourth quarter were within a permissible range of variability except for those which are detailed.

  16. Treatment of adults with unrecognized or inadequately repaired anorectal malformations: 17 cases of rectovestibular and rectoperineal fistulas

    NARCIS (Netherlands)

    Blaauw, I. de; Midrio, P.; Breech, L.; Bischoff, A.; Dickie, B.; Versteegh, H.P.; Pena, A.; Levitt, M.A.

    2013-01-01

    STUDY OBJECTIVE: To analyze all cases of congenital rectovestibular and rectoperineal fistulas diagnosed and treated later in life, and to describe presenting complaints, treatment, and outcome. DESIGN: Retrospective cohort study. SETTING: Pediatric surgery departments of 3 major referral centers in

  17. 腹腔镜下巨大食管裂孔疝修补术25例%Laparoscopic repair of giant hiatal hernia: analysis of 25 cases

    Institute of Scientific and Technical Information of China (English)

    赵宏志; 秦鸣放

    2011-01-01

    目的 探讨腹腔镜巨大食管裂孔疝修补术的临床特点和可行性.方法 2008年1月至2010年8月,应用腹腔镜治疗25例巨大食管裂孔疝,术中均使用专用补片修补食管裂孔,16例同时行胃底折叠术,记录围手术期相关指标,并随访观察治疗效果和术后复发情况.结果 25例均完成腹腔镜手术,手术85~210 min,平均106 min;术中出血量55~150 ml,平均94 ml.术后住院4~21天,平均6.8天.术后症状均得到缓解,无严重并发症,随访3~35个月,平均13.6个月,病人满意率为88%,4例出现轻度反酸症状,1例裂孔疝复发.结论 腹腔镜巨大食管裂孔疝修补术安全、可行,具有创伤小、恢复快、疗效可靠的特点,术中应用Bard CruraSoft补片可缩短手术时间,降低修补食管裂孔的难度,减少复发.%Objective To investigate the clinical characteristics and feasibility of laparoscopic repair of giant hiatal hernia. Methods From January 2008 to August 2010, 25 consecutive patients with giant hiatal hernia underwent laparoscopic repair. Crural closure was performed by means of two or three interrupted nonabsorbable sutures plus a tailored PTFE/ePTFE composite mesh. It was patched across the defect and secured to each crura with staples. Laparoscopic fundoplication was performed concomitantly in 16 cases according to the specific conditions of patients. Para-operative clinical parameters were recorded. All patients were routinely followed up. Clinical outcomes were collected and analyzed. Results All laparoscopic surgeries were accomplished successfully. The operating time was 85 -210 minutes (mean, 106 minutes) ,the operative blood loss was 55 - 150 ml( mean, 94 ml) ,the postoperative hospital stay was 4 -21 days( mean, 6.8 days). The symptoms in most cases were adequately relieved after operation. There was no severe postoperative morbidity. After the follow-up period of 3 - 35months ( mean, 13.6 months), the satisfaction rate of surgery was 88

  18. Smoking, DNA Adducts and Number of Risk DNA Repair Alleles in Lung Cancer Cases, in Subjects with Benign Lung Diseases and in Controls

    Directory of Open Access Journals (Sweden)

    Marco Peluso

    2010-01-01

    Full Text Available Smoke constituents can induce DNA adducts that cause mutations and lead to lung cancer. We have analyzed DNA adducts and polymorphisms in two DNA repair genes, for example, XRCC1 Arg194Trp and Arg399Gln genes and XRCC3 Thr241Met gene, in 34 lung cancer cases in respect to 30 subjects with benign lung cancer disease and 40 healthy controls. When the study population was categorized in base to the number of risk alleles, adducts were significantly increased in individuals bearing 3-4 risk alleles (OR=4.1 95% C.I. 1.28–13.09, P=.009. A significant association with smoking was noticed in smokers for more than 40 years carrying 3-4 risk alleles (OR=36.38, 95% C.I. 1.17–1132.84, P=.040. A not statistically significant increment of lung cancer risk was observed in the same group (OR=4.54, 95% C.I. 0.33–62.93, P=.259. Our results suggest that the analysis of the number of risk alleles predicts the interindividual variation in DNA adducts of smokers and lung cancer cases.

  19. Eye muscle repair - discharge

    Science.gov (United States)

    ... Lazy eye repair - discharge; Strabismus repair - discharge; Extraocular muscle surgery - discharge ... You or your child had eye muscle repair surgery to correct eye muscle ... term for crossed eyes is strabismus. Children most often ...

  20. Ventral hernia repair

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/007661.htm Ventral hernia repair To use the sharing features on this page, please enable JavaScript. Ventral hernia repair is surgery to repair a ventral hernia. ...

  1. Brain aneurysm repair

    Science.gov (United States)

    ... aneurysm repair; Dissecting aneurysm repair; Endovascular aneurysm repair - brain; Subarachnoid hemorrhage - aneurysm ... Your scalp, skull, and the coverings of the brain are opened. A metal clip is placed at ...

  2. Wandering Spleen and Organoaxial Gastric Volvulus after Morgagni Hernia Repair: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Noemi Cantone

    2016-01-01

    Full Text Available Wandering spleen and gastric volvulus are two rare entities that have been described in association with congenital diaphragmatic hernia. The diagnosis is difficult and any delay can result in ischemia and necrosis of both organs. We present a case of a 13-year-old girl, previously operated on for anterior diaphragmatic hernia and intrathoracic gastric volvulus, that presented to our service for a subdiaphragmatic gastric volvulus recurrence associated with a wandering spleen. In this report we reviewed the literature, analyzing the clinical presentation, diagnostic assessment, and treatment options of both conditions, in particular in the case associated with diaphragmatic hernia.

  3. Endovascular repair of ruptured aneurysm arising from fenestration of the horizontal segment of the anterior cerebral artery: case report.

    Science.gov (United States)

    Yoshida, Masahiro; Ezura, Masayuki; Sasaki, Kazuto; Chonan, Masashi; Mino, Masaki

    2012-01-01

    A 50-year-old man presented with an aneurysm arising from a fenestration of horizontal portion (A(1)) of the anterior cerebral artery manifesting as subarachnoid hemorrhage. Coil embolization was conducted and the aneurysm was occluded easily. Most reported cases of these types of aneurysms underwent direct surgery. Aneurysm arising from the A(1) fenestration is rare, but the present case shows that coil embolization can be an effective treatment modality. Three-dimensional rotational angiography and aneurysmography were helpful to characterize this complicated vascular structure.

  4. Subdural fluid collection and hydrocephalus following cervical schwannoma resection: hydrocephalus resolution after spinal pseudomeningocele repair: case report.

    Science.gov (United States)

    Benedetto, Nicola; Cagnazzo, Federico; Gambacciani, Carlo; Perrini, Paolo

    2016-12-01

    The authors report the case of a 31-year-old man who developed neck pain and headache 2 months after the uncomplicated resection of a cervical schwannoma. MR imaging revealed infratentorial subdural fluid collections and obstructive hydrocephalus associated with cervical pseudomeningocele. The clinical symptoms, subdural fluid collections, and ventricular dilation resolved after surgical correction of the pseudomeningocele. This report emphasizes that hydrocephalus may be related to disorders of cerebrospinal fluid flow dynamics induced by cervical pseudomeningocele. In these rare cases, both the hydrocephalus and the symptoms are resolved by the simple correction of the pseudomeningocele.

  5. Experience of 154 cases repair of inguinal hernia under local anesthesia%局部麻醉下手术治疗腹股沟疝154例

    Institute of Scientific and Technical Information of China (English)

    孙江阳; 陈大兴; 尹兴峰; 王超英; 袁玉峰; 刘志苏

    2012-01-01

    Objective To discuss the therapeutic effect and technical key points of repair of inguinal hernia under local anesthesia. Methods Retrospectively analyses of the clinical date of 154 cases who suffered inguinal hernia repair under local anesthesia in our hospital from April 2008 to June 2010. Preoperative state, operation time, postoperative complications, hospital stays and the fellow-up results were analyzed. Results The mean operation time were 40 min( range 30-90 min), the mean out-of-bed activity time were 6 h(range 5-12 h),the mean hospital stays were 3d(range 2-7 d). No patients was found with surgical-wound infection and urinary retention postoperation, all postoperative pain were mild,the most common postoperative complication was mild edema of scrotum(20 cases),but it go down after 3-5d with support of the testes. During the fellow-up(4-24 months),only 1 case recurrence, no patient has local pain and testicular atrophy. Conclusion Repair of inguinal hernia under local anesthesia is a simple, effective and safe modus operandi,it is easy to recover with few postoperative complcations and shorter hospital stays. It is especially suitable for old patients with chronic illnesses.%目的 探讨局部麻醉下行腹股沟疝修补术的临床疗效和技术要点.方法 回顾性分析2008年4月至2010年6月局部麻醉下行腹股沟疝修补术的154例的临床资料.对病人的术前状况、手术时间、术后并发症、住院天数以及回访情况进行综合分析.结果 手术时间为30~90 min(平均40 min),术后5~12 h下床活动,住院时间2~7 d(平均3 d).术后无切口感染、尿潴留等并发症,术后疼痛症状轻,最多见并发症为阴囊轻度水肿(20例),垫高阴囊3~5 d可消失.随访4~24个月,无局部疼痛和睾丸萎缩,仅1例复发.结论 局部麻醉下行腹股沟疝修补手术具有简单、有效、安全、并发症少、术后恢复快、缩短住院时间等优点,尤其适合并存慢性内科疾病的老年病人.

  6. Endovascular repair of a ruptured thoracic aortic dissection with a right sided aortic arch: A case report

    Directory of Open Access Journals (Sweden)

    Jeremy L. Irvan

    2017-01-01

    Conclusion: Right-sided aortic arch presents challenges in the emergency setting. CTA and post-processing reconstructions are very helpful. While the endoleaks prompted additional interventions, the end result was excellent. This case displays the importance of careful attention to detail and follow-up in these complicated patients.

  7. Health effects among refrigeration repair workers exposed to fluorocarbons.

    OpenAIRE

    1986-01-01

    Refrigeration repair workers may be intermittently exposed to fluorocarbons and their thermal decomposition products. A case of peripheral neuropathy (distal axonopathy) in a commercial refrigeration repairman prompted an epidemiological investigation of the health of refrigeration repair workers. No additional cases of peripheral neuropathy were identified among the 27 refrigeration repair workers studied. A reference group of 14 non-refrigeration repair workers was also studied. No differen...

  8. Laparoscopic transabdominal preperitoneal hernia repair:A report of 45 cases%经腹腹膜前疝修补术45例临床观察

    Institute of Scientific and Technical Information of China (English)

    丁世美; 肖东霖; 朱瑞凌; 孙文有; 彭学艳; 李会祥

    2015-01-01

    Objective To evaluate the feasibility and safety of laparoscopic transabdominal preperitoneal hernia repair (TAPP).Methods A total of 45 patients with inguinal hernia in People′s Hospital of Qujing Qilin District who underwent TAPP under general anesthesia,from June 201 3 to April 201 4,were enrolled in this retrospective study.The operation time,complication,length of stay and recurrence rate were recorded.Results All of the operations were successful.The mean operation time was (83 ±1 8 ) minutes,the mean postoperative hospital stay was (2.0 ±1 .0 ) days,and the inguinal hematoma /seroma occurred in 9 cases.After a follow-up of 5 to 1 0 months,a case of short-term recurrence was found at 1 month after the operation.While no long-term recurrence and no chronic pain in inguinal area were observed.Conclusion TAPP is a safe,feasible and effective tension-free repair for inguinal hernia.%目的:探讨经腹腹膜前疝修补术(TAPP)的可行性和安全性。方法回顾性分析2013年6月至2014年4月,曲靖市麒麟区人民医院收治腹股沟疝患者45例的临床资料,均在全身麻醉下行 TAPP 手术,观察手术时间、术后住院时间、术后并发症及复发情况。结果45例患者手术均获成功,平均手术时间(83±18)min,术后平均住院时间(2.0±1.0)d,术后腹股沟区血肿或积液9例,术后随访5~10个月,术后1个月内复发1例,无远期复发,未见腹股沟区慢性疼痛等并发症。结论TAPP 治疗腹股沟疝是一种安全有效的无张力疝修补技术。

  9. Surgical Repair of a Median Cleft of the Upper Lip via a Pfeifer Incision: A Case Report

    Science.gov (United States)

    Pandey, Rajeev; Gupta, Rajat; Bhagat, Nitin; Verma, Aviral

    2016-01-01

    Median cleft is the midline cleft of the lip. It develops due to incomplete or failed fusion of the median nasal prominence. It can present with minimal deformities such as involvement of the vermilion border, or complex clefting of the midline structures and brain. Median clefts are broadly classified as true and false clefts. This case report describes a rare case of median cleft of the upper lip involving the white roll, which was not associated with any other deformities. Treatment included reconstruction of the philtrum and the cupid's bow while maintaining vermilion fullness and continuity, and minimizing scar formation. Various techniques have been advocated for treatment of this type of median upper lip cleft. Here we describe a technique using Pfeifer incision to correct our patient's defect. Pfeifer incision consists of wavy lines and its use has been advocated for correction of various craniofacial abnormalities. PMID:27928243

  10. Posterior leukoencephalopathy following repair of an ileocecal anastomosis breakdown: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Kasper Ekkehard M

    2011-01-01

    Full Text Available Abstract Introduction Posterior reversible leukoencephalopathy syndrome refers to a constellation of neurologic symptoms related to temporary white matter changes. The disease typically presents in the context of an abrupt and drastic elevation in blood pressure (>180/110 mmHg. We report an unusual case of posterior reversible leukoencephalopathy syndrome in a post-operative setting, with a blood pressure parameter generally tolerated by most patients. Case presentation We report the case of a 22-year-old Caucasian man who suffered acute onset visual acuity loss four days after an ileocecal anastomosis. A head magnetic resonance imaging scan revealed findings typically associated with posterior reversible leukoencephalopathy syndrome. His symptoms developed in the context of blood pressure parameters that are typically well tolerated in a post-operative setting (150-160/80-90 mmHg. He did not have a history of renal failure or immunosuppression. His symptoms resolved with aggressive blood pressure management. Conclusions Posterior reversible leukoencephalopathy syndrome can occur in a post-operative setting with blood pressure parameters typically well-tolerated in most post-surgical patients. Timely diagnosis and treatment will minimize the risk of permanent neurologic injury.

  11. Case Report: ALCAPA syndrome: successful repair with an anatomical and physiological alternative surgical technique [version 2; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Luis Gustavo Vilá Mollinedo

    2016-08-01

    Full Text Available Anomalous left coronary artery from the pulmonary artery, or ALCAPA syndrome, is a rare congenital cardiac disease that can cause myocardial infarction, heart failure and even death in paediatric patients. Only few untreated patients survive until adult age. Here we present the case of a 33-year-old female patient with paroxysmal tachycardia, syncope and mild exertional dyspnoea. She was diagnosed with ALCAPA syndrome and underwent surgical correction with an alternative technique of left main coronary artery extension to the aorta.

  12. Quarterly coal report, July--September 1998

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-02-01

    The Quarterly Coal Report (QCR) provides comprehensive information about US coal production, distribution, exports, imports, receipts, prices, consumption, and stocks to a wide audience, including Congress, Federal and State agencies, the coal industry, and the general public. Coke production, consumption, distribution, imports, and exports data are also provided. This report presents detailed quarterly data for July through September 1998 and aggregated quarterly historical data for 1992 through the second quarter of 1998. 58 tabs.

  13. Leg ulcer and osteomyelitis due to methicillin-susceptible Staphylococcus aureus infection after fracture repair treatment: a case highlighting the potential role of prostaglandin E₁ vasodilator.

    Science.gov (United States)

    Bentivegna, Erminia; Citarrella, Emanuele; Vivaldi, Roberto; De Luca, Dario; Maira, Giovanna Grazia; Casuccio, Alessandra; Di Carlo, Paola

    2015-03-01

    Prostaglandins appear to reduce biofilm formation and chronicization of infections, and stimulate a rapid and effective clearance of infecting micro-organisms. We report a case of recovery from methicillin-susceptible Staphylococcus aureus (MSSA) osteomyelitis after multidisciplinary management with antibiotics, anti-thrombotics and prostaglandin E1 (PGE1) vasodilator, in a patient with tibial plateau fracture repaired with internal fixation devices. A 47-year-old HIV-negative male with chronic ulcer on the proximal third of the left leg was admitted to the Orthopaedic Unit of the Orestano Clinic in Palermo, Italy, for suspected osteomyelitis. A biopsy of the skin ulcer and blood cultures were performed and resulted positive for MSSA. Labelled leukocyte scintigraphy confirmed osteomyelitis. No clinical improvement was observed after combined antibiotic treatment with rifampicin plus trimethoprim-sulfamethoxazole. The patient underwent a 4-day therapeutic cycle: PGE1 (alprostadil 60 mg/day IV) combined with nadroparin calcium plus gentamicin, followed by treatment with aminaftone plus sulodexide plus levofloxacin. At discharge, the patient's painful symptoms had completely resolved and the ulcer had cicatrized; recovery from osteomyelitis was confirmed by scintigraphy. This treatment protocol including PGE1 may result in a significant improvement in quality of life and functional status of patients with a reduction in direct and indirect costs and economic benefit for the National Health Service.

  14. Extracorporeal membrane oxygenator as a bridge to successful surgical repair of bronchopleural fistula following bilateral sequential lung transplantation: a case report and review of literature

    Directory of Open Access Journals (Sweden)

    Machaal Ali

    2007-06-01

    Full Text Available Abstract Background Lung transplantation (LTx is widely accepted as a therapeutic option for end-stage respiratory failure in cystic fibrosis. However, airway complications remain a major cause of morbidity and mortality in these patients, serious airway complications like bronchopleural fistula (BPF are rare, and their management is very difficult. Case presentation A 47-year-old man with end-stage respiratory failure due to cystic fibrosis underwent bilateral sequential lung transplantation. Severe post-operative bleeding occurred due to dense intrapleural adhesions of the native lungs. He was re-explored and packed leading to satisfactory haemostasis. He developed a bronchopleural fistula on the 14th post-operative day. The fistula was successfully repaired using pericardial and intercostal vascular flaps with veno-venous extracorporeal membrane oxygenator (VV-ECMO support. Subsequently his recovery was uneventful. Conclusion The combination of pedicled intercostal and pericardial flaps provide adequate vascular tissue for sealing a large BPF following LTx. Veno-venous ECMO allows a feasible bridge to recovery.

  15. Spread patterns and effectiveness for surgery after ultrasound-guided rectus sheath block in adult day-case patients scheduled for umbilical hernia repair

    Directory of Open Access Journals (Sweden)

    Alberto Manassero

    2015-01-01

    Full Text Available Background and Aims: We conducted a prospective study to examine the local anesthetic (LA spread and the effectiveness for surgical anesthesia of ultrasound (US-guided rectus sheath block (RSB in adult patients undergoing umbilical hernia repair. Material and Methods: Thirty patients received at T-10 level a bilateral US-guided injection of 20 mL levobupivacaine 0.375% + epinephrine 5 μg/mL behind the rectus muscle to detach it from its sheath. Anesthetic spread into the rectus sheath was evaluated ultrasonographically at T-9 and T-11 levels and scored from 0 to 4. The RSB was defined effective for surgical anesthesia if it was able to guarantee an anesthetic level sufficient for surgery without any mepivacaine supplementation. Results: Overall, the block was effective for surgical anesthesia in 53.3% of patients (95% confidence interval, ±17.8. In the remaining patients, anesthesia supplementation was needed at cutaneous incision, whereas manipulation of the muscle and fascial planes was painless. No patients required general anesthesia. LA spreads as advocated (to T-9 and to T-11 bilaterally = spread score 4 in 8/30 patients (26.6%; in these cases, the block was 75% effective for surgery. The anesthetic spread was most negatively influenced by increased body mass index. Postoperative analgesia was excellent in 97% of patients. Conclusion: Use of RSB as an anesthetic management of umbilical herniorrhaphy is recommended only with anesthetic supplementation at the incision site.

  16. Umbilical and epigastric hernia repair.

    Science.gov (United States)

    Muschaweck, Ulrike

    2003-10-01

    The repair of umbilical and epigastric hernias still represents a challenge to surgeons. Although a common and relatively simple procedure, there is no exact protocol today on how the repair should be done. The Mayo technique and its alterations could not stand the test of time: a recurrence rate of 20% and higher is not acceptable for any surgical procedure. Although there is no consensus opinion, one thing is clear: the importance of an anatomic repair without tension and without an artificial enlargement of the defect. In 1987 Lichtenstein reported on 6321 cases of herniorraphy with a tension free repair, and in 1994 Stuart reemphasized that special importance in his editorial in the Lancet. A newer study from Brancato and coworkers in Italy also states the advantage of a tension-free prosthetic repair in 16 patients with epigastric hernia. We have gone even further and recommend a tailored-to-the-patient repair using a customized polypropylene mesh and a one-layer running suture. The advantages should be obvious: no artificial creation of an even bigger than original defect, a completely tension-free repair, and little to no recurrence of the hernia. Our results clearly prove that assumption. Moreover, the procedure is extremely safe and complications are very rare and minor. We conclude that using a mesh plug in a customized tension-free repair of umbilical and epigastric hernia shows many advantages over the commonly used methods. And we finally conclude with the words of Albert Einstein: "The only source of knowledge is experience."

  17. Damage diagnosis and compatible repair mortars

    NARCIS (Netherlands)

    Hees, R.P.J. van

    1999-01-01

    Mortars for repair and maintenance of historic masonry have to meet specific requirements. Several authors have made contributions, however many cases of failure show that there still is quite a lack of knowledge on the compatibility of repair mortars for historic masonry. The diagnosis of the cause

  18. Mitral valve repair in acquired dextrocardia.

    Science.gov (United States)

    Elmistekawy, Elsayed; Chan, Vincent; Hynes, Mark; Mesana, Thierry

    2015-10-01

    Surgical correction of valvular heart disease in patients with dextrocardia is extremely rare. We report a surgical case of mitral valve repair in a patient with acquired dextrocardia. Successful mitral valve repair was performed through a right lateral thoracotomy. We describe our surgical strategy and summarize the literature.

  19. ONSTEP versus laparoscopy for inguinal hernia repair

    DEFF Research Database (Denmark)

    Andresen, Kristoffer; Burcharth, Jakob; Rosenberg, Jacob

    2015-01-01

    INTRODUCTION: The optimal repair of inguinal hernias remains controversial. It is recommended that an inguinal hernia be repaired using a mesh, either with a laparoscopic or an open approach. In Denmark, the laparoscopic approach is used in an increasing number of cases. The laparoscopic repair has...... clinical trial described in this protocol is to evaluate chronic pain after inguinal hernia repair using the ONSTEP method versus the laparoscopic approach. METHODS: This study is designed as a non-inferiority, two-arm, multicentre, randomised clinical trial, with a 1:1 allocation to ONSTEP or laparoscopic...

  20. Vesicocervical fistula following vesicovaginal fistula repair report

    Directory of Open Access Journals (Sweden)

    Hamudur Rahman

    2016-07-01

    Full Text Available Vesicocervical fistula following vesicovaginal fistula repair is a very rare condition. It is a complication following repeated lower uterine cesarean section. We report a case of an young married woman who was admitted in the depart­ment of urology, Banghabandhu Sheikh Mujib Medical University Hospital with vesico-cervical fistula following vesico­vaginal fistula repair. Reposition of cervix into vaginal vault and repair of urinary bladder was done. There was no such report of vesicocervical fistula following vesicovaginal fistula repair from Bangladesh.

  1. ONSTEP versus laparoscopy for inguinal hernia repair

    DEFF Research Database (Denmark)

    Andresen, Kristoffer; Burcharth, Jakob; Rosenberg, Jacob

    2015-01-01

    INTRODUCTION: The optimal repair of inguinal hernias remains controversial. It is recommended that an inguinal hernia be repaired using a mesh, either with a laparoscopic or an open approach. In Denmark, the laparoscopic approach is used in an increasing number of cases. The laparoscopic repair has...... clinical trial described in this protocol is to evaluate chronic pain after inguinal hernia repair using the ONSTEP method versus the laparoscopic approach. METHODS: This study is designed as a non-inferiority, two-arm, multicentre, randomised clinical trial, with a 1:1 allocation to ONSTEP or laparoscopic...

  2. 10 CFR 34.29 - Quarterly inventory.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Quarterly inventory. 34.29 Section 34.29 Energy NUCLEAR... RADIOGRAPHIC OPERATIONS Equipment § 34.29 Quarterly inventory. (a) Each licensee shall conduct a quarterly physical inventory to account for all sealed sources and for devices containing depleted uranium...

  3. Apprentices & Trainees: September Quarter, 2012

    Science.gov (United States)

    National Centre for Vocational Education Research (NCVER), 2013

    2013-01-01

    This publication presents estimates of apprentice and trainee activity in Australia for the September quarter 2012. The figures in this publication are derived from the National Apprentice and Trainee Collection no.74 (December 2012 estimates). The most recent figures in this publication are estimated (those for training activity from the March…

  4. South African Crime Quarterly 59

    African Journals Online (AJOL)

    SA Crime QuArterly No. 59 • mArCh ... Section 77 of the Criminal Procedure Act 51 of 1977 deals with the treatment of persons who are unable to ..... resource considerations alone.36 .... membership of groups; as demonstrated in. President of ...

  5. Area-Wide Management of the Formosan subterranean termite, Coptotermes formosanus, Shiraki (Isoptera: Rhinotermitidae) in the New Orleans French Quarter

    Science.gov (United States)

    The Formosan subterranean termite, Coptotermes formosanus Shiraki (FST) was first introduced to the continental US after WWII. New Orleans’ French Quarter (FQ) in particular has been severely impacted experiencing reoccurring cycles of damages and repairs since FST was introduced to the region 65 ye...

  6. Permeability changes in coal resulting from gas desorption. Tenth quarterly report, January 1, 1992--March 31, 1992

    Energy Technology Data Exchange (ETDEWEB)

    Levine, J.R.; Johnson, P.M.

    1992-12-31

    Research continued on the study of coal permeability and gas desorption. This quarter, most of the effort involved identifying problems with the microbalance and then getting it repaired. Measurement of the amount of gas adsorbed with the microbalance involved corrections for the buoyancy change with pressure and several experiments with helium were made to determine this correction.

  7. Analysis of 28 cases of improved vaginal posterior wall bridge repair%阴道后壁改良桥式修补术28例分析

    Institute of Scientific and Technical Information of China (English)

    赵晓霞

    2015-01-01

    Objective:To discuss Using self prolapse vaginal posterior wall as bridge of posterior wall prolapse repair,at the same time strengthening small purse bulging of rectum,and observing its effectiveness and safety.Methods:28 patients with vaginal wall prolapse were selected from January 2012 to March 2014,using the modified bridge repair treatment,observing the operation time, bleeding volume,follow-up,objectively evaluating the effects of operation.Results:28 cases of the operation were successful, operation time was(13.16±5.32)min,operation hemorrhage was(8.18±4.16)mL,no operation complication,postoperative BP points were located in the(-2.6 ± 0.4)cm,associated symptoms disappeared or improved,following up of 1,3,6 months, the urinate, defecate was normal,no constipation symptoms,no recurrence occurred.Conclusion:Improved bridge repair in the treatment of posterior wall of the vagina is safe,effective,simpleand economic,has shorter operation time,less trauma,low cost and easy operation,no recurrence advantages.It is worth to popularize in the clinical application in basic hospital.%目的:探讨采用自身膨出的阴道后壁作为桥进行后壁膨出修补术,同时小荷包加固膨出的直肠,并观察其有效性和安全性。方法:2012年1月-2014年3月收治阴道后壁膨出患者28例,采用改良桥式修补术治疗,观察手术时间、出血量、随访情况,客观评价手术效果。结果:28例患者手术均获成功,手术时间(13.16±5.32)min,手术出血量(8.18±4.16)mL,无手术并发症发生,术后BP点均位于(-2.6±0.4)cm,相关症状消失或明显改善,随访1,3,6个月排尿、排便正常,无便秘症状出现,无一例复发。结论:改良桥式修补术治疗阴道后壁膨出安全,有效,简便及经济,具有手术时间短、创伤小、价廉易行、不易复发的优点,值得在基层医院临床推广应用。

  8. Dorsal variant blister aneurysm repair.

    Science.gov (United States)

    Couldwell, William T; Chamoun, Roukoz

    2012-01-01

    Dorsal variant proximal carotid blister aneurysms are treacherous lesions to manage. It is important to recognize this variant on preoperative angiographic imaging, in anticipation of surgical strategies for their treatment. Strategies include trapping the involved segment and revascularization if necessary. Other options include repair of the aneurysm rupture site directly. Given that these are not true berry aneurysms, repair of the rupture site involves wrapping or clip-grafting techniques. The case presented here was a young woman with a subarachnoid hemorrhage from a ruptured dorsal variant blister aneurysm. The technique used is demonstrated in the video and is a modified clip-wrap technique using woven polyester graft material. The patient was given aspirin preoperatively as preparation for the clip-wrap technique. It is the authors' current protocol to attempt a direct repair with clip-wrapping and leaving artery sacrifice with or without bypass as a salvage therapy if direct repair is not possible. Assessment of vessel patency after repair is performed by intraoperative Doppler and indocyanine green angiography. Intraoperative somatosensory and motor evoked potential monitoring is performed in all cases. The video can be found here: http://youtu.be/crUreWGQdGo.

  9. DNA repair. [UV radiation

    Energy Technology Data Exchange (ETDEWEB)

    Setlow, R.

    1978-01-01

    Some topics discussed are as follows: difficulty in extrapolating data from E. coli to mammalian systems; mutations caused by UV-induced changes in DNA; mutants deficient in excision repair; other postreplication mechanisms; kinds of excision repair systems; detection of repair by biochemical or biophysical means; human mutants deficient in repair; mutagenic effects of UV on XP cells; and detection of UV-repair defects among XP individuals. (HLW)

  10. Quarterly coal report, October--December 1996

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-05-01

    The Quarterly Coal Report (QCR) provides comprehensive information about US coal production, distribution, exports, imports, receipts, prices, consumption, and stocks to a wide audience, including Congress, Federal and State agencies, the coal industry, and the general public. Coke production, consumption, distribution, imports, and exports data are also provided. This report presents detailed quarterly data for October through December 1996 and aggregated quarterly historical data for 1990 through the third quarter of 1996. Appendix A displays, from 1988 on, detailed quarterly historical coal imports data. To provide a complete picture of coal supply and demand in the US, historical information has been integrated in this report. 8 figs., 72 tabs.

  11. Quarterly coal report, October--December 1998

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-07-01

    The Quarterly Coal Report (QCR) provides comprehensive information about US coal production, distribution, exports, imports, receipts, prices, consumption, and stocks to a wide audience, including Congress, Federal and State agencies, the coal industry, and the general public. Coke production, consumption, distribution, imports, and exports data are also provided. This report presents detailed quarterly data for October through December 1998 and aggregated quarterly historical data for 1992 through the third quarter of 1998. Appendix A displays, from 1992 on, detailed quarterly historical coal imports data. 58 tabs.

  12. Quarterly coal report, January--March 1998

    Energy Technology Data Exchange (ETDEWEB)

    Young, P.

    1998-08-01

    The Quarterly Coal Report (QCR) provides comprehensive information about US coal production, distribution, exports, imports, receipts, prices, consumption, and stocks to a wide audience, including Congress, Federal and State agencies, the coal industry, and the general public. Coke production, consumption, distribution, imports, and exports data are also provided. This report presents detailed quarterly data for January through March 1998 and aggregated quarterly historical data for 1992 through the fourth quarter of 1997. Appendix A displays, from 1992 on, detailed quarterly historical coal imports data. To provide a complete picture of coal supply and demand in the United States, historical information has been integrated in this report. 58 tabs.

  13. Quarterly coal report, April--June, 1998

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-11-01

    The Quarterly Coal Report (QCR) provides comprehensive information about US coal production, distribution, exports, imports, receipts, prices, consumption, and stocks to a wide audience, including Congress, Federal and State agencies, the coal industry, and the general public. Coke production, consumption, distribution, imports, and exports data are also provided. This report presents detailed quarterly data for April through June 1998 and aggregated quarterly historical data for 1992 through the first quarter of 1998. Appendix A displays, from 1992 on, detailed quarterly historical coal imports data. 58 tabs.

  14. 腹膜前间隙腹股沟疝修补术58例%Preperitoneal inguinal hernia repair in 58 cases

    Institute of Scientific and Technical Information of China (English)

    高占明; 王剑峰

    2015-01-01

    目的:总结开放式腹膜前间隙疝修补术治疗腹股沟疝的临床应用及疗效。方法回顾性分析2012年6月至2014年6月,河北省赤城县妇幼保健院收治的腹股沟疝患者58例,均行腹膜前间隙腹股沟疝修补术。观察患者围手术期手术时间、住院时间及相关并发症发生情况。结果本组58例患者均顺利完成手术,手术时间45~120 min,平均(55±3)min;住院时间3~7 d,平均(5.0±1.0) d。术后切口疼痛7例,使用止痛药物治疗予以缓解3例,余患者无需治疗;阴囊肿胀3例,行穿刺引流后治愈;切口皮下积液2例,经换药后痊愈。随访3~12个月,术后慢性疼痛2例,异物感2例,睾丸轻度萎缩1例,无复发。结论开放式腹膜前间隙无张力疝修补术治疗腹股沟疝是一种较为理想的手术方式,具有操作简单、恢复快、并发症少,复发率低的优势,学习曲线短,已广泛应用于外科临床实践。%Objective To summarize the clinical effectiveness of open preperitoneal herniorrhaphy for inguinal hernia. Methods A total of 58 cases of inguinal hernia who underwent preperitoneal hernia repair in Chicheng Maternal and Child Care Service Centre, from June 2012 to December 2014, were enrolled in this retrospective study. The operation time, length of hospitalization stay and complications were noted and recorded. Results All 58 operations were completed successfully, with a mean operation time of (55 ± 3) minuntes (range 45 to 120 minuntes) and a mean length of stay of (5. 0±1. 0) days (range 3 to 7 days). Postoperative incisional pain occurred in 7 patients. Three were relieved by pain killer, and the others could be improved without any treatment. There were 3 cases of scrotal swelling and 2 cases of wound subcutaneous effusion, which were treated by punctured drainage and dressing change, respectively. Following 3 to 12 months, there were 2 postoperative chronic pain, 2 fore body sensation, 1 mild testicular atrophy

  15. How the Brain Repairs Stuttering

    Science.gov (United States)

    Kell, Christian A.; Neumann, Katrin; von Kriegstein, Katharina; Posenenske, Claudia; von Gudenberg, Alexander W.; Euler, Harald; Giraud, Anne-Lise

    2009-01-01

    Stuttering is a neurodevelopmental disorder associated with left inferior frontal structural anomalies. While children often recover, stuttering may also spontaneously disappear much later after years of dysfluency. These rare cases of unassisted recovery in adulthood provide a model of optimal brain repair outside the classical windows of…

  16. Identification of genetic polymorphisms in DNA repair xenoderma pigmentosum group D gene and its association with head and neck cancer susceptibility in rural Indian population: a hospital based case-control study from south-western Maharashtra, India

    Directory of Open Access Journals (Sweden)

    Kailas D. Datkhile

    2016-06-01

    Conclusions: This study indicates that polymorphisms in cd199 of XPD gene could play a role in modifying genetic susceptibility of individual to head and neck cancer in Maharashtra patients. Thus, the case-control study suggest that selected DNA repair genes represent genetic determinants in oral carcinogenesis along with other risk factors in the rural Indian population. [Int J Res Med Sci 2016; 4(6.000: 1997-2005

  17. Single incision laparoscopic primary and incisional ventral hernia repair as the standard of care in the ambulatory setting; Does less equal better outcomes; Case series and literature review

    Directory of Open Access Journals (Sweden)

    Ross O. Downes

    2016-01-01

    Conclusion: SILS prosthetic repair of primary and incisional ventral hernia is easily feasible. In our series, SILS ventral hernia repair appears to be safe and effective. It may decrease parietal trauma augmenting its use in the ambulatory setting. Technology will continue to improve the wide applicability of this technique. Larger randomized trial studies are required to determine the rates of port-site incisional hernia compared with multiport laparoscopy.

  18. ONSTEP versus laparoscopy for inguinal hernia repair

    DEFF Research Database (Denmark)

    Andresen, Kristoffer; Burcharth, Jakob; Rosenberg, Jacob

    2015-01-01

    a learning curve of about 50-100 cases and decreases chronic pain, but slightly increases the risk of serious complications compared with open mesh repairs. Therefore, a simpler kind of operation is needed. The ONSTEP technique is a possible solution to this problem. The objective of the present randomised......INTRODUCTION: The optimal repair of inguinal hernias remains controversial. It is recommended that an inguinal hernia be repaired using a mesh, either with a laparoscopic or an open approach. In Denmark, the laparoscopic approach is used in an increasing number of cases. The laparoscopic repair has...... clinical trial described in this protocol is to evaluate chronic pain after inguinal hernia repair using the ONSTEP method versus the laparoscopic approach. METHODS: This study is designed as a non-inferiority, two-arm, multicentre, randomised clinical trial, with a 1:1 allocation to ONSTEP or laparoscopic...

  19. Imperfect repair and lifesaving in heterogeneous populations

    Energy Technology Data Exchange (ETDEWEB)

    Finkelstein, Maxim [Department of Mathematical Statistics, University of the Free State, PO Box 339, 9300 Bloemfontein (South Africa) and Max Planck Institute for Demographic Research, Rostock (Germany)]. E-mail: FinkelM.SCl@mail.uovs.ac.za

    2007-12-15

    In this theoretical paper we generalize the notion of minimal repair to the heterogeneous case, when the lifetime distribution function can be modeled by continuous or a discrete mixture of distributions. The statistical (black box) minimal repair and the minimal repair based on information just before the failure of an object are considered. The corresponding failure (intensity) rate processes are defined and analyzed. Demographic lifesaving model is also considered: each life is saved (cured) with some probability (or equivalently a proportion of individuals who would have died are now resuscitated and given another chance). Those who are saved experience the statistical minimal repair. Both of these models are based on the Poisson or non-homogeneous Poisson processes of underlying events, which allow for considering heterogeneity. We also consider the new model of imperfect repair in the homogeneous case and present generalizations to the heterogeneous setting.

  20. ONSTEP versus laparoscopy for inguinal hernia repair

    DEFF Research Database (Denmark)

    Andresen, Kristoffer; Burcharth, Jakob; Rosenberg, Jacob

    2015-01-01

    INTRODUCTION: The optimal repair of inguinal hernias remains controversial. It is recommended that an inguinal hernia be repaired using a mesh, either with a laparoscopic or an open approach. In Denmark, the laparoscopic approach is used in an increasing number of cases. The laparoscopic repair has...... a learning curve of about 50-100 cases and decreases chronic pain, but slightly increases the risk of serious complications compared with open mesh repairs. Therefore, a simpler kind of operation is needed. The ONSTEP technique is a possible solution to this problem. The objective of the present randomised...... clinical trial described in this protocol is to evaluate chronic pain after inguinal hernia repair using the ONSTEP method versus the laparoscopic approach. METHODS: This study is designed as a non-inferiority, two-arm, multicentre, randomised clinical trial, with a 1:1 allocation to ONSTEP or laparoscopic...

  1. The complex choreography of transcription-coupled repair.

    Science.gov (United States)

    Spivak, Graciela; Ganesan, Ann K

    2014-07-01

    A quarter of a century has elapsed since the discovery of transcription-coupled repair (TCR), and yet our fascination with this process has not diminished. Nucleotide excision repair (NER) is a versatile pathway that removes helix-distorting DNA lesions from the genomes of organisms across the evolutionary scale, from bacteria to humans. TCR, defined as a subpathway of NER, is dedicated to the repair of lesions that, by virtue of their location on the transcribed strands of active genes, encumber elongation by RNA polymerases. In this review, we will report on newly identified proteins, protein modifications, and protein complexes that participate in TCR in Escherichia coli and in human cells. We will discuss general models for the biochemical pathways and how and when cells might choose to utilize TCR or other pathways for repair or bypass of transcription-blocking DNA alterations.

  2. 腹腔镜腹股沟疝修补术300例%Laparoscopic Inguinal Hernia Repair: Report of 300 Cases

    Institute of Scientific and Technical Information of China (English)

    王卫军; 方钱; 李剑锋; 金鹏飞; 李智涛; 李嘉根

    2011-01-01

    Objective To evaluate the safety and efficacy of laparoscopic inguinal hernia repair.Methods The clinical data of 300 cases ( 357 sides) who received laparoscopic inguinal hernia repair, including 221 cases ( 273 sides) of transabdominal preperitoneal (TAPP) and 79 cases (84 sides) of totally extraperitoneal (TEP), from March 2005 to March 2010 were analyzed retrospectively.In TAPP group, the peritoneum was opened after pneumoperitoneum, the hernia was then pulled back so that to separate the preperitoneal space and place and nail the MESH.In the TEP group, the preperitoneal space was built by blunt dissection, and then Mesh was placed before gas release.Results The procedures were completed successfully in all the 300 cases without conversion to open surgery.The mean operation time for TAPP and TEP was 44.2 min ( 30 - 150 min) and 36.7 min ( 25 -110 min) respectively.No analgesic was used after the procedures.Complications included seroma ( 12.6% , 45/357), temporary nerve paresthesia (6.4% , 23/357), injury to the inferior epigastric artery (1.1% , 4/357), urinary retention (0.6% , 2/357) and injury to the spermatic duct (0.3% , 1/357).The mean postoperative hospital stay was 4.8 d (3 -10 d).The rate of patient taking normal activity in 2 and 4 weeks postoperation was 94.0% (282/300) and 100% respectively.267 patients were followed up for 2 - 60 months (mean,24.2months), during which no recurrence was found.Conclusions Both TAPP and TEP are safe and effective for hernia repair.Surgeons may choose any of them following their own experience.%目的 评价腹腔镜腹股沟疝修补术的安全性和有效性.方法 2005年3月~2010年3月行腹腔镜腹股沟疝修补术300例(357侧),其中TAPP 221例(273侧),TEP 79例(84侧).TAPP:建立气腹后打开腹膜,回纳疝囊,分离出腹膜前间隙,置入补片后钉合器固定,关闭腹膜.TEP:在腹膜前钝性建立足够间隙,回纳疝囊,置入补片覆盖缺损后放气.结果 300例手术全

  3. Laparoscopic Gastroduodenal Ulcer Perforation Repair Experience in 22 Cases and Experience%腹腔镜胃十二指肠溃疡穿孔修补术22例经验与体会

    Institute of Scientific and Technical Information of China (English)

    曾庆敏; 雷福明; 黄文生; 洪宇明; 高兆亚

    2016-01-01

    Objective Laparoscopic gastroduodenal ulcer perforation repair the preliminary operation experience and clini-cal experience. Methods Group selection from October 2012 to April 2016 22 cases of gastroduodenal ulcer perforation in patients with laparoscopic suture repair, the gastric ulcer perforation in 3 cases, 19 cases of duodenal ulcer perforation. Re-sults 22 cases are performed successfully, including transfer laparotomy in 4 cases, 3 cases of complications, including postoperative diaphragm under infection in 1 case, postoperative perforation in 1 case again, intestinal obstruction in 1 case, both the treatment and healing. No perioperative deaths, conclusion laparoscopic Conclusion Gastroduodenal ulcer perfora-tion repair should be strictly grasp the clinical indications, in order to reduce complications, intraoperative need to keep in mind the key points of operation;Revealing or repair difficulties and suspected cases of malignant lesions perforation should be timely transfer laparotomy.%目的:腹腔镜胃十二指肠溃疡穿孔修补术的初步手术经验与临床分析。方法整群选取2012年10月—2016年4月该院收治的22例胃十二指肠溃疡穿孔患者施行腹腔镜下缝合修补术,其中胃溃疡穿孔3例,十二指肠溃疡穿孔19例。结果22例手术均成功,其中中转开腹4例,发生并发症3例,其中术后膈下感染1例、术后再穿孔1例、肠梗阻1例,均经治疗而痊愈。无围手术期死亡病例。结论腹腔镜胃十二指肠溃疡穿孔修补术应严格把握临床适应症,为减少手术并发症,术中需牢记手术要点;遇到暴露或修补困难以及怀疑恶性病变穿孔的病例应及时中转开腹。

  4. Pain after groin hernia repair

    DEFF Research Database (Denmark)

    Callesen, T; Bech, K; Nielsen, R

    1998-01-01

    BACKGROUND: The purpose of the study was to provide a detailed description of postoperative pain after elective day-case open inguinal hernia repair under local anaesthesia. METHODS: This was a prospective consecutive case series study. After 500 hernia operations in 466 unselected patients aged 18...... between types of surgery or hernia. CONCLUSION: Pain remained a problem despite the pre-emptive use of opioids, non-steroidal anti-inflammatory drugs and local anaesthesia, irrespective of surgical technique....

  5. Strategic Studies Quarterly- Spring 2016

    Science.gov (United States)

    2016-01-01

    Khyber Pakhtunkhwa, bordering Afghanistan. A number of analysts agree that if conflict breaks out with India, Pakistan would immediately rede - ploy...the military should not risk its capacity to fight just to become an instrument of social progress but at the same rook pride in ending the...the " social experiments" conducted during his tenure are not yet known. The former Secretary STRATEGIC STUDIES QuARTERLY + SPRING 2016 [ 149] Book

  6. Primary repairing for iatrogenic injury of bile duct:a study of 31 cases%医源性胆管损伤一期修复31例体会

    Institute of Scientific and Technical Information of China (English)

    黄强; 刘臣海; 王成; 胡元国; 汤志刚; 邱陆军; 王士堂; 林先盛

    2011-01-01

    目的 探讨医源性胆管损伤后首次修复的体会.方法 回顾性分析和总结2004年1月至2010年6月安徽省立医院普通外科出现和收治的31例医源性胆管损伤一期修复的病例资料.结果 术中发现即时修复4例,修复方式为胆管修补+胆管引流术.合并胆汁性腹膜炎6例,均先行腹腔+胆管引流术,2个月后再行胆管-空肠Roux-en-Y吻合术.合并黄疸21例,均行胆管-空肠Roux-en-Y吻合,其中损伤后10d内修复5例,10d后修复16例,10d内进行修复者所需手术时间较10d后修复者长(P<0.05).术后均无胆漏出现,获得随访28例,随访4~60个月,2例术后1年出现吻合口狭窄,一期修复成功率为92.9%(26/28).结论 胆管损伤的处理应由有经验的胆道专科医师进行,单纯梗阻型胆管损伤10d后进行操作较容易,以胆管-空肠Roux-en-Y吻合为最佳术式.%Objective To explore the experience of primary repairing for iatrogenic injury of bile duct. Methods The clinical data of 31 cases of primary repairing for iatrogenic injury of bile duct admitted from January 2004 to June 2010 in the Department of General Surgery of Anhui Province Hospital were analyzed and summarized retrospectively. Results Four cases were found and repaired by biliary tract repairing and drainage during the first operation. Six cases of iatrogenic injury of bile duct combined with bile peritonitis were performed abdominal and biliary drainage firstly and then performed Roux-en-Y bile duct-jejunostomy after 2 months. Twenty-one cases combined with jaundice were performed Roux-en-Y bile duct-jejunostomy. Among them, injury repairs in 5 cases were performed within 10 days.Sixteen cases were performed in 10 days after the repairing. The former operation took more time than the latter (P<0.05).No postoperative bile leakage occurred. Twenty-eight cases were followed up for 4-60 months. Two cases occurred anastomotic stenosis after one year. The restoration success rate was 92.9

  7. 开放式肠造口旁疝手术修补法40例分析%Open repair for parastomal hernia: report of 40 cases

    Institute of Scientific and Technical Information of China (English)

    陈革; 唐健雄; 黄磊; 蔡昭; 袁祖荣

    2007-01-01

    Objective To study different procedures of open hernia repair for parastomal hernias. Methods We retrospetively analysed 30 patients with parastomal hernia who had been treated by open hernia repair at our hospital from june 2002 to june 2007. Operative methods, post-operative complications, post-operative hospitalization, and recurrence of hernia were studied. Results No-relocation intraperitonialention parastomal hernia repair has one recurrence. Relocated intraperitonial parastomal hernia repair was performed in one patient. Relocated intraperitonial parastomal hernia repair was done in one patient with seroma. No relocated intraperitonial parastomal hernia repair was done in two patients with delayed incision, nor intestinal erosion and obstruction. Hospital stay after operation with no-relocation intraperitonial parastomal hernia repair was 10~14 days. Hospitalization after operation with relocation intraperitonial parastomal hernia repair was18~21 days. Conclusion The results of hernia repair for parastomal hernias are promising.%目的 分析开放式肠造口旁疝的手术修补方法存在的问题.方法 对2002年6月至2007年6月30例肠造口旁疝患者的手术方式、术后并发症、住院时间、复发情况进行回顾分析.结果 原位腹腔内造口疝修补术和移位造口疝修补术各有1例复发.移位造口疝修补术后有1例皮下积液.原位腹膜前造口疝修补术有2例伤口愈合不良.未发生肠坏死及肠梗阻等术后并发症.原位腹腔内和腹膜前造口疝修补术后住院时间10~14 d,移位造口疝修补术后住院时间18~21 d.结论 肠造口旁疝修补术的方法还有待进一步改进.

  8. Pectus excavatum repair

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/002949.htm Pectus excavatum repair To use the sharing features on this page, please enable JavaScript. Pectus excavatum repair is surgery to correct pectus excavatum . This ...

  9. 无张力疝修补术治疗腹股沟疝436例报告%Treating436 cases of inguinal hernia by tension-free hernia repairing surgery

    Institute of Scientific and Technical Information of China (English)

    李继东; 冯帆

    2015-01-01

    Objective: To investigate clinical effects of tension-free hernia repairing srugery on inguinal hernia. Methods: Clinical data of 436 cases of inguinal hernia was analyzed retrospectively. Results: After the surgery, all patients were alive. 18 cases were infected, 12 cases of scrotal hematoma, 2 cases of recurrence, 2 cases of chronic pain. Conclusion: Tension-free hernia repairing surgery was effective on inguinal hernia, should be standardized in order to reduce the incidence of complications.%目的:探讨无张力疝修补术治疗腹股沟疝的临床效果。方法:回顾性分析2004年6月-2014年10月在焦作市人民医院普外一区开展腹股沟疝无张力修补术治疗的436例患者的临床资料。结果:无手术死亡病例。术后切口感染愈合不良者18例,阴囊血肿者12例,复发2例,慢性疼痛者2例。结论:无张力疝修补术治疗腹股沟疝安全有效,应规范化操作以降低并发症的发病率。

  10. Onychomycosis in close quarter living review of the literature.

    Science.gov (United States)

    Gazes, Michael I; Zeichner, Joshua

    2013-11-01

    Onychomycosis is defined as a fungal infection of the nail bed and/or nail plate. The prevalence of onychomycosis has increased dramatically as a worldwide condition in the twentieth century due to occlusive footwear, global wars and natural migration. Risk factors generally leading to onychomycosis development include bodily spread of dermatophyte and non-dermatophyte tinea pedis, peripheral vascular disease, damaged nails via sports and trauma, older age, genetics, immunodeficiency and diabetes. Many publications discuss prevalence, symptoms and treatment of the disease in individual cases, hospitals or specific locations, but few strongly link the cause of onychomycosis to living environments. This is a review of the current literature on the prevalence of onychomycosis and its relationship to surrounding living environments of those infected. A Pubmed search was performed with 'onychomycosis'. Articles were selected based on the relevance to close quarter living environments. All ages can be affected with onychomycosis, ranging from children in boarding schools to elderly in nursing homes. Although not directly linking living environments to transmission and infection in all articles reviewed, onychomycosis was very prevalent in many different close quarter living settings, including within families, boarding schools, military quarters and nursing homes. This review demonstrates that various close quarter living environments are highly associated with increased transmission and infection with onychomycosis.

  11. Quarterly coal report, October--December 1994

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-05-23

    The Quarterly Coal Report (QCR) provides comprehensive information about US coal production, distribution, exports, imports, receipts, prices, consumption, and stocks to a wide audience, including Congress, Federal and State agencies, the coal industry, and the general public. Coke production, consumption, distribution, imports, and exports data are also provided. The data presented in the QCR are collected and published by the Energy Information Administration (EIA) to fulfill data collection and dissemination responsibilities as specified in the Federal Energy Administration Act of 1974 (Public Law 93-275), as amended. This report presents detailed quarterly data for October through December 1994 and aggregated quarterly historical data for 1986 through the third quarter of 1994. Appendix A displays, from 1986 on, detailed quarterly historical coal imports data, as specified in Section 202 of the Energy Policy and Conservation Amendments Act of 1985 (Public Law 99-58). Appendix B gives selected quarterly tables converted to metric tons.

  12. Quarterly coal report, January--March 1995

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-08-24

    The Quarterly Coal Report (QCR) provides comprehensive information about US coal production, distribution, exports, imports, receipts, prices, consumption, and stocks to a wide audience, including Congress, Federal and State agencies, the coal industry, and the general public. Coke production, consumption, distribution, imports, and exports data are also provided. The data presented in the QCR are collected and published by the Energy Information Administration (EIA) to fulfill data collection and dissemination responsibilities as specified in the Federal Energy Administration Act of 1974 (Public Law 93-275), as amended. This report presents detailed quarterly data for January through March 1995 and aggregated quarterly historical data for 1987 through the fourth quarter of 1994. Appendix A displays, from 1987 on, detailed quarterly historical coal imports data, as specified in Section 202 of the Energy Policy and Conservation Amendments Act of 1985 (Public Law 99-58). Appendix B gives selected quarterly tables converted to metric tons.

  13. Quarterly coal report, October--December 1997

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-05-01

    The Quarterly Coal Report (QCR) provides comprehensive information about US coal production, distribution, exports, imports, receipts, prices, consumption, and stocks to a wide audience, including Congress, Federal and State agencies, the coal industry, and the general public. Coke production, consumption, distribution, imports, and exports data are also provided. The data presented in the QCR are collected and published by the Energy Information Administration (EIA) to fulfill data collection and dissemination responsibilities. This report presents detailed quarterly data for october through December 1997 and aggregated quarterly historical data for 1991 through the third quarter of 1997. Appendix A displays, from 1991 on, detailed quarterly historical coal imports data, as specified in Section 202 of the energy Policy and Conservation Amendments Act of 1985 (Public Law 99-58). Appendix B gives selected quarterly tables converted to metric tons. To provide a complete picture of coal supply and demand in the US, historical information has been integrated in this report. 8 figs., 73 tabs.

  14. Quarterly coal report, January--March 1994

    Energy Technology Data Exchange (ETDEWEB)

    1994-08-24

    The Quarterly Coal Report (QCR) provides comprehensive information about US coal production, distribution, exports, imports, receipts, prices, consumption, and stocks to a wide audience, including Congress, Federal and State agencies, the coal industry, and the general public. Coke production, consumption, distribution, imports, and exports data are also provided. The data presented in the QCR are collected and published by the Energy Information Administration (EIA) to fulfill data collection and dissemination responsibilities as specified in the Federal Energy Administration Act of 1974 (Public Law 93-275), as amended. This report presents detailed quarterly data for January through March 1994 and aggregated quarterly historical data for 1986 through the fourth quarter of 1993. Appendix A displays, from 1986 on, detailed quarterly historical coal imports data, as specified in Section 202 of the Energy Policy and Conservation Amendments Act of 1985 (Public Law 99-58). Appendix B gives selected quarterly tables converted to metric tons.

  15. Short-term energy outlook, quarterly projections, second quarter 1998

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-04-01

    The Energy Information Administration (EIA) prepares quarterly short-term energy supply, demand, and price projections. The details of these projections, as well as monthly updates, are available on the Internet at: www.eia.doe.gov/emeu/steo/pub/contents.html. The paper discusses outlook assumptions; US energy prices; world oil supply and the oil production cutback agreement of March 1998; international oil demand and supply; world oil stocks, capacity, and net trade; US oil demand and supply; US natural gas demand and supply; US coal demand and supply; US electricity demand and supply; US renewable energy demand; and US energy demand and supply sensitivities. 29 figs., 19 tabs.

  16. Applied Meteorology Unit (AMU) Quarterly Report - Fourth Quarter FY-09

    Science.gov (United States)

    Bauman, William; Crawford, Winifred; Barrett, Joe; Watson, Leela; Wheeler, Mark

    2009-01-01

    This report summarizes the Applied Meteorology Unit (AMU) activities for the fourth quarter of Fiscal Year 2009 (July - September 2009). Tasks reports include: (1) Peak Wind Tool for User Launch Commit Criteria (LCC), (2) Objective Lightning Probability Tool. Phase III, (3) Peak Wind Tool for General Forecasting. Phase II, (4) Update and Maintain Advanced Regional Prediction System (ARPS) Data Analysis System (ADAS), (5) Verify MesoNAM Performance (6) develop a Graphical User Interface to update selected parameters for the Hybrid Single-Particle Lagrangian Integrated Trajectory (HYSPLlT)

  17. Applied Meteorology Unit (AMU) Quarterly Report Third Quarter FY-08

    Science.gov (United States)

    Bauman, William; Crawford, Winifred; Barrett, Joe; Watson, Leela; Dreher, Joseph

    2008-01-01

    This report summarizes the Applied Meteorology Unit (AMU) activities for the third quarter of Fiscal Year 2008 (April - June 2008). Tasks reported on are: Peak Wind Tool for User Launch Commit Criteria (LCC), Anvil Forecast Tool in AWIPS Phase II, Completion of the Edward Air Force Base (EAFB) Statistical Guidance Wind Tool, Volume Averaged Height Integ rated Radar Reflectivity (VAHIRR), Impact of Local Sensors, Radar Scan Strategies for the PAFB WSR-74C Replacement, VAHIRR Cost Benefit Analysis, and WRF Wind Sensitivity Study at Edwards Air Force Base

  18. When "Other" Initiate Repair.

    Science.gov (United States)

    Schegloff, Emanuel A.

    2000-01-01

    Elaborates on the locus of other-initiated repair, and reports on a number of environments in which others initiate repair turns later than the one directly following the trouble-source turn. Describes several ways that other initiation of repair, which occurs in next-turn position, may be delayed within that position. (Author/VWL)

  19. 改良式消化性溃疡穿孔修补术治疗消化性溃疡穿孔68例%Sixty-eight cases of modified surgical repair of peptic ulcer perforation

    Institute of Scientific and Technical Information of China (English)

    张保远; 曹素琴

    2015-01-01

    Objective To investigate clinical efficacy of modified surgical repair on peptic ulcer perforation. Methods From June 2011 to June 2013,sixty-eight patients with peptic ulcer perforation in our hospital were selected as study group,including 30 cases of gastric ulcer perforation and 38 cases of duodenal ulcer perforation,the patients were treated by modified surgical repair. The data of the operation were reviewed and the clinical application value of the modi-fied repair were summarized. Results The operation time was(50. 2 ± 2. 5)min,post-operative hospitalization was (8. 2 ± 1. 1 ) d,postoperative follow-up was 3 ~ 6 months,1 cases of late gastric antrum cancer died at postoperative 2 months,1case of concurrent diaphrag-matic drainage of abscess in the drainage tube fully recovered. Three cases recurrecl after surgery for 6 months,the recur-rence rate was 4. 41%,2 cases recovered after the medicine conservative treatment,another 1 case after medical treatment was invalid for most gastric resection surgery recovery . The rest of the 63 cases of ulcer perforation were cured by surgical repair of a modified success,one-time repair cure rate was 92. 65%. Conclusions Improved surgical repair of peptic ul-cer perforation has good curative effect on patients with peptic ulcer perforation,and the operation is simple,recurrence rate is low,so it is worthy to be popularized.%目的:探讨改良式消化性溃疡穿孔修补术治疗消化性溃疡穿孔的临床效果。方法选择2011年6月至2013年6月收治的消化性溃疡穿孔患者68例,其中胃溃疡穿孔30例、十二指肠溃疡穿孔38例,均给予改良式消化性溃疡穿孔修补手术治疗。结果68例患者手术时间(50.2±2.5)min;术后平均住院(8.2±1.1)d;术后随访3~6个月,其中1例在术后2个月时胃窦癌晚期死亡,1例并发膈下脓肿在经引流管充分引流后痊愈。3例在术后6个月内复发,复发率为4.41%,其中2例经内

  20. Quarterly coal report, April--June 1990

    Energy Technology Data Exchange (ETDEWEB)

    1990-11-02

    The Quarterly Coal Report provides comprehensive information about US coal production, exports, imports, receipts, consumption, and stocks to a wide audience, including Congress, Federal and State agencies, the coal industry, and the general public. This issue presents detailed quarterly data for April 1990 through June 1990, aggregated quarterly historical data for 1982 through the second quarter of 1990, and aggregated annual historical data for 1960 through 1989 and projected data for selected years from 1995 through 2010. To provide a complete picture of coal supply and demand in the United States, historical information and forecasts have been integrated in this report. 7 figs., 37 tabs.

  1. The use of suture anchors to repair the ruptured quadriceps tendon.

    Science.gov (United States)

    Bushnell, Brandon D; Whitener, George B; Rubright, James H; Creighton, R Alexander; Logel, Kevin J; Wood, Mark L

    2007-07-01

    Quadriceps tendon rupture is an incapacitating injury that usually requires surgical repair. Traditional repair methods involve transpatellar suture tunnels, but recent reports have introduced the idea of using suture anchors to repair the ruptured tendon. We present 5 cases of our technique of using suture anchors to repair the ruptured quadriceps tendon.

  2. PECTUS EXCAVATUM: REPARACIóN CON LA TéCNICA DE NUSS. SERIE DE 10 CASOS Pectus excavatum: repair with Nuss technique. A series of 10 cases

    Directory of Open Access Journals (Sweden)

    Fernando Fierro-ávila

    2009-01-01

    Full Text Available Antecedentes. En 1997 Donald Nuss y colaboradores publicaron su experiencia en la Reparación Mínimamente Invasiva del Pectus Excavatum (RIMPE. Esta técnica basada en los principios físicos de la caja torácica y en las observaciones hechas a partir de la técnica abierta cambió radicalmente el tratamiento de la enfermedad, siendo adoptada por los cirujanos en el mundo entero. Objetivo. Describir los resultados de la Reparación Mínimamente Invasiva del Pectus Excavatum (RIMPE en la Clínica Infantil Colsubsidio. Material y métodos. Se realizó un estudio descriptivo de serie de casos de los pacientes tratados con la técnica de Nuss en la Clínica Infantil Colsubsidio durante el período comprendido entre diciembre 2004 y julio del 2008. La recolección de datos fue realizada con base en historias clínicas, tomando datos personales, familiares y paraclínicos. Se evaluaron los resultados quirúrgicos incluyendo tiempo de cirugía, complicaciones tempranas, complicaciones tardías y uso de analgésicos. Resultados. Se incluyeron 10 pacientes entre los 13 y 17 años. El 90 por ciento de los pacientes fueron hombres. El resultado estético fue satisfactorio en todos los casos. Las complicaciones más frecuentes fueron dos de neumotórax y dos de desplazamiento de la barra. No se presentó ningún caso de infección, alergia, derrame pleural, pericarditis, o hemotórax . Discusión. Esta serie de casos describe nuestra experiencia inicial, encontrando que la cirugía de Nuss es una técnica segura, reproducible, con buenos resultados en la mayoría de los pacientes y con una rápida recuperación funcional y estética. Las complicaciones que se presentaron en nuestra serie corresponden a las reportadas en la literatura mundial.Background. In 1997 Donald Nuss and cols published their experience in the Minimally Invasive Repair for Pectus Excavatum (MIRPE. This procedure, based on the physical properties of the thoracic cage and the

  3. Quarterly coal report, January--March 1993

    Energy Technology Data Exchange (ETDEWEB)

    1993-08-20

    The United States produced 242 million short tons of coal in the first quarter of 1993, a decrease of 6 percent (14 million short tons) from the amount produced during the first quarter of 1992. The decrease was due to a decline in production east of the Mississippi River. All major coal-producing States in this region had lower coal production levels led by West Virginia, which produced 5 million short tons less coal. The principal reasons for the overall drop in coal output compared to a year earlier were: A decrease in demand for US coal in foreign markets; a slower rate of producer/distributor stock build-up; and a drawn-down of electric utility coal stocks. Distribution of US coal in the first quarter of 1993 was 10 million short tons lower than in the first quarter of 1992, with 5 million short tons less distributed to both electric utilities and overseas markets. The average price of coal delivered to electric utilities during the first quarter of 1993 was $28.65 per short ton, the lowest value since the first quarter of 1980. Coal consumption in the first quarter of 1993 was 230 million short tons, 4 percent higher than in the first quarter of 1992, due primarily to a 5-percent increase in consumption at electric utility plants. Total consumer stocks, at 153 million short tons, and electric utility stocks, at 144 million short tons, were at their lowest quarterly level since the end of 1989. US. coal exports totaled 19 million short tons, 6 million short tons less than in the first quarter of 1992, and the lowest quarterly level since 1988. The decline was primarily due to a 1-million-short-ton drop in exports to each of the following destinations: Italy, France, Belgium and Luxembourg, and Canada.

  4. PFBC HGCU test facility technical progress report. First Quarter, CY 1994

    Energy Technology Data Exchange (ETDEWEB)

    1994-04-01

    This is the eighteenth Technical Progress Report submitted in connection with the cooperative agreement between the DOE and Ohio Power Company for the Tidd PFBC Hot Gas Clean Up Test Facility. During this quarter, the Tidd Hot Gas Clean Up System operated for 835 hours during six separate test runs. The system was starting into a seventh run at the end of the quarter. Highlights of this period are summarized below: the longest run during the quarter was approximately 333 hours; filter pressure drop was stable during all test runs this quarter using spoiling air to the primary cyclone upstream of the Advanced Particle Filter (APF); the tempering air system was commissioned this quarter which enabled the unit to operate at full load conditions while limiting the gas temperature in the APF to 1,400 F; during a portion of the one run, the tempering air was removed and the filter operated without problems up to 1,450 F; ash sampling was performed by Battelle personnel upstream and downstream of the APF and ash loading and particle size distribution data were obtained, a summary report is included; a hot area on the APF head was successfully repaired in service; a hot spot on the top of an expansion joint was successfully repaired by drilling holes from the inside of the pipe and pumping in refractory insulation; a corrosion inspection program for the HGCU system was issued giving recommendations for points to inspect; filter internal inspections following test runs 13 and 17 revealed a light coating (up to 1/4 inch thick) of residual ash on the candles and some ash bridging between the dust sheds and inner rows of candles. Data from these inspections are included with this report.

  5. 对于腹股沟疝无张力修补术41例及腹股沟嵌顿疝修补术4例临床分析%Clinical Analysis of 4 Cases of Incarcerated Hernia in 41 Cases and Groin Tension-free Repair of Inguinal Hernia

    Institute of Scientific and Technical Information of China (English)

    姚增庆

    2014-01-01

    目的探析腹股沟疝无张力修补术及腹股沟嵌顿疝修补术的临床治疗效果。方法将我院接收的45例腹股沟疝患者作为观察对象,分析总结腹股沟疝无张力修补术及腹股沟嵌顿疝修补术的临床效果。结果本组45例患者,有4例患者为急诊手术行腹股沟嵌顿疝修补术,41例患者行腹股沟疝无张力修补术,手术后有4例患者发生尿潴留,2例患者出现阴囊水肿,3例患者有伤口异物感,2例患者有切口哆开。所有患者均随访2~3个月,未见有复发病例。结论腹股沟疝无张力修补手术简单安全创伤小,手术后恢复快。复发率低,是较为理想的手术方式,值得临床应用和推广,腹股沟嵌顿疝急诊手术宜选用传统疝修补术。%Objective To explore surgical repair of inguinal hernia without tension and inguinal incarcerated hernia repair of clinical therapeutic ef ect. Methods 45 patients with inguinal hernia were to be received in our as research object, analysis summary repair and inguinal incarcerated inguinal hernia without tension hernia repair of clinical ef ect. Results 45 patients, there are four patients for emergency operation line of inguinal incarcerated hernia repair, 41 cases of patients with inguinal hernia repair without tension, occur ed in 4 patients urinary retention after operation, 2 cases of patients with scrotal edema, 3 patients had wound foreign body sensation, 2 patients had cut duo. Al patients were fol owed up for 2~3 months, no recur ence cases. Conclusion The inguinal hernia without tension repair operation simple and safe smal trauma, rapid recovery after surgery. The recur ence rate is low, is the ideal way of surgery, worthy of clinical application and popularization, inguinal incarcerated hernia emergency operation appropriate chooses the traditional hernia repair.

  6. Arthroscopic Bankart repair combined with remplissage technique for the treatment of anterior shoulder instability with engaging Hill-Sachs lesion: a report of 49 cases with a minimum 2-year follow-up.

    Science.gov (United States)

    Zhu, Yi-Ming; Lu, Yi; Zhang, Jin; Shen, Jie-Wei; Jiang, Chun-Yan

    2011-08-01

    Engaging Hill-Sachs lesions are known to be a risk factor for recurrence dislocation after arthroscopic repair in patients with anterior shoulder instability. For a large engaging Hill-Sachs lesion, arthroscopic remplissage is a solution. Arthroscopic Bankart repair combined with the Hill-Sachs remplissage technique can achieve good results without significant impairment of shoulder function. Case Series; Level of evidence, 4. Forty-nine consecutive patients who underwent arthroscopic Bankart repair and Hill-Sachs remplissage for anterior shoulder instability were followed up for a mean duration of 29.0 months (range, 24-35 months). There were 42 males and 7 females with a mean age of 28.4 years (range, 16.7-54.7 years). All patients had diagnosed traumatic unidirectional anterior shoulder instability with a bony lesion of glenoid and an engaging Hill-Sachs lesion. Physical examination, radiographs, and magnetic resonance imaging were performed during postoperative follow-up. The American Shoulder and Elbow Surgeons (ASES) score, Constant score, and Rowe score were used to evaluate shoulder function. The active forward elevation increased a mean of 8.0° (range, -10° to 80°) postoperatively. However, the patients lost 1.9° (range, -40° to 30°) of external rotation to the side. Significant improvement was detected with regard to the ASES score (84.7 vs 96.0, P lesion was shown by magnetic resonance imaging. Arthroscopic Bankart repair combined with Hill-Sachs remplissage can restore shoulder stability without significant impairment of shoulder function in patients with engaging Hill-Sachs lesions.

  7. Method of repairing discontinuity in fiberglass structures

    Science.gov (United States)

    Gelb, L. L.; Helbert, W. B., Jr.; Enie, R. B.; Mulliken, R. F. (Inventor)

    1974-01-01

    Damaged fiberglass structures are repaired by substantially filling the irregular surfaced damaged area with a liquid, self-curing resin, preferably an epoxy resin mixed with chopped fiberglass, and then applying to the resin surface the first of several woven fiberglass swatches which has stitching in a zig-zag pattern parallel to each of its edges and a fringe of warp and fill glass fibers about the edges outward of the stitching. The method is especially applicable to repair of fiberglass rocket engine casings and is particularly advantageous since it restores the repaired fiberglass structure to substantially its original strength without any significant changes in the geometry or mass of the structure.

  8. Weldon Spring Site Remedial Action Project quarterly environmental data summary (QEDS) for fourth quarter 1998

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-02-01

    This report contains the Quarterly Environmental Data Summary (QEDS) for the fourth quarter of 1998 in support of the Weldon Spring Site Remedial Action Project Federal Facilities Agreement. The data, except for air monitoring data and site KPA generated data (uranium analyses) were received from the contract laboratories, verified by the Weldon Spring Site verification group, and merged into the database during the fourth quarter of 1998. KPA results for on-site total uranium analyses performed during fourth quarter 1998 are included. Air monitoring data presented are the most recent complete sets of quarterly data.

  9. United States housing, fourth quarter 2013

    Science.gov (United States)

    Delton Alderman

    2017-01-01

    In the beginning of 2013, the U.S. housing construction market indicated increases in all sectors; yet, by the fourth quarter’s end, only housing under construction improved. Moderation and declines are to be expected in the fourth quarter, as winter is setting in. Permits, starts, housing under construction, completions, and new and existing house sales all exceeded...

  10. United States housing, second quarter 2013

    Science.gov (United States)

    Delton Alderman

    2017-01-01

    The U.S. housing market’s quarter two results were disap¬pointing compared with the first quarter. Although overall expected gains did not materialize, certain sectors improved slightly. Housing under construction, completions, and new and existing home sales exhibited slight increases. Overall permit data declined, and the decrease in starts was due primarily to a...

  11. [Complications of inguinal hernia repair].

    Science.gov (United States)

    Forte, A; D'Urso, A; Gallinaro, L S; Lo Storto, G; Bosco, M R; Vietri, F; Beltrami, V

    2002-03-01

    It's shown by literature and confirmed by Author's experience that, on account of the excellent results, prosthetic repair of inguinal hernia is more effective than "conventional" (Bassini, Mc Vay, Shouldice). Between January 1993 and December 2000 were observed 875 patients with inguinal hernia (814 monolateral, 61 bilateral); all patients underwent a Lichtenstein repair both in the primary version and in its variations (internal ring plastic, trasversalis plicate, plug repair). The patients were discharged from hospital within 24 hours after surgery in 90% of cases. No important intraoperative complications were observed; the patients restarting work varied from 3 to 15 days after the discharging in relation to patient anxiety, onset of complications and to the type of work. The complications observed were: urine retention (1.6%), superficial haematoma (1.3%), superficial infection (1%), wound suppuration (0.5%), serous effusion (0.7%), postsurgery pain (2.1%), scrotal edema (1.7%), persistent inguinal neuralgia (0.6), local hypoesthesia (4.3%), ischemical orchitis (0.1%), recurrence (0.2%). In conclusion Authors assert that "tension free" repair allows optimal results both for the surgery point (easiness of the technique, repeatability, less invasivity, scanty incident of recurrences, low frequency of postoperative complications) and in economic terms, allowing an early mobilization of the patients. A further improvement would be obtained with more care in surgical and patient management, with more excellent results.

  12. Applied Meteorology Unit (AMU) Quarterly Report - Fourth Quarter FY-10

    Science.gov (United States)

    Bauman, William; Crawford, Winifred; Barrett, Joe; Watson, Leela; Wheeler, Mark

    2010-01-01

    Three AMU tasks were completed in this Quarter, each resulting in a forecast tool now being used in operations and a final report documenting how the work was done. AMU personnel completed the following tasks (1) Phase II of the Peak Wind Tool for General Forecasting task by delivering an improved wind forecasting tool to operations and providing training on its use; (2) a graphical user interface (GUI) she updated with new scripts to complete the ADAS Update and Maintainability task, and delivered the scripts to the Spaceflight Meteorology Group on Johnson Space Center, Texas and National Weather Service in Melbourne, Fla.; and (3) the Verify MesoNAM Performance task after we created and delivered a GUI that forecasters will use to determine the performance of the operational MesoNAM weather model forecast.

  13. Idaho National Laboratory Quarterly Occurrence Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Mitchell, Lisbeth Ann [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2015-11-01

    This report is published quarterly by the Idaho National Laboratory (INL) Quality and Performance Management Organization. The Department of Energy (DOE) Occurrence Reporting and Processing System (ORPS), as prescribed in DOE Order 232.2, “Occurrence Reporting and Processing of Operations Information,” requires a quarterly analysis of events, both reportable and not reportable, for the previous 12 months. This report is the analysis of 85 reportable events (18 from the 4th Qtr FY-15 and 67 from the prior three reporting quarters), as well as 25 other issue reports (including events found to be not reportable and Significant Category A and B conditions) identified at INL during the past 12 months (8 from this quarter and 17 from the prior three quarters).

  14. The Proposal of Demand Estimation of Repairable Items for the Weapon Systems During the Initial Support Period: F-16 Case Study

    Directory of Open Access Journals (Sweden)

    Bahtiyar Eren

    2012-02-01

    Full Text Available Every country that has military systems such as aircraft, radar, warship or tank has to meet the operational needs of those military systems in order to keep them ready for military operations. Logistics support needs are defined basically either before or after procurement. If they are defined before procurement, they are called "initial support requirement", otherwise called "sustainment support requirement". Due to the fact that new system will be added into the Turkish military inventory, it is focused on the initial support requirement phase. In addition to that, it is focused on repairable items since most of the material acquisition cost within the initial support budget is allocated to repairable items. In this study, within the scope of initial support requirements,the method that produces much better results in terms of quantity and cost perspective than the ones used in Turkey and USA is established and demonstrated by using real data set of F-16.

  15. A non-invasive technique for standing surgical repair of urinary bladder rupture in a post-partum mare: a case report

    Directory of Open Access Journals (Sweden)

    Stephen JO

    2009-11-01

    Full Text Available Abstract An 11-year-old mare presented 36 hours after foaling with a ruptured bladder. Uroperitoneum was diagnosed on ultrasound and from the creatinine concentration of the peritoneal fluid. Bladder endoscopy demonstrated tissue necrosis and a rent in the dorsocranial aspect of the bladder. Following stabilisation, including abdominal drainage and lavage, the mare was taken to standing surgery. Under continuous sedation and epidural anaesthesia, and after surgical preparation, a Balfour retractor was placed in the vagina. Using sterile lubricant and moderate force, it was possible to insert a hand into the bladder. The tear was easily palpable on the dorsal portion of the bladder. Two fingers were inserted through the tear and used to provide traction to evert the bladder completely into the vagina where it could grasped with the surgeons other hand to prevent further trauma. A second surgeon could then visualise the entire tear and repaired this using a single layer of size zero PDS suture in a single continuous pattern. As soon as the bladder was repaired, it was replaced via the urethra. The mare did well after surgery and was discharged after 48 hours, apparently normal. This report is the first describing repair of the bladder without an abdominal incision or incision into the urethral sphincter. This greatly reduces the chance of possible complications such as urine pooling after surgery with the previously described standing technique or bladder trauma due to traction with abdominal surgery.

  16. Sudden cardiac death after repair of anomalous origin of left coronary artery from right sinus of Valsalva with an interarterial course : Case report and review of the literature.

    Science.gov (United States)

    Nguyen, A L; Haas, F; Evens, J; Breur, J M P J

    2012-11-01

    Anomalous aortic origin of the coronary artery from the opposite sinus with interarterial course (AAOCA) is a rare condition with a high risk of sudden cardiac death (SCD) during or after strenuous exertion. SCD after repair of this anomaly is extremely rare. Here we present a 15-year-old athlete who collapsed on the basketball court in whom an anomalous origin of the left coronary artery from the right sinus of Valsalva with interarterial course (ALCA) was diagnosed. In spite of extensive pre-sport participation testing, SCD occurred shortly after surgical correction. We reviewed the literature to establish an evidence-based recommendation to aid physicians in conducting the optimal pre-sport participation management for the prevention of SCD in patients with a surgically corrected AAOCA/ALCA, especially for those who participate in strenuous exercise. Review of the literature (60 articles with 325 patients) reveals that post-surgical, pre-sport participation testing varies greatly but that mortality after surgical repair is extremely low (1.5 %). In conclusion, SCD can still rarely occur after repair of AAOCA despite extensive pre-sport participation testing. This should raise awareness among physicians treating these patients and raises the question whether or not return-to-play guidelines need to be revised.

  17. QUARTER-WISE COMPARATIVE PREVALENCE OF MASTITIS IN BUFFALOES AND CROSSBRED COWS

    Directory of Open Access Journals (Sweden)

    A. Z. Khan and G. Muhammad1

    2005-01-01

    Full Text Available The present study was designed to determine the quarter-wise comparative prevalence of mastitis in buffaloes and crossbred cows. Milk samples collected from 50 dairy buffaloes and 50 crossbred cows were tested for subclinical mastitis by Surf Field Mastitis Test. In addition, all milk samples were processed for isolation and identification of pathogens. In buffaloes, overall prevalence of subclinical mastitis was 27%, clinical mastitis 4% and blind quarters 10%. In crossbred cows, subclinical mastitis was observed in 36%, clinical mastitis in 5.5% and blind quarters in 8% quarters. Prevalence was higher (32% in hindquarters of crossbred cows than those of buffaloes (29%. Among the isolates, Staphylococcus aureus showed the highest (45% frequency, followed by Streptococcus agalactiae (23%, E. coli (18% and Bacillus spp. (14% in buffaloes. In case of crossbred cows, Staphylococcus aureus , Streptococcus agalactiae , E. coli and Bacillus spp. were isolated from 48, 30, 13 and 8% milk samples respectively.

  18. Optimality in DNA repair.

    Science.gov (United States)

    Richard, Morgiane; Fryett, Matthew; Miller, Samantha; Booth, Ian; Grebogi, Celso; Moura, Alessandro

    2012-01-07

    DNA within cells is subject to damage from various sources. Organisms have evolved a number of mechanisms to repair DNA damage. The activity of repair enzymes carries its own risk, however, because the repair of two nearby lesions may lead to the breakup of DNA and result in cell death. We propose a mathematical theory of the damage and repair process in the important scenario where lesions are caused in bursts. We use this model to show that there is an optimum level of repair enzymes within cells which optimises the cell's response to damage. This optimal level is explained as the best trade-off between fast repair and a low probability of causing double-stranded breaks. We derive our results analytically and test them using stochastic simulations, and compare our predictions with current biological knowledge.

  19. 整形外科缝合技术I期修复面部外伤的84例体会%Plastic surgeons suture technology I repair experience of 84 cases of facial trauma

    Institute of Scientific and Technical Information of China (English)

    郭崴

    2014-01-01

    目的:探讨整形外科缝合技术应用于面部外伤Ⅰ期修复的效果。方法收集2011年1月至2013年1月,我院收治的面部外伤患者84例,应用整形外科缝合技术进行修复治疗,总结治疗效果及经验。结果本组84例患者均经整形外科技术修复,创面Ⅰ期愈合,经皮瓣或皮片修复者均成活,且颜色基本接近正常肤色。随访1~3年未见组织错位、增生性瘢痕形成、功能障碍以及面部器官移位等。结论整形外科缝合技术应用于面部软组织损伤修复可实现外观及功能的良好恢复,为Ⅱ期修复提供有利条件。%Objective to study the plastic surgeons suture technique is applied to facial trauma Ⅰ repair effect. Methods collected from January 2011 to January 2011, our hospital 84 cases of patients with facial trauma and orthopedic surgical suture technique was used to repair treatment, summarizes the treatment effect and experience. Results 84 patients were repaired by plastic surgery technique, Ⅰ healing of the wound, the skin flap or skin repair are survival, and basic close to normal skin color. follow-up of 1 ~ 3 years did not see dislocation, hyperplastic scar formation, dysfunction and facial organs shift, etc. Conclusion the orthopedic surgical suture technique is applied to repair of facial soft tissue injuries can achieve good recovery of appearance and function, provide favorable conditions for Ⅱ phase.

  20. Large myelomeningocele repair

    Directory of Open Access Journals (Sweden)

    Farideh Nejat

    2011-01-01

    Full Text Available Background: Wound closure is accomplished in most cases of myelomeningocele (MMC by undermining of the skin edges surrounding the defect. However, large defects cannot be closed reliably by this simple technique. Due to the technical challenge associated with large MMC, surgeons have devised different methods for repairing large defects. In this paper, we report our experience of managing large defects, which we believe bears a direct relationship to decrease the incidence of wound complications. Materials and Methods: Forty children with large MMCs underwent surgical repair and represent our experience. We recommend using all hairy skin around the defect as a way to decrease the tension on the edges of the wound and the possible subsequent necrosis. It is our experience that vertical incision on one or two flanks parallel to the midline can decrease the tension of the wound. Moreover, ventriculo-peritoneal shunting for children who developed hydrocephalus was performed simultaneously, which constitutes another recommendation for preventing fluid collection and build up of pressure on the wound. Results: Patients in this study were in the age range of 2 days to 8 years. The most common location of MMC was in the thoracolumbar area. All but four patients had severe weakness in lower extremities. We used as much hairy skin around the MMC sac as possible in all cases. Vertical incisions on one or both flanks and simultaneous shunt procedure were performed in 36 patients. We treated children with large MMC defects with acceptable tension-free closure. Nonetheless, three patients developed superficial skin infection and partial wound dehiscence, and they were managed conservatively. Conclusions: We recommend using all hairy skin around the MMC defect for closure of large defects. In cases that were expected to be at a higher risk to develop dehiscence release incisions on one or two flanks towards the fascia were found to be useful. Simultaneous

  1. PETROBAS amazon gas pipeline - repair logistics evaluation study

    Energy Technology Data Exchange (ETDEWEB)

    Faertes, Denise [Petrobas, Rio de Janeiro, (Brazil); Domingues, Joaquim [DNV, Rio de Janeiro, (Brazil)

    2010-07-01

    Repair logistics is often a challenge in the pipeline industry because of extreme operating conditions. This paper presents an evaluation of the repair logistics at the Urucu-Coari-Manaus gas pipeline in Brazil. This study establishes strategies for each identified failure scenario, classified by type of repair, logistics, resources and costs. Several meetings and brain-storming workshops, bringing together experienced teams from PETROBRAS took place. They provided an analysis of operating conditions for different pipeline sections and an evaluation of the best practices and strategies to be adopted for pipeline repair. Different repair strategies and logistics options were compared with a base case crisis scenario to evaluate gains in terms of repair time reductions. A cost analysis was then done to prioritize these strategies. This study provided important support to the decision making process, with respect to different repair resources and logistics options. It provided formal and innovative solutions.

  2. Dental materials for cleft palate repair.

    Science.gov (United States)

    Sharif, Faiza; Ur Rehman, Ihtesham; Muhammad, Nawshad; MacNeil, Sheila

    2016-04-01

    Numerous bone and soft tissue grafting techniques are followed to repair cleft of lip and palate (CLP) defects. In addition to the gold standard surgical interventions involving the use of autogenous grafts, various allogenic and xenogenic graft materials are available for bone regeneration. In an attempt to discover minimally invasive and cost effective treatments for cleft repair, an exceptional growth in synthetic biomedical graft materials have occurred. This study gives an overview of the use of dental materials to repair cleft of lip and palate (CLP). The eligibility criteria for this review were case studies, clinical trials and retrospective studies on the use of various types of dental materials in surgical repair of cleft palate defects. Any data available on the surgical interventions to repair alveolar or palatal cleft, with natural or synthetic graft materials was included in this review. Those datasets with long term clinical follow-up results were referred to as particularly relevant. The results provide encouraging evidence in favor of dental and other related biomedical materials to fill the gaps in clefts of lip and palate. The review presents the various bones and soft tissue replacement strategies currently used, tested or explored for the repair of cleft defects. There was little available data on the use of synthetic materials in cleft repair which was a limitation of this study. In conclusion although clinical trials on the use of synthetic materials are currently underway the uses of autologous implants are the preferred treatment methods to date.

  3. Laparoscopic Transabdominal Preperitoneal Approach for Bilateral Inguinal Hernia Repair in 17 Cases%腹腔镜下腹膜前修补术治疗双侧腹股沟疝17例

    Institute of Scientific and Technical Information of China (English)

    李奎; 孙亮; 舒若; 郭姝婧; 罗华友

    2015-01-01

    目的:探讨双侧腹股沟疝腹腔镜下腹膜前修补术的效果。方法2011年7月~2012年6月我院行腹腔镜经腹腹膜前双侧腹股沟疝修补术17例,全麻后建立气腹,回纳疝内容物,切开腹膜并分离腹膜前间隙,游离疝囊和腹膜返折,分离耻骨后间隙( Retzius间隙)和腹股沟后间隙( Bogrus间隙),将补片完整覆盖双侧的耻骨肌孔,补片的内缘在耻骨联合处重叠,并使用钉枪固定确切,随后关闭腹膜裂口,关闭气腹完成手术。结果17例均成功完成腹腔镜双侧腹股沟疝修补。手术时间73~115 min,平均95 min。术中出血量9~53 ml,平均24 ml。术后疝囊内血清肿1例,皮下穿刺抽吸后包块消失;术后下腹壁疼痛1例,未特殊处理,术后1个月疼痛消失。无补片排异反应,无肠梗阻,肠粘连等发生。16例随访19~26个月,平均22个月,无复发。结论腹腔镜下经腹腹膜前双侧腹股沟疝修补术安全有效,在修复复发疝和巨大疝有独到优势,值得临床推广。%Objective To discuss the efficacy of laparoscopic transabdominal preperitoneal ( TAPP) approach for bilateral inguinal hernia repair . Methods A retrospective analysis was made on clinical data of 17 cases of laparoscopic transabdominal preperitoneal bilateral inguinal hernia repair from July 2011 to June 2012.The pneumoperitoneum was established after general anesthesia .The hernia contents were returned .The peritoneum was opened and the preperitoneal space was separated .Then the hernia sac and peritoneal reflextion were dissociated , and the retropubic space ( Retzius space ) and retroinguinal space ( Bogrus space ) were separated .Patches were used to cover the bilateral myopectineal orifice completely , overlapping the inner edge of the patch in the pubic symphysis , and fixed by using a nail gun .The peritoneum gap was closed and the pneumoperitoneum was removed to finish the operation

  4. Clinical analysis of implantation of allogeneic sclera in operations of the external eye repair in 35 cases%同种异体巩膜移植在外眼整复术中的应用

    Institute of Scientific and Technical Information of China (English)

    白莹; 王秀兰

    2012-01-01

    Objective To assess the clinical effect of implantation of allogeneic sclera in operations of the external eye repair.Methods Allogeneic sclera was used for eyelid reconstruction,Hydroxyapatite ceramics implantation and early expose,correction ptosis,treating minor degree eyeball atrophy etc in 35 case.The effect was observed.Results There was no rejection and had a full function.and external appearance improved in all case.Conclusion Allogeneic sclera is easy to gain and simply preserved ; it should be used widely in the external eye repair.%目的 分析并探讨同种异体巩膜移植在外眼整复术中应用的临床效果.方法 对35例(35眼)应用同种异体巩膜分别行替代睑板重建眼睑、羟基磷灰石义眼台植入及早期暴露修复、上睑下垂的矫正、轻度眼球萎缩等术式,并观察其效果.结果 35例均未发生排斥反应,功能恢复良好,外观改善.结论 异体巩膜取材简单,保存方便,移植效果好,在外眼整复术中应用广泛.

  5. Revisional laparoscopic parastomal hernia repair.

    Science.gov (United States)

    Zacharakis, Emmanouil; Shalhoub, Joseph; Selvapatt, Nowlan; Darzi, Ara; Ziprin, Paul

    2008-01-01

    We herein report a laparoscopically performed re-do operation on a patient who had previously undergone a laparoscopic parastomal hernia repair. We describe the case of a 71-year-old patient who presented within 3 months of her primary laparoscopic parastomal hernia repair with recurrence. On relaparoscopy, dense adhesions to the mesh were found, and the mesh had migrated into the hernia sac. This had allowed loops of small bowel to herniate into the sac. The initial part of the procedure involved the lysis of adhesions. A piece of Gore-Tex DualMesh with a central keyhole and a radial slit was cut so that it could provide at least 3 cm to 5 cm of overlap of the fascial defect. The tails of the mesh were wrapped around the bowel, and the mesh was secured to the margins of the hernia with circumferential metal tacking and 4 transfascial sutures. The patient remains in satisfactory condition and no recurrence or any surgery-related problem has been observed during 8 months of follow-up. Revisional laparoscopic repair of parastomal hernias seems feasible and has been shown to be safe and effective in this case. The success of this approach depends on longer follow-up reports and standardization of the technical elements.

  6. Shuttle Repair Tools Automate Vehicle Maintenance

    Science.gov (United States)

    2013-01-01

    Successfully building, flying, and maintaining the space shuttles was an immensely complex job that required a high level of detailed, precise engineering. After each shuttle landed, it entered a maintenance, repair, and overhaul (MRO) phase. Each system was thoroughly checked and tested, and worn or damaged parts replaced, before the shuttle was rolled out for its next mission. During the MRO period, workers needed to record exactly what needed replacing and why, as well as follow precise guidelines and procedures in making their repairs. That meant traceability, and with it lots of paperwork. In 2007, the number of reports generated during electrical system repairs was getting out of hand-placing among the top three systems in terms of paperwork volume. Repair specialists at Kennedy Space Center were unhappy spending so much time at a desk and so little time actually working on the shuttle. "Engineers weren't spending their time doing technical work," says Joseph Schuh, an electrical engineer at Kennedy. "Instead, they were busy with repetitive, time-consuming processes that, while important in their own right, provided a low return on time invested." The strain of such inefficiency was bad enough that slow electrical repairs jeopardized rollout on several occasions. Knowing there had to be a way to streamline operations, Kennedy asked Martin Belson, a project manager with 30 years experience as an aerospace contractor, to co-lead a team in developing software that would reduce the effort required to document shuttle repairs. The result was System Maintenance Automated Repair Tasks (SMART) software. SMART is a tool for aggregating and applying information on every aspect of repairs, from procedures and instructions to a vehicle s troubleshooting history. Drawing on that data, SMART largely automates the processes of generating repair instructions and post-repair paperwork. In the case of the space shuttle, this meant that SMART had 30 years worth of operations

  7. Experience of treatment of 58 cases of tension-free hernia repair under local anesthesia%局麻下无张力疝修补术58例治疗体会

    Institute of Scientific and Technical Information of China (English)

    侯培华

    2014-01-01

    目的:总结在局部麻醉下行无张力疝修补手术治疗腹股沟疝的临床经验。方法:对58例腹股沟疝患者在局麻下行无张力疝修补手术的临床资料进行分析。结果:局部麻醉下镇痛效果满意,手术时间30~50分钟,平均住院5.5天,术后阴囊血肿2例,术后疼痛2例,异物感1例,尿潴留1例,随访6个月~3年无复发病例。结论:局部麻醉下行腹股沟疝修补术具有手术操作简便、恢复快、术后痛苦小、并发症降低等优点,适合在基层医院推广开展。%Objective:To summarize the clinical experience of tension-free hernia repair under local anesthesia for inguinal hernia.Methods:We analyzed the clinical data of 58 cases with tension-free hernia repair under local anesthesia for inguinal hernia.Results:Analgesia effect with local anesthesia was satisfactory.The operation time was 30 to 50 minutes.The average hospitalization time was 5.5 days.After operation,2 cases had hematoma of scrotum,2 cases had pain,1 case had foreign body sensation,and 1 case had urinary retention.Follow up of 6 months to 3 years,there was no recurrence.Conclusion:Inguinal hernia repair with local anesthesia has many advantages,such as simple operation,quick recovery,less complications and so on.It is suitable for promotion in basic hospital.

  8. Strategic Petroleum Reserve: Annual/quarterly report

    Energy Technology Data Exchange (ETDEWEB)

    1994-02-16

    Section 165 of the Energy Policy and Conservation Act (Public Law 94-163), as amended, requires the Secretary of Energy to submit annual and quarterly reports to the President and the Congress on activities of the Strategic Petroleum Reserve. This report combines the fourth quarter 1993 Quarterly Report with the 1993 Annual Report. Key activities described include appropriations; life extension planning; expansion planning; Strategic Petroleum Reserve oil acquisition; the oil stabilization program; and the refined petroleum product reserve test programs. Sections of this report also describe the program mission; the storage facility development program; environmental compliance; budget and finance; and drawdown and distribution.

  9. Econometric Methods within Romanian Quarterly National Accounts

    Directory of Open Access Journals (Sweden)

    Livia Marineta Drăguşin

    2013-04-01

    Full Text Available The aim of the present paper is to synthesise the main econometric methods (including the mathematical and statistical ones used in the Romanian Quarterly National Accounts compilation, irrespectively of Quarterly Gross Domestic Product (QGDP. These methods are adapted for a fast manner to operatively provide information about the country macroeconomic evolution to interested users. In this context, the mathematical and econometric methods play an important role in obtaining quarterly accounts valued in current prices and in constant prices, in seasonal adjustments and flash estimates of QGDP.

  10. Repairs of composite structures

    Science.gov (United States)

    Roh, Hee Seok

    Repair on damaged composite panels was conducted. To better understand adhesively bonded repair, the study investigates the effect of design parameters on the joint strength. The design parameters include bondline length, thickness of adherend and type of adhesive. Adhesives considered in this study were tested to measure their tensile material properties. Three types of adhesively bonded joints, single strap, double strap, and single lap joint were considered under changing bondline lengths, thickness of adherend and type of adhesive. Based on lessons learned from bonded joints, a one-sided patch repair method for composite structures was conducted. The composite patch was bonded to the damaged panel by either film adhesive FM-73M or paste adhesive EA-9394 and the residual strengths of the repaired specimens were compared under varying patch sizes. A new repair method using attachments has been suggested to enhance the residual strength. Results obtained through experiments were analyzed using finite element analysis to provide a better repair design and explain the experimental results. It was observed that the residual strength of the repaired specimen was affected by patch length. Method for rapid repairs of damaged composite structures was investigated. The damage was represented by a circular hole in a composite laminated plate. Pre-cured composite patches were bonded with a quick-curing commercial adhesive near (rather than over) the hole. Tensile tests were conducted on specimens repaired with various patch geometries. The test results showed that, among the methods investigated, the best repair method restored over 90% of the original strength of an undamaged panel. The interfacial stresses in the adhesive zone for different patches were calculated in order to understand the efficiencies of the designs of these patch repairs. It was found that the composite patch that yielded the best strength had the lowest interfacial peel stress between the patch and

  11. 单纯手术修补结合奥美拉唑治疗胃溃疡穿孔33例%Simple Operative Repair Combined with Omeprazole in Treating 33 Cases of Gastric Ulcer Perforation

    Institute of Scientific and Technical Information of China (English)

    肖虹; 高少琳

    2013-01-01

    Objective To investigate the effect and the clinical value of simple operative repair combined with omeprazole in treating gastric ulcer perforation.Methods The clinical data of 63 patients with gastric ulcer perforation treated in this hospital from June 2007 and June 2012 were retrospectively analyzed.Among them,the control group(30 cases) was treated by repair alone while the treatment group(33 cases) was given omeprazole on the basis of simple operative repair.Then the effects were compared between the two groups.Results The two groups were successful in performing operation.But the effect in the treatment group was superior to that in the control group(P < 0.05).The incidence rates of the postoperative complications had no statistical difference between the two groups (P > 0.05).Conclusion The combination of simple operative repair combined with omeprazole has better effect for treating gastric ulcer perforation and deserves to be popularized in clinic.%目的 观察单纯手术修补结合奥美拉唑治疗胃溃疡穿孔的疗效,探讨其临床价值.方法 回顾性分析2007年6月至2012年6月胃溃疡穿孔患者63例的临床资料,其中对照组30例仅行单纯手术修补治疗,治疗组33例在单纯手术修补治疗基础上给予奥美拉唑治疗,比较两组疗效.结果 两组均顺利完成手术,治疗组疗效优于对照组(P<0.05);两组术后并发症发生率差异无统计学意义(P>0.05).结论 单纯手术修补结合奥美拉唑治疗胃溃疡穿孔效果良好,值得临床推广.

  12. The Repair of a Report of 32 Cases of Laparoscopic Gastroduodenal Ulcer Perforation%腹腔镜下胃十二指肠溃疡穿孔修补术32例

    Institute of Scientific and Technical Information of China (English)

    刘景德; 申卫红; 刘紫帆

    2015-01-01

    目的:探讨腹腔镜下胃十二指肠溃疡穿孔修补术治疗方法。方法对收治的胃十二指肠溃疡穿孔行腹腔镜下修补术32例。结果32例患者均成功完成腹腔镜下穿孔修补术。手术用时40~110 min,平均55 min;术后住院数5~10天,平均住院天数为7天,在腹腔引流管每天引流液少于20 mL时拔出引流管,在3~5天之间。术后1例患者因刀口疼痛使用了止痛药物,未出现腹腔感染情况。1例出现Trocar孔感染,反复换药后愈合。结论腹腔镜下胃十二指肠溃疡穿孔修补术是治疗胃十二指肠溃疡穿孔的可靠方法。%Objective To study the method of laparoscopic repair in the treatment of perforated gastroduodenal ul⁃cer. Methods 32 cases of gastric and duodenal ulcer in our hospital in 2013 November~2014 year in August admitted to the perforation underwent laparoscopic gastric ulcer perforation repair were analyzed retrospectively. Results 32 patients were successfully performed laparoscopic perforation repair. Operation when using 40--110min, using an average of about 55min, postoperative hospitalization number 5 to 10 days, the average hospital stay was 7 days, every day in the tube drain⁃age liquid less than 20ml pull out the drainage tube drainage of abdominal cavity, between about 3 to 5 days. In 1 patients with incision pain used analgesic drugs. No abdominal cavity infection. One case of Trocar infection healed after dressing change hole, repeatedly. Conclusion Laparoscopic gastric ulcer perforation repair is a reliable method for the treatment of perforated gastric or duodenal ulcer is better than open operation.

  13. Hypospadias Repair: A Single Centre Experience

    Directory of Open Access Journals (Sweden)

    Mansoor Khan

    2014-01-01

    Full Text Available Objectives. To determine the demographics and analyze the management and factors influencing the postoperative complications of hypospadias repair. Settings. Hayatabad Medical Complex Peshawar, Pakistan, from January 2007 to December 2011. Material and Methods. All male patients presenting with hypospadias irrespective of their ages were included in the study. The data were acquired from the hospital’s database and analyzed with Statistical Package for Social Sciences (SPSS. Results. A total of 428 patients with mean age of 8.12 ± 5.04 SD presented for hypospadias repair. Midpenile hypospadias were the most common. Chordee, meatal abnormalities, cryptorchidism, and inguinal hernias were observed in 74.3%, 9.6%, 2.8%, and 2.1% cases, respectively. Two-stage (Bracka and TIP (tubularized incised urethral plate repairs were performed in 76.2% and 20.8% of cases, respectively. The most common complications were edema and urethrocutaneous fistula (UCF. The complications were significantly lower in the hands of specialists than residents (P-value = 0.0086. The two-stage hypospadias repair resulted in higher complications frequency than single-stage repair (P value = 0.0001. Conclusion. Hypospadias surgery has a long learning curve because it requires a great deal of temperament, surgical skill and acquaintance with magnifications. Single-stage repair should be encouraged wherever applicable due to its lower postoperative complications.

  14. The forked flap repair for hypospadias

    Directory of Open Access Journals (Sweden)

    Anil Chadha

    2012-01-01

    Full Text Available Context: Despite the abundance of techniques for the repair of Hypospadias, its problems still persist and a satisfactory design to correct the penile curvature with the formation of neourethra from the native urethral tissue or genital or extragenital tissues, with minimal postoperative complications has yet to evolve. Aim: Persisting with such an endeavor, a new technique for the repair of distal and midpenile hypospadias is described. Materials and Methods: The study has been done in 70 cases over the past 11 years. The "Forked-Flap" repair is a single stage method for the repair of such Hypospadias with chordee. It takes advantage of the rich vascular communication at the corona and capitalizes on the established reliability of the meatal based flip-flap. The repair achieves straightening of the curvature of the penis by complete excision of chordee tissue from the ventral surface of the penis beneath the urethral plate. The urethra is reconstructed using the native plate with forked flap extensions and genital tissue relying on the concept of meatal based flaps. Water proofing by dartos tissue and reinforcement by Nesbit′s prepucial tissue transfer completes the one stage procedure. Statistical Analysis: An analysis of 70 cases of this single stage technique of repair of penile hypospadias with chordee, operated at 3 to 5 years of age over the past 11 years is presented. Results and Conclusion: The Forked Flap gives comparable and replicable results; except for a urethrocutaneous fistula rate of 4% no other complications were observed.

  15. Lichtenstein versus Onstep for inguinal hernia repair

    DEFF Research Database (Denmark)

    Andresen, Kristoffer; Burcharth, Jakob; Rosenberg, Jacob

    2013-01-01

    Inguinal hernia is a common condition that affects millions of people world-wide every year. In Denmark (population of 5.5 million), more than 10,000 repairs of inguinal hernias are performed annually. The optimal surgical procedure for mesh placement and fixation is still being debated because...... of long-term complications such as persisting pain and impairment of sexual function. The Onstep approach is a newer type of groin hernia repair with promising preliminary results in terms of very few cases of chronic pain and recurrences. This protocol describes a randomised clinical trial the objective...... of which is to evaluate chronic pain and sexual dysfunction after inguinal hernia repair using the Lichtenstein repair compared with the Onstep approach....

  16. Lichtenstein versus Onstep for inguinal hernia repair

    DEFF Research Database (Denmark)

    Andresen, Kristoffer; Burcharth, Jakob; Rosenberg, Jacob

    2013-01-01

    Inguinal hernia is a common condition that affects millions of people world-wide every year. In Denmark (population of 5.5 million), more than 10,000 repairs of inguinal hernias are performed annually. The optimal surgical procedure for mesh placement and fixation is still being debated because...... of which is to evaluate chronic pain and sexual dysfunction after inguinal hernia repair using the Lichtenstein repair compared with the Onstep approach....... of long-term complications such as persisting pain and impairment of sexual function. The Onstep approach is a newer type of groin hernia repair with promising preliminary results in terms of very few cases of chronic pain and recurrences. This protocol describes a randomised clinical trial the objective...

  17. A NEW METHOD TO SHORTEN THE LENGTH OF NERVE GRAFT AND TO SECURE THE NERVE REPAIR (AN INTRAOPERATIVE EXPERIENCE BASED ON 30 CASES OF OBSTETRICAL BRACHIAL PLEXUS PALSY)

    OpenAIRE

    2012-01-01

    Purpose: to compare the result of using a stay stitch to bridge the nerve gaps with repair the nerve gap without using a stay stitch, to compare both ways on the length of graft, number of grafts and number of cables per graft. Methods: a comparative study between 2 groups of babies with OBPP in which each group consists of 15 infants. In all the patients in both groups, neuroma excision and nerve grafting was indicated. In group (A) the defects were measured directly after neuroma excision w...

  18. Idaho National Laboratory Quarterly Occurrence Analysis 4th Quarter FY 2016

    Energy Technology Data Exchange (ETDEWEB)

    Mitchell, Lisbeth Ann [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2016-11-01

    This report is published quarterly by the Idaho National Laboratory (INL) Quality and Performance Management Organization. The Department of Energy (DOE) Occurrence Reporting and Processing System, as prescribed in DOE Order 232.2, “Occurrence Reporting and Processing of Operations Information,” requires a quarterly analysis of events, both reportable and not reportable, for the previous 12 months. This report is the analysis of 84 reportable events (29 from the 4th quarter fiscal year 2016 and 55 from the prior three reporting quarters), as well as 39 other issue reports (including events found to be not reportable and Significant Category A and B conditions) identified at INL during the past 12 months (two from this quarter and 37 from the prior three quarters).

  19. Idaho National Laboratory Quarterly Occurrence Analysis for the 1st Quarter FY2017

    Energy Technology Data Exchange (ETDEWEB)

    Mitchell, Lisbeth Ann [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2017-01-01

    This report is published quarterly by the Idaho National Laboratory (INL) Quality and Performance Management Organization. The Department of Energy (DOE) Occurrence Reporting and Processing System (ORPS), as prescribed in DOE Order 232.2, “Occurrence Reporting and Processing of Operations Information,” requires a quarterly analysis of events, both reportable and not reportable, for the previous 12 months. This report is the analysis of 82 reportable events (13 from the 1st quarter (Qtr) of fiscal year (FY) 2017 and 68 from the prior three reporting quarters), as well as 31 other issue reports (including events found to be not reportable and Significant Category A and B conditions) identified at INL during the past 12 months (seven from this quarter and 24 from the prior three quarters).

  20. 20 CFR 404.1412 - Compensation quarters of coverage.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Compensation quarters of coverage. 404.1412... the Railroad Retirement Program § 404.1412 Compensation quarters of coverage. As used in this subpart, a compensation quarter of coverage is any quarter of coverage computed with respect to...

  1. Workshop on DNA repair.

    NARCIS (Netherlands)

    A.R. Lehmann (Alan); J.H.J. Hoeijmakers (Jan); A.A. van Zeeland (Albert); C.M.P. Backendorf (Claude); B.A. Bridges; A. Collins; R.P.D. Fuchs; G.P. Margison; R. Montesano; E. Moustacchi; A.T. Natarajan; M. Radman; A. Sarasin; E. Seeberg; C.A. Smith; M. Stefanini (Miria); L.H. Thompson; G.P. van der Schans; C.A. Weber (Christine); M.Z. Zdzienika

    1992-01-01

    textabstractA workshop on DNA repair with emphasis on eukaryotic systems was held, under the auspices of the EC Concerted Action on DNA Repair and Cancer, at Noordwijkerhout (The Netherlands) 14-19 April 1991. The local organization of the meeting was done under the auspices of the Medical Genetic C

  2. Laparoscopic lumbar hernia repair.

    Science.gov (United States)

    Madan, Atul K; Ternovits, Craig A; Speck, Karen E; Pritchard, F Elizabeth; Tichansky, David S

    2006-04-01

    Lumbar hernias are rare clinical entities that often pose a challenge for repair. Because of the surrounding anatomy, adequate surgical herniorraphy is often difficult. Minimally invasive surgery has become an option for these hernias. Herein, we describe two patients with lumbar hernias (one with a recurrent traumatic hernia and one with an incisional hernia). Both of these hernias were successfully repaired laparoscopically.

  3. 平片无张力修补术治疗成人脐疝28例临床体会%Application of tension-free hernia repair for umbilical hernia in adults:a report of 28 cases

    Institute of Scientific and Technical Information of China (English)

    姜民; 王约青; 夏惠钟

    2012-01-01

    目的 探讨平片无张力修补术在治疗成人脐疝中的临床应用价值.方法 回顾分析28例平片无张力修补成人脐疝的病例,观察手术时间、住院时间,随访观察术后并发症及复发情况.结果 全部病例均获得成功,手术时间平均65min,平均住院时间6.5d.术后随访6个月~3年,无复发病例.结论 平片无张力修补术是治疗成人脐疝的一种有效而可靠的术式,具有手术操作安全、并发症少、复发率低等优点.%Objective To discuss the value of tensio-free hernia repair for umbilical hernia( UH ) in adults. Methods The data of 28 adult UH patients treated with tensio- free hernia repair were analyzed. The operative time,average hospital stay,complication and recurrence rate were studied. Results All cases were operated successfully. The mean operation time was 65 min. The average hospital stay was 6. 5 days. The follow-up period ranged from 6 to 36 months,and no recurrence was observed. Conclusion Tension-free hernia repair is an effective and credible operative method for UH in adults, and it has many advantages, such as safety, fewer complications and lower recurrence rate.

  4. The prolene hernia system in tension-free repair of inguinal saddle hernia: report of 11 cases%PHS 应用在腹股沟马鞍疝无张力修补术11例分析

    Institute of Scientific and Technical Information of China (English)

    张国虎; 薛刚; 龚加庆; 田伏洲

    2007-01-01

    目的 探讨PHS在腹股沟马鞍疝无张力修补术中的治疗效果和手术经验.方法 对11例使用PHS行无张力修补术的腹股沟马鞍疝患者进行分析.结果 在局麻下完成手术,手术时间25~60 min,全组留院观察24~72 h,无阴囊积液、切口感染、血肿及其它与手术有关的并发症.随访6个月~30个月,无复发,无异物感.结论 PHS修补牢靠,对于腹股沟马鞍疝的手术治疗更有针对性.重视手术的技巧是手术成功的关键.%Objective To assess the prolene hernia system ( PHS) in tension-free repair of inguinal saddle hernia. Methods Eleven cases using PHS were studied. Results All patients were underwent the operation under local anesthesia, and the operation lasted for 35 to 60 minutes . They were monitored in wards for 24 to 72 hours. No scrotal swelling, hematoma, and wound infection happened after the operation. Follow-up lasted for 6 to 30 months , and none of the patients relapsed or had a sensation of foreign body. Conclusion PHS is safe and effective in tension-free repair of hernia, and it is fit to repair of inguinal saddle hernia.

  5. HIF-1α transgenic bone marrow cells can promote tissue repair in cases of corticosteroid-induced osteonecrosis of the femoral head in rabbits.

    Directory of Open Access Journals (Sweden)

    Hao Ding

    Full Text Available Although corticosteroid-induced osteonecrosis of the femoral head (ONFH is common, the treatment for it remains limited and largely ineffective. We examined whether implantation of hypoxia inducible factor-1α (HIF-1α transgenic bone marrow cells (BMCs can promote the repair of the necrotic area of corticosteroid-induced ONFH. In this study, we confirmed that HIF-1α gene transfection could enhance mRNA expression of osteogenic genes in BMCs in vitro. Alkaline phosphatase activity assay and alizarin red-S staining indicated HIF-1α transgenic BMCs had enhanced osteogenic differentiation capacity in vitro. Furthermore, enzyme linked immunosorbent assay (ELISA for VEGF revealed HIF-1α transgenic BMCs secreted more VEGF as compared to normal BMCs. An experimental rabbit model of early-stage corticosteroid-induced ONFH was established and used for an evaluation of cytotherapy. Transplantation of HIF-1α transgenic BMCs dramatically improved the bone regeneration of the necrotic area of the femoral head. The number and volume of blood vessel were significantly increased in the necrotic area of the femoral head compared to the control groups. These results support HIF-1α transgenic BMCs have enhanced osteogenic and angiogenic activity in vitro and in vivo. Transplantation of HIF-1α transgenic BMCs can potentially promote the repair of the necrotic area of corticosteroid-induced ONFH.

  6. DNA repair protocols

    DEFF Research Database (Denmark)

    Bjergbæk, Lotte

    In its 3rd edition, this Methods in Molecular Biology(TM) book covers the eukaryotic response to genomic insult including advanced protocols and standard techniques in the field of DNA repair. Offers expert guidance for DNA repair, recombination, and replication. Current knowledge of the mechanisms...... that regulate DNA repair has grown significantly over the past years with technology advances such as RNA interference, advanced proteomics and microscopy as well as high throughput screens. The third edition of DNA Repair Protocols covers various aspects of the eukaryotic response to genomic insult including...... recent advanced protocols as well as standard techniques used in the field of DNA repair. Both mammalian and non-mammalian model organisms are covered in the book, and many of the techniques can be applied with only minor modifications to other systems than the one described. Written in the highly...

  7. INTERNAL REPAIR OF PIPELINES

    Energy Technology Data Exchange (ETDEWEB)

    Bill Bruce; Nancy Porter; George Ritter; Matt Boring; Mark Lozev; Ian Harris; Bill Mohr; Dennis Harwig; Robin Gordon; Chris Neary; Mike Sullivan

    2005-07-20

    The two broad categories of fiber-reinforced composite liner repair and deposited weld metal repair technologies were reviewed and evaluated for potential application for internal repair of gas transmission pipelines. Both are used to some extent for other applications and could be further developed for internal, local, structural repair of gas transmission pipelines. Principal conclusions from a survey of natural gas transmission industry pipeline operators can be summarized in terms of the following performance requirements for internal repair: (1) Use of internal repair is most attractive for river crossings, under other bodies of water, in difficult soil conditions, under highways, under congested intersections, and under railway crossings. (2) Internal pipe repair offers a strong potential advantage to the high cost of horizontal direct drilling when a new bore must be created to solve a leak or other problem. (3) Typical travel distances can be divided into three distinct groups: up to 305 m (1,000 ft.); between 305 m and 610 m (1,000 ft. and 2,000 ft.); and beyond 914 m (3,000 ft.). All three groups require pig-based systems. A despooled umbilical system would suffice for the first two groups which represents 81% of survey respondents. The third group would require an onboard self-contained power unit for propulsion and welding/liner repair energy needs. (4) The most common size range for 80% to 90% of operators surveyed is 508 mm (20 in.) to 762 mm (30 in.), with 95% using 558.8 mm (22 in.) pipe. Evaluation trials were conducted on pipe sections with simulated corrosion damage repaired with glass fiber-reinforced composite liners, carbon fiber-reinforced composite liners, and weld deposition. Additional un-repaired pipe sections were evaluated in the virgin condition and with simulated damage. Hydrostatic failure pressures for pipe sections repaired with glass fiber-reinforced composite liner were only marginally greater than that of pipe sections without

  8. Quarterly Fishery Surveys - Salton Sea [ds428

    Data.gov (United States)

    California Department of Resources — In the spring of 2003, California Department of Fish and Game (CDFG) personnel began quarterly sampling of Salton Sea fish at fourteen stations around the sea, as...

  9. 76 FR 22910 - ACHP Quarterly Business Meeting

    Science.gov (United States)

    2011-04-25

    ... From the Federal Register Online via the Government Publishing Office ADVISORY COUNCIL ON HISTORIC PRESERVATION ACHP Quarterly Business Meeting AGENCY: Advisory Council on Historic Preservation. ACTION: Notice... c. Southwest Renewable Energy Development and Historic Preservation Working Group IX. New Business...

  10. Laparoscopic repair of a Morgagni hernia

    Directory of Open Access Journals (Sweden)

    Sherigar J

    2005-01-01

    Full Text Available We report a case of laparoscopic repair of symptomatic Morgagni hernia (MH in an adult. A tension-free closure of the defect was carried out using a polypropylene mesh. The recovery was quick and uneventful. Two years after surgery, the patient is doing well. A search of the English-language surgical literature revealed a total of 55 cases of laparoscopic repair of MH reported: 40 in adults and 15 in children. The various modalities of diagnosis, operative techniques, and disease presentation are discussed.

  11. INTERNAL REPAIR OF PIPELINES

    Energy Technology Data Exchange (ETDEWEB)

    Robin Gordon; Bill Bruce; Ian Harris; Dennis Harwig; George Ritter; Bill Mohr; Matt Boring; Nancy Porter; Mike Sullivan; Chris Neary

    2004-12-31

    The two broad categories of fiber-reinforced composite liner repair and deposited weld metal repair technologies were reviewed and evaluated for potential application for internal repair of gas transmission pipelines. Both are used to some extent for other applications and could be further developed for internal, local, structural repair of gas transmission pipelines. Principal conclusions from a survey of natural gas transmission industry pipeline operators can be summarized in terms of the following performance requirements for internal repair: (1) Use of internal repair is most attractive for river crossings, under other bodies of water, in difficult soil conditions, under highways, under congested intersections, and under railway crossings. (2) Internal pipe repair offers a strong potential advantage to the high cost of horizontal direct drilling when a new bore must be created to solve a leak or other problem. (3) Typical travel distances can be divided into three distinct groups: up to 305 m (1,000 ft.); between 305 m and 610 m (1,000 ft. and 2,000 ft.); and beyond 914 m (3,000 ft.). All three groups require pig-based systems. A despooled umbilical system would suffice for the first two groups which represents 81% of survey respondents. The third group would require an onboard self-contained power unit for propulsion and welding/liner repair energy needs. (4) The most common size range for 80% to 90% of operators surveyed is 508 mm (20 in.) to 762 mm (30 in.), with 95% using 558.8 mm (22 in.) pipe. Evaluation trials were conducted on pipe sections with simulated corrosion damage repaired with glass fiber-reinforced composite liners, carbon fiber-reinforced composite liners, and weld deposition. Additional un-repaired pipe sections were evaluated in the virgin condition and with simulated damage. Hydrostatic failure pressures for pipe sections repaired with glass fiber-reinforced composite liner were only marginally greater than that of pipe sections without

  12. Clinical effect analysis of twenty-four cases with laparoscopic hiatal hernia repair%补片修补食管裂孔疝24例疗效分析

    Institute of Scientific and Technical Information of China (English)

    阿依都·阿不都热依木; 张辅江; 朱学鹏; 姜伟; 郭文江; 克力木; 张成

    2015-01-01

    Objective To investigate the superiority and applicability of patch repair in hiatal hernia surgery. Methods A retrospective analysis from April 2009 to January 2015 in Bazhou People′s Hospital was performed,24 cases were hiatal hernia, the patients underwent patch repair for hiatal hernia, Nissen fundoplication was in 12 cases, Toupet fundoplication in eight cases, Dor fundoplication in four cases. Results 24 patients were operated successfully completely, the operation time were 60 to 200 minutes, average were 120 minutes, blood loss were 20 to 100 ml, mean postoperative hospital stay were 6. 1 days, started to feed in 2 days after operation, drainage tubes were pulled out within 2 days after operation. Followed-up 7 to 46 months,subcutaneous and mediastinal emphysema was 1 case,4 cases were with Nissen fundoplication,swallowed hard in one year after the operation, after one year relieved. Conclusion Patch repair for hiatal hernia surgery is safe, reliable, with shorter operative time, less wound, less short-term relapse,less postoperative complications. For hiatal hernia,patch repair is a safe,effective treatment.%目的:探讨补片修补食管裂孔疝术的应用经验。方法回顾性分析2009年4月至2015年1月,新疆巴州人民医院收治的24例食管裂孔疝患者的临床资料,患者均行补片修补食管裂孔疝,其中Nissen胃底折叠术12例,Toupet胃底折叠术8例,Dor胃底折叠术4例。结果24例患者手术均顺利完成,手术时间60~200 min,平均120 min,失血量20~100 ml,术后平均住院6.1 d,术后2 d内进食,引流管在术后2 d内拔出。随访7~46个月,术后皮下纵隔气肿1例,其中4例行Nissen胃底折叠术,术后1年内有明显吞咽因难,1年后吞咽困难症状逐渐缓解。结论补片修补食管裂孔疝术具有安全可靠、手术时间短、创伤小、短期复发少、术后并发症少等优点。对于食管裂孔疝,补片修补食管裂孔疝术是一种安全、有效的治疗方法。

  13. One-stage repair of hand tendon injuries by DIKFIM:a report of 126 cases%可吸收医用膜在手肌腱损伤一期修复中的应用

    Institute of Scientific and Technical Information of China (English)

    程青; 刘利波; 李军尧

    2011-01-01

    Objective: To investigate the therapeutic effects of one-stage repair of hand tendon injuries by DIKFIM. Methods: 126 patients with(285 tendons) hand injuries were enrolled, 86 male and 40 female, aging from 5 to 60 years, with an average of 31.6 years. Forty-two patients were cut by glasses, 44 by knife, 28 patients by saw and 12 patients got crushed. The flexor tendon injuries(98 cases 182 tendons) in this study consisted of 11 cases(12 tendons) of Ⅰ zone, 37 cases(63 tendons) of Ⅱ zone, 26 cases(47 tendons) of Ⅲ zone, 10 cases(26 tendons) of Ⅳ zone and 14 cases(34 tendons) of Ⅴ zone. The extensor tendon injuries were 28 cases(103 tendons). Seventy-two patients complicated with injuries of blood vessel and nerve, and 55 patients also hand fingers fractures. All the patients were treated with modified Kessler method to repair tendon and given DIKFIM at one-stage, and were given early rehabilitation step by step. In the control group of 120 patients with (282 tendons) hand injuries, 78 patients were male and 42 patients were female, aging from 8 to 62 years, with an average of 33.2 years. Fifty patients were cut by glasses, 38 by knife, 22 patients saw, and 10 patients crushed. The flexor tendon injuries(88 cases 180 tendons) consisted of 14 cases( 14 tendons) of Ⅰ zone, 35 cases(64 tendons) of Ⅱ zone, 20 cases(44 tendons) of Ⅲ zone, 10 cases(22 tendons) of Ⅳ zone and 9 cases(36 tendons) of Ⅴ zone.The extensor tendon injuries were 32 cases( 102 tendons). Sixty-eight patients complicated with injuries of blood vessel and nerve, and 50 patients also hand fingers fractures. All the patients were treated with modified Kessler method to repair their tendons, and were given early rehabilitation. Results: After the treatment, 126 patients were followed up from 3 to 24 months. According to TAM standard,59 patients recovered excellently, 52 well, 10 moderately fine and 5 failed, curative rate being 88.10% (P <0.05, compared with the control group

  14. DNA repair variants and breast cancer risk.

    Science.gov (United States)

    Grundy, Anne; Richardson, Harriet; Schuetz, Johanna M; Burstyn, Igor; Spinelli, John J; Brooks-Wilson, Angela; Aronson, Kristan J

    2016-05-01

    A functional DNA repair system has been identified as important in the prevention of tumour development. Previous studies have hypothesized that common polymorphisms in DNA repair genes could play a role in breast cancer risk and also identified the potential for interactions between these polymorphisms and established breast cancer risk factors such as physical activity. Associations with breast cancer risk for 99 single nucleotide polymorphisms (SNPs) from genes in ten DNA repair pathways were examined in a case-control study including both Europeans (644 cases, 809 controls) and East Asians (299 cases, 160 controls). Odds ratios in both additive and dominant genetic models were calculated separately for participants of European and East Asian ancestry using multivariate logistic regression. The impact of multiple comparisons was assessed by correcting for the false discovery rate within each DNA repair pathway. Interactions between several breast cancer risk factors and DNA repair SNPs were also evaluated. One SNP (rs3213282) in the gene XRCC1 was associated with an increased risk of breast cancer in the dominant model of inheritance following adjustment for the false discovery rate (P breast cancer risk or their modification by breast cancer risk factors were observed.

  15. Correção endovascular de aneurisma de aorta abdominal em paciente com rim em ferradura: relato de caso Endovascular repair of an abdominal aortic aneurysm in patient with horseshoe kidney: a case report

    Directory of Open Access Journals (Sweden)

    Eduardo Keller Saadi

    2008-09-01

    Full Text Available O rim em ferradura é uma anomalia congênita rara que pode causar várias dificuldades técnicas durante a correção convencional de aneurisma de aorta abdominal. Relatamos o caso de uma paciente de 68 anos com rim em ferradura, aneurisma de aorta abdominal sintomático e disfunção renal leve. A paciente foi submetida a correção endovascular, sendo utilizada uma endoprótese bifurcada. O pós-operatório foi livre de complicações. O diagnóstico e a técnica endovascular são discutidos, assim como a literatura revisada.Horseshoe kidney is a rare congenital anomaly that may cause various technical problems during conventional repairs of abdominal aortic aneurysms. We report the case of a 68-year-old woman with a horseshoe kidney, symptomatic abdominal aortic aneurysm and mild renal failure. The patient underwent endovascular repair using a bifurcated endoprosthesis. The postoperative was uneventful. We describe the diagnosis and the endovascular technique and literature review.

  16. 局麻下补片修补术治疗腹股沟疝36例临床观察%Clinical Observation of Local Anesthesia Patch Repair of Inguinal Hernia in 36 Cases

    Institute of Scientific and Technical Information of China (English)

    吴宜平

    2016-01-01

    目的:观察并分析局麻下补片修补术治疗腹股沟疝的效果。方法将我院在2006年8月~2013年8月收治的72例腹股沟疝患者分为观察组和对照组,每组36例,对照组予以常规修补术治疗,观察组采用局麻下补片修补术治疗,对两组患者治疗效果进行比较。结果两组患者手术顺利,观察组的手术时间更短,术后24小时所有患者均可下床自由活动,观察组患者的治疗效果优于对照组,治疗有效率更高,不良反应和并发症发生率更低,但这2年的复发率更低,P <0.05,差异具有统计学意义。结论临床上采用局麻下补片修补术治疗腹股沟疝效果更好。%Objective To observe and analyze the patch repair under local anesthesia effect for the treatment of inguinal hernia. Methods 72 patients with inguinal hernia were divided into observation group and control group the hospital fom August 2006 to August 2013, 36 cases in each group, control group routine repair treatment, observation group was treated with patch repair under local anesthesia, to compare the effect of two groups of patients. Results Two groups of patients with surgery goes well, the observation group of shorter operation time, postoperative 24 hours free all of the patients are under the bed, the curative effect of observation group of patients is better than that of control group, the treatment efficiency is higher, lower incidence of adverse reactions and complications, but these two years of lower recurrence rate, P<0.05, significant difference, statistically significant. Conclusion Using the patch repair under local anesthesia clinical treatment of inguinal hernia is better, worthy of promotion of use.

  17. INTERNAL REPAIR OF PIPELINES

    Energy Technology Data Exchange (ETDEWEB)

    Robin Gordon; Bill Bruce; Ian Harris; Dennis Harwig; George Ritter; Bill Mohr; Matt Boring; Nancy Porter; Mike Sullivan; Chris Neary

    2004-08-17

    The two broad categories of fiber-reinforced composite liner repair and deposited weld metal repair technologies were reviewed and evaluated for potential application for internal repair of gas transmission pipelines. Both are used to some extent for other applications and could be further developed for internal, local, structural repair of gas transmission pipelines. Principal conclusions from a survey of natural gas transmission industry pipeline operators can be summarized in terms of the following performance requirements for internal repair: (1) Use of internal repair is most attractive for river crossings, under other bodies of water, in difficult soil conditions, under highways, under congested intersections, and under railway. (2) Internal pipe repair offers a strong potential advantage to the high cost of horizontal direct drilling when a new bore must be created to solve a leak or other problem. (3) Typical travel distances can be divided into three distinct groups: up to 305 m (1,000 ft.); between 305 m and 610 m (1,000 ft. and 2,000 ft.); and beyond 914 m (3,000 ft.). All three groups require pig-based systems. A despooled umbilical system would suffice for the first two groups which represents 81% of survey respondents. The third group would require an onboard self-contained power unit for propulsion and welding/liner repair energy needs. (4) The most common size range for 80% to 90% of operators surveyed is 508 mm (20 in.) to 762 mm (30 in.), with 95% using 558.8 mm (22 in.) pipe. Evaluation trials were conducted on pipe sections with simulated corrosion damage repaired with glass fiber-reinforced composite liners, carbon fiber-reinforced composite liners, and weld deposition. Additional un-repaired pipe sections were evaluated in the virgin condition and with simulated damage. Hydrostatic failure pressures for pipe sections repaired with glass fiber-reinforced composite liner were only marginally greater than that of pipe sections without liners

  18. The Latarjet procedure for the treatment of recurrence of anterior instability of the shoulder after operative repair: a retrospective case series of forty-nine consecutive patients.

    Science.gov (United States)

    Schmid, Samuel L; Farshad, Mazda; Catanzaro, Sabrina; Gerber, Christian

    2012-06-06

    Recurrence of anterior shoulder instability after operative repair is an uncommon but disabling condition for which treatment options have been insufficiently studied. Coracoid transfer as described by Latarjet is a highly successful primary operation for recurrent anterior shoulder instability. The purpose of this study was to verify the hypothesis that this procedure is also effective for treating recurrent glenohumeral instability after previous operative repair. Forty-nine consecutive patients with either one (n = 32), two (n = 12), or at least three (n = 5) previous stabilizations other than a Latarjet procedure and recurrence of anterior glenohumeral instability associated with a lesion of the anterior aspect of the glenoid rim had revision with a coracoid transfer as described by Latarjet. Clinical outcomes at a mean of thirty-eight months postoperatively included the subjective shoulder value, the Constant-Murley score, and glenohumeral stability. Standardized anteroposterior and axial radiographs before and after the Latarjet revision were used to grade the degree of glenohumeral osteoarthritis. The results in all forty-nine patients were reviewed. No shoulder redislocated, subluxations recurred in two patients, and five patients reported slight, unspecified shoulder symptoms. No revision surgery was needed. Forty-three shoulders (88%) were subjectively graded as excellent or good; three, fair; and three, poor. Dissatisfaction was associated with persistent pain, and patients with preoperative pain had a twentyfold higher probability of having postoperative pain. The mean subjective shoulder value increased from 53% preoperatively to 79% at the time of follow-up (p Latarjet can effectively restore anterior glenohumeral shoulder stability if previous operation(s) have failed to do so. If recurrence is associated with chronic pain, the pain is likely to persist and compromise the subjective outcome.

  19. The one-stage rhinoplasty septal perforation repair.

    Science.gov (United States)

    Foda, H M

    1999-08-01

    A combined septal perforation repair and rhinoplasty was performed in 20 patients (12 males, eight females; age range 16-36, mean age 29.6) presenting with septal perforations (size 1-4 cm) and external nasal deformities. The external rhinoplasty approach was used for all cases and the perforation was repaired using bilateral intranasal mucosal advancement flaps with a connective tissue interposition graft in between. The perforation was totally closed in 18 cases (90 per cent) with complete resolution of the pre-operative symptoms occurring in 16 (80 per cent). Cosmetically, 19 cases (95 per cent) were very satisfied with their aesthetic result. The exposure provided by the external approach proved to be very helpful in the process of septal perforation repair. Our results show that septal perforation repair could safely be combined with rhinoplasty and that some of the rhinoplasty manoeuvres used could even facilitate the process of septal perforation repair.

  20. Achilles Tendon Repair, A Modified Technique

    Directory of Open Access Journals (Sweden)

    Sohrab Keyhani

    2013-12-01

    Full Text Available   Background: Wound complications following open repair for acute Achilles tendon ruptures (AATR remain the subject of significant debate. The aim of this study is to investigate the effects of covering repaired AATR using well-nourished connective tissues (paratenon and deep fascia to avoid complications after open repair.   Methods: In this case series study, open repair was performed for 32 active young patients with AATR. After the tendon was repaired, the deep fascia and paratenon was used to cover the Achilles tendon. Patients were followed for two years and any wound complication was recorded. During the last visit, the American Orthopedic Foot and Ankle Society (AOFAS ankle-hind foot score was completed for all patients. Calf circumference and ankle range of motion were measured and compared with the contralateral side. Patients were asked about returning to previous sports activities and limitations with footwear. Results: Only, one patient developed deep wound infection (3%. None of the patients had any discomfort around the operation area, limitation with footwear, sural nerve injury, re-rupture, and skin adhesion. The AOFAS score averaged 92.5±6. Two patients (7% were unable to return to previous sports activities because of moderate pain in heavy physical exercises. The calf circumference and ankle ROM were similar between healthy and operated sides. Conclusion: The present study showed that fascial envelope for full covering of the repaired Achilles tendon may help to prevent the occurrence of wound complications.

  1. Achilles Tendon Repair, A Modified Technique

    Directory of Open Access Journals (Sweden)

    Sohrab Keyhani

    2013-12-01

    Full Text Available Background: Wound complications following open repair for acute Achilles tendon ruptures (AATR remain the subject of significant debate. The aim of this study is to investigate the effects of covering repaired AATR using well-nourished connective tissues (paratenon and deep fascia to avoid complications after open repair.   Methods: In this case series study, open repair was performed for 32 active young patients with AATR. After the tendon was repaired, the deep fascia and paratenon was used to cover the Achilles tendon. Patients were followed for two years and any wound complication was recorded. During the last visit, the American Orthopedic Foot and Ankle Society (AOFAS ankle-hind foot score was completed for all patients. Calf circumference and ankle range of motion were measured and compared with the contralateral side. Patients were asked about returning to previous sports activities and limitations with footwear. Results: Only, one patient developed deep wound infection (3%. None of the patients had any discomfort around the operation area, limitation with footwear, sural nerve injury, re-rupture, and skin adhesion. The AOFAS score averaged 92.5±6. Two patients (7% were unable to return to previous sports activities because of moderate pain in heavy physical exercises. The calf circumference and ankle ROM were similar between healthy and operated sides. Conclusion: The present study showed that fascial envelope for full covering of the repaired Achilles tendon may help to prevent the occurrence of wound complications.

  2. Laparoscopic lumbar hernia repair in a child with lumbocostovertebral syndrome.

    Science.gov (United States)

    Jones, Sarah L; Thomas, Iona; Hamill, James

    2010-02-01

    Lumbocostovertebral syndrome is the association of a congenital lumbar hernia with rib and vertebral anomalies. We report the first case of a laparoscopic repair of a lumbar hernia in a child with lumbocostovertebral syndrome. Laparoscopic lumbar hernia repair appears to be safe and feasible in children.

  3. 无张力疝修补术治疗腹股沟疝402例%402 cases report of without tension hernia repair in treatment of inguinal hernia

    Institute of Scientific and Technical Information of China (English)

    杨东方; 赵广锋

    2013-01-01

      目的评价无张力疝修补术治疗腹股沟疝的临床疗效。方法回顾性分析2008年1月~2012年12月我院行开放式腹股沟疝无张力修补术治疗腹股沟疝402例的临床资料,对不同术式的手术时间、术后疼痛、切口感染、切口血肿以及术后疝复发等相关并发症进行观察和总结。结果统计中无手术死亡病例,术后短期出现切口下血肿3例,切口脂肪液化6例,血肿4例,切口感染4例,随访中有1例术后5个月疝复发,2例术后出现慢性轻度疼痛,1例患者出现睾丸疼痛。Lichenstein术的近期和远期并发症均显著地大于Rutkow术(P<0.05)。结论开放式无张力疝修补术治疗腹股沟疝安全有效,同时具有创伤小,恢复快,住院时间短,复发率低及术后并发症少等优点,合理的术式选择和规范化操作可以获得良好的治疗效果。%Objective To evaluate the clinical curative effect without tension hernia repair in treatment of inguinal hernia. Methods The clinical data of 402 cases of inguinal hernia given open without tension hernia repair from January 2008 to December 2012 in our hospital were retrospectively analyzed, the related complications such as operation time of different operative methods, postoperative pain, infection of incision,incision hematoma and postoperative hernia recurrence, were observed and summarized. Results There were no the no surgical deaths, postoperative 3 cases appeared under the incision hematoma, 6 cases had the fat liquefaction of incision, 4 cases had seroma, 4 cases had infection of incisional wound, 1 case of postoperative follow-up may hernia recurrence, 1 case had chronic mild pain, and 1 case had testicular pain after surgery. The recent and forward complication rate in Lichenstein were significant higher than those in Rutkow (P<0.05). Conclusion Open without tension hernia repair in treatment of inguinal hernia is safe and effective,at the same

  4. Cartilage change after arthroscopic repair for an isolated meniscal tear.

    Science.gov (United States)

    Soejima, Takashi; Murakami, Hidetaka; Inoue, Takashi; Kanazawa, Tomonoshin; Katouda, Michihiro; Nagata, Kensei

    2005-01-01

    To investigate the direct effect to the cartilage caused by the meniscal repair, we examined patients who underwent an isolated meniscal repair without any other abnormalities by arthroscopic examination. A total of 17 patients were examined by second-look arthroscopy after an average interval of 9 months from the meniscal repair, and have been evaluated the status of the repaired meniscus and of the relative femoral condylar cartilage. Changes in the severity of the cartilage lesion between at the time of meniscal repair and the time of the second-look arthroscopy were considered based on the status of the repaired meniscus. Regardless of the healing status of the repair site, it was possible to prevent degeneration in the cartilage in 9 of the 10 patients who demonstrated no degeneration in the meniscal body. Of the 7 patients who demonstrated degeneration in the meniscal body, progression in cartilage degeneration was noted as 1 grade in 2 patients and 2 grades in another 3 patients. Even in those in which stable fusion of the repair site was achieved, the condition of the inner meniscal body was not necessarily maintained favorably in all cases, indicating that degeneration in the meniscal body was a risk factor for cartilage degeneration. It was concluded that recovery could not be expected even at 9 months after the repair if the lesion had already demonstrated degeneration in the meniscal body at the time of repair.

  5. Ocular findings in Quarter Horses with hereditary equine regional dermal asthenia.

    Science.gov (United States)

    Mochal, Cathleen A; Miller, William W; Cooley, A James; Linford, Robert L; Ryan, Peter L; Rashmir-Raven, Ann M

    2010-08-01

    To compare ocular structures of Quarter Horses homozygous for hereditary equine regional dermal asthenia (HERDA) with those of Quarter Horses not affected by HERDA (control horses) and to determine the frequency of new corneal ulcers for horses with and without HERDA during a 4-year period. Cohort study of ocular structures and retrospective case series of horses with and without HERDA. The cohort portion of the study involved 10 Quarter Horses with HERDA and 10 Quarter Horses without HERDA; the retrospective case series involved 28 horses with HERDA and 291 horses without HERDA. Ophthalmic examinations, Schirmer tear tests, tonometry, corneal pachymetry, histologic examinations, and scanning electron microscopy (SEM) were performed in cohorts of Quarter Horses with and without HERDA. Records were reviewed to determine the incidence of corneal ulcers in horses with and without HERDA during a 4-year period. Corneal thickness of horses with HERDA was significantly less than that of control horses, but tear production of horses with HERDA was significantly greater than that of control horses. Results of SEM revealed zones of disorganized, haphazardly arranged collagen fibrils in corneas of horses with HERDA that were not evident in corneas of control horses. The incidence of corneal ulcers was significantly greater for horses with HERDA than for horses without HERDA during the 4-year period. Alterations in corneal thickness, arrangement of collagen fibers, and incidence of corneal ulcers indicated that abnormalities in horses with HERDA were not limited to the skin.

  6. Idaho National Laboratory Quarterly Occurrence Analysis - 3rd Quarter FY-2016

    Energy Technology Data Exchange (ETDEWEB)

    Mitchell, Lisbeth Ann [Idaho National Laboratory

    2016-09-01

    This report is published quarterly by the Idaho National Laboratory (INL) Quality and Performance Management Organization. The Department of Energy (DOE) Occurrence Reporting and Processing System (ORPS), as prescribed in DOE Order 232.2, “Occurrence Reporting and Processing of Operations Information,” requires a quarterly analysis of events, both reportable and not reportable, for the previous 12 months. This report is the analysis of 73 reportable events (23 from the 3rd Qtr FY-16 and 50 from the prior three reporting quarters), as well as 45 other issue reports (including events found to be not reportable and Significant Category A and B conditions) identified at INL during the past 12 months (16 from this quarter and 29 from the prior three quarters).

  7. Idaho National Laboratory Quarterly Occurrence Analysis - 1st Quarter FY 2016

    Energy Technology Data Exchange (ETDEWEB)

    Mitchell, Lisbeth Ann [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2016-03-01

    This report is published quarterly by the Idaho National Laboratory (INL) Quality and Performance Management Organization. The Department of Energy (DOE) Occurrence Reporting and Processing System (ORPS), as prescribed in DOE Order 232.2, “Occurrence Reporting and Processing of Operations Information,” requires a quarterly analysis of events, both reportable and not reportable, for the previous 12 months. This report is the analysis of 74 reportable events (16 from the 1st Qtr FY-16 and 58 from the prior three reporting quarters), as well as 35 other issue reports (including events found to be not reportable and Significant Category A and B conditions) identified at INL during the past 12 months (15 from this quarter and 20 from the prior three quarters).

  8. Investigating AGN Variability Using Combined Multi-Quarter Kepler Data

    Science.gov (United States)

    Revalski, Mitchell; Nowak, D.; Wiita, P. J.; Wehrle, A. E.; Unwin, S. C.

    2014-01-01

    The study of long and short term variability in active galactic nuclei (AGN) yields deeper insight into the physical nature of their emissions from the accretion disk around, and relativistic jets powered by, a galaxy’s central super-massive black hole. We have now obtained a total of eleven quarters of Kepler data on four radio-loud AGN. Our prior work involved calculating power spectral densities (PSDs) on these data both with and without corrections for various instrumental artifacts. We now focus on combining these data sets into one continuous set for each object which spans approximately 2.5 years at a 30 minute sampling rate with >98% duty cycle. The process of stringing together these data is complicated by the quarterly rolls the Kepler space satellite telescope conducts, which causes each target to fall on a different CCD four times per year. We attempt to overcome this problem with a scaling procedure that maintains the original percentage of variations and scales all eleven quarters to the overall average. We calculate PSDs on these stitched light curves both with and without various end-matching techniques applied to increase the accuracy of the PSDs. The PSDs computed for the stitched light curves allow us to probe a full decade lower in frequency than our previous work and show comparable slopes to the PSDs calculated for individual quarters, suggesting we are linking the quarters appropriately. Our average PSD slopes are consistent with ground based observations of other quasars, falling approximately between -1.6 and -1.9. In addition, we have used original codes to bin and average individual PSDs to reduce the bias introduced on the slope fitting process induced by the uneven population of points in the PSDs. This allows for a more accurate power law fitting and tends to steepen the overall slope by approximately 0.1 in the majority of cases. We note increased flaring in one of our objects on the order of 15%, with our remaining three objects

  9. Progress of peripheral nerve repair

    Institute of Scientific and Technical Information of China (English)

    陈峥嵘

    2002-01-01

    Study on repair of peripheral nerve injury has been proceeding over a long period of time. With the use of microsurgery technique since 1960s,the quality of nerve repair has been greatly improved. In the past 40 years, with the continuous increase of surgical repair methods, more progress has been made on the basic research of peripheral nerve repair.

  10. Primary repair of colon injuries: clinical study of nonselective approach

    Directory of Open Access Journals (Sweden)

    Krivokapic Zoran V

    2010-12-01

    Full Text Available Abstract Background This study was designed to determine the role of primary repair and to investigate the possibility of expanding indications for primary repair of colon injuries using nonselective approach. Methods Two groups of patients were analyzed. Retrospective (RS group included 30 patients managed by primary repair or two stage surgical procedure according to criteria published by Stone (S/F and Flint (Fl. In this group 18 patients were managed by primary repair. Prospective (PR group included 33 patients with primary repair as a first choice procedure. In this group, primary repair was performed in 30 cases. Results Groups were comparable regarding age, sex, and indexes of trauma severity. Time between injury and surgery was shorter in PR group, (1.3 vs. 3.1 hours. Stab wounds were more frequent in PR group (9:2, and iatrogenic lesions in RS group (6:2. Associated injuries were similar, as well as segmental distribution of colon injuries. S/F criteria and Flint grading were similar. In RS group 15 primary repairs were successful, while in two cases relaparotomy and colostomy was performed due to anastomotic leakage. One patient died. In PR group, 25 primary repairs were successful, with 2 immediate and 3 postoperative (7-10 days deaths, with no evidence of anastomotic leakage. Conclusions Results of this study justify more liberal use of primary repair in early management of colon injuries. Trial registration Current Controlled Trials ISRCTN94682396

  11. Achilles tendon repair

    Science.gov (United States)

    Achilles tendon rupture-surgery; Percutaneous Achilles tendon rupture repair ... To fix your torn Achilles tendon, the surgeon will: Make a cut down the back of your heel Make several small cuts rather than one large cut ...

  12. Diaphragmatic hernia repair - slideshow

    Science.gov (United States)

    ... presentations/100014.htm Diaphragmatic hernia repair - series—Normal anatomy To use the sharing ... Overview The chest cavity includes the heart and lungs. The abdominal cavity includes the liver, the stomach, ...

  13. Eye muscle repair - slideshow

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/presentations/100062.htm Eye muscle repair - series—Normal anatomy To use the sharing ... the eyeball to the eye socket. The external muscles of the eye are found behind the conjunctiva. ...

  14. Tracheoesophageal fistula repair - slideshow

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/presentations/100103.htm Tracheoesophageal fistula repair - series—Normal anatomy To use the sharing ... Editorial team. Related MedlinePlus Health Topics Esophagus Disorders Fistulas Tracheal Disorders A.D.A.M., Inc. is ...

  15. Inguinal hernia repair - slideshow

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/presentations/100027.htm Inguinal hernia repair - series—Normal anatomy To use the sharing ... to slide 4 out of 4 Overview A hernia occurs when part of an organ protrudes through ...

  16. INTERNAL REPAIR OF PIPELINES

    Energy Technology Data Exchange (ETDEWEB)

    Robin Gordon; Bill Bruce; Ian Harris; Dennis Harwig; Nancy Porter; Mike Sullivan; Chris Neary

    2004-04-12

    The two broad categories of deposited weld metal repair and fiber-reinforced composite liner repair technologies were reviewed for potential application for internal repair of gas transmission pipelines. Both are used to some extent for other applications and could be further developed for internal, local, structural repair of gas transmission pipelines. Preliminary test programs were developed for both deposited weld metal repair and for fiber-reinforced composite liner repair. Evaluation trials have been conducted using a modified fiber-reinforced composite liner provided by RolaTube and pipe sections without liners. All pipe section specimens failed in areas of simulated damage. Pipe sections containing fiber-reinforced composite liners failed at pressures marginally greater than the pipe sections without liners. The next step is to evaluate a liner material with a modulus of elasticity approximately 95% of the modulus of elasticity for steel. Preliminary welding parameters were developed for deposited weld metal repair in preparation of the receipt of Pacific Gas & Electric's internal pipeline welding repair system (that was designed specifically for 559 mm (22 in.) diameter pipe) and the receipt of 559 mm (22 in.) pipe sections from Panhandle Eastern. The next steps are to transfer welding parameters to the PG&E system and to pressure test repaired pipe sections to failure. A survey of pipeline operators was conducted to better understand the needs and performance requirements of the natural gas transmission industry regarding internal repair. Completed surveys contained the following principal conclusions: (1) Use of internal weld repair is most attractive for river crossings, under other bodies of water, in difficult soil conditions, under highways, under congested intersections, and under railway crossings. (2) Internal pipe repair offers a strong potential advantage to the high cost of horizontal direct drilling (HDD) when a new bore must be created

  17. Pectus excavatum repair - slideshow

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/presentations/100035.htm Pectus excavatum repair - series—Normal anatomy To use the sharing ... Go to slide 4 out of 4 Overview Pectus excavatum is a deformity of the front of the ...

  18. Hiatal hernia repair - slideshow

    Science.gov (United States)

    ... presentations/100028.htm Hiatal hernia repair - series—Normal anatomy To use the sharing features on ... Overview The esophagus runs through the diaphragm to the stomach. It functions to carry food from the mouth ...

  19. Repairing ceramic insulating tiles

    Science.gov (United States)

    Dunn, B. R.; Laymance, E. L.

    1980-01-01

    Fused-silica tiles containing large voids or gauges are repaired without adhesives by plug insertion method. Tiles are useful in conduits for high-temperature gases, in furnaces, and in other applications involving heat insulation.

  20. Rotator cuff repair - slideshow

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/presentations/100229.htm Rotator cuff repair - series—Normal anatomy To use the sharing ... to slide 4 out of 4 Overview The rotator cuff is a group of muscles and tendons that ...

  1. Cleft lip repair - slideshow

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/presentations/100010.htm Cleft lip repair - series—Normal anatomy To use the sharing ... abnormal opening in the middle of the upper lip. A cleft palate is an opening in the roof of ...

  2. Giant duodenal ulcer perforation: a case of innovative repair with an antrum gastric patch Perforación de ulcus gigante duodenal: reparación innovadora mediante una plastia del antro gástrico

    Directory of Open Access Journals (Sweden)

    Javier A. Cienfuegos

    2012-08-01

    Full Text Available Backgrounds: the treatment of a perforated giant duodenal ulcer (GUDs represents a formidable surgical challenge regarding the duodenal wall defect repair in severe peritonitis setting. A high incidence of dehiscence and hospital mortality (15-40%- has been reported with the majority of the techniques. We report a case of GUDs perforation successfully treated with a subtotal gastrectomy and a gastric patch with the remnant antrum, for repairing the duodenal defect. Case report: a 63-years-old man with antecedents of peptic ulcer disease presents a large duodenal ulcer perforation with 48 hrs delay and associated with severe peritonitis and a retroperitoneal collection. A subtotal gastrectomy with Billroth II reconstruction and reconstruction of the duodenal defect with a patch of the remnant antrum was carried out. The patient was discharged at 17th postoperative day with good tolerance. Discussion: the duodenal defect repair with a patch of the remant antrum, represents a valid alternative in similar circumstances. To our knowledge, it appears to be the first clinical description of this technique.Antecedentes: el tratamiento de un ulcus duodenal gigante (UDG; > 2 cm perforado entraña una gran dificultad técnica, por la reparación del gran defecto duodenal; y por la peritonitis sobreañadida. Todas las técnicas descritas se asocian con un índice elevado de dehiscencias y una mortalidad del 15-40%. Describimos por primera vez el caso de un UDG perforado, tratado mediante una gastrectomía subtotal y con una plastia del antro gástrico remanente. Caso clínico: varón de 63 años que se interviene de un UDG perforado en la 2ª porción duodenal asociado con peritonitis severa y disección de la gotiera parieto-cólica derecha retroperitoneo. Se realiza gastrectomía tipo Bilroth II y reparación del defecto duodenal mediante una plastia con la pared del antro gástrico remanente. El paciente fue dado de alta a los 17 días. Discusión: la

  3. Clinical Statistic Analysis in Tension-free Repair of Abdominal Wall Hernias in 165 Cases%165例腹外疝无张力修补术的临床统计分析

    Institute of Scientific and Technical Information of China (English)

    冯文清

    2011-01-01

    To discuss the clinical effect on tension-free repair of abdominal wall hernias and its application value,clinical data on 165 cases of tension-free repair of abdominal wal1 hernias were compared as well as the application of their main modus operandi,such as Litchtenstein operation,Rutkow and IPOM(intraperitoneal onlay mesh) operation in the applied situation,respectively.The results show that all the sufferers of 165 cases didn't recrudesce in from half year to four years after the operation.There are no obvious statistic difference in hospital days,incidence rate of complication,recurernce rates between 102 side Lichtenstein operation,59 side Rutkow operation and 102 side IPOM operation,but there are obvious statistic differences in material costs,operation fees and the total expenditures of treatment in hospital(P〈0.05).To compare with the traditional repair of abdominal wal1 hernias,tension-free one has more credible curative effect,with less pain after operation,quicker recovery and lower recurrent rate.Litchtenstein operation is simpler,with lower expenditure and wider indications than Rutkow and IPOM ones,which is especially feasible for promotion in primary hospitals.%为了探讨腹外疝无张力修补术的临床疗效、运用价值,对比分析了165例无张力修补术的临床资料及其主要术式的应用情况.结果显示:165例腹外疝患者行无张力疝修补术后随访6~48个月均无复发;102例/侧Lichtenstein手术5、9例/侧Rutkow手术和12例/侧IPOM手术在住院天数、并发症发生率、复发率等方面的统计学差异并不明显(P〉0.05);材料费、手术费以及总治疗费用差异均达到显著水平(P〈0.05).与传统腹外疝修补术相比,无张力修补术疗效可靠,术后疼痛轻,恢复快,复发率低;其中,Lichtenstein手术较RutkowI、POM手术费用更低,且操作简单、适应症宽,尤其适合在基层医院推广.

  4. Grey Repairable System Analysis

    Institute of Scientific and Technical Information of China (English)

    Renkuan Guo; Charles Ernie Love

    2006-01-01

    In this paper, we systematically discuss the basic concepts of grey theory, particularly the grey differential equation and its mathematical foundation, which is essentially unknown in the reliability engineering community. Accordingly,we propose a small-sample based approach to estimate repair improvement effects by partitioning system stopping times into intrinsic functioning times and repair improvement times. An industrial data set is used for illustrative purposes in a stepwise manner.

  5. Combining rhinoplasty with septal perforation repair.

    Science.gov (United States)

    Foda, Hossam M T; Magdy, Emad A

    2006-11-01

    A combined septal perforation repair and rhinoplasty was performed in 80 patients presenting with septal perforations (size 1 to 5 cm) and external nasal deformities. The external rhinoplasty approach was used for all cases and the perforation was repaired using bilateral intranasal mucosal advancement flaps with a connective tissue interposition graft in between. Complete closure of the perforation was achieved in 90% of perforations of size up to 3.5 cm and in only 70% of perforations that were larger than 3.5 cm. Cosmetically, 95% were very satisfied with their aesthetic result. The external rhinoplasty approach proved to be very helpful in the process of septal perforation repair especially in large and posteriorly located perforations and in cases where the caudal septal cartilage was previously resected. Our results show that septal perforation repair can be safely combined with rhinoplasty and that some of the routine rhinoplasty maneuvers, such as medial osteotomies and dorsal lowering, could even facilitate the process of septal perforation repair.

  6. COMPARATIVE STUDY OF LICHTENSTEIN VERSUS DESARDA REPAIR FOR INGUINAL HERNIA

    Directory of Open Access Journals (Sweden)

    Sowmya

    2015-12-01

    Full Text Available BACKGROUND Inguinal hernia repair is the most frequently performed operation in any general surgical unit. The Bassini’s, Shouldice and other tissue-based techniques are still being acceptable for primary inguinal hernia repair. Desarda’s technique is originally a tissue based hernia repair using an undetached strip of external oblique aponeurosis to strengthen the posterior wall of the inguinal canal. The aim of the present study was to compare Lichtenstein hernia repair and Desarda herniorrhaphy. METHODS A total of 40 patients with primary unilateral inguinal hernia were subjected either to Desarda herniorrhaphy or Lichtenstein hernioplasty. The patients were followed in terms of recurrence rate, post-operative complications, convalescence, chronic pain and cost effectiveness. RESULTS During the followup all patients had either mild or moderate pain, but the pain intensity was more in Lichtenstein repair compared to Desarda repair in the immediate postoperative period. In Lichenstein repair patients had chronic groin pain even at the end of one year, but none of the patients in Desarda repair had chronic groin pain. Complications such as seroma and wound infection were less in Desarda repair. Time taken to resume normal activities was significantly less in case of Desarda herniorrhaphy; however, there was no recurrence observed in both the groups during the followup period. Average cost incurred for Desarda repair was significantly less than Lichtenstein repair. CONCLUSION Lichtenstein method of hernia repair is simple and safe. But the mesh prosthesis has its drawbacks. Desarda hernia repair is based on physiological principles and the results are good with less convalescence period and fewer recurrences and no chronic groin pain. It is more cost effective.

  7. Wellbore Seal Repair Using Nanocomposite Materials

    Energy Technology Data Exchange (ETDEWEB)

    Stormont, John [Univ. of New Mexico, Albuquerque, NM (United States)

    2016-08-31

    Nanocomposite wellbore repair materials have been developed, tested, and modeled through an integrated program of laboratory testing and numerical modeling. Numerous polymer-cement nanocomposites were synthesized as candidate wellbore repair materials using various combinations of base polymers and nanoparticles. Based on tests of bond strength to steel and cement, ductility, stability, flowability, and penetrability in opening of 50 microns and less, we identified Novolac epoxy reinforced with multi-walled carbon nanotubes and/or alumina nanoparticles to be a superior wellbore seal material compared to conventional microfine cements. A system was developed for testing damaged and repaired wellbore specimens comprised of a cement sheath cast on a steel casing. The system allows independent application of confining pressures and casing pressures while gas flow is measured through the specimens along the wellbore axis. Repair with the nanocomposite epoxy base material was successful in dramatically reducing the flow through flaws of various sizes and types, and restoring the specimen comparable to an intact condition. In contrast, repair of damaged specimens with microfine cement was less effective, and the repair degraded with application of stress. Post-test observations confirm the complete penetration and sealing of flaws using the nanocomposite epoxy base material. A number of modeling efforts have supported the material development and testing efforts. We have modeled the steel-repair material interface behavior in detail during slant shear tests, which we used to characterize bond strength of candidate repair materials. A numerical model of the laboratory testing of damaged wellbore specimens was developed. This investigation found that microannulus permeability can satisfactorily be described by a joint model. Finally, a wellbore model has been developed that can be used to evaluate the response of the wellbore system (casing, cement, and microannulus

  8. Extensor tendon repair an overview

    Directory of Open Access Journals (Sweden)

    Mansoor Bin Fayed

    2015-04-01

    Full Text Available The incidence of extensor injuries is more than that of flexor tendon injuries. This is to a great extent because of the extensors being superficially placed and covered by skin and subcutaneous tissue over the distal part of the upper extremity. Thus they are more vulnerable to blunt and sharp trauma, the proximal and distal forearm present with laceration and cut with sharp weapon. Extensor tendon injuries are often taken lightly by many, repairs being taken-up at the ER. Repair is done in or if the retrieval of tendon ends is difficult or the wound is complicated with associated injuries such as fractures or in cases of tendon retraction. Delayed primary repair can be undertaken from 7-10 days. Assessment of the injured finger has to be very meticulous. Extension of finger is brought about by the interossei and lumbricals which are the short muscles of the hand. They extend the proximal interphalangeal joints and distal interphalangeal joints and flex metacarpophalangeal joint, these intrinsic muscles are innervated by the ulnar and median nerves. The long extensors are innervated by the radial nerve, they primarily extend the metacarpophalangeal joints and also interphalangeal joints. In cases of injury the intrinsic system may compensate for an extensor deficit. Closed injuries of zone I may be managed by splinting of the distal interphalangeal joints and open injuries in the zone I and II can be treated with tenodermodesis. Proximal interphalangeal joints and distal interphalangeal joints are immobilized in zone 3 and 4. Metacarpophalangeal joint is immobilized in full extension and the wrist in 10o extension.

  9. Laparoscopic repair for inguinal hernia in old-aged patients: 56 cases report%老年人腹腔镜腹股沟疝修补术(附56例报告)

    Institute of Scientific and Technical Information of China (English)

    潘玉琴; 吴卫东; 方芳

    2012-01-01

    目的:总结老年人腹腔镜腹股沟疝修补术的经验,分析术中和术后情况,了解该术式在老年病人中使用的安全性.方法:回顾分析2007年1月至2011年12月行腹腔镜腹股沟疝修补术56例64侧病人的临床资料,其中单侧腹股沟疝48例(斜疝34例,直疝10例,股疝4例),双侧腹股沟疝8例.术后平均随访时间(36±11)个月.结果:56例中完成经腹腹膜前(transabdominal preperitoneal,TAPP)补片植入术26例,完全腹膜外(totally extraperitoneal,TEP)补片植入术30例.平均手术时间TAPP(78±14)min,TEP(64±10)min;术后平均住院时间(5.8±1.8)d;术后并发症依次为暂时性神经感觉异常37.5%(21/56)、慢性疼痛28.6%(16/56)和血清肿21.4%(12/56).术后复发率1.8% (1/56).结论:腹腔镜腹股沟疝修补在老年病人的使用中,有创伤小、恢复快、复发率低、安全性好等优点.%Objective To analyze the clinical data of laparoscopic repairing for inguinal hernia in old-aged patients. Methods Clinical data of 56 cases with inguinal hernia in our department from Jan 2007 to Dec 2011 were retrospectively analyzed. There were 48 cases of single-sided hernia, including 34 indirect inguinal hernia, 10 direct inguinal hernia and 4 femoral hernia. The rest 8 cases were double-sided inguinal hernia. The follow-up was done on (36± 11) months after operation. Results All cases underwent laparoscopic repair successfully. There were 26 case with transabdominal preperitoneal (TAPP) and 30 cases with totally extraperitoneal (TEP). The average operative time was (78± 14) min for TAPP and(64±10) min for TEP. The average length of postoperative stay was(5,8±1.8) days. The most common postoperative complications were transient paresthesia (37.5%,21/56), chronic pain(28.6%, 16/56) and seroma (21.4%, 12/ 56). The recurrence rate was 1.8%(l/56). Conclusions Laparoscopic repair for inguinal hernia has the advantage of less trauma, faster recovery and lower recurrent rate for

  10. Repair of a large soft tissue defect in the leg with cross-leg bridge free transfer of a latissimus dorsi myocutaneous flap: a case report

    Directory of Open Access Journals (Sweden)

    ZHANG Gong-lin

    2012-12-01

    Full Text Available 【Abstract】A 48-year-old man sustained a traffic accident injury to his left leg. It was an open fracture of the left tibia and fibula accompanied by a large soft tissue de-fect (27 cm×7 cm. Doppler examination revealed the poste-rior tibial artery was occluded due to thrombosis. Three weeks after injury, the latissimus dors myocutaneous flap was elevated with a T-shaped vascular pedicle and was in-terposed between the two vascular ends of the posterior tibial vessel of the contralateral leg. Two end to end anasto-moses were performed between the two vascular ends of the posterior tibial vessel of the contralateral leg and the latissimus dors myocutaneous flap’s T-shaped vascular pedicle. The latissimus dorsi myocutaneous flap was used for repair of a large soft tissue defect of the left leg. The vascular pedicle was cut off after 28 days and the flap sur-vived completely. After 3-years’ follow-up postoperatively, a good contour was confirmed at the recipient area. The right tibia and fibula fractures were confirmed healing radiologically. The posterior tibial artery of contralateral leg was demonstrated patent by clinical and Doppler examinations. Key words: Surgical flaps; Leg injuries; Soft tissue injuries; Wound healing

  11. Repair of a soft tissue defect of medial malleolus with cross-leg bridge free transfer of anterolateral thigh muscle flap: a case report

    Directory of Open Access Journals (Sweden)

    ZHANG Gong-lin

    2012-11-01

    Full Text Available 【Abstract】A 38-year-old man sustained a traffic accident injury to his right medial malleolus and leg. It was an open fracture of the right tibia and fibula accompanied by a large soft tissue defect of the right medial malleolus sized 12 cm×4 cm. Doppler examination revealed that the tibialis posterior vessel was occluded due to thrombosis. The anterior tibial artery was patent. Three weeks after injury, the left anterolateral thigh muscle flap was harvested and transplanted to the right medial malleolus defect area for repair of the soft tissue defect, and an end-to-side anasto-mosis was performed between the posterior tibial vessel of the contralateral leg and the muscle flap’s vascular pedicle. A split thickness free skin graft was used to cover the muscle flap and around the flap’s vascular pedicle. The vascular pedicle was cut off after 28 days and the muscle flap sur-vived completely. After 3-year follow-up postoperatively, the right tibia and fibula fractures were confirmed healing radiologically. The posterior tibial artery of contralateral leg was patent by clinical and Doppler examinations. This tech-nique can be used to preserve the flow and patency of re-cipient arteries. Key words: Surgical flaps; Soft tissue injuries; Leg injuries; Wound healing

  12. Repair of a large soft tissue defect in the leg with cross-leg bridge free transfer of a latissimus dorsi myocutaneous flap: a case report

    Institute of Scientific and Technical Information of China (English)

    ZHANG Gong-lin; CHEN Ke-ming; ZHANG Jun-hua; WANG Shi-yong

    2012-01-01

    A 48-year-old man sustained a traffic accident injury to his left leg.It was an open fracture of the left tibia and fibula accompanied by a large soft tissue defect (27 cm×7 cm).Doppler examination revealed the posterior tibial artery was occluded due to thrombosis.Three weeks after injury,the latissimus dors myocutaneous flap was elevated with a T-shaped vascular pedicle and was interposed between the two vascular ends of the posterior tibial vessel of the contralateral leg.Two end to end anastomoses were performed between the two vascular ends of the posterior tibial vessel of the contralateral leg and the latissimus dors myocutaneous flap's T-shaped vascular pedicle.The latissimus dorsi myocutaneous flap was used for repair of a large soft tissue defect of the left leg.The vascular pedicle was cut offafter 28 days and the flap survived completely.After 3-years' follow-up postoperatively,a good contour was confirmed at the recipient area.The right tibia and fibula fractures were confirmed healing radiologically.The posterior tibial artery of contralateral leg was demonstrated patent by clinical and Doppler examinations.

  13. Repair of a soft tissue defect of medial malleolus with cross-leg bridge free transfer of anterolateral thigh muscle flap: a case report

    Institute of Scientific and Technical Information of China (English)

    ZHANG Gong-lin; CHEN Ke-ming; ZHANG Jun-hua; WANG Shi-yong

    2012-01-01

    A 38-year-old man sustained a traffic accident injury to his right medial malleolus and leg.It was an open fracture of the right tibia and fibula accompanied by a large soft tissue defect of the right medial malleolus sized 12 cm×4 cm.Doppler examination revealed that the tibialis posterior vessel was occluded due to thrombosis.The anterior tibial artery was patent.Three weeks after injury,the left anterolateral thigh muscle flap was harvested and transplanted to the right medial malleolus defect area for repair of the soft tissue defect,and an end-to-side anastomosis was performed between the posterior tibial vessel of the contralateral leg and the muscle flap's vascular pedicle.A split thickness free skin graft was used to cover the muscle flap and around the flap's vascular pedicle.The vascular pedicle was cut off after 28 days and the muscle flap survived completely.After 3-year follow-up postoperatively,the right tibia and fibula fractures were confirmed healing radiologically.The posterior tibial artery of contralateral leg was patent by clinical and Doppler examinations.This technique can be used to preserve the flow and patency of recipient arteries.

  14. Idaho National Laboratory Quarterly Performance Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Mitchell, Lisbeth [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2014-11-01

    This report is published quarterly by the Idaho National Laboratory (INL) Quality and Performance Management Organization. The Department of Energy (DOE) Occurrence Reporting and Processing System (ORPS), as prescribed in DOE Order 232.2, “Occurrence Reporting and Processing of Operations Information,” requires a quarterly analysis of events, both reportable and not reportable, for the previous 12 months. This report is the analysis of 60 reportable events (23 from the 4th Qtr FY14 and 37 from the prior three reporting quarters) as well as 58 other issue reports (including not reportable events and Significant Category A and B conditions) identified at INL from July 2013 through October 2014. Battelle Energy Alliance (BEA) operates the INL under contract DE AC07 051D14517.

  15. ER Consolidated Quarterly Report October 2014

    Energy Technology Data Exchange (ETDEWEB)

    Cochran, John R. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2014-10-01

    This Environmental Restoration Operations (ER) Consolidated Quarterly Report (ER Quarterly Report) provides the status of ongoing corrective actions and related Long- Term Stewardship (LTS) activities being implemented by Sandia National Laboratories, New Mexico (SNL/NM) ER for the April, May, and June 2014 quarterly reporting period. Section 2.0 provides the status of ER Operations activities including closure activities for the Mixed Waste Landfill (MWL), project management and site closure, and hydrogeologic characterizations. Section 3.0 provides the status of LTS activities that relate to the Chemical Waste Landfill (CWL) and the associated Corrective Action Management Unit (CAMU). Section 4.0 provides the references noted in Section I of this report.

  16. Quarterly report for the electricity market. 1. quarter of 2012; Kvartalsrapport for kraftmarknaden. 1. kvartal 2012

    Energy Technology Data Exchange (ETDEWEB)

    Pettersen, Finn Erik Ljaastad; Eliston, Anton Jaynanand; Guren, Ingri; Homqvist, Erik; Lund, Per Tore Jensen; Magnussen, Ingrid; Rasmussen, Kristian; Ulriksen, Margit Iren

    2012-07-01

    The first quarter of 2012 was unusually mild and wetter than normal. Total inflow was 16.8 TWh, 7.5 TWh more than normal. This ensured a high reservoir levels and at the end of the quarter the filling was 50.5 percent. It is 12.5 percentage points over the normal for the time of year and 32.4 percentage points higher than the same time last year. Norway had a power consumption of 37.5 TWh in the first quarter, which is 2.3 percent less than in the same quarter last year. the past 12 months, consumption has been 124.2 TWh, compared with 129.7 TWh the preceding 12 months. Power production in Norway was 42.3 TWh in the first quarter - an increase of 32.3 percent compared with the same quarter last year. The last 12 months have the Norwegian production been 138.5 TWh compared to 117.7 TWh the the previous 12 months. The production increase is due to milder and wetter weather than normal over the past year. This involvement also high the exports abroad. In the first quarter, Norway had a net export of 4.8 TWh, compared with a net import of 6.4 TWh in the first quarter last year. The good resource, combined with a low consumption gave a low price level in wholesale market for electricity. On average for the fourth quarter was the average spot price in the South and West Norway, Nok 272 and 275 / MWh. In Eastern Norway, the average price of Nok 283 / MWh, while it was Nok 285 / MWh in the Middle and Northern Norway. (Author)

  17. Quarterly report for the electricity market. 2. quarter of 2012; Kvartalsrapport for kraftmarknaden. 2. kvartal 2012

    Energy Technology Data Exchange (ETDEWEB)

    Eliston, Anton Jaynand; Holmqvist, Erik; Lund, Per Tore Jensen; Magnussen, Ingrid; Viggen, Kjerstin Dahl; Willumsen, Mats Oeivind; Guren, Ingrid; Ulriksen, Margit Iren

    2012-07-01

    Fourth quarter of 2011 was unusually mild and wet, resulting in high energy inflow to the Norwegian reservoirs. Total inflow for the year was 149.2 TWh, 26.7 TWh more than normal. This ensured record-high 80.3 percent load factor at the end of the quarter.The stored energy amount in the reservoirs was thus 29.5 TWh greater than at the end of 2010/2011. Norway had a power consumption of 34.1 TWh in the fourth quarter. Compared with the same quarter of 2010, a decrease of 4.2 TWh, which can be connected to the mild weather development. The total Norwegian electricity consumption in 2011 was 125.1 TWh, or 6.9 TWh less than in 2010. Electricity production in the fourth quarter of 2011 was 38.3 GWh, an increase of 3.7 TWh from the same quarter the year before. The production increase were a result of the large volume of water in the system. Power production for the year 2011 was 128.1 TWh, an increase of 3.7 TWh from 2010. Kraft surplus was therefore large, and it was Norwegian net export of 4.2 TWh in the fourth quarter, and 3.0 TWh total for the year. In comparison, in the fourth quarter of 2010 Norwegian net import of 0.8 TWh and 7.5 TWh annually. The good resource combined with the low consumption gave a unusually low price levels in the wholesale market for electricity. On average for fourth quarter, the price of power in the East and South-East Norway Nok 264 / MWh, in western Norway Nok 260 / MWh, in Central Norway Nok 270 / MWh (eb)

  18. Quarterly report for the electricity market. 2. quarter of 2012; Kvartalsrapport for kraftmarknaden. 2. kvartal 2012

    Energy Technology Data Exchange (ETDEWEB)

    Pettersen, Finn Erik Ljaastad; Eliston, Anton Jayanand; Vaeringstad, Thomas; Lund, Per Tore Jensen; Magnussen, Ingrid; Langseth, Benedicte; Willumsen, Mats Oeivind; Rasmussen, Kristian; Guren, Ingri

    2012-07-01

    Second quarter of 2012 was cold. Total inflow was 47.0 TWh, 8.8 TWh less than normal. At the end of the quarter, the reservoir level 68.4 percent. It is 1.8 percentage points above normal for time of year and 1.2 percentage points higher than the same time last year. Norway had a power consumption of 28.2 TWh in the second quarter, which is 4.2 percent higher than in the same quarter last year. The last 12 months the consumption have been 125.7 TWh, compared with 128.7 TWh the preceding 12 months. The power production in Norway was 33.3 TWh in the second quarter - an increase of 26.1 percent compared with the same quarter last year. The last 12 months the Norwegian production has been 145.8 TWh, compared with 120.9 TWh the preceding 12 months. The production increase is due to that the last year has been much wetter than the preceding. This has also given high export abroad. In the second quarter Norway had a net export of 5.1 TWh, compared with a net import of 0.6 TWh in the second quarter last year. The good resource gave a low price level in the wholesale market for electricity. On average for the second quarter was the average spot price in West, Southwest and Eastern Norway, 201, 202 and 203 Nok / MWh. In Central and Northern Norway, the average price 218 and 213 Nok/ MWh. (eb)

  19. Sinopec's Profits up Drastically in First Quarter

    Institute of Scientific and Technical Information of China (English)

    Wang Yuxiao

    2003-01-01

    @@ Sinopec, Asia's largest refiner,announced on April 29 that its net first quarter profit skyrocketed almost 12-fold as it sold more refined oil and petrochemical products, cashing in on the international price hikes in oil during the period. However, analysts said the growth of China's second largest oil company is expected to recede in the second quarter as oil prices fall due to the end of the Iraq War. They still anticipate the company's full-year profit will increase by 15 percent or more on the back of a domestic oil market recovery.

  20. 美國專利產品的修理與再製之區分與案例類型 Distinction between Repair and Reconstruction of a Patented Product and Category of Cases in United States

    Directory of Open Access Journals (Sweden)

    陳佳麟 Jia-Lin Chen

    2006-12-01

    and reconstruction in 1850, and numerous cases have been decided in different levels of courts. This paper analyzes the recent patent infringement cases in United States regarding distinction between repair and reconstruction of patent products to obtain the guideline.

  1. South African Crime Quarterly 56

    African Journals Online (AJOL)

    Edited by Chandré Gould and Andrew Faull

    Constitutional Court against the Supreme Court's ruling that he is obliged to issue such a certificate; and. (2) to have the ... South African courts may find Zimbabwean case law helpful in .... irrational or unreasonable administrative decisions,.

  2. South African Crime Quarterly 57

    African Journals Online (AJOL)

    Institute for Security Studies/UCT

    The Criminal Procedure Act of 1977 contains various elements that guide a court in ... This includes the criminal justice system, ..... case that they were not flight risks, let alone ..... African, Indian and Coloured designated groups, unless the.

  3. Effect of Relaxing Incisions on the Maxillary Growth after Primary Unilateral Cleft Palate Repair in Mild and Moderate Cases: A Randomized Clinical Trial

    Science.gov (United States)

    Cotrina-Rabanal, Omar; Figallo-Hudtwalcker, Olga; Gonzalez-Vereau, Alicia

    2017-01-01

    Background: The purpose of this study was to evaluate the association between the use of relaxing incisions and maxillary growth disturbance after primary palatoplasty in patients with unilateral cleft lip and palate. Methods: This is a prospective, randomized, double-blind controlled trial study with ethical committee approval between 2 groups of patients with unilateral cleft lip and palate who were operated on using the two-flap and one-flap techniques from 2008 to 2011. Two groups of patients with unilateral cleft lip and palate were operated on using the mentioned techniques by the Outreach Surgical Center Program Lima since 2008. Data collection was accomplished by evaluation of maxillary arch dimensions and dental arch relationships (scored using the 5-year-olds’ index). Results: The mean score for the 5-year-olds’ index was 2.57 for two-flap technique and 2.80 for one-flap technique without statistical significant differences (P = 0.71). Our comparative study did not find statistically significant differences in maxillary arch dimensions between the studied techniques for unilateral cleft palate repair. Good levels of agreement were observed according to the κ statistics. Conclusions: The results arising from this clinical trial do not provide statistical evidence that one technique let us obtain better maxillary development than the other at 5 years. The use of relaxing incisions was not associated with maxillary growth impairment. A technique with limited relaxing incisions does not has better maxillary growth. Additional longer term study is necessary to confirm this preliminary report. PMID:28203502

  4. Application of microsurgical technique on repairment of forefeet degloving injury in 12 case report%采用显微外科技术修复前足脱套伤12例报告

    Institute of Scientific and Technical Information of China (English)

    廖明新; 连伟飞; 林华斌

    2016-01-01

    目的:介绍采用显微外科技术修复前足脱套伤的临床经验和疗效。方法2012年9月~2013年12月,应用股前外侧穿支皮瓣修复前足脱套性损伤12例,其中男10例,女2例。致伤原因:车祸伤5例,重物砸伤4例,机器伤3例。致伤部位包括:跖跗关节以远7例,跖骨中段以远5例,其中9例合并有跖骨和/或趾骨骨折。患足在清除坏死皮肤软组织后均出现不同程度的肌腱、骨外露,软组织缺损区域包括前足负重区,软组织缺损面积范围10cm×5cm~25cm×10cm。所有创面均使用股前外侧穿支游离皮瓣修复,切取皮瓣大小为12cm×7cm~27cm×12cm。结果本组10例皮瓣完全成活,2例皮瓣边缘部分坏死。术后10位患者获得随访,随访6~12个月,皮瓣生长良好,前足功能恢复理想,可负重行走,足底无溃疡形成。采用英国医学研究会提出的感觉功能评定标准进行评定:8例皮瓣感觉恢复至S2,4例皮瓣恢复到S3。结论股前外侧中、下段皮瓣厚度与足底软组织厚度相近,阔筋膜坚韧而致密,类似足底组织结构,可很好的恢复足底耐磨、耐压、缓冲震荡的功能。游离此部位的穿支皮瓣修复前足脱套伤是一种较为理想的方法。%Objective To introduce the clinical experience and the efficacy on the repairment of forefeet degloving injury applied by microsurgical technique.Methods To apply anterolateral thigh perforator flap to repair the forefeet degloving injury in 12 patients of 10 male and 2 female from Septmeber 2012 to December 2013. The injured causes were vehicle accident 5 cases, bruised by heavy weight 4 cases, and machine injury 3 cases. The injured positions were distal to tarsometatarsal joint 7 cases and distal to metatarsal middle part 5 cases, thereinto, 9 cases of combined metatarsal fractures and / or phalangeal fractures. Different degree of tendon and bone exposure had been appeared on

  5. Obstetric fistulae repair in a Nigerian Tertiary Health Institution ...

    African Journals Online (AJOL)

    Gynaecologists performed 61.7% of cases using the vaginal route while ... Bivariate analysis showed that younger age at presentation, gravidity, VVF type ... It is recommended that early presentation for repair and capacity building of specialist ...

  6. Modified Kugel补片在腹股沟嵌顿疝修补术中的应用28例%Clinical experience of Modified Kugel patch used in inguinal incarcerated hernia repairing in 28 cases

    Institute of Scientific and Technical Information of China (English)

    曾荻洵; 任波; 向君华; 陈建军

    2011-01-01

    Objective: To discuss the operation skills and evaluate the effects of Modified Kugel patch in inguinal incar cerated hernia. Methods: The clinical data of 28 cases performed inguinal incarcerated hernia repairing used Modified Kugel patch from April 2005 to January 2010 at Hospital of National University of Defense Technology were analyzed ret rospectively. Results: The mean operative time was 58 minutes. The mean length of hospital stay was 7 5 days. The patients had quick convalescence. Operation complications were few and no severe. The follow-up period ranged from 6 to 48 months, and no recurrence was observed. Conclusion: Repairing of inguinal incarcerated hernia using Modified Kugel patch is a safe and effective procedure with few complications and low recurrence. This method is especially suitable for transversalis fascia weakness or serious defect in patients.%目的:探讨Modified Kugel补片治疗腹股沟嵌顿疝的技术要点,评价其效果.方法:回顾性分析国防科大医院2005年4月~2010年1月应用Modified Kugel补片手术治疗腹股沟嵌顿疝28例患者临床资料.结果:平均手术时间为58 min,术后平均住院151为7.5 d,术后恢复快,并发症少、轻.随访6~48个月.无复发.结论:Modified Kugel补片治疗腹股沟嵌顿疝是一种安全可靠、并发症少、复发率低的修补方式,尤其适宜于腹横筋膜薄弱或缺损较重的患者.

  7. Quarterly Progress Report Fuels Development Operation October - December 1960

    Energy Technology Data Exchange (ETDEWEB)

    Cadwell, J. J. [Hanford Site (HNF), Richland, WA (United States); Tobin, J. C. [Hanford Site (HNF), Richland, WA (United States); Last, G. A. [Hanford Site (HNF), Richland, WA (United States); Evans, E. A. [Hanford Site (HNF), Richland, WA (United States); Minor, J. E. [Hanford Site (HNF), Richland, WA (United States)

    1961-01-13

    The present Quarterly Report is the continuation of a series issued by the new Fuels Development Operation. Reports in this series combine portions of the quarterly reports by the former Metallurgy Research and Fuel Technology Sub-Sections.

  8. Genetic predictions of racing performance in quarter horses

    National Research Council Canada - National Science Library

    Willham, R. L; Wilson, D. E

    1991-01-01

    .... Research on the racing performance of quarter horses has been used to develop genetic prediction summaries on all horses with at least one start on record at the American Quarter Horse Association...

  9. ARM Operations Quarterly Report October 1-December 31, 2013

    Energy Technology Data Exchange (ETDEWEB)

    Voyles, Jimmy W. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2013-12-31

    The U.S. Department of Energy requires national user facilities to report time-based operating data. This quarterly report is written to comply with this requirement. This reports on the first quarter facility statistics.

  10. Environmental Biosciences Program Quarterly Report

    Energy Technology Data Exchange (ETDEWEB)

    Lawrence C. Mohr, M.D.

    2009-01-30

    Current research projects have focused Environmental Biosciences Program (EBP) talent and resources on providing the scientific basis for risk-based standards, risk-based decision making and the accelerated clean-up of widespread environmental hazards. These hazards include trichloroethylene, low-dose ionizing radiation (gamma and neutron) and alpha radiation from plutonium. Trichloroethylene research has been conducted as a joint collaborative effort with the University of Georgia. Work on the trichloroethylene research projects has been slowed as a result of funding uncertainties. The impact of these funding uncertainties has been discussed with the United States Department of Energy (DOE). Laboratory work has been completed on several trichloroethylene risk assessment projects, and these projects have been brought to a close. Plans for restructuring the performance schedule of the remaining trichloroethylene projects have been submitted to the department. A comprehensive manuscript on the scientific basis of trichloroethylene risk assessment is in preparation. Work on the low-dose radiation risk assessment projects is also progressing at a slowed rate as a result of funding uncertainties. It has been necessary to restructure the proponency and performance schedule of these projects, with the project on Low-Dose Radiation: Epidemiology Risk Models transferred to DOE Office of Science proponency under a separate funding instrument. Research on this project will continue under the provisions of the DOE Office of Science funding instrument, with progress reported in accordance with the requirements of that funding instrument. Progress on that project will no longer be reported in quarterly reports for DE-FC09-02CH11109. Following a meeting at the Savannah River Site on May 8, 2008, a plan was submitted for development of an epidemiological cohort study and prospective medical surveillance system for the assessment of disease rates among workers at the Savannah River

  11. 腹腔镜食管裂孔疝修补术143例临床分析%Laparoscopic hiatal hernia repair: a clinical analysis of 143 cases

    Institute of Scientific and Technical Information of China (English)

    赵宏志; 秦鸣放; 王庆; 勾承月; 李宁

    2011-01-01

    Objective To explore the feasibility and clinical value of laparoscopic surgery in treating patients with hiatal hernia. Methods From June 2001 to February 2010, 143 cases of hiatal hernia were enrolled to undertake laparoscopic hiatal hernia repair at Nankai Hospital of Tianjin City. Laparoscopic fundoplication was performed concomitantly in some cases if appropriate. Paraoperative clinical parameters were recorded and analyzed. All cases were followed up routinely. Clinical outcomes were collected and analyzed. Results All 143 cases of laparoscopic operations were accomplished successfully. No conversions were needed. Mean operation time was 86 minutes (range: 55-210 minutes). Mean intraoperative blood lose was 76 mL (range: 40-150 mL). Mean postoperative hospital stay was 4.6 days (range: 3-21 days). Clinical symptoms were relieved in all cases. No mortality and severe complications were noted.Mean follow up period was 3.8 years (range: 3 months to 9 years). Rate of satisfaction for operation was 91.67%. Mild dysphagia occurred in 8 cases. Reflux recurrence occurred in 5 cases, in whom 4 cases were controlled by antacid medicine and 1 case need open surgical revision. Conclusion Laparoscopic hiatal hernia repair has the advantages of minimal trauma, fast recovery, safe and high reliability.%目的 探讨腹腔镜手术治疗食管裂孔疝的可行性和临床应用价值.方法 对2001年6月至2010年2月天津市南开医院143例食管裂孔疝行腹腔镜食管裂孔疝修补术的资料进行分析.结果 143例均完成腹腔镜手术,无中转开腹病例,手术时间55~210min,平均86min;术中出血量40~150mL,平均76mL;术后住院时间3~21d.平均4.6d.术后临床症状均得到缓解,无严重并发症及死亡病例.134例得到随访,随访时间3个月至9年,平均3.8年,手术结果满意率91.67%.8例进固体食物时有轻度哽噎感,5例反酸症状复发,其中4例应用抑酸药物后可控制,1例行开腹手术治疗.结论

  12. A novel method for repair of testis rupture after gunshot trauma: repair with Tutoplast processed pericardium.

    Science.gov (United States)

    Ciftci, Seyfettin; Ozkul, Bahattin; Ustuner, Murat; Nagihanlnan; Culha, Mustafa Melih

    2014-12-01

    Gunshot wound injury to the external genitalia is relatively uncommon. However, if a testis isaffected in such a case, early surgical exploration should be carried out. A 16-year-old boy presented with right testicular rupture. Tunica albugineal defect could not be closed primarily. We used a Tutoplast® processed bovine pericardium to repair the defect of tunica albuginea. At his 3-month follow-up visit, there was no complication. Doppler blood flow of testis was normal. In this case, preservation of testis tissue was obtained with early exploration and repair of the big tunica albugineal defect with Tutoplast® processed pericardium.

  13. Acute diaphragmatic rupture following open type IV paraesophageal hernia repair.

    Science.gov (United States)

    Reames, Bradley N; Reddy, Rishindra M

    2011-06-01

    Open primary transthoracic repair is a well established treatment for large paraesophageal hernias. The rate of major post-operative complications has been reported to be low, and no cases of acute diaphragmatic injury have previously been reported. Here we present a case of open primary transthoracic repair of a type IV paraesophageal hernia that was complicated by rupture of the left diaphragm in the immediate post-operative period, and was successfully repaired with Gore DualMesh® (W.L Gore and Assoc. Flagstaff, AZ). © JSCR.

  14. Detecting and Correcting Speech Repairs

    CERN Document Server

    Heeman, P A; Heeman, Peter; Allen, James

    1994-01-01

    Interactive spoken dialog provides many new challenges for spoken language systems. One of the most critical is the prevalence of speech repairs. This paper presents an algorithm that detects and corrects speech repairs based on finding the repair pattern. The repair pattern is built by finding word matches and word replacements, and identifying fragments and editing terms. Rather than using a set of prebuilt templates, we build the pattern on the fly. In a fair test, our method, when combined with a statistical model to filter possible repairs, was successful at detecting and correcting 80\\% of the repairs, without using prosodic information or a parser.

  15. Laparoscopic repair for vesicouterine fistulae

    Directory of Open Access Journals (Sweden)

    Rafael A. Maioli

    2015-10-01

    . Discussion: Laparoscopy has advantages over open surgery in that it is associated with less pain, shorter length of hospital stay, better cosmesis, quicker recovery, and equal efficacy. Although cases of VUF are rarely noted, the laparoscopic skill obtained through other urological procedures suggest, that laparoscopic repair may be the procedure of choice for such cases (2. The reported operative time for the laparoscopic repair of VUF in the literature varies between 140 and 220 min (3. However, laparoscopic techniques should be considered as a mode of abdominal access and should not influence the method of surgical repair. Surgical success should depend on the adherence to good technique rather than the approach. Hence, this method appears to be a viable alternative for surgeons experienced with laparoscopic suturing techniques. Conclusion: Laparoscopic repair appears to be a viable alternative for surgeons experienced with laparoscopic suturing techniques.

  16. 腹腔镜胃十二指肠溃疡穿孔修补36例临床观察%Laparoscopic repair of peptic ulcer perforation:a report of 36 cases

    Institute of Scientific and Technical Information of China (English)

    张文革; 张辉; 王锋

    2011-01-01

    目的:观察腹腔镜胃十二指肠溃疡穿孔修补的效果.方法:分析74例胃十二指肠溃疡穿孔修补术患者的临床资料,其中行腹腔镜胃十二指肠穿孔修补术(腔镜组)36例,开腹手术穿孔修补术(开腹组)38例.观察2组患者的手术时间、出血量及术后胃肠道恢复时间、疼痛程度、并发症发生率、住院时间、住院费用等.结果:所有患者手术均顺利完成,腔镜组无中转开腹.2组患者在手术时间、术中出血量、术后疼痛评分、胃肠功能恢复时间、住院时间及住院费用差异均有统计学意义(P0.05).结论:腹腔镜溃疡穿孔修补术具有创伤小、术后恢复快和并发症发生率低等优点,是治疗胃十二指肠溃疡穿孔的一种安全有效的术式,值得临床推广.%Objective: To investigate the clinical effect of laparoscopic reparation on peptic ulcer perforation. Methods: The clinical data of 74 cases were retrospectively reviewed from 2005 to 2010. Thirty-six cases were performed with laparoscopic repair( laparoscopic group) and 38 cases underwent open surgery( open surgery group) . The mean blood loss,mean surgery time,recovery of the stomach and intestines function,hospital stay,hospital cost and the rate of complications were observed. Results:Compared with the open surgery group, the mean blood loss, mean surgery time, recovery of the stomach and intestines function, and hospital stay in laparoscopic group had statistically significant difference ( P 0. 05). Conclusions:The laparoscopic repair in patients with peptic ulcer perforation is safety and effective, so it is worth to recommend its clinical use.

  17. Synchronous femoral hernias diagnosed during endoscopic inguinal hernia repair.

    Science.gov (United States)

    Putnis, Soni; Wong, April; Berney, Christophe

    2011-12-01

    During totally extraperitoneal (TEP) endoscopic repair of inguinal hernias, it is possible to see the internal opening of the femoral canal. The aim of our study was to determine the incidence of synchronous femoral hernias found in patients undergoing TEP endoscopic inguinal hernia repair. This was a retrospective review of prospectively collected data on 362 consecutive patients who underwent 484 TEP endoscopic inguinal hernia repairs during a 5-year period, May 2005 to May 2010. During surgery, both inguinal and femoral canal orifices were routinely inspected. The presence of unilateral or bilateral inguinal and femoral hernias was recorded and repaired accordingly. There were a total of 362 patients. More males (343, 95%) underwent a TEP hernia repair than females (19, 5%). There were more cases of unilateral (240/362, 66%) than bilateral (122/362, 34%) inguinal hernias. A total of 18 cases of synchronous femoral hernias were found during operation. There was a higher incidence of femoral hernia in females (7/19, 37%) compared to males (11/343, 3%) (P hernias were clinically detectable preoperatively. Females undergoing elective inguinal hernia repair are more likely to have a synchronous femoral hernia than males. We suggest that all women presenting with an inguinal hernia also have a formal assessment of the femoral canal. TEP endoscopic inguinal hernia repair is an ideal approach as both inguinal and femoral orifices can be assessed and hernias repaired simultaneously during surgery.

  18. 10 CFR 34.69 - Records of quarterly inventory.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Records of quarterly inventory. 34.69 Section 34.69 Energy... INDUSTRIAL RADIOGRAPHIC OPERATIONS Recordkeeping Requirements § 34.69 Records of quarterly inventory. (a) Each licensee shall maintain records of the quarterly inventory of sealed sources and of...

  19. 12 CFR 620.10 - Preparing the quarterly report.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Preparing the quarterly report. 620.10 Section 620.10 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM DISCLOSURE TO SHAREHOLDERS Quarterly Report § 620.10 Preparing the quarterly report. (a) Each institution of the Farm Credit...

  20. Natural gas imports and exports. Second quarter report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-12-31

    The Office of Natural Gas and Petroleum Import and Export Activities prepares quarterly reports summarizing the data provided by companies authorized to import or export natural gas. Companies are required, as a condition of their authorizations, to file quarterly reports. This report is for the second quarter of 1997 (April through June).

  1. Functional evaluation of a CAD/CAM prosthesis for immediate defect repair after total maxillectomy: a case series of 18 patients with maxillary sinus cancer.

    Science.gov (United States)

    Jiang, Fei-Fei; Hou, Yan; Lu, Li; Ding, Xiao-Xu; Li, Wei; Yan, Ai-Hui

    2015-01-01

    To evaluate the facial profiles and functional recovery of 18 patients treated by a computer-aided designed/manufactured hollow obturator prosthesis (CAD/CAM prosthesis) after total maxillectomy for malignant maxillary sinus tumor. A retrospective observational study was performed to evaluate the facial profiles and functional recovery of 18 patients with T3-4a N0 M0 maxillary sinus cancer, who were treated by total maxillectomy and simultaneous implantation of a computer-aided designed/manufactured hollow obturator prosthesis (CAD/CAM prosthesis). Follow-ups were performed 1, 3, 6, and 12 months after surgery. Facial measurements, speech intelligibility, and chewing and swallowing functions were examined. Thirteen patients converted to a permanent prosthesis 6 months after surgery. Comparisons were made between patients with and without the CAD/CAM or permanent prosthesis at various times using SPSS13.0 statistical software (SPSS Inc., Chicago, IL, USA). Speech intelligibility, facial depression, and eyeball prolapse results showed improvements with prosthesis use at 1, 3, and 6 months after surgery (p prosthesis use at 1, 3, and 6 months, and reached level I or II with permanent prosthesis use at 12 months after surgery. Simultaneous CAD/CAM prosthesis implantation recovered the facial profile, enhanced the speaking, swallowing, and chewing functions, and improved the quality of life of patients. Tumor recurrence can be detected by direct observation of the postoperative maxillary cavity. Therefore, this operation is recommended for simultaneous excision repair and functional reconstruction after total maxillectomy. This surgical treatment of maxillary sinus cancer is applied rarely in China, but it has a good effect based on our observation. Simultaneous CAD/CAM prosthesis implantation after total maxillectomy can recover the facial profile, enhance the speaking, swallowing, and chewing functions, and improve the quality of life of patients. Tumor recurrence

  2. Quarterly coal report, April 1995--June 1995

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-11-01

    This document provides comprehensive information about U.S. coal production, distribution, imports, exports, prices, and consumption. Coke production, consumption, distribution, imports, and exports are also provided. This report presents compiled data for April thru June, and historical data for 1987 thru the first quarter of 1995.

  3. Bangladesh Quarterly Economic Update - December 2014

    OpenAIRE

    Asian Development Bank

    2015-01-01

    The Bangladesh Quarterly Economic Update (QEU) has been produced by the Bangladesh Resident Mission of the Asian Development Bank since March 2001. The QEU provides information and analysis on Bangladesh’s macroeconomic and sector developments, key development challenges, and policy and institutional reforms. The QEU has wide readership in government, academia, development partners, private sector, and civil society.

  4. Bangladesh Quarterly Economic Update June 2014

    OpenAIRE

    Asian Development Bank

    2014-01-01

    The Bangladesh Quarterly Economic Update (QEU) has been produced by the Bangladesh Resident Mission of the Asian Development Bank since March 2001. The QEU provides information and analysis on Bangladesh’s macroeconomic and sector developments, key development challenges, and policy and institutional reforms. The QEU has wide readership in government, academia, development partners, private sector, and civil society.

  5. Bangladesh Quarterly Economic Update September 2014

    OpenAIRE

    Asian Development Bank

    2014-01-01

    The Bangladesh Quarterly Economic Update (QEU) has been produced by the Bangladesh Resident Mission of the Asian Development Bank since March 2001. The QEU provides information and analysis on Bangladesh’s macroeconomic and sector developments, key development challenges, and policy and institutional reforms. The QEU has wide readership in government, academia, development partners, private sector, and civil society.

  6. "The Career Development Quarterly": A Centennial Retrospective

    Science.gov (United States)

    Savickas, Mark L.; Pope, Mark; Niles, Spencer G.

    2011-01-01

    "The Career Development Quarterly" has been the premier journal in the field of vocational guidance and career intervention since its inception 100 years ago. To celebrate its centennial, 3 former editors trace its evolution from a modest and occasional newsletter to its current status as a major professional journal. They recount its history of…

  7. Musculoskeletal injuries in nonracing quarter horses.

    Science.gov (United States)

    Scott, Mike

    2008-04-01

    Quarter horses used for western performance competitions commonly sustain a variety of musculoskeletal injuries. It is important for the veterinarian to have an understanding of some of the breed characteristics and the nature of the competitions in which individual horses are being used so as to diagnose, treat, and prevent injury as effectively as possible.

  8. Transient Fanconi syndrome in Quarter horses.

    Science.gov (United States)

    Ohmes, Cameon M; Davis, Elizabeth G; Beard, Laurie A; Vander Werf, Karie A; Bianco, Alex W; Giger, Urs

    2014-02-01

    Two Quarter horses with weight loss had glucosuria, euglycemia, and a mild metabolic acidosis suggesting a proximal renal tubular defect. Further testing revealed transient generalized aminoaciduria, lactic aciduria, and glucosuria, indicating Fanconi syndrome. Both horses recovered with supportive therapy. This is the first report of acquired Fanconi syndrome in horses.

  9. Apprentices and Trainees: March Quarter, 2010

    Science.gov (United States)

    National Centre for Vocational Education Research (NCVER), 2010

    2010-01-01

    This publication presents estimates of apprentice and trainee activity in Australia for the March quarter 2010. The figures in this publication are derived from the National Apprentice and Trainee Collection no.64 (June 2010 estimates). The most recent figures in this publication are estimated (those for training activity from the September…

  10. Quarter-controlled milking in dairy cows

    NARCIS (Netherlands)

    Ipema, A.H.; Hogewerf, P.H.

    2008-01-01

    The design of a milking stall with special functions for monitoring and control is described. The milk removal process per quarter is described. The milking stall was equipped with four milk containers, whose advancing weight was recorded permanently. The data were online converted into milk flow ra

  11. Apprentices and Trainees: September Quarter, 2009

    Science.gov (United States)

    National Centre for Vocational Education Research (NCVER), 2010

    2010-01-01

    This publication presents estimates of apprentice and trainee activity in Australia for the September quarter 2009. The figures in this publication are derived from the National Apprentice and Trainee Collection no. 62 (December 2009 estimates). There were 425,500 apprentices and trainees in-training as at 30 September 2009, a decrease of 2.4%…

  12. Apprentices and Trainees: December Quarter, 2009

    Science.gov (United States)

    National Centre for Vocational Education Research (NCVER), 2010

    2010-01-01

    This publication presents estimates of apprentice and trainee activity in Australia for the December quarter 2009. The figures in this publication are derived from the National Apprentice and Trainee Collection no.63 (March 2010 estimates). There were 414 900 apprentices and trainees in-training as at 31 December 2009, a decrease of 0.6% from the…

  13. "The Career Development Quarterly": A Centennial Retrospective

    Science.gov (United States)

    Savickas, Mark L.; Pope, Mark; Niles, Spencer G.

    2011-01-01

    "The Career Development Quarterly" has been the premier journal in the field of vocational guidance and career intervention since its inception 100 years ago. To celebrate its centennial, 3 former editors trace its evolution from a modest and occasional newsletter to its current status as a major professional journal. They recount its history of…

  14. "Library Quarterly" Management Literature, 1931-2004

    Science.gov (United States)

    Young, Arthur P.

    2006-01-01

    Management literature appearing in "Library Quarterly," 1931-2004, is examined in this essay. A total of 145 articles are identified that focus on administrative and managerial issues related to libraries during this period. Management literature is construed expansively and includes accounting, administration, assessment, budgets, facilities,…

  15. 77 FR 3784 - ACHP Quarterly Business Meeting

    Science.gov (United States)

    2012-01-25

    ... From the Federal Register Online via the Government Publishing Office ADVISORY COUNCIL ON HISTORIC PRESERVATION ACHP Quarterly Business Meeting AGENCY: Advisory Council on Historic Preservation. ACTION: Notice... Implementation C. Bureau of Land Management Nationwide Programmatic Agreement VIII. New Business IX. Adjourn...

  16. The Research Quarterly and its Antecedents.

    Science.gov (United States)

    Park, Roberta J.

    1980-01-01

    There is little evidence that indicates that the American Alliance for Health, Physical Education, Recreation, and Dance (AAHPERD) has given vigorous, sustained support to the Research Quarterly. Many scholars may become disillusioned with this policy and submit their research to other more specialized journals. (CJ)

  17. Approximating the DGP of China's Quarterly GDP

    NARCIS (Netherlands)

    Ph.H.B.F. Franses (Philip Hans); H. Mees (Heleen)

    2010-01-01

    textabstractWe demonstrate that the data generating process (DGP) of China’s cumulated quarterly Gross Domestic Product (GDP, current prices), as it is reported by the National Bureau of Statistics of China, can be (very closely) approximated by a simple rule. This rule is that annual growth in any

  18. Approximating the DGP of China's Quarterly GDP

    NARCIS (Netherlands)

    Ph.H.B.F. Franses (Philip Hans); H. Mees (Heleen)

    2010-01-01

    textabstractWe demonstrate that the data generating process (DGP) of China’s cumulated quarterly Gross Domestic Product (GDP, current prices), as it is reported by the National Bureau of Statistics of China, can be (very closely) approximated by a simple rule. This rule is that annual growth in any

  19. A COMPARATIVE STUDY BETWEEN LAPAROSCOPIC TRANSABDOMINAL PREPERITONEAL REPAIR AND TOTAL EXTRAPERITONEAL REPAIR OF INGUINAL HERNIA

    Directory of Open Access Journals (Sweden)

    Narendra

    2016-05-01

    Full Text Available BACKGROUND Groin hernia surgeries have come a long way since knowledge of modern surgery. Among them laparoscopic hernia repair is the advanced and better method in terms of less pain and speedy recovery. AIMS AND OBJECTIVES To compare and assess the outcome between laparoscopic transabdominal preperitoneal repair and total extraperitoneal repair of inguinal hernia. 1. To compare the duration of procedure between two techniques. 2. To assess the complications encountered (Intraoperative and postoperative. 3. To evaluate the post-operative pain. MATERIALS AND METHODS 40 cases of groin hernia admitted in Sri Siddhartha Medical College, Tumkur, between 2013 and 2015 randomly picked for TAPP and TEP surgeries, assigning 20 for each, prospective analysis made results compared and evaluated using Fischer’s test and Chisquare test. RESULTS Comparatively TEP repair took more operative time and TAPP repair had more post-operative pain. CONCLUSION No major complications seen in both procedures. Laparoscopy repair has long learning curve, which demands skills. TEP is more technically demanding and takes more time than TAPP, but with postoperative pain in comparison.

  20. A new incision for unilateral cleft lip repair developed using animated simulation of repair on computer

    Directory of Open Access Journals (Sweden)

    Sahay A

    2007-01-01

    Full Text Available Background: Unilateral cleft lip repair continues to leave behind some amount of dissatisfaction, as a scope for further improvement is always felt. Most surgeons do not like to deviate from the standard Millard′s/ triangular techniques, or their minor modifications, as no one likes to experiment on the face for fear of unfavourable outcomes. The computer can be utilized as a useful tool in the analysis and planning of surgery and new methods can be developed and attempted subsequently with greater confidence. Aim: We decided to see if an improved lip repair could be developed with the use of computers. Materials and Methods: Analysis of previous lip repairs was done to determine where an improvement was required. Movement of tissues, by simulating an ideal repair, using image warping software, on digital images of cleft lip was studied in animation sequences. A repair which could reproduce these movements was planned. A new incision emerged, which had combined the principles of Millard′s and Randall / Tennyson repairs, with additional features. The new method was performed on 30 cases. Conclusions: The results were encouraging as the shortcomings of these methods were minimized, and the advantages maximized.

  1. Idaho National Laboratory Quarterly Performance Analysis for the 2nd Quarter FY 2015

    Energy Technology Data Exchange (ETDEWEB)

    Mitchell, Lisbeth A. [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2015-04-01

    This report is published quarterly by the Idaho National Laboratory (INL) Quality and Performance Management Organization. The Department of Energy (DOE) Occurrence Reporting and Processing System (ORPS), as prescribed in DOE Order 232.2, “Occurrence Reporting and Processing of Operations Information,” requires a quarterly analysis of events, both reportable and not reportable, for the previous 12 months. This report is the analysis of events for the 2nd Qtr FY-15.

  2. Idaho National Laboratory Quarterly Performance Analysis - 3rd Quarter FY2014

    Energy Technology Data Exchange (ETDEWEB)

    Lisbeth A. Mitchell

    2014-09-01

    This report is published quarterly by the Idaho National Laboratory (INL) Performance Assurance Organization. The Department of Energy (DOE) Occurrence Reporting and Processing System (ORPS), as prescribed in DOE Order 232.2, “Occurrence Reporting and Processing of Operations Information,” requires a quarterly analysis of events, both reportable and not reportable, for the previous 12 months. This report is the analysis of occurrence reports and other non-reportable issues identified at INL from July 2013 through June 2014.

  3. Effects of Game Location, Quality of Opposition, and Starting Quarter Score in the Outcome of Elite Water Polo Quarters.

    Science.gov (United States)

    Ruano, Miguel Á; Serna, Ana D; Lupo, Corrado; Sampaio, Jaime E

    2016-04-01

    The notational analysis is used to investigate teams' performance in water polo, especially focused on the determinants of success. Recently, a new topic has emerged "the situational variables," which includes the game conditions that may influence the performance at a behavioral level. The aim of this study was to identify the interactive effects of starting quarter score (SQS) (i.e., score difference at the beginning of each quarter and at the final score) and game location (GL) (i.e., home and away teams) in relation to quality of opposition (i.e., positions of difference between opposing teams at the end-of-season rankings) in elite men's water polo games. Data comprised 528 games (n = 2,112 quarters) from the first Spanish water polo division. A linear regression analysis was applied to show the impact of SQS and GL in relation to quality of opposition (unbalanced and balanced) for quarter (all quarters, and second, third, and fourth quarters). Results showed that SQS has an important effect for all quarters (0.16) and for the second (0.14) and third (0.14) quarters in balanced games (whereas the fourth quarter has an unpredictable outcome), and for each quarter (all quarters: 0.33; second quarter: 0.55; third quarter: 0.44; fourth quarter: 0.26) in unbalanced games. In addition, GL effects emerged for balanced (0.31) and unbalanced (0.45) games for all quarters and specifically for the second quarter of the unbalanced games. Therefore, this study showed that the elite water polo game dynamics, indirectly providing a reference for coaches (i.e., effective tactical approach) and physical trainers (i.e., high performance intensities), plans to improve their players' performance.

  4. 临床桩核修复失败原因初步探讨%The initial investigation of the causes of 32 failure cases on post-core repair in clinic

    Institute of Scientific and Technical Information of China (English)

    张文怡; 张健; 钱梅; 李长福; 高平

    2011-01-01

    目的:分析桩核修复失败的原因,探讨临床上影响桩核修复的可能因素,选择最适合患者的桩核冠系统.方法:收集因桩核修复失败前来天津医科大学口腔医院修复科就诊的病例132例134颗牙,年龄20-80岁,常规门诊检查、拍摄X线片及询问病史,并进行问卷调查,观察桩核修复失败常见的临床表现并分析桩核修复失败的原因.结果:①桩核松脱91颗(67.9%);牙体劈裂43颗(32.1%).②在91颗桩核松脱病例中,桩核修复时间最短4个月,最长16年,平均5年,较常见的原因为牙体缺损至龈下(43.9%),桩长度不足(17.6%),桩与根管不密合(13.2%)、患者饮食习惯及咬合(8.8%)、桩锥度过大 (8.8%)、修复时间≥5年(4.4%)和义齿基牙(3.3%);③ 43颗牙体劈裂病例中,20颗为非贵金属铸造桩且根管壁薄(46.5%),12颗为螺纹桩(27.9%),11颗牙颈部继发龋(25.6%);④所收集134颗病例中以前牙和前磨牙的修复失败较多,120颗为金属铸造桩核,13颗螺纹桩和1颗纤维桩,除纤维桩采用树脂粘结剂粘结外,其余均采用水门汀粘结剂.结论:所收集病例中桩核修复失败的主要临床表现有桩核松脱、牙体劈裂等.其主要影响因素有桩核的设计、患牙本身条件、粘接剂、修复体在牙弓中的位置以及患者习惯等.医师应严格掌握适应证,注意正确的临床操作和精确的技工制作,患者应定期复诊,以减少修复失败.%Objective: To analyse the causes of 32 failure cases on post-core repair in clinic. Discuss the possible factors which influence the post-core repair and choose the most suitable post and core crowns system for patients. Methods: Thirty-two failure cases with post-core cure were entered into the study. These cases were collected from prosthodontic departmerit of stomatology hospital of Tianjin medical university from 2008 to 201l, 134 teeth of 132 patients, aged between 20to 80. Common examination, X-ray and medical history

  5. Groin hernia repair in young males: mesh or sutured repair?

    DEFF Research Database (Denmark)

    Bisgaard, T; Bay-Nielsen, M; Kehlet, H

    2010-01-01

    Large-scale data for the optimal inguinal hernia repair in younger men with an indirect hernia is not available. We analysed nationwide data for risk of reoperation in younger men after a primary repair using a Lichtenstein operation or a conventional non-mesh hernia repair....

  6. FY 1991 environmental research programs for the DOE Field Office, Nevada: Work plan and quarterly reports, fourth quarter report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1991-10-01

    This research includes a wide range of research and support activities associated with the Weapons Testing Program conducted at the Nevada Test Site (NTS). Ongoing and new environmental research programs to be conducted by DRI over the period of this contract include archaeological studies, site mitigation plans, compliance activities, and historical research; offsite community radiation monitoring support; environmental compliance activities related to state and federal regulations; hydrologic assessment of containment of underground nuclear detonations; hydrology/radionuclide investigations designed to better understand and predict the possible subsurface movement of radionuclides at the NTS; and support of various statistical and data management and design, laboratory, field, and administrative activities. In addition to these, archaeological site characterization, flood hazards for rail transportation, and paleofaunal investigations will be carried out in support of the Yucca Mountain Project. Other areas of the overall program which required DRI support are classified security activities, radiation safety and training, quality assurance and control, computer protection and historical data management, review and classification of DRI documents, and preparation of any special reports, e.g., quarterly reports, not included in the requirements of the individual projects. A new set of programs funded by the Office of Technology Development will be in place by the third quarter of FY 1991. These projects will address environmental restoration and waste management concerns, among other related topics. In accordance with specific contract requirements for each activity, DRI will produce summary, status and final reports and, in some cases, journal articles which will present the results of specific research efforts. This document contains the work plan, including project descriptions, tasks, deliverables and quarterly progress reports on each project for FY 1991.

  7. Cleft lip and palate repair

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/002979.htm Cleft lip and palate repair To use the sharing features on this page, please enable JavaScript. Cleft lip and cleft palate repair is surgery to fix birth defects ...

  8. Abdominal aortic aneurysm repair - open

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/007392.htm Abdominal aortic aneurysm repair - open To use the sharing features on this page, please enable JavaScript. Open abdominal aortic aneurysm repair is surgery to fix a widened part ...

  9. Medialized repair for retracted rotator cuff tears.

    Science.gov (United States)

    Kim, Young-Kyu; Jung, Kyu-Hak; Won, Jun-Sung; Cho, Seung-Hyun

    2017-08-01

    The purpose of this study was to evaluate the functional outcomes of medialized rotator cuff repair and the continuity of repaired tendon in chronic retracted rotator cuff tears. Thirty-five consecutive patients were selected from 153 cases that underwent arthroscopic rotator cuff repair for more than medium-sized posterosuperior rotator cuff tears between July 2009 and July 2012 performed with the medialized repair. All cases were available for at least 2 years of postoperative follow-up. The visual analog scale of pain, muscle strength, Constant score, American Shoulder and Elbow Surgeons (ASES) score, and University of California-Los Angeles score were evaluated. At the final follow-up, all clinical outcomes were significantly improved. The visual analog scale score for pain improved from 6 ± 1 preoperatively to 2 ± 1 postoperatively. The range of motion increased from preoperatively to postoperatively: active forward elevation, from 134° ± 49° to 150° ± 16°; active external rotation at the side, from 47° ± 15° to 55° ± 10°; and active internal rotation, from L3 to L1. The shoulder score also improved: Constant score, from 53.5 ± 16.7 to 79 ± 10; American Shoulder and Elbow Surgeons score, from 51 ± 15 to 82 ± 8; and University of California-Los Angeles score, from 14 ± 4 to 28 ± 4. The retear cases at the final follow-up were 6 (17%). Medialized repair may be useful in cases in which anatomic bone-to-tendon repair would be difficult because of the excessive tension of the repaired tendon and a torn tendon that does not reach the anatomic insertion. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  10. Nanomaterials promise better bone repair

    OpenAIRE

    Qifei Wang; Jianhua Yan; Junlin Yang; Bingyun Li

    2016-01-01

    Nanomaterials mimicking the nano-features of bones and offering unique smart functions are promising for better bone fracture repair. This review provides an overview of the current state-of-the-art research in developing and using nanomaterials for better bone fracture repair. This review begins with a brief introduction of bone fracture repair processes, then discusses the importance of vascularization, the role of growth factors in bone fracture repair, and the failure of bone fracture rep...

  11. Laparoscopic repair of femoral hernia

    OpenAIRE

    Yang, Xue-Fei; Liu, Jia-Lin

    2016-01-01

    Laparoscopic repair of inguinal hernia is mini-invasive and has confirmed effects. Femoral hernia could be repaired through the laparoscopic procedures for inguinal hernia. These procedures have clear anatomic view in the operation and preoperatively undiagnosed femoral hernia could be confirmed and treated. Lower recurrence ratio was reported in laparoscopic procedures compared with open procedures for repair of femoral hernia. The technical details of laparoscopic repair of femoral hernia, ...

  12. Aircraft Propeller Hub Repair

    Energy Technology Data Exchange (ETDEWEB)

    Muth, Thomas R. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Peter, William H. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2015-02-13

    The team performed a literature review, conducted residual stress measurements, performed failure analysis, and demonstrated a solid state additive manufacturing repair technique on samples removed from a scrapped propeller hub. The team evaluated multiple options for hub repair that included existing metal buildup technologies that the Federal Aviation Administration (FAA) has already embraced, such as cold spray, high velocity oxy-fuel deposition (HVOF), and plasma spray. In addition the team helped Piedmont Propulsion Systems, LLC (PPS) evaluate three potential solutions that could be deployed at different stages in the life cycle of aluminum alloy hubs, in addition to the conventional spray coating method for repair. For new hubs, a machining practice to prevent fretting with the steel drive shaft was recommended. For hubs that were refurbished with some material remaining above the minimal material condition (MMC), a silver interface applied by an electromagnetic pulse additive manufacturing method was recommended. For hubs that were at or below the MMC, a solid state additive manufacturing technique using ultrasonic welding (UW) of thin layers of 7075 aluminum to the hub interface was recommended. A cladding demonstration using the UW technique achieved mechanical bonding of the layers showing promise as a viable repair method.

  13. Quarterly coal report July--September 1996, February 1997

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-02-01

    The Quarterly Coal Report (QCR) provides comprehensive information about US coal production, distribution, exports, imports, receipts, prices, consumption, and stocks to a wide audience, including Congress, Federal and State agencies, the coal industry, and the general public. Coke production, consumption, distribution, imports, and exports data are also provided. This report presents detailed quarterly data for July through September 1996 and aggregated quarterly historical data for 1990 through the second quarter of 1996. Appendix A displays, from 1988 on, detailed quarterly historical coal imports data. 8 figs., 72 tabs.

  14. Quarterly coal report July--September 1996, February 1997

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-02-01

    The Quarterly Coal Report (QCR) provides comprehensive information about US coal production, distribution, exports, imports, receipts, prices, consumption, and stocks to a wide audience, including Congress, Federal and State agencies, the coal industry, and the general public. Coke production, consumption, distribution, imports, and exports data are also provided. This report presents detailed quarterly data for July through September 1996 and aggregated quarterly historical data for 1990 through the second quarter of 1996. Appendix A displays, from 1988 on, detailed quarterly historical coal imports data. 8 figs., 72 tabs.

  15. Extracorporeal membrane oxygenator as a bridge to successful surgical repair of bronchopleural fistula following bilateral sequential lung transplantation: a case report and review of literature

    OpenAIRE

    2007-01-01

    Abstract Background Lung transplantation (LTx) is widely accepted as a therapeutic option for end-stage respiratory failure in cystic fibrosis. However, airway complications remain a major cause of morbidity and mortality in these patients, serious airway complications like bronchopleural fistula (BPF) are rare, and their management is very difficult. Case presentation A 47-year-old man with end-stage respiratory failure due to cystic fibrosis underwent bilateral sequential lung transplantati...

  16. Endovascular repair of a juxtarenal saccular aneurysm using the Multilayer Flow Modulator: report of the first case performed in a Public Hospital in Brazil

    Directory of Open Access Journals (Sweden)

    Rodrigo Gibin Jaldin

    2014-09-01

    Full Text Available Endovascular treatment of abdominal aortic aneurysms (AAA, involving the exits of the renal and visceral arteries still constitutes a considerable challenge. Many different techniques have been developed over the years in attempts to surmount the difficulties presented by these cases. Techniques that have gained prominence include fenestrated or branched stents, methods involving parallel prostheses, such as the chimney, periscope and sandwich techniques, and, more recently, flow modulation with Multilayer stents. We describe a case of a complex juxtarenal saccular AAA with a high surgical risk, both according to cardiological assessment and because the patient had a difficult airway caused by a total laryngectomy for early stage laryngeal neoplasm. In view of the technical simplicity of using Multilayer stents, the presence of chronic obstructive aortoiliac disease, ostial stenosis of the renal artery and a small diameter suprarenal aorta, options involving fenestrated/branched stents and techniques involving parallel prostheses were ruled out, because of the need for multiple accesses. In view of the dilemma it presented, we describe this case as a therapeutic challenge and present the treatment option employed, which has been successful over the short term.

  17. Repair of radial and digital nerve defect with human acellular nerve allograft:6 cases report%去细胞同种异体神经移植修复桡神经和指神经缺损六例

    Institute of Scientific and Technical Information of China (English)

    唐举玉; 俞芳; 吴攀峰; 黄臻; 梁捷予; 何波; 刘小林

    2014-01-01

    Objective To explore the safety and clinical effect of the human acellular nerve allograft (hANG) for repairing peripheral nerve defects.Methods During November,2009 to October,2010,6 patients with 3 digital nerve defects and 3 radial nerve defects were repaired with hANG.During postoperation period,safety was evaluated by local wound response and laboratory testing,while the efficacy was evaluated by British Medical Research Council sensory function assessment standards,static 2-point discrimination (2PD) and Semmes-Weinstein monofilament testing.Results Three patients with 6 digital nerve defects received hANG transplant.The length of nerve graft was 20-50 mm(mean 30.8 mm).After followed up for 31-40 months,the excellent rate of 2PD was 66.7%.Two of 3 patients rahabilited as well as the normal.Three patients with radial nerve defects,whose length of nerve graft was 35-60 mm(mean 48.3 mm).The strength of extensor carpiradialis longus muscle had restored Ⅲ in 1 case,and other 2 cases had no restoration.Conclusion hANG is safe and effective for repairing peripheral nerve defects,especially for digital nerve defects.%目的 探讨去细胞同种异体神经(hANG)移植修复周围神经缺损的安全性和有效性. 方法 2009年9月-2010年10月,应用hANG移植修复周围神经缺损6例,其中指神经缺损3例、桡神经缺损3例,术后观察伤口愈合情况及生化、免疫学检查,采用英国医学研究会感觉功能评定标准、Semmes-Weinstein单丝触觉和静态两点辨别觉(2PD)评价hANG的临床效果. 结果 所有病例切口术后无红肿及渗出、愈合良好.3例指神经损伤患者共有6条指神经缺损,神经移植长度20~ 50 mm(平均30.8 mm),随访31~40个月,静态2PD优良率66.7%,其中2例4条指神经缺损患者术后感觉基本恢复正常;3例桡神经损伤患者,神经移植长度35 ~ 60 mm(平均48.3 mm),随访18 ~ 36个月,其中l例桡侧腕伸肌肌力恢复至Ⅲ级,术后

  18. 腓骨肌腱修复跟腱断裂24例的临床分析%Peroneal tendon repair achilles tendon rupture of 24 cases

    Institute of Scientific and Technical Information of China (English)

    黄春吉

    2009-01-01

    目的 分析腓骨长肌腱用于修复跟腱断裂的手术方法 和经验.方法 将腓骨长肌腱在远端处切断,经皮下隧道移位修复跟腱断裂24例.结果根据Arner-Lindholm评定标准,24例中优14例,良10例.未发生跟腱再次断裂.2例出现伤口感染,1例出现皮肤与跟腱粘连.结论 对疑有跟腱断裂的患者未进行认真的体检是导致跟腱断裂误诊的重要原因.避免误诊、尽早手术及循序渐进的术后康复锻炼是提高疗效的有效措施.用腓骨长肌腱重建陈旧性和某些急性跟腱断裂是一种安全可行、疗效满意的手术方法 .%Objective To conclude the method and experience of reconstruction of achilles tendon rupture with peroneus longus tendon transfer.Methods In 24 cases,reconstruction the achilles tendon ruptured by cutting the peroneus longus tendon at the distal end and transferred through subcutaneous tunnel.Results According to ArnerLindholm critera,14 cases were graded as excellent,10 cases as good.No rerupture of Achilles tendon occurred.There were 2 cases occurred wound infection and 1 conglutination.Conclusions The suspected Achilles tendon rupture in patients with a serious medical examination did not lead to an achilles tendon rupture is the major cause of misdiagnosis.Avoid misdiagnosis,as soon as possible after surgery and gradual rehabilitation exercise is to improve the efficacy of effective measures.The peroneus longus tendon transfer is a safe and satisfied way to reconstructing the old and certain fresh rupture of the Achilles tendon.

  19. Laparoscopic repair of vesicovaginal fistula

    Directory of Open Access Journals (Sweden)

    Miłosz Wilczyński

    2011-06-01

    Full Text Available A vesicovaginal fistula is one of the complications that a gynaecologist is bound to face after oncological operations, especially in postmenopausal women. Over the years there have been introduced many techniques of surgical treatment of this entity, including transabdominal and transvaginal approaches.We present a case of a 46-year-old patient who suffered from urinary leakage via the vagina due to the presence of a vesicovaginal fistula that developed after radical abdominal hysterectomy and subsequent radiotherapy. The decision was made to repair it laparoscopically due to retracted, fibrous and scarred tissue in the vaginal apex that precluded a transvaginal approach. A small cystotomy followed by an excision of fistula borders was performed. After six-month follow-up no recurrence of the disease has been noted.We conclude that laparoscopy is an interesting alternative to traditional approaches that provides comparable results.

  20. Revision of Failed Artroscopic Bankart Repairs

    Science.gov (United States)

    Muiño, José María Silberberg; Gimenez, Martín Alejandro; Salvucci, Mauro Gabriel Maroa; Ferro, Diego; Rullan, Ramón Muiña

    2017-01-01

    Objectives: To present our functional outcomes from patients treated arthroscopically for a failed Bankart repair, using suture anchors and capsulolabral tissue only. Methods: Series of 22 patients presented with a recurrence of instability after a previous stabilization surgery (3 Latarjet, Bankart 19). We treated them by a an all-arthroscopic procedure, avoiding bone grafts, when glenoid track was found to be enough to proceed. The failure was associated with trauma in 11 patients, a non-anatomic repair in 6 patients, capsular laxity in 4 patients and a non-union of the coracoid graft in 1 patient. Revision surgery included: Bankart repair with anchors in 17 cases, a posterior-inferior capsulo-labral plication in one case, and 5 remplissages. In 4 cases subscapularis augmentation was used because of poor capsular quality. Screw removal was necessary when treating the non-union case. Patients were followed-up by a minimum of 23 months (range 23-26), and evaluated by the UCLA Test, SS test and Rowe score. Results: Thirteen patients had an excellent result, 6 good, 2 satisfactory and one bad result, according to UCLA score. The mean Rowe score was 90.4, at final follow up. The Simple Shoulder Test went from an 8 preoperative to an 11 postoperative, mean scores. 19 of 22 patients returned to the same level of activity prior to the injury. Complications: recurrence in 2 cases, subluxation in 2 and one shoulder stiffness that required an arthrolysis. Conclusion: An arthroscopic revision surgery, after a failed Bankart repair, presents satisfactory results in selected patients. Arthroscopic vision allows a correct diagnosis of injuries as possible causes of failure and subsequent treatment.

  1. Visceral hybrid reconstruction of thoracoabdominal aortic aneurysm after open repair of type a aortic dissection by the Bentall procedure with the elephant trunk technique: A case report

    Directory of Open Access Journals (Sweden)

    Marjanović Ivan

    2014-01-01

    Full Text Available Introduction. Reconstruction of chronic type B dissection and thoracoabdominal aortic aneurysm (TAAA remaining after the emergency reconstruction of the ascending thoracic aorta and aortic arch for acute type A dissection represents one of the major surgical challenges. Complications of chronic type B dissection are aneurysmal formation and rupture of an aortic aneurysm with a high mortality rate. We presented a case of visceral hybrid reconstruction of TAAA secondary to chronic dissection type B after the Bentall procedure with the elephant trunk technique due to acute type A aortic dissection in a high-risk patient. Case report. A 62 year-old woman was admitted to our institution for reconstruction of Crawford type I TAAA secondary to chronic dissection. The patient had had an acute type A aortic dissection 3 years before and undergone reconstruction by the Bentall procedure with the elephant trunk technique with valve replacement. On admission the patient had coronary artery disease (myocardial infarction, two times in the past 3 years, congestive heart disease with ejection fraction of 25% and chronic obstructive pulmonary disease. On computed tomography (CT of the aorta TAAA was revealed with a maximum diameter of 93 mm in the descending thoracic aorta secondary to chronic dissection. All the visceral arteries originated from the true lumen with exception of the celiac artery (CA, and the end of chronic dissection was below the origin of the superior mesenteric artery (SMA. The patient was operated on using surgical visceral reconstruction of the SMA, CA and the right renal artery (RRA as the first procedure. Postoperative course was without complications. Endovascular TAAA reconstruction was performed as the second procedure one month later, when the elephant trunk was used as the proximal landing zone for the endograft, and distal landing zone was the level of origin of the RRA. Postoperatively, the patient had no neurological deficit and

  2. Review of the Proposed Quarterly Coal Review

    Energy Technology Data Exchange (ETDEWEB)

    1981-04-01

    This Review of the Proposed Quarterly Coal Review is the second of two reports and contains the results of our analysis of issues regarding the publication of a new summary publication, the Quarterly Coal Review. The first report on the QCR was submitted to the Office of Energy Data Operations (OEDO) in January 1981 and included results of our analysis and recommendations concerning data availability and content organization. This report concentrates on data presentation and publication format for the proposed QCR. Comprised of two sections, the report addresses chapter and table formats and presents a detailed analysis of chapter content. The first section of this report, Chapter, Table and Graph Formats, consists of findings and recommendations on the ordering, titling, end notes and cosmetics of the tables proposed for the QCR. The next section, Detailed Analysis of Chapter Content, is the result of a more in-depth analysis of chapters in the QCR.

  3. Nanomaterials promise better bone repair

    Directory of Open Access Journals (Sweden)

    Qifei Wang

    2016-10-01

    Full Text Available Nanomaterials mimicking the nano-features of bones and offering unique smart functions are promising for better bone fracture repair. This review provides an overview of the current state-of-the-art research in developing and using nanomaterials for better bone fracture repair. This review begins with a brief introduction of bone fracture repair processes, then discusses the importance of vascularization, the role of growth factors in bone fracture repair, and the failure of bone fracture repair. Next, the review discusses the applications of nanomaterials for bone fracture repair, with a focus on the recent breakthroughs such as nanomaterials leading to precise immobilization of growth factors at the molecular level, promoting vascularization without the use of growth factors, and re-loading therapeutic agents after implantation. The review concludes with perspectives on challenges and future directions for developing nanomaterials for improved bone fracture repair.

  4. Computed tomography angiography and magnetic resonance imaging performance of acute segmental single compartment syndrome following an Achilles tendon repair: A case report and literature review

    Institute of Scientific and Technical Information of China (English)

    Li-Feng Jiang; Hang Li; Zeng-Feng Xin; Li-Dong Wu

    2016-01-01

    Acute compartment syndrome of the lower extremity is a serious postinjury complication that requires emergency treatment.Early diagnosis is of paramount importance for a good outcome.Four muscle compartments in the calf (anterior,lateral,deep posterior,and superficial posterior) may be individually or collectively affected.Acute segmental single-compartment syndrome is an extremely rare condition characterized by high pressure in a single compartment space with threatening of the segmental tissue viability.In this case report,we describe a young man with Achilles tendon rupture who complained of postoperative pain in the anterior tibial region.Emergent computed tomography angiography and magnetic resonance imaging revealed local muscle edema.Segmental anterior compartment syndrome was diagnosed and fasciotomy was performed.

  5. 外伤性眼睑畸形的整复治疗(附68例报告)%Repair and reconstruction of traumatic eyelids deformities: A report of 68 cases

    Institute of Scientific and Technical Information of China (English)

    宋慧锋; 柴家科; 高全文; 许明火; 梁黎明; 王祎蓉; 陈保国; 郝永红

    2012-01-01

    Objective To explore the plastic and reconstructive methods of traumatic eyelids deformities. Methods Data of 68 cases of traumatic eyelids deformities (157 eyelids), collected by the First Affiliated Hospital of General Hospital of PLA from June 2002 to June 2011, were retrospectively analyzed, including eyelid ectropion, defect of partial or overall eyelid, cicatriz contraction of inner canthus, eyelid adherence and perioptic cicatices, etc. Restitution was done by debridement with skin grafting, transfer of local skin flaps, transfer of orbicularis muscle flaps, soft-tissue expansion, reconstruction of tarsal plates, transfer of frontalis flaps and canthus ligament suspension. Results All the eyelids deformities were repaired successfully. The functions and configurations were satisfactory after six months to eight years follow-up. Conclusion Traumatic eyelid deformity should be repaired as early as possible by appropriate methods according to the cause, type and range of the injury and local conditions.%目的 探讨各类外伤性眼睑畸形的合理整复方法.方法 回顾性分析2002年6月-2011年6月解放军总医院第一附属医院收治的各类外伤性眼睑畸形68例,共计157个眼睑,其中包括睑外翻、眼睑部分或全部缺损、内眦瘢痕挛缩、眼睑粘连、眼周瘢痕等,采用急诊清创植皮、局部皮瓣(或瘢痕瓣)转移、眼轮匝肌皮瓣转移、软组织扩张术、睑板重建、额肌瓣转移、眦韧带悬吊等手术方法进行整复.结果 68例外伤性眼睑畸形外观及功能均明显改善,眼睑正常解剖结构基本得到恢复.结论 针对不同致伤原因、损伤程度、周围情况、伤后时间选择合适的手术方法,尽早恢复眼睑的解剖学结构,是外伤性眼睑畸形整复的关键.

  6. A Walk around Irkutsk’s Quarters

    Directory of Open Access Journals (Sweden)

    Elena Grigoryeva

    2016-10-01

    Full Text Available The article presents the key issues of the Concept of reconstruction of the 11 Irkutsk’s quarters adjacent to the Trading Axis. While remaining basic, the trading function should reduce its overwhelming domination to be in harmony with other functions of the city environment, which attract inhabitants and guests to the historical area of Irkutsk, that is culture, education, leisure, recreation, and housing.

  7. A Notice Soliciting Contribution to Peace Quarterly

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Dear readers at home and abroad:Peace quarterly in English is published by the Chinese People’s Association for Peace and Disarmament(CPAPD)since its founding in June 1985.Over the past 30 years,we have received kind support from all your readers in China and overseas.We wish to take this opportunity to express our appreciation to you all from the bottom of our hearts.

  8. 3D mesh with abdominal wall suspension in transabdominal preperitoneal hernia repair:a series of 71 cases%3D 补片腹壁悬吊法经腹腹膜前疝修补术71例

    Institute of Scientific and Technical Information of China (English)

    苏海龙; 于文涛; 穆林松; 隋武; 林洋; 王云慧

    2015-01-01

    Objective To analyze the clinical effectiveness of 3D mesh with abdominal wall suspension in transabdominal preperitoneal hernia repair (TAPP).Methods A total of 71 cases of inguinal hernia who underwent TAPP using 3D mesh with abdominal wall suspension in Yantai Yuhuangding Hospital from January 2011 to July 2014 were retrospectively analyzed,in order to summarize the operation skills and clinical experience.Results All cases in this series were performed under laparoscopy.The operating time was 50 to 100 minutes in unilateral hernia operation,and 90 to 140 minutes in bilateral hernia operation. With little intraoperative bleeding and no drainage,the patients were discharged in 2 to 5 days.1 case of epigastric artery injury occurred during the operation,meanwhile,the laparoscopic bleeding suture was performed.Postoperative inguinal or scrotal seroma was found in 5 cases,which were gradually self-absorbed in 1 month of observation.After a mean follow-up of 6 months (range 1 to 12 months),no recurrence and no abnormal sensation in groin were observed.Conclusion 3D mesh with abdominal wall suspension in TAPP is relatively safe,effective,more economical and easy to perform,and it is suitable for surgeons,who just begin to learn laparoscopic hernia repair.%目的:分析3D 补片腹壁悬吊法经腹腹膜前疝修补术(TAPP)的临床疗效。方法回顾性分析2011年1月至2014年7月,山东烟台青岛大学附属烟台毓璜顶医院采用腹壁悬吊法固定3D 补片行 TAPP 术71例的临床资料,总结手术要点及临床体会。结果本组患者均在腹腔镜下完成,单侧疝手术时间50~100 min,双侧疝手术时间90~140 min,术中出血极少,均未置引流,术后2~5 d 出院。术中腹壁下动脉损伤1例,行腹腔镜下缝扎止血,术后发生腹股沟区或阴囊血清肿5例,经观察1个月余,均逐渐自动吸收;无腹股沟区感觉异常,术后随访1~12个月,平均6

  9. Laparoscopic Incisional Hernia Repair in Obese Patients

    Science.gov (United States)

    2005-01-01

    . Conclusions: A general surgeon with training in basic laparoscopy can safely perform laparoscopic incisional hernia repair on obese patients with minimal complications. The procedure requires a short leaning curve of no more than 3 cases and few extra materials to be feasible at any hospital in the US. Patient satisfaction with this technique is certainly gratifying. PMID:15791970

  10. Emergent cardiopulmonary bypass during pectus excavatum repair

    Directory of Open Access Journals (Sweden)

    Ryan Craner

    2013-01-01

    Full Text Available Pectus excavatum is a chest wall deformity that produces significant cardiopulmonary disability and is typically seen in younger patients. Minimally invasive repair of pectus excavatum or Nuss procedure has become a widely accepted technique for adult and pediatric patients. Although it is carried out through a thoracoscopic approach, the procedure is associated with a number of potential intraoperative and post-operative complications. We present a case of cardiac perforation requiring emergent cardiopulmonary bypass in a 29-year-old male with Marfan syndrome and previous mitral valve repair undergoing a Nuss procedure for pectus excavatum. This case illustrates the importance of vigilance and preparation by the surgeons, anesthesia providers as well as the institution to be prepared with resources to handle the possible complications. This includes available cardiac surgical backup, perfusionist support and adequate blood product availability.

  11. 2nd Quarter Transportation Report FY 2014

    Energy Technology Data Exchange (ETDEWEB)

    Gregory, L.

    2014-07-30

    This report satisfies the U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Field Office (NNSA/NFO) commitment to prepare a quarterly summary report of radioactive waste shipments to the Nevada National Security Site (NNSS) Radioactive Waste Management Complex (RWMC) at Area 5. There were no shipments sent for offsite treatment and returned to the NNSS this quarter. This report summarizes the second quarter of fiscal year (FY) 2014 low-level radioactive waste (LLW) and mixed low-level radioactive waste (MLLW) shipments. This report also includes annual summaries for FY 2014 in Tables 4 and 5. Tabular summaries are provided which include the following: Sources of and carriers for LLW and MLLW shipments to and from the NNSS; Number and external volume of LLW and MLLW shipments; Highway routes used by carriers; and Incident/accident data applicable to LLW and MLLW shipments. In this report shipments are accounted for upon arrival at the NNSS, while disposal volumes are accounted for upon waste burial. The disposal volumes presented in this report do not include minor volumes of non-radioactive materials that were approved for disposal. Volume reports showing cubic feet (ft3) generated using the Low-Level Waste Information System may vary slightly due to differing rounding conventions.

  12. Late outcome of right ventricular outflow tract repair using bicuspid pulmonary prosthesis in tetralogy of Fallot surgery repair: case report Resultado tardio da reconstrução da via de saída do ventrículo direito com prótese pulmonar bicúspide na correção da tetralogia de Fallot: relato de caso

    Directory of Open Access Journals (Sweden)

    Miguel Angel Maluf

    2009-12-01

    Full Text Available We present a case of a 19 year-old female patient, with tetralogy of Fallot and hypoplastic pulmonary ring. Diagnosis was performed by echocardiography and cardiac catheterization. The surgical repair was performed at the age of 2 years old. A right ventricular outflow tract remodeling was performed using a porcine pulmonary bicuspid prosthesis. The patient presented a uneventful follow-up during 17 years. Postoperative assessment has shown: mild pulmonary insufficiency and mild pulmonary ventricle gradient, satisfactory right ventricular performance and prosthesis not presenting calcification. This is an option to correct the tetralogy of Fallot adopted by our Institution in the last two decades.É apresentado o caso de uma paciente de 19 anos de idade, sexo feminino, portadora de tetralogia de Fallot com anel pulmonar hipoplásico. O diagnóstico foi feito com ecoDopplercardiograma e cateterismo cardíaco. A correção cirúrgica foi realizada com 2 anos de idade. Para a reconstrução da valva pulmonar e via de saída do ventrículo foi utilizada prótese bivalvular pulmonar porcina. A paciente teve boa evolução clínica durante 17 anos. A avaliação pós-operatória demonstrou: discreta insuficiência pulmonar, discreto gradiente transvalvar pulmonar, desempenho do ventrículo direito preservado e prótese pulmonar sem calcificação. Esse é o procedimento adotado pela nossa Instituição para a correção da tetralogia de Fallot, nos últimos 20 anos.

  13. Decalcificated human dentin matrix in autogenous repair of skull defects

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@In the management of traumatic skull defect, the classical treatment has usually been adopted, i.e.,primary debridement and secondary repair of bone defect, especially in cases of open lacerated skull fracture. 1 In general, the use of prosthetic material in repair is often not so satisfactory either in China or abroad. Decalcificated human dentin matrix (DHDM)has been used in autogenous repair of traumatic skull defect in primary operation and a good curative effect has been gained since the time from September 1996 to March 1998. Clinical results and CT scanning observation are reported in the following.

  14. Biology of biological meshes used in hernia repair.

    Science.gov (United States)

    Novitsky, Yuri W

    2013-10-01

    Successful repair of most hernias requires the use of a prosthetic implant for reinforcement of the defect. Because of the need for prosthetic implants to resist infections as well to support repairs in contaminated or potentially contaminated fields, biological meshes have been developed to take the place of nondegradable synthetic meshes in cases where mesh infection is of high concern. The ideal is a biological matrix that resists infection while providing durable reinforcement of a hernia repair. This article reviews the validity of assumptions that support the purported notion of the biological behavior of biological meshes.

  15. Inguinal hernia repair under local anesthesia:22 cases of perioperative syncope%局部神经阻滞麻醉下腹股沟疝无张力修补术围手术期晕厥22例

    Institute of Scientific and Technical Information of China (English)

    贺志敬; 康惠涛

    2014-01-01

    目的:探讨局部区域神经阻滞麻醉下腹股沟疝围手术期内晕厥的原因和对策。方法回顾性分析2011年3月至2013年8月,河南省巩义市人民医院对进行379例腹股沟疝患者围手术期发生晕厥的22例患者行及时对症处理和原因分析。结果17例患者在3 min内渐恢复,5例患者脉搏<45次/min,给予阿托品针0.5 mg静脉注射,5 min后渐恢复。间隔30 min监测生命体征1次至正常。恢复后均无精神、神经系统症状,其中4例因摔伤行皮肤清创缝合,3例推迟手术时间。患者无神经系统、心血管系统后遗症。结论麻醉药品、手术方式不是引起局部神经阻滞麻醉腹股沟疝围手术期出现晕厥的直接原因,围手术期内良好的医患沟通、对患者机体综合评估、充分的围手术期准备可预防和减少晕厥发生。%Objective To explore the causes and countermeasures of syncopein perioperative period of inguinal hernia repair under local nerve block anesthesia.Methods During March 201 1 to August 201 3, 22 out of 379 patients who underwent inguinal hernia repair in Gongyi People′s Hospital occurred perioperative syncope.All of them got prompt treatment in time,and the causes were analyzed.Results 1 7 patients gradually recovered in 3 minutes,and 5 patients were treated by injection of 0.5 mg atropine because of bradyarrhythmia (below 45/minutes)which return to normal in 5 minutes.The vital sign of patients were checked once per 30 minutes.After that,patients were free from mental or neurological symptoms,except for 4 cases of surgical debridement due to fall injury.No nervous or cardiovascular system sequelae was left.Conclusions Narcotic drugs or inguinal hernia operation itself is not the direct reason which causes the perioperative syncope ininguinal hernia repair under local nerve block anesthesia.While a good doctor-patient communication,comprehensive physiological evaluation and well

  16. Timing cervicovesical fistula repair with repeat cesarean section.

    Science.gov (United States)

    Geoffrion, Roxana; Hyakutake, Momoe T

    2014-08-01

    We present a case in which there was optimal management of recurrent cervicovesical fistula. The patient sustained a fistula shortly after a cesarean for cephalopelvic disproportion in the second stage. She underwent an unsuccessful attempt at vaginal repair 3 months postpartum and continued experiencing intermittent urinary leakage through the vagina. She expressed a wish for further childbearing and was counseled to undergo fistula repair at the time of repeat cesarean section. Twenty-seven months after her first delivery, she had a second healthy pregnancy and the repair of her cervicovesical fistula was performed with collagen graft interposition at the time of her elective cesarean section. This case report highlights the importance of surgical timing and comments on various factors that possibly enhance the success of the fistula repair.

  17. Balanitis xerotica obliterans with urethral stricture after hypospadias repair.

    Science.gov (United States)

    Uemura, S; Hutson, J M; Woodward, A A; Kelly, J H; Chow, C W

    2000-01-01

    Three cases of urethral stricture due to balanitis xerotica obliterans (BXO) after hypospadias repair are reported. The first patient showed white, dense scarring on the prepuce before the hypospadias repair and developed a stricture of the urethra after the operation. The second and the third were uneventful for 6 and 2 years, respectively, after the hypospadias repair, and then developed urethral strictures. Pathologic diagnosis of the stenotic lesion is essential. Complete excision of the affected urethra with topical steroid ointment or sublesional triamcinolone injection is recommended for this condition. Although the complication of BXO after hypospadias repair is rare (3 out of 796 cases with hypospadias in our series), surgeons need to be aware of this condition as a cause for late onset of urethral problems.

  18. Mixed Waste Management Facility groundwater monitoring report. Second quarter 1994

    Energy Technology Data Exchange (ETDEWEB)

    Chase, J.A.

    1994-09-01

    Currently, 125 wells monitor groundwater quality in the uppermost aquifer beneath the Mixed Waste Management Facility (MWMF) at the Savannah River Site. Samples from the wells are analyzed for selected heavy metals, indicator parameters, radionuclides, volatile organic compounds, and other constituents. During second quarter 1994, chloroethene (vinyl chloride), 1,1-dichloroethylene, gross alpha, lead, tetrachloroethylene, trichloroethylene, or tritium exceeded final Primary Drinking Water Standards (PDWS) in approximately half of the downgradient wells at the MWMF. Consistent with historical trends, elevated constituent levels were found primarily in Aquifer Zone. As in previous quarters, tritium and trichloroethylene were the most widespread elevated constituents during second quarter 1994. Sixty-two of the 125 monitoring wells contained elevated tritium activities. Trichloroethylene concentrations exceeded the final PDWS in 23 wells. Chloroethene, 1,1-dichloroethylene, lead, and tetrachloroethylene, elevated in one or more wells during second quarter 1994, also occurred in elevated levels during first quarter 1994. These constituents generally were elevated in the same wells during both quarters. Gross alpha, which was not elevated in any well during first quarter 1994, was elevated in one well during second quarter. Copper, mercury, and nonvolatile beta were elevated during first quarter 1994 but not during second quarter.

  19. Electrophysiological studies in American Quarter horses with neuroaxonal dystrophy.

    Science.gov (United States)

    Finno, Carrie J; Aleman, Monica; Ofri, Ron; Hollingsworth, Steven R; Madigan, John E; Winfield, Laramie; Bannasch, Danika L

    2012-09-01

    Neuroaxonal dystrophy (NAD) is a disease characterized by the sudden onset of neurologic signs in horses ranging from 4 to 36 months of age. Equine degenerative myeloencephalopathy (EDM), a disease that has been associated with low vitamin E concentrations, is considered a more advanced form of NAD. The objective of this report is to describe the electrophysiological features of NAD/EDM in American Quarter horses (QHs). HORSES: Six NAD/EDM-affected QHs and six unaffected QHs were evaluated by ophthalmic examination and electroretinography. Five of the NAD/EDM-affected QH and five unaffected QHs were also evaluated by electroencephalography (EEG). Ophthalmic examination, ERGs, and EEGs were unremarkable in NAD/EDM cases. Neuroaxonal dystrophy/EDM does not appear to cause clinical signs of ocular disease or functional ERG/EEG deficits in QHs. © 2012 American College of Veterinary Ophthalmologists.

  20. Coal liquefaction. Quarterly report, January--March 1977

    Energy Technology Data Exchange (ETDEWEB)

    None

    1977-12-01

    Current ERDA work in coal liquefaction is aimed at improved process configurations for both catalytic and non-catalytic processes to provide more attractive processing economics and lower capital investment. Coal liquefaction can now be achieved under more moderate processing conditions and more rapidly than was the case in the 1930's. The advantage of coal liquefaction is that the entire range of liquid products, including heavy boiler fuel, distillate fuel oil, gasoline, jet fuel, and diesel oil, can be produced from coal by varying the type of process and operating conditions used in the process. Furthermore, coal-derived liquid fuels also have the potential for use as chemical feedstocks. To determine the most efficient means of utilizing coal resources, ERDA is sponsoring the development of several conversion processes that are currently in the pilot plant stage. Nineteen projects under development are described and progress for each in the quarter is detailed briefly. (LTN)

  1. Aortic coarctation repair in the adult.

    Science.gov (United States)

    Cardoso, Goncalo; Abecasis, Miguel; Anjos, Rui; Marques, Marta; Koukoulis, Giovanna; Aguiar, Carlos; Neves, José Pedro

    2014-07-01

    Aortic coarctation can be repaired surgically or percutaneously. The decision should be made according to the anatomy and location of the coarctation, age of the patient, presence of other cardiac lesions, and other anatomic determinants (extensive collaterals or aortic calcification). This article reviews the different therapeutic options available, explaining the differences between children and adults, describing different approaches to the same disease, exemplified by three cases of nonclassic surgical approach and one percutaneous treatment.

  2. Flow diversion in vasculitic intracranial aneurysms? Repair of giant complex cavernous carotid aneurysm in polyarteritis nodosa using Pipeline embolization devices: first reported case.

    Science.gov (United States)

    Martinez Santos, Jaime; Kaderali, Zul; Spears, Julian; Rubin, Laurence A; Marotta, Thomas R

    2016-07-01

    Intracranial aneurysms in polyarteritis nodosa (PAN) are exceedingly rare lesions with unpredictable behavior that pose real challenges to microsurgical and endovascular interventions owing to their inflammatory nature. We introduce a safe and effective alternative for treating these aneurysms using Pipeline embolization devices (PEDs). A 20-year-old man presented with diplopia, headaches, chronic abdominal pain, and weight loss. Diagnostic evaluations confirmed PAN, including bilateral giant cavernous carotid aneurysms. Cyclophosphamide and steroids achieved significant and sustained clinical improvement, with a decision to follow the aneurysms serially. Seven years later the left unruptured aneurysm enlarged, causing a sudden severe headache and a cavernous sinus syndrome. Treatment of the symptomatic aneurysm was pursued using flow diversion (PED) and the internal carotid artery was successfully reconstructed with a total of four overlapping PEDs. At 6 months follow-up, complete exclusion of the aneurysm was demonstrated, with symptomatic recovery. This is the first description of using a flow-diverting technique in an inflammatory vasculitis. In this case, PEDs not only attained a definitive closure of the aneurysm but also reconstructed the damaged and fragile arterial segment affected with vasculitis.

  3. Eyes wide shut - unusual two stage repair of pectus excavatum and annuloaortic ectasia in a 37 year old marfan patient: case report

    Directory of Open Access Journals (Sweden)

    Barriuso Clemente

    2011-05-01

    Full Text Available Abstract We report about a 37 year old male patient with a pectus excavatum. The patient was in NYHA functional class III. After performed computed tomography the symptoms were thought to be related to the severity of chest deformation. A Ravitch-procedure had been accomplished in a district hospital in 2009. The crack of a metal bar led to a reevaluation 2010, in which surprisingly the presence of an annuloaortic ectasia (root 73 × 74 mm in direct neighborhood of the formerly implanted metal-bars was diagnosed. Echocardiography revealed a severe aortic valve regurgitation, the left ventricle was massively dilated presenting a reduced ejection fraction of 45%. A marfan syndrome was suspected and the patient underwent a valve sparing aortic root replacement (David procedure in our institution with an uneventful postoperative course. A review of the literature in combination with discussion of our case suggests the application of stronger recommendations towards preoperative cardiovascular assessment in patients with pectus excavatum.

  4. External skeletal fixator intramedullary pin tie-in for the repair of tibiotarsal fractures in raptors: 37 cases (1995-2011).

    Science.gov (United States)

    Bueno, Irene; Redig, Patrick T; Rendahl, Aaron K

    2015-11-15

    To evaluate the outcome of the application of an external skeletal fixator intramedullary pin tie-in (TIF) to tibiotarsal fractures in raptors. Retrospective case series. Thirty-four raptors with 37 tibiotarsal fractures. Medical records and radiographs for raptors with tibiotarsal fractures that were treated at The Raptor Center at the University of Minnesota between 1995 and 2011 were reviewed. Descriptive statistics were generated and univariate logistic regression analyses were used to assess whether age, sex, body weight, location and nature of the fracture, and type of surgical reduction were significantly associated with whether the fracture healed following surgical reduction and TIF application. 31 of 37 (84%) tibiotarsal fractures successfully healed following surgical reduction and TIF application. The mean healing time was 38 days (range, 15 to 70 days). None of the variables assessed were significantly associated with whether the tibiotarsal fracture healed. Twenty of the 34 (59%) raptors were eventually rehabilitated and released. Results indicated that most tibiotarsal fractures were successfully managed by surgical reduction and stabilization with a TIF. However, other comorbidities (eg, systemic infections and visual deficits) negatively affected the rehabilitation of raptors and sometimes resulted in euthanasia despite the fact that the tibiotarsal fracture had healed, and those comorbidities, along with the variables evaluated (eg, age, sex, and nature of the fracture), should be used as triage criteria and prognostic indicators.

  5. PRP and Metaplasia in repaired tendon

    Institute of Scientific and Technical Information of China (English)

    Kamal Seyed-Forootan; Hamid Karimi; Ahmad-Reza Dayani

    2014-01-01

    Objective:To evaluate effects ofPRP injection in strengthening of repaired tendon.Methods:This study was conducted in animal lab of our hospital on20 rats.The animals were divided into two groups randomly and distal third of leftAchillis tendons were cut and then repaired with Vicryl2/0.The first group was control group and in the second group0.5 cc ofPRP was injected into the repair site.After4 weeks all of the rats were executed and70% of tendons were sent randomly for tensilometry and the force that required to rupture the tendons were measured.In next stage the tendons were sent for pathological exam.Results:The force that was needed to rupture the tendon were not significantly different in the two groups.Neovascularization were more prevalent inPRP group but not statistically significant.There were two cases ofCartilage Metaplasia inPRP group.Conclusion:It seems that usingPRP has no effect on strengthening the tendons repair and may have some adverse effects.It usage needs further studies to evaluate their probable adverse side effects.

  6. Clinical Analysis of 59 Cases of Inguinal Hernia Repaired with Tension-free Hernioplasty%无张力疝修补术治疗腹股沟疝59例临床分析

    Institute of Scientific and Technical Information of China (English)

    权峰涛

    2011-01-01

    目的 探讨无张力修补手术治疗腹股沟疝的临床疗效.方法 回顾性分析2009年3月至2010年3月在我院治疗的59例腹股沟疝患者的临床资料.所有患者均采用疝环充填无张力疝修补术治疗,其中单侧斜疝38例,单侧直疝17例,双侧斜疝4例.结果 59例患者全部治愈,无切口感染,均为甲级愈合,恢复快,术后并发症少.随访1 ~12个月,无一例复发.结论 无张力疝修补术治疗腹股沟疝,并发症少,复发率低,安全可靠,值得在临床上推广应用.%Objective To evaluate the therapeutic effects of tension-free hernioplasty in inguinal hernia.Methods A retrospective analysis of clinical data was conducted in 59 patients with inguinal hernia who were admitted in our hospital from March 2009 to March 2010. All the patients were treated with plug mesh tension-free hernia repair. Among them,38 cases were unilateral indirect inguinal hernia; 17 cases were unilateral direct inguinal hernia, and 4 cases were bilateral indirect inguinal hernia. Results All patients had been healed by first intenion with no death or incisional infection, and no major complication. All cases got the follow-up survey from 1 to 12 months. There was no recurrence during the follow-up. Conclusion Tension free hernioplasty has the advantages of less complication and low relapse rate,which is a safe and reliable methed to cure inguinal hernia.

  7. Idaho National Laboratory Quarterly Performance Analysis - 1st Quarter FY2015

    Energy Technology Data Exchange (ETDEWEB)

    Mitchell, Lisbeth A. [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2015-03-01

    This report is published quarterly by the Idaho National Laboratory (INL) Quality and Performance Management Organization. The Department of Energy (DOE) Occurrence Reporting and Processing System (ORPS), as prescribed in DOE Order 232.2, “Occurrence Reporting and Processing of Operations Information,” requires a quarterly analysis of events, both reportable and not reportable, for the previous 12 months. This report is the analysis of 73 reportable events (27 from the 1St Qtr FY-15 and 46 from the prior three reporting quarters), as well as 38 other issue reports (including nine not reportable events and Significant Category A and B conditions reported during the1st Qtr FY-15) identified at INL during the past 12 months.

  8. 4. DNA REPAIR CAPACITY IN LUNG CANCER PATIENTS

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@The ability for DNA repair is an important host factor which influences the individual susceptibility to genotoxic carcinogen exposures. It has been shown in different case-control studies that DNA repair capacity (DRC) can be reduced in lung cancer patients.We have used an alkaline comet assay to measure the cellular DRC in peri-pheral blood lymphocytes of lung cancer patients and tumor-free control

  9. Mending fences: repairing boundaries through ego state therapy.

    Science.gov (United States)

    Phillips, Maggie

    2013-07-01

    Ego state therapy has often been cited as an effective treatment to help repair fragmentation related to posttraumatic stress and dissociative disorders. This article explores how specialized work with ego states can help to clarify and strengthen internal and external boundaries, create greater boundary flexibility, and contribute to containment and self-regulation. Applications of direct and indirect hypnosis to repair boundary issues through ego state therapy are emphasized, and clinical case examples are used to illustrate results.

  10. Transnasal endoscopic repair of pediatric meningoencephalocele

    Directory of Open Access Journals (Sweden)

    Amit Kumar Keshri

    2016-01-01

    Full Text Available Introduction: Encephaloceles in relation to the nose are rare lesions affecting the skull base. In the pediatric population, majority are congenital lesions manifesting as nasal masses requiring surgical intervention. Materials and Methods: A retrospective study of 6 consecutive patients below 12 years of age with intranasal meningoencephalocele treated by endonasal endoscopic approach at our tertiary centre was done. The follow up period ranged from 6 months to 2 years. A detailed clinical and radiological evaluation of these cases was done. Endonasal endoscopic repair (gasket seal/fat plug was carried out in all cases. Results: Out of 6 patients, 4 patients had post-traumatic and rest 2 cases had congenital meningo-encephaloceles. All patients were asymptomatic in post-operative follow up period. One patient had minor complication of nasal alar collapse due to intra-operative adherence of encephalocele to cartilaginous framework. Conclusion: Transnasal endoscopic repair of anterior skull base meningoencephalocele is a minimally invasive single stage surgery, and has advantage in terms of lesser hospital stay, cost of treatment, and better cosmesis. The repair technique should be tailored to the size of defect to provide a water-tight seal for better outcome.

  11. Open aortic surgery after thoracic endovascular aortic repair.

    Science.gov (United States)

    Coselli, Joseph S; Spiliotopoulos, Konstantinos; Preventza, Ourania; de la Cruz, Kim I; Amarasekara, Hiruni; Green, Susan Y

    2016-08-01

    In the last decade, thoracic endovascular aortic aneurysm repair (TEVAR) has emerged as an appealing alternative to the traditional open aortic aneurysm repair. This is largely due to generally improved early outcomes associated with TEVAR, including lower perioperative mortality and morbidity. However, it is relatively common for patients who undergo TEVAR to need a secondary intervention. In select circumstances, these secondary interventions are performed as an open procedure. Although it is difficult to assess the rate of open repairs after TEVAR, the rates in large series of TEVAR cases (>300) have ranged from 0.4 to 7.9 %. Major complications of TEVAR that typically necessitates open distal aortic repair (i.e., repair of the descending thoracic or thoracoabdominal aorta) include endoleak (especially type I), aortic fistula, endograft infection, device collapse or migration, and continued expansion of the aneurysm sac. Conversion to open repair of the distal aorta may be either elective (as for many endoleaks) or emergent (as for rupture, retrograde complicated dissection, malperfusion, and endograft infection). In addition, in select patients (e.g., those with a chronic aortic dissection), unrepaired sections of the aorta may progressively dilate, resulting in the need for multiple distal aortic repairs. Open repairs after TEVAR can be broadly classified as full extraction, partial extraction, or full salvage of the stent-graft. Although full and partial stent-graft extraction imply failure of TEVAR, such failure is generally absent in cases where the stent-graft can be fully salvaged. We review the literature regarding open repair after TEVAR and highlight operative strategies.

  12. Idaho National Laboratory Quarterly Event Performance Analysis FY 2013 4th Quarter

    Energy Technology Data Exchange (ETDEWEB)

    Lisbeth A. Mitchell

    2013-11-01

    This report is published quarterly by the Idaho National Laboratory (INL) Performance Assurance Organization. The Department of Energy Occurrence Reporting and Processing System (ORPS) as prescribed in DOE Order 232.2 “Occurrence Reporting and Processing of Operations Information” requires a quarterly analysis of events, both reportable and not reportable for the previous twelve months. This report is the analysis of occurrence reports and deficiency reports (including not reportable events) identified at the Idaho National Laboratory (INL) during the period of October 2012 through September 2013.

  13. Idaho National Laboratory Quarterly Performance Analysis - 2nd Quarter FY2014

    Energy Technology Data Exchange (ETDEWEB)

    Lisbeth A. Mitchell

    2014-06-01

    This report is published quarterly by the Idaho National Laboratory (INL) Performance Assurance Organization. The Department of Energy Occurrence Reporting and Processing System (ORPS), as prescribed in DOE Order 232.2, “Occurrence Reporting and Processing of Operations Information,” requires a quarterly analysis of events, both reportable and not reportable, for the previous 12 months. This report is the analysis of occurrence reports and other deficiency reports (including not reportable events) identified at INL from January 2014 through March 2014.

  14. Development of a control system for the teat-end vacuum in individual quarter milking systems.

    Science.gov (United States)

    Ströbel, Ulrich; Rose-Meierhöfer, Sandra; Oz, Hülya; Brunsch, Reiner

    2013-06-13

    Progress in sensor technique and electronics has led to a decrease in the costs of electronic and sensor components. In modern dairy farms, having udders in good condition, a lower frequency of udder disease and an extended service life of dairy cows will help ensure competitiveness. The objective of this study was to develop a teat-end vacuum control system with individual quarter actor reaction. Based on a review of the literature, this system is assumed to protect the teat tissue. It reduces the mean teat-end vacuum in the maximum vacuum phase (b) to a level of 20 kPa at a flow rate of 0.25 L/min per quarter. At flow rates higher than 1.50 L/min per quarter, the teat-end vacuum can be controlled to a level of 30 kPa, because in this case it is desirable to have a higher vacuum for the transportation of the milk to the receiver. With this system it is possible for the first time to supply the teat end with low vacuum at low flow rates and with higher vacuum at increasing flow rates in a continuous process with a three second reaction-rate on individual quarter level. This system is completely automated.

  15. Quarterly coal report July--September 1995, February 1996

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-02-16

    The Quarterly Coal Report (QCR) provides comprehensive information about US coal production, distribution, exports, imports, receipts, prices, consumption, and stocks to a wide audience, including Congress, Federal and State agencies, the coal industry, and the general public. Coke production, consumption, distribution, imports, and exports data are also provided. The data presented in the QCR are collected and published by the Energy Information Administration (EIA) to fulfill data collection and dissemination responsibilities as specified in the Federal Energy Administration Act of 1974 (Public Law 93-275), as amended. This report presents detailed quarterly data for July through September 1995 and aggregated quarterly historical data for 1987 through the second quarter of 1995. Appendix A displays, from 1987 on, detailed quarterly historical coal imports data, as specified in Section 202 of the Energy Policy and Conservation Amendments Act of 1985 (Public Law 99-58). Appendix B gives selected quarterly tables converted to metric tons.

  16. A Collective Review on Mesh-Based Repair of Umbilical and Epigastric Hernias.

    Science.gov (United States)

    Ponten, Jeroen E H; Thomassen, Irene; Nienhuijs, Simon W

    2014-10-01

    In accordance with the tension-free principles for other hernias, umbilical and epigastric hernia repair should probably be mesh-based. The number of randomized studies is increasing, most of them showing significantly less recurrences with the use of a mesh. Different devices are available and are applicable by several approaches. The objective of this review was to evaluate recent literature for the different types of mesh for umbilical and epigastric hernia repair and recurrences after mesh repair. A multi-database search was conducted to reveal relevant studies since 2001 reporting mesh-based repair of primary umbilical/epigastric hernia and their outcomes in adult patients. A total of 20 studies were included, 15 of them solely involved umbilical hernias, whereas the remaining studies included epigastric hernias as well. A median of 124 patients (range, 17-384) was investigated per study. Three quarters of the included studies had a follow-up of at least 2 years. Six studies described the results of laparoscopic approach, of which one reported a recurrence rate of 2.7 %; in the remaining studies, no recurrences occurred. Two comparative studies reported a lower incidence of complications and postoperative pain after laparoscopic repair compared to open repair. Seventeen studies reported results of open techniques, of which seven studies showed no recurrence. Other studies reported recurrence rates up to 3.1 %. A wide range of complication rates were reported (0-33 %). This collective review showed acceptable recurrence rates for mesh-based umbilical and epigastric hernia repair. A wide range of devices was investigated. A tendency toward more complications after laparoscopic repair was found compared to open repair.

  17. Strategic Studies Quarterly, Volume 4, Number 3, Fall 2010

    Science.gov (United States)

    2010-01-01

    1948-12 May 1949)—perhaps the best- known relief operation in American history—the Air Force provided vital S QUARTER! > • FAU 2010 \\_ •’ I food...and personnel to begin performing at least the first two functions immediately. [28] STRATEGIC STUDIES QUARTERLY • FAU 2010 Guidelines for Nation...assistance, as measured as a share of GDP, than more-settled societies. Whereas most STRATEGIC STUDIES QUARTERLY • FAU 2010 [35] James F. Dobbins

  18. 20 CFR 404.145 - When you acquire a quarter of coverage.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false When you acquire a quarter of coverage. 404... DISABILITY INSURANCE (1950- ) Insured Status and Quarters of Coverage Quarters of Coverage § 404.145 When you acquire a quarter of coverage. If we credit you with a quarter of coverage (QC) for a calendar...

  19. 20 CFR 404.140 - What is a quarter of coverage.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false What is a quarter of coverage. 404.140... DISABILITY INSURANCE (1950- ) Insured Status and Quarters of Coverage Quarters of Coverage § 404.140 What is a quarter of coverage. (a) General. A quarter of coverage (QC) is the basic unit of social...

  20. Two Ports Laparoscopic Inguinal Hernia Repair in Children

    Directory of Open Access Journals (Sweden)

    Medhat M. Ibrahim

    2015-01-01

    Full Text Available Introduction. Several laparoscopic treatment techniques were designed for improving the outcome over the last decade. The various techniques differ in their approach to the inguinal internal ring, suturing and knotting techniques, number of ports used in the procedures, and mode of dissection of the hernia sac. Patients and Surgical Technique. 90 children were subjected to surgery and they undergone two-port laparoscopic repair of inguinal hernia in children. Technique feasibility in relation to other modalities of repair was the aim of this work. 90 children including 75 males and 15 females underwent surgery. Hernia in 55 cases was right-sided and in 15 left-sided. Two patients had recurrent hernia following open hernia repair. 70 (77.7% cases were suffering unilateral hernia and 20 (22.2% patients had bilateral hernia. Out of the 20 cases 5 cases were diagnosed by laparoscope (25%. The patients’ median age was 18 months. The mean operative time for unilateral repairs was 15 to 20 minutes and bilateral was 21 to 30 minutes. There was no conversion. The complications were as follows: one case was recurrent right inguinal hernia and the second was stitch sinus. Discussion. The results confirm the safety and efficacy of two ports laparoscopic hernia repair in congenital inguinal hernia in relation to other modalities of treatment.