WorldWideScience

Sample records for electrosurgical excisional procedure

  1. Loop Electrosurgical Excision Procedure (LEEP)

    Science.gov (United States)

    ... applied to your cervix to stop any bleeding. Electrocautery also may be used to control bleeding. The ... the uterus at the top of the vagina. Electrocautery: A procedure in which an instrument works with ...

  2. Risk of persistent high-grade squamous intraepithelial lesion after electrosurgical excisional treatment with positive margins: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Caroline Alves de Oliveira

    Full Text Available CONTEXT AND OBJECTIVE: Even if precursor lesions of cervical cancer are properly treated, there is a risk of persistence or recurrence. The aim here was to quantify the risks of persistence of high-grade intraepithelial squamous lesions, one and two years after cervical electrosurgical excisional treatment with positive margins. DESIGN AND SETTING: Systematic review of the literature and meta-analysis at Instituto Fernandes Figueira. METHODS: This meta-analysis was on studies published between January 1989 and July 2009 that were identified in Medline, Scopus, Embase, Cochrane, SciELO, Lilacs, Adolec, Medcarib, Paho, Wholis, Popline, ISI Web of Science and Sigle. Articles were selected if they were cohort studies on electrosurgical excisional treatment of high-grade squamous intraepithelial lesions with a minimum follow-up of one year, a histopathological outcome of persistence of these lesions and a small risk of bias. RESULTS: The search identified 7,066 articles and another 21 in the reference lists of these papers. After applying the selection and exclusion criteria, only four articles were found to have extractable data. The risk of persistence of high-grade intraepithelial lesions after one year was 11.36 times greater (95% confidence interval, CI: 5.529-23.379, P < 0.0001 in patients with positive margins and after two years, was four times greater (95% CI: 0.996-16.164, although without statistical significance. CONCLUSION: This meta-analysis confirms the importance of positive margins as an indicator of incomplete treatment after the first year of follow-up and highlights the need for appropriately chosen electrosurgical techniques based on disease location and extent, with close surveillance of these patients.

  3. Loop electrosurgical excision procedure in Greek patients with vaginal intraepithelial neoplasia and history of cervical cancer.

    Science.gov (United States)

    Terzakis, E; Androutsopoulos, G; Zygouris, D; Grigoriadis, C; Arnogiannaki, N

    2011-01-01

    The aim of our study was to evaluate the therapeutic effectiveness of loop electrosurgical excision procedure (LEEP) in Greek patients with vaginal intraepithelial neoplasia (VAIN) and history of cervical cancer. Between January 2002 and January 2009, eight women with histologically confirmed VAIN and history of cervical cancer were included in our study. For the LEEP procedure we used a high frequency Electrosurgery Unit with at least 80 W output. Complete response rate, at 12 months of follow-up, was 75%. Recurrence rate, at 12 months of follow-up, was 25%. Complete response rate, at 24 months of follow up, was 62.5%. Recurrence rate, at 24 months of follow up, was 37.5%. LEEP may constitute a valuable excisional method for the treatment of VAIN in cases with a history of cervical cancer. It provides an interpretable specimen of the whole lesion within a few minutes. It needs a short period of training and has low cost.

  4. Outcomes after an excisional procedure for cervical intraepithelial neoplasia in HIV-infected women

    Science.gov (United States)

    Reimers, Laura L.; Sotardi, Susan; Daniel, David; Chiu, Lydia G.; Arsdale, Anne Van; Wieland, Daryl L.; Leider, Jason M.; Xue, Xiaonan; Strickler, Howard D.; Garry, David J.; Goldberg, Gary L.; Einstein, Mark H.

    2011-01-01

    Objective To determine predictors of treatment failure and recurrence after surgical excisional procedures for CIN in HIV-infected women. Methods A retrospective cohort study was conducted in which 136 eligible HIV-infected women treated for CIN between 1999 and 2005 were included. Data were abstracted from charts and computer databases. Treatment failures were defined as the presence of CIN 1+ at initial follow-up. Recurrences were defined as the presence of CIN 1+ subsequent to initial normal follow-up. Results Treatment failure at initial follow-up was common, occurring in 51% of CIN 1 and 55% of CIN 2+. Most lesions detected at treatment failure were high grade (>70%), regardless of the grade of initial lesion. Significant risk factors for treatment failure were loop electrosurgical excision procedure (LEEP) compared to cold knife conization (RR=1.76; 95% CI: 1.15–2.64), and low CD4+ count (p = 0.04). Among those with an initial normal clinical evaluation, 55% eventually recurred. As with treatment failure, most lesions detected at recurrence were high grade. Risk factors for recurrence included use of LEEP (hazard ratio [HR] = 3.38; 95% CI: 1.55–7.39), higher HIV RNA level, and the presence of positive margins at treatment (HR = 6.12; 95% CI: 1.90–19.73). Conclusions Most CIN treatment of HIV-infected women studied either failed or resulted in recurrence. Of particular concern, many of these subsequent lesions were high grade. Conization, however, was associated with significantly less failure/recurrence than LEEP. Clinicians treating CIN in HIV-infected women should avoid raising expectations of cure and instead focus on the achievable goal of cancer prevention until there are better therapies for this patient population. PMID:20605046

  5. Depth of cervical cone removed by loop electrosurgical excision procedure and subsequent risk of spontaneous preterm delivery

    DEFF Research Database (Denmark)

    Noehr, Bugge; Jensen, Allan; Frederiksen, Kirsten

    2009-01-01

    OBJECTIVE: To investigate the association between cone depth of the loop electrosurgical excision procedure (LEEP) of the cervix and subsequent risk of spontaneous preterm delivery. METHODS: The study included all deliveries in Denmark over a 9-year period, 1997-2005, with information obtained fr...

  6. A randomized clinical trial comparing cervical dysplasia treatment with cryotherapy vs loop electrosurgical excision procedure in HIV-seropositive women from Johannesburg, South Africa.

    Science.gov (United States)

    Smith, Jennifer S; Sanusi, Busola; Swarts, Avril; Faesen, Mark; Levin, Simon; Goeieman, Bridgette; Ramotshela, Sibongile; Rakhombe, Ntombiyenkosi; Williamson, Anna L; Michelow, Pam; Omar, Tanvier; Hudgens, Michael G; Firnhaber, Cynthia

    2017-08-01

    Mortality associated with cervical cancer is a public health concern for women, particularly in HIV-seropositive women in resource-limited countries. HIV-seropositive women are at a higher risk of high-grade cervical precancer, which can eventually progress to invasive carcinoma as compared to HIV-seronegative women. It is imperative to identify effective treatment methods for high-grade cervical precursors among HIV-seropositive women. Randomized controlled trial data are needed comparing cryotherapy vs loop electrosurgical excision procedure treatment efficacy in HIV-seropositive women. Our primary aim was to compare the difference in the efficacy of loop electrosurgical excision procedure vs cryotherapy for the treatment of high-grade cervical intraepithelial neoplasia (grade ≥2) among HIV-seropositive women by conducting a randomized clinical trial. HIV-seropositive women (n = 166) aged 18-65 years with histology-proven cervical intraepithelial neoplasia grade ≥2 were randomized (1:1) to cryotherapy or loop electrosurgical excision procedure treatment at a government hospital in Johannesburg. Treatment efficacy was compared using 6- and 12-month cumulative incidence posttreatment of: (1) cervical intraepithelial neoplasia grade ≥2; (2) secondary endpoints of histologic cervical intraepithelial neoplasia grade ≥3 and grade ≥1; and (3) high-grade and low-grade cervical cytology. The study was registered (ClinicalTrials.govNCT01723956). From January 2010 through August 2014, 166 participants were randomized (86 loop electrosurgical excision procedure; 80 cryotherapy). Cumulative cervical intraepithelial neoplasia grade ≥2 incidence was higher for cryotherapy (24.3%; 95% confidence interval, 16.1-35.8) than loop electrosurgical excision procedure at 6 months (10.8%; 95% confidence interval, 5.7-19.8) (P = .02), although by 12 months, the difference was not significant (27.2%; 95% confidence interval, 18.5-38.9 vs 18.5%; 95% confidence interval, 11

  7. Impact of a Video Intervention for Rural Peruvian Women With Cervical Neoplasia Before Loop Excisional Procedures.

    Science.gov (United States)

    Ferris, Daron G; Condorhuaman, Wendy Shulay Guevara; Waller, Jennifer; Lilienthal, Anneliese

    2015-07-01

    Indigenous Peruvian women have very high rates of cervical cancer. This study assessed the impact of an educational video on impoverished rural Peruvian women seeking loop excision surgery. Women completed baseline, postvideo and postsurgery questionnaires that assessed knowledge and attitudes about the procedure. Differences between groups were examined using repeated measures analysis of variance. Women who watched the video were significantly more calm (2.6, 2.6, and 2.3, respectively; P = 0.04), relaxed (2.5, 2.5, and 2.1, respectively; P = 0.02), and content (3.4, 3.4, and 2.4, respectively, P < 0.01) at postvideo and postsurgery assessments compared with mean results at the baseline assessment. The same women were also significantly more tense (2.5, 2.0, and 2.0, respectively; P = 0.01), upset (1.6, 1.1, and 1.1, respectively; P = 0.01), and worried (3.0, 2.0, and 2.0, respectively; P = 0.01) at baseline compared with postvideo and postsurgery results. Approximately 93% of women believed that other women scheduled to have loop excision surgery should also watch the video. Dissemination of culturally sensitive video information minimizes adverse emotional responses associated with loop excision procedures before surgery. Such an intervention quickly improves the psychological well-being of women eventually subjected to surgical management of cervical neoplasia.

  8. 21 CFR 876.4300 - Endoscopic electrosurgical unit and accessories.

    Science.gov (United States)

    2010-04-01

    ... Endoscopic electrosurgical unit and accessories. (a) Identification. An endoscopic electrosurgical unit and... device includes the electrosurgical generator, patient plate, electric biopsy forceps, electrode, flexible snare, electrosurgical alarm system, electrosurgical power supply unit, electrical clamp, self...

  9. LASER treatment for women with high-grade vaginal intraepithelial neoplasia: A propensity-matched analysis on the efficacy of ablative versus excisional procedures.

    Science.gov (United States)

    Bogani, Giorgio; Ditto, Antonino; Martinelli, Fabio; Mosca, Lavinia; Chiappa, Valentina; Rossetti, Diego; Leone Roberti Maggiore, Umberto; Sabatucci, Ilaria; Lorusso, Domenica; Raspagliesi, Francesco

    2018-05-14

    To investigate the long-term effectiveness of LASER treatment in women affected by high-grade vaginal intra-epithelial neoplasia. Data of consecutive women treated for high-grade vaginal intra-epithelial neoplasia were retrieved. Efficacy and long-term effectiveness of ablative and excisional procedures were tested using a propensity-matched algorithm. Risk of recurrence over the time was assessed using Kaplan-Meier and Cox models. Overall, 204 patients met the inclusion criteria. LASER ablation and exicision were performed in 169 (82.8%) and 35 (17.2%) patients. A total of 41 (20%) patients developed high-grade vaginal intraepithelial neoplasia at a median follow-up of 65 (range, 6-120) months. We observed that only HPV persistence (HR: 2.37 [95%CI:1.03, 5.42]; P = 0.04) was associated with the risk of recurrence at multivariate analysis. Seven (3.4%) invasive cancers of the lower genital tract were observed in our population. Considering the efficacy of type of procedure (after we applied the propensity-matched analysis), we observed that type of procedure did not influence persistence of HPV infection (22.8% after excision and 15.7% after ablation; P = 0.424). Similarly, recurrence (17.1% vs. 18.6%; P = 1.00) and lower genital tract (2.8% vs. 1.4%; P = 1.00) rates were similar between groups. Women affected by high-grade vaginal intra-epithelial neoplasia are at high risk of recurrence. LASER ablation seems to be equivalent to excision in term of long-term effectiveness. Lasers Surg. Med. 9999:1-7, 2018. © 2018 Wiley Periodicals, Inc. © 2018 Wiley Periodicals, Inc.

  10. A systematic review of the effects of visual inspection with acetic acid, cryotherapy, and loop electrosurgical excision procedures for cervical dysplasia in HIV-infected women in low- and middle-income countries.

    Science.gov (United States)

    Forhan, Sara E; Godfrey, Catherine C; Watts, D Heather; Langley, Carol L

    2015-04-15

    Cervical cancer, almost all of which is caused by human papillomavirus, accounts for 12% of female cancers worldwide and is more common among HIV-infected women. Nine of 10 deaths from cervical cancer occur in low- and middle-income countries (LMICs). Simple screening methods and outpatient treatment of precursor lesions save lives but the benefit of these interventions among HIV-infected women is uncertain. We reviewed evidence of the effects of screening with visual inspection with acetic acid (VIA), and outpatient treatment for cervical precancer among HIV-infected women in LMIC. A systematic review of articles published from January 1995 through July 2013 was conducted using key terms for VIA cervical screening, cervical precancer treatment with cryotherapy or loop electrosurgical excision procedure, HIV-infected women, low-resource settings, and outcomes, including morbidity and mortality. Of 2159 articles screened, 14 met inclusion criteria; all considered only morbidity outcomes. No articles dealt with the long-term impact of screening/treatment on cervical cancer incidence or mortality among HIV-infected women. Articles reported on performance of VIA, prevalence of cervical dysplasia, and complications and rates of recurrent dysplasia after treatment. Dysplasia prevalence and recurrence were higher among HIV-infected compared with HIV-uninfected women but morbidity from treatment was similar. Few data exist on long-term outcomes of VIA, cryotherapy, or loop electrosurgical excision procedure interventions among HIV-infected women in LMIC; longer-term outcomes research is needed to assess the effects of VIA or other screening modalities and outpatient treatment on prevention of cervical cancer among HIV-infected women.

  11. Pain Management for Gynecologic Procedures in the Office.

    Science.gov (United States)

    Ireland, Luu Doan; Allen, Rebecca H

    2016-02-01

    Satisfactory pain control for women undergoing office gynecologic procedures is critical for both patient comfort and procedure success. Therefore, it is important for clinicians to be aware of the safety and efficacy of different pain control regimens. This article aimed to review the literature regarding pain control regimens for procedures such as endometrial biopsy, intrauterine device insertion, colposcopy and loop electrosurgical excisional procedure, uterine aspiration, and hysteroscopy. A search of published literature using PubMed was conducted using the following keywords: "pain" or "anesthesia." These terms were paired with the following keywords: "intrauterine device" or "IUD," "endometrial biopsy," "uterine aspiration" or "abortion," "colposcopy" or "loop electrosurgical excisional procedure" or "LEEP," "hysteroscopy" or "hysteroscopic sterilization." The search was conducted through July 2015. Articles were hand reviewed and selected by the authors for study quality. Meta-analyses and randomized controlled trials were prioritized. Although local anesthesia is commonly used for gynecologic procedures, a multimodal approach may be more effective including oral medication, a dedicated emotional support person, and visual or auditory distraction. Women who are nulliparous, are postmenopausal, have a history of dysmenorrhea, or suffer from anxiety are more likely to experience greater pain with gynecologic procedures. Evidence for some interventions exists; however, the interpretation of intervention comparisons is limited by the use of different regimens, pain measurement scales, patient populations, and procedure techniques. There are many options for pain management for office gynecologic procedures, and depending on the procedure, different modalities may work best. The importance of patient counseling and selection cannot be overstated.

  12. Effect of Anti-Sticking Nanostructured Surface Coating on Minimally Invasive Electrosurgical Device in Brain.

    Science.gov (United States)

    Cheng, Han-Yi; Ou, Keng-Liang; Chiang, Hsi-Jen; Lin, Li-Hsiang

    2015-10-01

    The purpose of the present study was to examine the extent of thermal injury in the brain after the use of a minimally invasive electrosurgical device with a nanostructured copper-doped diamond-like carbon (DLC-Cu) surface coating. To effectively utilize an electrosurgical device in clinical surgery, it is important to decrease the thermal injury to the adjacent tissues. The surface characteristics and morphology of DLC-Cu thin film was evaluated using a contact angle goniometer, scanning electron microscopy, and atomic force microscopy. Three-dimensional biomedical brain models were reconstructed using magnetic resonance images to simulate the electrosurgical procedure. Results indicated that the temperature was reduced significantly when a minimally invasive electrosurgical device with a DLC-Cu thin film coating (DLC-Cu-SS) was used. Temperatures decreased with the use of devices with increasing film thickness. Thermographic data revealed that surgical temperatures in an animal model were significantly lower with the DLC-Cu-SS electrosurgical device compared to an untreated device. Furthermore, the DLC-Cu-SS device created a relatively small region of injury and lateral thermal range. As described above, the biomedical nanostructured film reduced excessive thermal injury with the use of a minimally invasive electrosurgical device in the brain.

  13. Evaluation of stray radiofrequency radiation emitted by electrosurgical devices

    International Nuclear Information System (INIS)

    De Marco, M; Maggi, S

    2006-01-01

    Electrosurgery refers to the passage of a high-frequency, high-voltage electrical current through the body to achieve the desired surgical effects. At the same time, these procedures are accompanied by a general increase of the electromagnetic field in an operating room that may expose both patients and personnel to relatively high levels of radiofrequency radiation. In the first part of this study, we have taken into account the radiation emitted by different monopolar electrosurgical devices, evaluating the electromagnetic field strength delivered by an electrosurgical handle and straying from units and other electrosurgical accessories. As a summary, in the worst case a surgeon's hands are exposed to a continuous and pulsed RF wave whose magnetic field strength is 0.75 A m -1 (E-field 400 V m -1 ). Occasionally stray radiation may exceed ICNIRP's occupational exposure guidelines, especially close to the patient return plate. In the second part of this paper, we have analysed areas of particular concern to prevent electromagnetic interference with some life-support devices (ventilators and electrocardiographic devices), which have failed to operate correctly. Most clinically relevant interference occurred when an electrosurgery device was used within 0.3 m of medical equipment. In the appendix, we suggest some practical recommendations intended to minimize the potential for electromagnetic hazards due to therapeutic application of RF energy

  14. 21 CFR 886.4100 - Radiofrequency electrosurgical cautery apparatus.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Radiofrequency electrosurgical cautery apparatus... SERVICES (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4100 Radiofrequency electrosurgical cautery apparatus. (a) Identification. A radiofrequency electrosurgical cautery apparatus is an AC...

  15. A simple approach to calculate active power of electrosurgical units

    Directory of Open Access Journals (Sweden)

    André Luiz Regis Monteiro

    Full Text Available Abstract Introduction: Despite of more than a hundred years of electrosurgery, only a few electrosurgical equipment manufacturers have developed methods to regulate the active power delivered to the patient, usually around an arbitrary setpoint. In fact, no manufacturer has a method to measure the active power actually delivered to the load. Measuring the delivered power and computing it fast enough so as to avoid injury to the organic tissue is challenging. If voltage and current signals can be sampled in time and discretized in the frequency domain, a simple and very fast multiplication process can be used to determine the active power. Methods This paper presents an approach for measuring active power at the output power stage of electrosurgical units with mathematical shortcuts based on a simple multiplication procedure of discretized variables – frequency domain vectors – obtained through Discrete Fourier Transform (DFT applied on time-sampled voltage and current vectors. Results Comparative results between simulations and a practical experiment are presented – all being in accordance with the requirements of the applicable industry standards. Conclusion An analysis is presented comparing the active power analytically obtained through well-known voltage and current signals against a computational methodology based on vector manipulation using DFT only for time-to-frequency domain transformation. The greatest advantage of this method is to determine the active power of noisy and phased out signals with neither complex DFT or ordinary transform methodologies nor sophisticated computing techniques such as convolution. All results presented errors substantially lower than the thresholds defined by the applicable standards.

  16. Loop electrosurgical excision of the cervix and subsequent risk for spontaneous preterm delivery: a population-based study of singleton deliveries during a 9-year period

    DEFF Research Database (Denmark)

    Noehr, Bugge; Jensen, Allan; Frederiksen, Kirsten

    2009-01-01

    OBJECTIVE: Our aim was to assess the association between loop electrosurgical excision procedure (LEEP) and the subsequent risk for spontaneous preterm delivery, with the use of population-based data from various nationwide registries. STUDY DESIGN: The study population consisted of all singleton...

  17. Loop electrosurgical excision of the cervix and risk for spontaneous preterm delivery in twin pregnancies

    DEFF Research Database (Denmark)

    Noehr, Bugge; Jensen, Allan; Frederiksen, Kirsten

    2009-01-01

    OBJECTIVE: To investigate the association between three cervical procedures (biopsy with no treatment, ablation, and loop electrosurgical excision procedure [LEEP]) and subsequent spontaneous preterm delivery in twin pregnancies using population-based data from various nationwide registries....... METHODS:: The study population consisted of all twin deliveries in Denmark during a 9-year period, 1997-2005. Information on the deliveries, including cervical procedures, was obtained from various national registries. In all, 9,868 deliveries were eligible for analyses, of which 3,228 were delivered...... spontaneously preterm (32.7%). Preterm delivery was defined as gestational age between 21 weeks and 37 weeks. Logistic regression analyses were used to evaluate the association between cervical procedures and preterm delivery. RESULTS: Twin pregnancies subsequent to LEEP had a significantly increased risk...

  18. The mechanical fingerprint of murine excisional wounds.

    Science.gov (United States)

    Pensalfini, Marco; Haertel, Eric; Hopf, Raoul; Wietecha, Mateusz; Werner, Sabine; Mazza, Edoardo

    2018-01-01

    A multiscale mechanics approach to the characterization of murine excisional wounds subjected to uniaxial tensile loading is presented. Local strain analysis at a physiological level of tension uncovers the presence of two distinct regions within the wound: i) a very compliant peripheral cushion and ii) a core area undergoing modest deformation. Microstructural visualizations of stretched wound specimens show negligible engagement of the collagen located in the center of a 7-day old wound; fibers remain coiled despite the applied tension, confirming the existence of a mechanically isolated wound core. The compliant cushion located at the wound periphery appears to protect the newly-formed tissue from excessive deformation during the phase of new tissue formation. The early remodeling phase (day 14) is characterized by a restored mechanical connection between far field and wound center. The latter remains less deformable, a characteristic possibly required for cell activities during tissue remodeling. The distribution of fibrillary collagens at these two time points corresponds well to the identified heterogeneity of mechanical properties of the wound region. This novel approach provides new insight into the mechanical properties of wounded skin and will be applicable to the analysis of compound-treated wounds or wounds in genetically modified tissue. Biophysical characterization of healing wounds is crucial to assess the recovery of the skin barrier function and the associated mechanobiological processes. For the first time, we performed highly resolved local deformation analysis to identify mechanical characteristics of the wound and its periphery. Our results reveal the presence of a compliant cushion surrounding a stiffer wound core; we refer to this heterogeneous mechanical behavior as "mechanical fingerprint" of the wound. The mechanical response is shown to progress towards that of the intact skin as healing takes place. Histology and multiphoton microscopy

  19. A Study on Performance and Safety Tests of Electrosurgical Equipment.

    Science.gov (United States)

    Tavakoli Golpaygani, A; Movahedi, M M; Reza, M

    2016-09-01

    Modern medicine employs a wide variety of instruments with different physiological effects and measurements. Periodic verifications are routinely used in legal metrology for industrial measuring instruments. The correct operation of electrosurgical generators is essential to ensure patient's safety and management of the risks associated with the use of high and low frequency electrical currents on human body. The metrological reliability of 20 electrosurgical equipment in six hospitals (3 private and 3 public) was evaluated in one of the provinces of Iran according to international and national standards. The achieved results show that HF leakage current of ground-referenced generators are more than isolated generators and the power analysis of only eight units delivered acceptable output values and the precision in the output power measurements was low. Results indicate a need for new and severe regulations on periodic performance verifications and medical equipment quality control program especially in high risk instruments. It is also necessary to provide training courses for operating staff in the field of meterology in medicine to be acquianted with critical parameters to get accuracy results with operation room equipment.

  20. A Study on Performance and Safety Tests of Electrosurgical Equipment

    Directory of Open Access Journals (Sweden)

    Tavakoli Golpaygani A.

    2016-09-01

    Full Text Available Introduction: Modern medicine employs a wide variety of instruments with different physiological effects and measurements. Periodic verifications are routinely used in legal metrology for industrial measuring instruments. The correct operation of electrosurgical generators is essential to ensure patient’s safety and management of the risks associated with the use of high and low frequency electrical currents on human body. Material and Methods: The metrological reliability of 20 electrosurgical equipment in six hospitals (3 private and 3 public was evaluated in one of the provinces of Iran according to international and national standards. Results: The achieved results show that HF leakage current of ground-referenced generators are more than isolated generators and the power analysis of only eight units delivered acceptable output values and the precision in the output power measurements was low. Conclusion: Results indicate a need for new and severe regulations on periodic performance verifications and medical equipment quality control program especially in high risk instruments. It is also necessary to provide training courses for operating staff in the field of meterology in medicine to be acquianted with critical parameters to get accuracy results with operation room equipment.

  1. Tactile Electrosurgical Ablation: A Technique for the Treatment of Intractable Heavy and Prolonged Menstrual Bleeding

    Directory of Open Access Journals (Sweden)

    Ali M. El Saman

    2015-01-01

    Full Text Available Objective. To study the efficacy and safety of tactile electrosurgical ablation (TEA in stopping a persistent attack of abnormal uterine bleeding not responding to medical and hormonal therapy. Methods. This is a case series of 19 cases with intractable abnormal uterine bleeding, who underwent TEA at the Women’s Health Center of Assiut University. The outcomes measured were; patient’s acceptability, operative time, complications, menstrual outcomes, and reintervention. Results. None of the 19 counseled cases refused the TEA procedure which took 6–10 minutes without intraoperative complications. The procedure was successful in the immediate cessation of bleeding in 18 out of 19 cases. During the 24-month follow-up period, 9 cases developed amenorrhea, 5 had scanty menstrual bleeding, 3 were regularly menstruating, 1 case underwent repeat TEA ablation, and one underwent a hysterectomy. Conclusions. TEA represents a safe, inexpensive, and successful method for management of uterine bleeding emergencies with additional long-term beneficial effects. However, more studies with more cases and longer follow-up periods are warranted.

  2. Percutaneous excisional biopsy of clinically benign breast lesions with vacuum-assisted system: comparison of three devices.

    Science.gov (United States)

    Wang, Zhi Li; Liu, Gang; Huang, Yan; Wan, Wen Bo; Li, Jun Lai

    2012-04-01

    The aim of this study was to compare three devices in percutaneous excisional biopsy of clinically benign breast lesions in terms of complete excision rate, duration of procedure and complications. In a retrospective study from March 2005 to May 2009, 983 lesions underwent ultrasound-guided excisional biopsy with three vacuum-assisted systems, respectively. The lesions were category 3 lesions as determined by ultrasound imaging according to Breast Imaging Reporting and Data System (BI-RADS) (n=951) or had been confirmed as benign by a previous core needle biopsy (n=32). The completely excision rate, duration of procedure and complications (hematoma, pain and ecchymosis) were recorded. 99.7% (980/983) lesions were demonstrated to be benign by pathology after percutaneous excisional biopsy. The overall complete excision rate was 94.8% (932/983). In lesions whose largest diameter equal to or larger than 1.5cm, the complete excision rates of EnCor(®) group (97.8%, 348/356) and Mammotome(®) group (97.2%, 139/143) were significantly higher than that of Vacora(®) group (91.9%, 445/484) (P<0.05). The EnCor(®) group (6.6±6.5min) had a significant less duration than Mammotome(®) (10.6±9.3min) and Vacora(®) group (25.6±23.3min) (P<0.05). Hematoma occurred more in EnCor(®) group and Mammotome(®) group than in Vacora(®) group (P<0.05). All these three vacuum-assisted systems are highly successful for excisional biopsy of benign breast lesions. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  3. Evidence-Based Management of Pain After Excisional Haemorrhoidectomy Surgery: A PROSPECT Review Update.

    Science.gov (United States)

    Sammour, Tarik; Barazanchi, Ahmed W H; Hill, Andrew G

    2017-02-01

    The aim of this systematic review was to update previous PROSPECT ( http://www.postoppain.org ) review recommendations for the management of pain after excisional haemorrhoidectomy. Randomized studies and reviews published in the English language from July 2006 (end date of last review) to March 2016, assessing analgesic, anaesthetic, and operative interventions pertaining to excisional haemorrhoidectomy in adults, and reporting pain scores, were retrieved from the EMBASE and MEDLINE databases. An additional 464 studies were identified of which 74 met the inclusion criteria. There were 48 randomized controlled trials and 26 reviews. Quantitative analyses were not performed, as there were limited numbers of trials with a sufficiently homogeneous design. Pudendal nerve block, with or without general anaesthesia, is recommended for all patients undergoing haemorrhoidal surgery. Either closed haemorrhoidectomy, or open haemorrhoidectomy with electrocoagulation of the pedicle is recommended as the primary procedure. Combinations of analgesics (paracetamol, non-steroidal anti-inflammatory drugs, and opioids), topical lignocaine and glyceryl trinitrate, laxatives, and oral metronidazole are recommended post-operatively. The recommendations are largely based on single intervention, not multimodal intervention, studies.

  4. Diode laser for excisional biopsy of peripheral ossifying fibroma

    Directory of Open Access Journals (Sweden)

    Kirti Chawla

    2014-01-01

    Full Text Available Peripheral Ossifying Fibroma is one of the commonest occurring reactive lesions on gingiva. It is associated with local irritational factors and often interferes with speech, mastication and maintenance of oral hygiene, in addition to being aesthetically unpleasant. It is usually treated with surgical excision using scalpel and removal of irritational factors, often resulting in mucogingival defect. Other modalities such as radiosurgery and electrocautery have also been used for its management, but they cause changes in microarchitecture of biopsy specimen, altering the histologic picture for true diagnosis. We are presenting a case of excisional biopsy of this lesion in an adult female using a diode laser with excellent post-operative results, without affecting microarchitecture of biopsy specimen. The patient is being followed for last 1 year and no sign of recurrence has been found. A diode laser may offer a good alternative modality for management of such cases.

  5. Excisional surgery for cancer cure: therapy at a cost.

    LENUS (Irish Health Repository)

    Coffey, J C

    2012-02-03

    Excisional surgery is one of the primary treatment modalities for cancer. Minimal residual disease (MRD) is the occult neoplastic disease that remains in situ after curative surgery. There is increasing evidence that tumour removal alters the growth of MRD, leading to perioperative tumour growth. Because neoplasia is a systemic disease, this phenomenon may be relevant to all patients undergoing surgery for cancer. In this review we discuss the published work that addresses the effects of tumour removal on subsequent tumour growth and the mechanisms by which tumour excision may alter residual tumour growth. In addition, we describe therapeutic approaches that may protect patients against any oncologically adverse effects of tumour removal. On the basis of the evidence presented, we propose a novel therapeutic paradigm; that the postoperative period represents a window of opportunity during which the patient may be further protected against the oncological effects of tumour removal.

  6. Excisional Bleb Revision for Management of Failed Ahmed Glaucoma Valve.

    Science.gov (United States)

    Eslami, Yadollah; Fakhraie, Ghasem; Moghimi, Sasan; Zarei, Reza; Mohammadi, Masoud; Nabavi, Amin; Yaseri, Mehdi; Izadi, Ali

    2017-12-01

    To evaluate the outcome of excisonal bleb revision in patients with failed Ahmed glaucoma valve (AGV). In total, 29 patients with uncontrolled intraocular pressure (IOP) despite of maximal tolerated medical therapy at least 6 months after AGV implantation were enrolled in this prospective interventional case series. Excision of fibrotic tissue around the reservoir with application of mitomycin C 0.02% was performed. IOP, number of glaucoma medications were evaluated at baseline and 1 week and 1, 3, 6, and 12 months postoperatively. Complete and qualified success was defined as IOP≤21 mm Hg with or without glaucoma medications, respectively. Intraoperative and postopervative complications were also recorded. Mean IOP was reduced from 30±4.2 mm Hg at baseline to 19.2±3.1 mm Hg at 12-month follow-up visit (Pglaucoma medications was decrease from 3.2±0.5 at baseline to 1.9±0.7 at 12-month follow-up (Pglaucoma surgeries were significantly associated with the failure of excisonal bleb revision. Excisional bleb revision could be considered as a relatively effective alternative option for management of inadequate IOP control after AGV implantation.

  7. Correlação entre o Diagnóstico Histológico da Biópsia e o da Conização por Cirurgia de Alta Freqüência por Alça (CAF no Tratamento da Neoplasia Intra-epitelial Cervical Correlation between the Histological Report of Biopsy and Conization by the Loop Electrosurgical Excision Procedure (LEEP in the Treatment of Cervical Intraepithelial Neoplasia

    Directory of Open Access Journals (Sweden)

    Cássia Raquel Teatin Juliato

    2000-03-01

    ógica posterior.Purpose: to evaluate conization by the loop electrosurgical excision procedure (LEEP for the diagnosis and treatment of cervical intraepithelial neoplasms (CIN, the importance of the margins and follow-up of these women. Methods: 95 women who underwent conization by LEEP for CIN and microinvasive carcinoma from January 1996 to December 1997 were evaluated. For statistical analysis, we used the kappa agreement coefficient and the tendency test of Cochran Armitage. Results: among 63 cases who underwent colposcopically directed biopsy before the conization, the cone presented the same grade of lesion in 20 and no residual disease in 8. The cone lesion presented a higher grade in 24 cases and one of them was a microinvasive carcinoma. Among the 25 women who underwent the cone biopsy with a previous biopsy suggestive of cervicitis or CIN 1, 56% had CIN 2 or 3 in the cone. Among the 32 women without previous biopsy, 15 had CIN 2 or 3, and four had microinvasive carcinoma in the cone. Regarding the margins of the cone, 25 cases presented some grade of CIN in the endocervical margins and 2/10 who underwent a second procedure presented residual disease on histological analysis. Among the 70 women with free cone margins, 2/4 who underwent a second procedure had residual disease on histological analysis. Conclusion: conization by LEEP without previous directed biopsy depends on the experience of the colposcopist. The second resection after LEEP for the diagnosis and treatment of CIN depends not only on the presence of disease in the cone margins but also on the follow-up. A second histological analysis is recommended in cases with microinvasive carcinoma and glandular lesion and affected margins.

  8. Fatores de risco de recidiva de lesões intra-epiteliais cervicais após conização por cirurgia de alta freqüência em mulheres portadoras e não portadoras do vírus da imunodeficiência humana Risk factors for cervical intraepithelial lesions after loop electrosurgical excision procedure in HIV-infected and non-infected women

    Directory of Open Access Journals (Sweden)

    Maria Inês de Miranda Lima

    2006-09-01

    risk factors associated with cervical intraepithelial lesion recurrence after LEEP conization. METHODS: nested case-control study in a cohort of 201 patients with cervical intraepithelial lesion, that were submitted to LEEP conization. Average follow-up of these patients was 2 years. Ninety-four HIV-infected women and 107 non-infected were enrolled. Cervical conization was achieved by the Loop Electrosurgical Excision Procedure (LEEP. Evaluated surgical biopsy histopathological characteristics were lesion grade, lesion borders and glandular involvement. After surgery all patients were submitted to a colposcopy and cytological evaluation every six months. Recurrent lesions were defined it confirmed by biopsy after surgery. Cases were patients with and controls patients without recurrence. chi2 test and multivariable analysis by logistic regression were used for group comparisons. Kaplan Meier's method was performed for the survival analyses (log-rank test. RESULTS: 40 patients had lesion recurrence. Initially, significant variables were: partner number, HIV-infection, lesion borders and glandular involvement. The most frequent recurrence occurred when there were simultaneous association between positive margins and glandular involvement as indicator for recurrence risk. After logistic regression analysis the main factors associated with lesion recurrence were: glandular involvement (OR-9.1; 95% CI:13.0- 27.5; HIV-infection (OR-4.6; 95% IC:1.1-6.3; compromised margins (OR-2.6; 95% IC:1.9-11.2. CONCLUSIONS: risk factors associated with cervical intraepitelial lesion recurrence were HIV-infection, glandular involvement and compromised margins.

  9. The electrosurgical knife in an optimized intermittent cutting mode for the endoscopic treatment of benign web-like tracheobronchial stenosis.

    Science.gov (United States)

    Amat, Beatriz; Esselmann, Albert; Reichle, Guenther; Rohde, Hans-Juergen; Westhoff, Michael; Freitag, Lutz

    2012-01-01

    The established endoscopic treatment of web-like tracheobronchial stenosis is laser vaporization, but the appearance on the market of a new cutting mode with a lower coagulation effect has been proposed as an alternative to laser due to less injury to the tissue. To study the clinical and functional consequences, as well as the side effects of this technique. Afterwards, we investigated whether the use of an electrosurgical knife with this technique is as effective and convenient as an ND-YAG-laser. Between March 2005 and July 2007, included for study were 22 patients who had undergone 34 interventional bronchoscopy procedures with the VIO-300-D radiofrequency system, using a mode of the Endo-cut I program in conjunction with the reusable knife electrode. All of the patients treated (100%) presented improvements in their symptoms, in the tracheobronchial lumen diameter and in lung function, which were statistically significant. Symptom-free time was 157 ± 93 days. There was an overall decrease observed in mean obstruction (Pbenign web-like tracheobronchial stenosis as all the patients showed clinical and functional improvement, and less than 50% required a second intervention. In comparison with laser therapy, an advantage of this technique is that less fibrin is produced, probably due to the reduced anti-coagulation effect. Copyright © 2011 SEPAR. Published by Elsevier Espana. All rights reserved.

  10. Endoscopic electrosurgical papillotomy and manometry in biliary tract disease.

    Science.gov (United States)

    Geenen, J E; Hogan, W J; Shaffer, R D; Stewart, E T; Dodds, W J; Arndorfer, R C

    1977-05-09

    Endoscopic papillotomy was performed in 13 patients after cholecystectomy for retained or recurrent common bile duct calculi (11 patients) and a clinical picture suggesting papillary stenosis (two patients). Following endoscopic papillotomy, ten of the 11 patients spontaneously passed common bile duct (CBD) stones verified on repeated endoscopic retrograde cholangiopancreatography (ERCP) study. One patient failed to pass a large CBD calculus; one patient experienced cholangitis three months after in inadequate papillotomy and required operative intervention. Endoscopic papillotomy substantially decreased the pressure gradient existing between the CBD and the duodenum in all five patients studied with ERCP manometry. Endoscopic papillotomy is a relatively safe and effective procedure for postcholecystectomy patients with retained or recurrent CBD stones. The majority of CBD stones will pass spontaneously if the papillotomy is adequate.

  11. Effectiveness of dynamic MRI for diagnosing pericicatricial minimal residual breast cancer following excisional biopsy

    International Nuclear Information System (INIS)

    Kawashima, Hiroko; Tawara, Mari; Suzuki, Masayuki; Matsui, Osamu; Kadoya, Masumi

    2001-01-01

    The purpose of this study was to investigate the effectiveness of dynamic MRI for diagnosing pericicatricial minimal residual breast cancer following excisional biopsy. Twenty-six patients who underwent excisional biopsy of a tumor or calcified lesion of the breast underwent gadolinium-enhanced dynamic MRI by the fat-saturated 2D fast spoiled gradient echo (SPGR) sequence (group 1), 24 patients by the spectral IR enhanced 3D fast gradient echo (Efgre3d) sequence (group 2). Pericicatricial residual cancer was confirmed histologically in 29 of the 50 patients. The overall sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of MRI for residual cancer diagnosis was 66, 81, 72, 83 and 63%. A nodular, thick and discontinuous enhanced rim around the scar is indicative of a residual tumor. However, false-positive findings due to granulation or proliferative fibrocystic change remain limitations

  12. Effectiveness of dynamic MRI for diagnosing pericicatricial minimal residual breast cancer following excisional biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Kawashima, Hiroko E-mail: hirokok@med.kanazawa-u.ac.jp; Tawara, Mari; Suzuki, Masayuki; Matsui, Osamu; Kadoya, Masumi

    2001-10-01

    The purpose of this study was to investigate the effectiveness of dynamic MRI for diagnosing pericicatricial minimal residual breast cancer following excisional biopsy. Twenty-six patients who underwent excisional biopsy of a tumor or calcified lesion of the breast underwent gadolinium-enhanced dynamic MRI by the fat-saturated 2D fast spoiled gradient echo (SPGR) sequence (group 1), 24 patients by the spectral IR enhanced 3D fast gradient echo (Efgre3d) sequence (group 2). Pericicatricial residual cancer was confirmed histologically in 29 of the 50 patients. The overall sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of MRI for residual cancer diagnosis was 66, 81, 72, 83 and 63%. A nodular, thick and discontinuous enhanced rim around the scar is indicative of a residual tumor. However, false-positive findings due to granulation or proliferative fibrocystic change remain limitations.

  13. Functional significance of periostin in excisional skin repair: Is the devil in the detail?

    OpenAIRE

    Elliott, Christopher G.; Kim, Shawna S.; Hamilton, Douglas W.

    2012-01-01

    In the past year, three papers have been published exploring the role of the matricellular protein periostin in excisional skin repair. These papers all show a delay in wound closure and the kinetics of this delay are strikingly similar across the three reports. The similarities between these papers end, however, when each investigates the mechanism through which periostin influences skin repair. Three proposed mechanisms have been identified: (1) myofibroblast differentiation, (2) keratinocy...

  14. LONG TERM RESULTS AFTER STAPLED HEMORRHOIDOPEXY ALONE AND COMPLEMENTED BY EXCISIONAL HEMORRHOIDECTOMY: A RETROSPECTIVE COHORT STUDY.

    Science.gov (United States)

    Araujo, Sergio Eduardo Alonso; Horcel, Lucas de Araujo; Seid, Victor Edmond; Bertoncini, Alexandre Bruno; Klajner, Sidney

    2016-01-01

    Stapled hemorrhoidopexy is associated with less postoperative pain and faster recovery. However, it may be associated with a greater risk of symptomatic recurrence. We hypothesized that undertaking a limited surgical excision of hemorrhoid disease after stapling may be a valid approach for selected patients. To compare long-term results after stapled hemorrhoidopexy with and without complementation with closed excisional technique. In a retrospective uni-institutional cohort study, sixty-five (29 men) patients underwent stapled hemorrhoidopexy and 21 (13 men) underwent stapled hemorrhoidopexy with excision. The same surgeons operated on all cases. Patients underwent stapled hemorrhoidectomy associated with excisional surgery if symptoms attributable to external hemorrhoid piles were observed preoperatively, or if residual prolapse or bulky external disease was observed after the firing of the stapler. A closed excisional diathermy hemorrhoidectomy without vascular ligation was utilized in all complemented cases. All clinical variables were obtained from a questionnaire evaluation obtained through e-mail, telephone interview, or office follow-up. The median duration of postoperative follow-up was 48.5 (6-40) months. Patients with grades 3 and 4 hemorrhoid disease were operated on more frequently using stapled hemorrhoidopexy complemented with excisional technique (95.2% vs. 55.4%, p=0.001). Regarding respectively stapled hemorrhoidopexy and stapled hemorrhoidopexy complemented with excision, there was no difference between the techniques in relation to symptom recurrence (43% and 33%, p=0.45) and median interval between surgery and symptom recurrence (30 (8-84) and 38.8 (8-65) months, p=0.80). Eight (12.3%) patients were re-operated after stapled hemorrhoidopexy and 2 (9.6%), after hemorrhoidopexy with excision (p=0.78). Patient distribution in both groups according to the degree of postoperative satisfaction was similar (p=0.97). Stapled hemorrhoidopexy combined

  15. Healing of excisional wound in alloxan induced diabetic sheep: A planimetric and histopathologic study

    Directory of Open Access Journals (Sweden)

    Farshid Sarrafzadeh-Rezaei

    2013-09-01

    Full Text Available Healing of skin wound is a multi-factorial and complex process. Proper treatment of diabetic wounds is still a major clinical challenge. Although diabetes mellitus can occur in ruminants, healing of wounds in diabetic ruminants has not yet been investigated. The aim of this study was to evaluate healing of ovine excisional diabetic wound model. Eight 4-month-old Iranian Makoui wethers were equally divided to diabetic and nondiabetic groups. Alloxan monohydrate (60 mg kg-1, IV was used for diabetes induction. In each wether, an excisional wound was created on the dorsum of the animal. Photographs were taken in distinct times for planimetric evaluation. Wound samples were taken on day 21 post-wounding for histopathologic evaluations of epidermal thickness, number of fibroblasts and number of new blood vessels. The planimetric study showed slightly delay in wound closure of diabetic animals, however, it was not significantly different from nondiabetic wounds (p ≥ 0.05. Furthermore, epidermal thickness, number of fibroblasts and number of blood vessels were significantly lower in diabetic group (p < 0.05. We concluded that healing of excisional diabetic wounds in sheep may be compromised, as seen in other species. However, contraction rate of these wounds may not be delayed due to metabolic features of ruminants and these animals might go under surgeries without any serious concern. However, healing quality of these wounds may be lower than normal wounds.

  16. Skin-Tissue-sparing Excision with Electrosurgical Peeling (STEEP): a surgical treatment option for severe hidradenitis suppurativa Hurley stage II/III.

    Science.gov (United States)

    Blok, J L; Spoo, J R; Leeman, F W J; Jonkman, M F; Horváth, B

    2015-02-01

    Surgery is the only curative treatment for removal of the persistent sinus tracts in the skin that are characteristic of severe hidradenitis suppurativa (HS). Complete resection of the affected tissue by wide excision is currently regarded as the preferred surgical technique in these cases. However, relatively large amounts of healthy tissue are removed with this method and suitable skin-tissue-saving techniques aiming at creating less-extensive surgical defects are therefore needed in severe HS. We describe a skin-tissue-saving surgical technique for HS Hurley stage II-III disease: the Skin-Tissue-sparing Excision with Electrosurgical Peeling (STEEP) procedure. In contrast to wide excisions that generally reach into the deep subcutaneous fat, the fat is maximally spared with the STEEP procedure by performing successive tangential excisions of lesional tissue until the epithelialized bottom of the sinus tracts has been reached. From here, secondary intention healing can occur. In addition, fibrotic tissue is completely removed in the same manner as this also serves as a source of recurrence. This tissue-sparing technique results in low recurrence rates, high patient satisfaction with relatively short healing times and favourable cosmetic outcomes without contractures. © 2014 European Academy of Dermatology and Venereology.

  17. Short-term outcomes of excisional atherectomy in lower limb arterial disease.

    Science.gov (United States)

    Werner-Gibbings, Keagan; Dubenec, Steven

    2017-06-01

    Endovascular interventions are increasingly utilized in managing occlusive peripheral vascular disease. Angioplasty and stenting remain the mainstay of endovascular management; however, newer treatment modalities such as excisional atherectomy provide the clinician with additional treatment options. While demonstrating promising results in available trials, a paucity of data exist regarding peripheral atherectomy. The purpose of this retrospective clinical study was to assess the efficacy and safety of excisional atherectomy with the TurboHawk atherectomy device (Covidien/ev3, Plymouth, MN, USA) in the treatment of lower limb peripheral vascular disease and to evaluate the learning curve involved in the institution of a new treatment modality. A retrospective analysis was performed on all patients undergoing atherectomy for symptomatic lower limb peripheral vascular disease by a single clinician between November 2011 and June 2013. Forty-seven vessels on 28 legs in 24 patients were treated during the period. Atherectomy was possible in 98% of cases. The 6- and 12-month primary patency was 72.6 and 58.9%, respectively. The primary-assisted patency was 93.2% at 6 months and 74.6% at 12 months. There were significantly greater patency rates in the TransAtlantic Inter-Society Consensus A + B lesions and a non-significant trend towards improved patency rates in claudicants versus critical limb ischaemia. There were four instances of embolization and four cases of dissection. Excisional atherectomy provides a further option for the minimally invasive management of peripheral vascular disease. It has similar patency rates to established endovascular therapies and should be considered among the treatment options in patients with favourable pathology. © 2014 Royal Australasian College of Surgeons.

  18. Photobiomodulation by helium neon and diode lasers in an excisional wound model: A single blinded trial

    Directory of Open Access Journals (Sweden)

    Snehil Dixit

    2012-01-01

    Full Text Available Background: Application of different kinds of lasers in clinical and experimental studies causes photobiomodulation that works at localized cellular and humoral level on various biological systems. Increased numbers of fibroblasts, myofibroblast, and degranulation of mast cells have been the observed benefits post-irradiation. Objective: Was to find out the effect of irradiation with energy densities of 3.38 J/cm 2 , 8 J/cm 2 , and 18 J/cm 2 on animal tissue (albino wistar rats in an excisional wound model and to assess changes in biochemical (hydroxyproline and histopathological levels in excisional wound model. Materials and Methods: The animals were divided into 4 groups, which were labeled as L1, diode laser (18 J/cm 2 , L2 Helium-neon (He-Ne, 8 J/cm 2 , L3 diode laser (3.38 J/cm 2 , and sham treatment for control was depicted by C, respectively. Histological and hydroxyproline analysis was performed on 7, 14, 21 days of post-wounding. One-way analysis of variance, ANOVA and Bonferroni′s multiple comparison tests were done for tissue hydroxyproline levels. Results: There was no significant increase in the hydroxyproline content (P < 0.005 when observed in study group and compared to controls. Whereas significant epithelizations was seen in group treated with He-Ne laser of intensity of 8 J/cm 2 . Conclusion: The experimental observations suggest that low intensity helium-neon laser of 8 J/cm 2 intensity facilitated photo stimulation by tissue repair, but failed to show significant tissue hydroxyproline levels in excisional wound model.

  19. Altered procollagen gene expression in mid-gestational mouse excisional wounds.

    Science.gov (United States)

    Goldberg, Stephanie R; Quirk, Gerald L; Sykes, Virginia W; Kordula, Tomasz; Lanning, David A

    2007-11-01

    Many pathologic conditions are characterized by excessive tissue contraction and scar formation. Previously, we developed a murine model of excisional wound healing in which mid-gestational wounds heal scarlessly compared with late-gestational wounds. We theorized that variations in procollagen gene expression may contribute to the scarless and rapid closure. Time-dated pregnant FVB strain mice underwent laparotomy and hysterotomy on embryonic days 15 (E15) and 18 (E18). Full-thickness, excisional wounds (3 mm) were made on each of 4 fetuses per doe and then harvested at 32, 48, or 72 h. Control tissue consisted of age-matched normal fetal skin. Procollagen types 1alpha1, 1alpha2, and 3 gene expressions were measured by real-time polymerase chain reaction and normalized to glyceraldehyde-3-phosphate dehydrogenase. Trichrome staining was also performed. Procollagen 1alpha1 expression was decreased in E15 wounds at 32 h compared with their normal skin groups. Procollagen types 1alpha2 and 3 expressions were both increased in the E15 groups compared with the E18 groups at 48 h. At 72 h, the E15 wounds had a collagen density similar to the surrounding normal skin while E18 wounds exhibited increased collagen deposition in a disorganized pattern. This study demonstrates that the pattern of gene expression for types 1 and 3 collagen varies between mid- and late-gestational mouse excisional wounds. These alterations in procollagen expression may contribute to a pattern of collagen deposition in the mid-gestational fetuses that is more favorable for scarless healing with less type 1 and more type 3 collagen.

  20. Efficacy of Mesoglycan in Pain Control after Excisional Hemorrhoidectomy: A Pilot Comparative Prospective Multicenter Study

    Directory of Open Access Journals (Sweden)

    Gaetano Gallo

    2018-01-01

    Full Text Available Introduction. Various pain management strategies for patients undergoing open excisional hemorrhoidectomy have been proposed, yet postoperative pain remains a frequent complaint. Objective. To determine whether mesoglycan (30 mg two vials i.m. once/day for the first 5 days postoperative, followed by 50 mg 1 oral tablet twice/day for 30 days would reduce the edema of the mucocutaneous bridges and thus improve postoperative pain symptoms. Patients and Methods. For this prospective observational multicenter study, 101 patients undergoing excisional diathermy hemorrhoidectomy for III-IV degree hemorrhoidal disease were enrolled at 5 colorectal referral centers. Patients were assigned to receive either mesoglycan (study group SG or a recommended oral dose of ketorolac tromethamine of 10 mg every 4–6 hours, not exceeding 40 mg per day and not exceeding 5 postoperative days according to the indications for short-term management of moderate/severe acute postoperative pain, plus stool softeners (control group CG. Results. Postoperative thrombosis (SG 1/48 versus CG 5/45 (p<0.001 and pain after rectal examination (p<0.001 were significantly reduced at 7–10 days after surgery in the mesoglycan-treated group, permitting a faster return to work (p<0.001; however, in the same group, the incidence of postoperative bleeding, considered relevant when needing a readmission or an unexpected outpatient visit, was higher, possibly owing to the drug’s antithrombotic properties. Conclusions. The administration of mesoglycan after an open diathermy excisional hemorrhoidectomy can reduce postoperative thrombosis and pain at 7–10 days after surgery, permitting a faster return to normal activities.

  1. How Frequency of Electrosurgical Current and Electrode Size Affect the Depth of Electrocoagulation.

    Science.gov (United States)

    Taheri, Arash; Mansoori, Parisa; Bahrami, Naeim; Alinia, Hossein; Watkins, Casey E; Feldman, Steven R

    2016-02-01

    Many factors affect the depth of electrocoagulation. To evaluate the effect of current frequency and electrode size on the depth of electrocoagulation. In this in vitro study, 4 cylindrical electrodes (2, 2.3, 3, and 4 mm) were used to apply 3 electrosurgical currents (0.4, 1.5, and 3 MHz) to bovine liver. Each electrode was placed at different points on the surface of the liver, and energy at various levels and frequencies was delivered to the tissue. Subsequently, cross-sections of the liver were analyzed. Coagulation started at the periphery of the electrode-tissue contact area. With higher energy levels, coagulation spreads to involve the remainder of the contact area. Neither the frequency nor the electrode size had any effect on this coagulation pattern. The frequency of the current also did not show any relation with depth of coagulation; however, there was a direct correlation between the size of the electrode and the depth of coagulation. Larger-tip electrodes provided deeper coagulation compared with finer-tip electrodes.

  2. Operating room fire prevention: creating an electrosurgical unit fire safety device.

    Science.gov (United States)

    Culp, William C; Kimbrough, Bradly A; Luna, Sarah; Maguddayao, Aris J

    2014-08-01

    To reduce the incidence of surgical fires. Operating room fires represent a potentially life-threatening hazard and are triggered by the electrosurgical unit (ESU) pencil. Carbon dioxide is a fire suppressant and is a routinely used medical gas. We hypothesize that a shroud of protective carbon dioxide covering the tip of the ESU pencil displaces oxygen, thereby preventing fire ignition. Using 3-dimensional modeling techniques, a polymer sleeve was created and attached to an ESU pencil. This sleeve was connected to a carbon dioxide source and directed the gas through multiple precisely angled ports, generating a cone of fire-suppressive carbon dioxide surrounding the active pencil tip. This device was evaluated in a flammability test chamber containing 21%, 50%, and 100% oxygen with sustained ESU activation. The sleeve was tested with and without carbon dioxide (control) until a fuel was ignited or 30 seconds elapsed. Time to ignition was measured by high-speed videography. Fires were ignited with each control trial (15/15 trials). The control group median ± SD ignition time in 21% oxygen was 3.0 ± 2.4 seconds, in 50% oxygen was 0.1 ± 1.8 seconds, and in 100% oxygen was 0.03 ± 0.1 seconds. No fire was observed when the fire safety device was used in all concentrations of oxygen (0/15 trials; P fire ignition was 76% to 100%. A sleeve creating a cone of protective carbon dioxide gas enshrouding the sparks from an ESU pencil effectively prevents fire in a high-flammability model. Clinical application of this device may reduce the incidence of operating room fires.

  3. Excisional biopsy, auxillary node dissection and definitive radiotherapy for Stages I and II breast cancer

    International Nuclear Information System (INIS)

    Danoff, B.F.; Pajak, T.F.; Solin, L.J.; Goodman, R.L.

    1985-01-01

    From 1977 to 1982, 189 patients with clinical Stage I and II breast cancer underwent excisional biopsy and auxillary node dissection followed by definitive radiotherapy at the University of Pennsylvania. One hundred and nine patients had T 1 lesions and 80 had T 2 lesions. Histologically negative nodes were found in 136 patients (72%) and histologically positive nodes in 53 patients. Median follow-up from the completion of radiotherapy was 26 months. The four year actuarial disease free survival is 82% for pathologic Stage I and 70% for pathologic Stage II. Cosmesis was judged to be good to excellent in 90% and fair in 9%. Complications included arm edema (7%), symptomatic pneumonitis (1%), rib fractures (1%), pericarditis (1%) and pleural effusion (1%). Primary radiotherapy for Stages I and II breast cancer produces a local-regional control rate of 95% and good to excellent cosmesis in 90% of the patients. While these results are preliminary, they compare favorably with other reported series

  4. Scar formation following excisional and burn injuries in a red Duroc pig model.

    Science.gov (United States)

    Blackstone, Britani N; Kim, Jayne Y; McFarland, Kevin L; Sen, Chandan K; Supp, Dorothy M; Bailey, J Kevin; Powell, Heather M

    2017-08-01

    Scar research is challenging because rodents do not naturally form excessive scars, and burn depth, size, and location cannot be controlled in human longitudinal studies. The female, red Duroc pig model has been shown to form robust scars with biological and anatomical similarities to human hypertrophic scars. To more closely mimic the mode of injury, recreate the complex chemical milieu of the burn wound environment and enhance scar development, an animal model of excessive burn-induced scarring was developed and compared with the more commonly used model, which involves excisional wounds created via dermatome. Standardized, full-thickness thermal wounds were created on the dorsum of female, red Duroc pigs. Wounds for the dermatome model were created using two different total dermatome settings: ∼1.5 mm and ≥ 1.9 mm. Results from analysis over 150 days showed that burn wounds healed at much slower rate and contracted more significantly than dermatome wounds of both settings. The burn scars were hairless, had mixed pigmentation, and displayed fourfold and twofold greater excess erythema values, respectively, compared with ∼1.5 mm and ≥ 1.9 mm deep dermatome injuries. Burn scars were less elastic, less pliable, and weaker than scars resulting from excisional injuries. Decorin and versican gene expression levels were elevated in the burn group at day 150 compared with both dermatome groups. In addition, transforming growth factor-beta 1 was significantly up-regulated in the burn group vs. the ∼1.5 mm deep dermatome group at all time points, and expression remained significantly elevated vs. both dermatome groups at day 150. Compared with scars from dermatome wounds, the burn scar model described here demonstrates greater similarity to human hypertrophic scar. Thus, this burn scar model may provide an improved platform for studying the pathophysiology of burn-related hypertrophic scarring, investigating current anti-scar therapies, and development of

  5. Excisional wound healing is delayed in a murine model of chronic kidney disease.

    Directory of Open Access Journals (Sweden)

    Akhil K Seth

    Full Text Available BACKGROUND: Approximately 15% of the United States population suffers from chronic kidney disease (CKD, often demonstrating an associated impairment in wound healing. This study outlines the development of a surgical murine model of CKD in order to investigate the mechanisms underlying this impairment. METHODS: CKD was induced in mice by partial cauterization of one kidney cortex and contralateral nephrectomy, modifying a previously published technique. After a minimum of 6-weeks, splinted, dorsal excisional wounds were created to permit assessment of wound healing parameters. Wounds were harvested on postoperative days (POD 0, 3, 7, and 14 for histological, immunofluorescent, and quantitative PCR (qPCR. RESULTS: CKD mice exhibited deranged blood chemistry and hematology profiles, including profound uremia and anemia. Significant decreases in re-epithelialization and granulation tissue deposition rates were found in uremic mice wounds relative to controls. On immunofluorescent analysis, uremic mice demonstrated significant reductions in cellular proliferation (BrdU and angiogenesis (CD31, with a concurrent increase in inflammation (CD45 as compared to controls. CKD mice also displayed differential expression of wound healing-related genes (VEGF, IL-1β, eNOS, iNOS on qPCR. CONCLUSIONS: These findings represent the first reported investigation of cutaneous healing in a CKD animal model. Ongoing studies of this significantly delayed wound healing phenotype include the establishment of renal failure model in diabetic strains to study the combined effects of CKD and diabetes.

  6. CO2 and diode laser for excisional biopsies of oral mucosal lesions. A pilot study evaluating clinical and histopathological parameters.

    Science.gov (United States)

    Suter, Valérie G A; Altermatt, Hans Jörg; Sendi, Pedram; Mettraux, Gérald; Bornstein, Michael M

    2010-01-01

    The present pilot study evaluates the histopathological characteristics and suitability of CO2 and diode lasers for performing excisional biopsies in the buccal mucosa with special emphasis on the extent of the thermal damage zone created. 15 patients agreed to undergo surgical removal of their fibrous hyperplasias with a laser. These patients were randomly assigned to one diode or two CO2 laser groups. The CO2 laser was used in a continuous wave mode (cw) with a power of 5 W (Watts), and in a pulsed char-free mode (cf). Power settings for the diode laser were 5.12 W in a pulsed mode. The thermal damage zone of the three lasers and intraoperative and postoperative complications were assessed and compared. The collateral thermal damage zone on the borders of the excisional biopsies was significantly smaller with the CO, laser for both settings tested compared to the diode laser regarding values in pm or histopathological index scores. The only intraoperative complication encountered was bleeding, which had to be controlled with electrocauterization. No postoperative complications occurred in any of the three groups. The CO2 laser seems to be appropriate for excisional biopsies of benign oral mucosal lesions. The CO2 laser offers clear advantages in terms of smaller thermal damage zones over the diode laser. More study participants are needed to demonstrate potential differences between the two different CO2 laser settings tested.

  7. Comparison of stapled haemorrhoidopexy with traditional excisional surgery for haemorrhoidal disease (eTHoS): a pragmatic, multicentre, randomised controlled trial.

    Science.gov (United States)

    Watson, Angus J M; Hudson, Jemma; Wood, Jessica; Kilonzo, Mary; Brown, Steven R; McDonald, Alison; Norrie, John; Bruhn, Hanne; Cook, Jonathan A

    2016-11-12

    Two commonly performed surgical interventions are available for severe (grade II-IV) haemorrhoids; traditional excisional surgery and stapled haemorrhoidopexy. Uncertainty exists as to which is most effective. The eTHoS trial was designed to establish the clinical effectiveness and cost-effectiveness of stapled haemorrhoidopexy compared with traditional excisional surgery. The eTHoS trial was a large, open-label, multicentre, parallel-group, pragmatic randomised controlled trial done in adult participants (aged 18 years or older) referred to hospital for surgical treatment for grade II-IV haemorrhoids. Participants were randomly assigned (1:1) to receive either traditional excisional surgery or stapled haemorrhoidopexy. Randomisation was minimised according to baseline EuroQol 5 dimensions 3 level score (EQ-5D-3L), haemorrhoid grade, sex, and centre with an automated system to stapled haemorrhoidopexy or traditional excisional surgery. The primary outcome was area under the quality of life curve (AUC) measured with the EQ-5D-3L descriptive system over 24 months, assessed according to the randomised groups. The primary outcome measure was analysed using linear regression with adjustment for the minimisation variables. This trial is registered with the ISRCTN registry, number ISRCTN80061723. Between Jan 13, 2011, and Aug 1, 2014, 777 patients were randomised (389 to receive stapled haemorrhoidopexy and 388 to receive traditional excisional surgery). Stapled haemorrhoidopexy was less painful than traditional excisional surgery in the short term and surgical complication rates were similar between groups. The EQ-5D-3L AUC score was higher in the traditional excisional surgery group than the stapled haemorrhoidopexy group over 24 months; mean difference -0·073 (95% CI -0·140 to -0·006; p=0·0342). EQ-5D-3L was higher for stapled haemorrhoidopexy in the first 6 weeks after surgery, the traditional excisional surgery group had significantly better quality of life

  8. Specific sizes of hyaluronan oligosaccharides stimulate fibroblast migration and excisional wound repair.

    Directory of Open Access Journals (Sweden)

    Cornelia Tolg

    Full Text Available The extracellular matrix polysaccharide hyaluronan (HA plays a key role in both fibrotic and regenerative tissue repair. Accumulation of high molecular weight HA is typical of regenerative repair, which is associated with minimal inflammation and fibrosis, while fragmentation of HA is typical of postnatal wounds, which heal in the presence of inflammation and transient fibrosis. It is generally considered that HA oligosaccharides and fragments of a wide size range support these processes of adult, fibrotic wound repair yet the consequences of sized HA fragments/oligosaccharides to each repair stage is not well characterized. Here, we compared the effects of native HA, HA oligosaccharide mixtures and individual sizes (4-10 mer oligosaccharides, 5 and, 40 kDa of HA oligosaccharides and fragments, on fibroblast migration in scratch wound assays and on excisional skin wound repair in vivo. We confirm that 4-10 mer mixtures significantly stimulated scratch wound repair and further report that only the 6 and 8 mer oligosaccharides in this mixture are responsible for this effect. The HA 6 mer promoted wound closure, accumulation of wound M1 and M2 macrophages and the M2 cytokine TGFβ1, but did not increase myofibroblast differentiation. The effect of 6 mer HA on wound closure required both RHAMM and CD44 expression. In contrast, The 40 kDa HA fragment inhibited wound closure, increased the number of wound macrophages but had no effect on TGFβ1 accumulation or subsequent fibrosis. These results show that specific sizes of HA polymer have unique effects on postnatal wound repair. The ability of 6 mer HA to promote wound closure and inflammation resolution without increased myofibroblast differentiation suggests that this HA oligosaccharide could be useful for treatment of delayed or inefficient wound repair where minimal fibrosis is advantageous.

  9. Tissue responses to postoperative laser therapy in diabetic rats submitted to excisional wounds.

    Directory of Open Access Journals (Sweden)

    Cristiano de Loura Santana

    Full Text Available In a previous study about low-level laser therapy biomodulation on a full-thickness burn model we showed that single and fractionated dose regimens increased wound healing and leukocyte influx similarly when compared with untreated control. In order to verify if this finding would be similar in an impaired wound model, we investigated the effect of single and multiple irradiations on wound closure rate, type of inflammatory infiltrate, myofibroblasts, collagen deposition, and optical retardation of collagen in diabetic rats. Female Wistar rats in the same estrous cycle had diabetes induced with streptozotocin and an 8-mm excisional wound performed with a punch. The experimental groups were: control group--untreated ulcer; single-dose group--ulcer submitted to single dose of diode laser therapy (λ = 660 ± 2 nm; P = 30 mW; energy density: 4 J/cm2 and fractionated-dose group--ulcer submitted to 1 J/cm2 laser therapy on Days 1, 3, 8, and 10. The ulcers were photographed on the experimental days and after euthanasia tissue samples were routinely processed for histological and immunohistochemistry analyses. Independently of the energy density, laser therapy accelerated wound closure by approximately 40% in the first three days in comparison to the control group. Laser therapy increased acute inflammatory infiltrate until Day 3. Both laser groups exhibited more myofibroblasts and better collagen organization than the control group. The findings demonstrate that low-level laser therapy in the immediate postoperative period can enhance the tissue repair process in a diabetes model. Similar effects were achieved with laser therapy applied a single time with an energy density of 4 J/cm2 and applied four times with an energy density of 1 J/cm2. The application of laser therapy in the inflammatory phase was the most important factor to the enhancement of the tissue repair process.

  10. Abdominal fat pad excisional biopsy for the diagnosis and typing of systemic amyloidosis.

    Science.gov (United States)

    Garcia, Yessica; Collins, A Bernard; Stone, James R

    2018-02-01

    In the past, the diagnosis and typing of amyloidosis often required an invasive biopsy of an internal organ, such as the heart or kidneys. Abdominal fat pad excisional biopsy (FPEB) offers a less invasive approach, but the sensitivity of this technique has been unclear. To determine the sensitivity of FPEB for immunoglobulin light chain (AL) and transthyretin (ATTR) amyloidosis, we performed a retrospective clinicopathologic analysis of 97 patients who had undergone FPEB, of which 16 were positive for amyloid. The most significant pretest feature predicting a positive FPEB was a serum free light chain κ/λ ratio less than .5, and in this group of patients the probability of a positive biopsy was dependent on the size of the biopsy (P=.004). In FPEBs, the amyloid was present in multiple distinct patterns: pericellular, septal, medium-sized vessel, small vessel, and nodular. For patients with AL amyloidosis for which direct typing was attempted using the FPEB tissue, the amyloid was successfully typed in the FPEB in 90% of cases. The overall sensitivity of FPEB was 79% for AL amyloidosis and 12% for ATTR amyloidosis (P=.0003). In patients with AL amyloidosis, the sensitivity of FPEB was dependent on biopsy size, with small biopsies (≤700 mm 3 ) having a sensitivity of ~50%, and large biopsies (>700 mm 3 ) having a sensitivity of ~100%. This study demonstrates that FPEB has high sensitivity for AL amyloidosis, and can be routinely used to type the amyloid. However, FPEB has low sensitivity for ATTR amyloidosis in our patient population. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Research of electrosurgical unit with novel antiadhesion composite thin film for tumor ablation: Microstructural characteristics, thermal conduction properties, and biological behaviors.

    Science.gov (United States)

    Shen, Yun-Dun; Lin, Li-Hsiang; Chiang, Hsi-Jen; Ou, Keng-Liang; Cheng, Han-Yi

    2016-01-01

    The objective of this study was to use surface functionalization to evaluate the antiadhesion property and thermal injury effects on the liver when using a novel electrosurgical unit with nanostructured-doped diamond-like carbon (DLC-Cu) thin films for tumor ablations. The physical and chemical properties of DLC-Cu thin films were characterized by contact angle goniometer, scanning electron microscope, and transmission electron microscope. Three-dimensional (3D) hepatic models were reconstructed using magnetic resonance imaging to simulate a clinical electrosurgical operation. The results indicated a significant increase of the contact angle on the nanostructured DLC-Cu thin films, and the antiadhesion properties were also observed in an animal model. Furthermore, the surgical temperature in the DLC-Cu electrosurgical unit was found to be significantly lower than the untreated unit when analyzed using 3D models and thermal images. In addition, DLC-Cu electrodes caused a relatively small injury area and lateral thermal effect. The results indicated that the nanostructured DLC-Cu thin film coating reduced excessive thermal injury and tissue adherence effect in the liver. © 2015 Wiley Periodicals, Inc.

  12. Injectable Polyurethane Composite Scaffolds Delay Wound Contraction and Support Cellular Infiltration and Remodeling in Rat Excisional Wounds

    Science.gov (United States)

    Adolph, Elizabeth J.; Hafeman, Andrea E.; Davidson, Jeffrey M.; Nanney, Lillian B.; Guelcher, Scott A.

    2011-01-01

    Injectable scaffolds present compelling opportunities for wound repair and regeneration due to their ability to fill irregularly shaped defects and deliver biologics such as growth factors. In this study, we investigated the properties of injectable polyurethane biocomposite scaffolds and their application in cutaneous wound repair using a rat excisional model. The scaffolds have a minimal reaction exotherm and clinically relevant working and setting times. Moreover, the biocomposites have mechanical and thermal properties consistent with rubbery elastomers. In the rat excisional wound model, injection of settable biocomposite scaffolds stented the wounds at early time points, resulting in a regenerative rather than a scarring phenotype at later time points. Measurements of wound width and thickness revealed that the treated wounds were less contracted at day 7 compared to blank wounds. Analysis of cell proliferation and apoptosis showed that the scaffolds were biocompatible and supported tissue ingrowth. Myofibroblast formation and collagen fiber organization provided evidence that the scaffolds have a positive effect on extracellular matrix remodeling by disrupting the formation of an aligned matrix under elevated tension. In summary, we have developed an injectable biodegradable polyurethane biocomposite scaffold that enhances cutaneous wound healing in a rat model. PMID:22105887

  13. Benign core biopsy of probably benign breast lesions 2 cm or larger: correlation with excisional biopsy and long-term follow-up

    OpenAIRE

    Jung, Hyun Kyung; Moon, Hee Jung; Kim, Min Jung; Kim, Eun-Kyung

    2014-01-01

    Purpose: To evaluate the accuracy of benign core biopsy of probably benign breast lesions (category 3) 2 cm or larger on the basis of excisional biopsy and long-term follow-up. Methods: We retrospectively reviewed 146 category 3 lesions in 146 patients 2 cm or larger which were diagnosed as benign by ultrasound (US)-guided core biopsy. Patients were initially diagnosed as benign at core needle biopsy and then followed up with excisional biopsy (surgical excision, n=91; US-guided vacuum assist...

  14. Case study: Solitary intra-cystic papilloma - Advances in consultant radiographic practitioner led ultrasound guided mammotome excisional biopsy

    International Nuclear Information System (INIS)

    Lawson, Sarah

    2008-01-01

    Working practices in Breast Radiology have changed and advanced in the past few years, resulting in an increase in the number of small, indeterminate, non-palpable breast lesions detected. One such lesion is the breast papillary lesion which is essentially an epithelial proliferation with an associate increased risk of breast carcinoma. The current management of an intra-cystic breast papilloma diagnosed by 14 g core biopsy is highly contentious as traditionally management is by surgical biopsy. Recent advances have demonstrated that excision by 8 or 11-gauge Ultrasound guided Mammotomy can be a safe alternative, allowing non-operative removal. The consultant radiographic practitioner role has been integral in establishing the policies needed to support and establish ultrasound guided Mammotome excisional biopsy

  15. Peripheral Lymph Node Excisional Biopsy: Yield, Relevance, and Outcomes in a Remote Surgical Setup

    Directory of Open Access Journals (Sweden)

    Ashish Lal Shrestha

    2018-01-01

    Full Text Available Objective. To study the patient profile for symptomatic peripheral lymphadenopathy in terms of histopathological findings and demography and evaluate the yield, relevance, and outcomes of peripheral lymph node biopsy (PLNB as a diagnostic step in a remote setup in the absence of less invasive options like fine-needle aspiration cytology (FNAC or ultrasonogram- (USG- guided FNAC. Methods. A retrospective review of patients undergoing PLNB between 1 May 2011 and 30 April 2013 was done. Demographics, histopathological reports, and outcomes were studied. Results. Of 132 patients, 51 (38.63% were male and 81 (61.36% were female. There were 48 (36.3% patients in the age group less than 16 years, and 84 (63.6% were beyond 16 years. The commonest site of biopsy was the neck in 114 (86.36% patients. The histopathological diagnosis was tuberculosis (TB in 60 (45.45% patients, reactive lymphadenitis in 29 (21.9%, nonspecific granuloma in 18 (13.6%, lymphoma in 7 (5.3%, acute lymphadenitis in 7 (5.3%, metastatic secondary in 3 (2.2%, and other benign causes in 8 (6.06%. Conclusions. PLNB is a procedure with good diagnostic yield in evaluation of peripheral lymphadenopathy. Its relevance is appreciable in a remote setup where less invasive options are unavailable. Its simplicity and lack of mortality/significant morbidity make it a valid option in rural surgical practice.

  16. Curcuma purpurascens BI. rhizome accelerates rat excisional wound healing: involvement of Hsp70/Bax proteins, antioxidant defense, and angiogenesis activity

    Science.gov (United States)

    Rouhollahi, Elham; Moghadamtousi, Soheil Zorofchian; Hajiaghaalipour, Fatemeh; Zahedifard, Maryam; Tayeby, Faezeh; Awang, Khalijah; Abdulla, Mahmood Ameen; Mohamed, Zahurin

    2015-01-01

    Purpose Curcuma purpurascens BI. is a member of Zingiberaceae family. The purpose of this study is to investigate the wound healing properties of hexane extract of C. purpurascens rhizome (HECP) against excisional wound healing in rats. Materials and methods Twenty four rats were randomly divided into 4 groups: A) negative control (blank placebo, acacia gum), B) low dose of HECP, C) high dose of HECP, and D) positive control, with 6 rats in each group. Full-thickness incisions (approximately 2.00 cm) were made on the neck area of each rat. Groups 1–4 were treated two-times a day for 20 days with blank placebo, HECP (100 mg/kg), HECP (200 mg/kg), and intrasite gel as a positive control, respectively. After 20 days, hematoxylin and eosin and Masson’s trichrome stainings were employed to investigate the histopathological alterations. Protein expressions of Bax and Hsp70 were examined in the wound tissues using immunohistochemistry analysis. In addition, levels of enzymatic antioxidants and malondialdehyde representing lipid peroxidation were measured in wound tissue homogenates. Results Macroscopic evaluation of wounds showed conspicuous elevation in wound contraction after topical administration of HECP at both doses. Moreover, histopathological analysis revealed noteworthy reduction in the scar width correlated with the enhanced collagen content and fibroblast cells, accompanied by a reduction of inflammatory cells in the granulation tissues. At the molecular level, HECP facilitates wound-healing process by downregulating Bax and upregulating Hsp70 protein at the wound site. The formation of new blood vessel was observed in Masson’s trichrome staining of wounds treated with HECP (100 and 200 mg/kg). In addition, HECP administration caused a significant surge in enzymatic antioxidant activities and a decline in lipid peroxidation. Conclusion These findings suggested that HECP accelerated wound-healing process in rats via antioxidant activity, angiogenesis

  17. The N-butyl alcohol extract from Hibiscus rosa-sinensis L. flowers enhances healing potential on rat excisional wounds.

    Science.gov (United States)

    Shen, Hui-Min; Chen, Chun; Jiang, Ji-Yang; Zheng, Yi-Lin; Cai, Wen-Feng; Wang, Bin; Ling, Zhen; Tang, Liu; Wang, Yuan-Hang; Shi, Gang-Gang

    2017-02-23

    Hibiscus rosa-sinensis L. (HRS), a folk medicine named Zhujin in China, possess anti-tumor, antioxidant, antibacterial, low density lipoprotein oxidation prevention and macrophage death prevention effects. The leaves and red flowers of HRS have been traditionally used to treat with furuncle and ulceration. To investigate the efficacy and possible mechanism of the N-butyl alcohol extract of HRS (NHRS) red flowers in wound healing by analyzing the collagen fiber deposition, angiogenic activity and macrophages action of the NHRS. In an excisional wound healing model in rats, different concentrations of NHRS, or recombinant bovine basic fibroblast growth factor (rbFGF), were respectively applied twice daily for 9 days. Histopathology was assessed on day 9 via hematoxylin and eosin (HE) and Masson's trichrome (MT) staining, and immunohistochemistry for vascular endothelial growth factor (VEGF), transforming growth factor-β1 (TGF-β1) and CD68. Immunomodulation by NHRS was evaluated by a carbon clearance test in mice. Wound healing post-surgery was greater in the rbFGF-control, NHRS-M and MHRS-H groups than in the model and 5% dimethylsulfoxide (DMSO)-control groups after the third day. By the sixth day the wound contraction of NHRS-M and MHRS-H groups was much higher than the rbFGF-control group. HE and MT staining revealed that epithelialization, fibroblast distribution, collagen deposition of NHRS-M- and NHRS-H-control groups were significantly higher than the model group. Moreover, immunohistochemistry showed more intense staining of VEGF, TGF-β1 and CD68 in the rbFGF- and NHRS-control groups, compared to that in model and 5% DMSO-control groups. The clearance and phagocytic indices of NHRS-M- and NHRS-H-control groups were significantly higher than that of the carboxyl methyl cellulose (CMC) group in mice. NHRS accelerates wound repair via enhancing the macrophages activity, accelerating angiogenesis and collagen fiber deposition response mediated by VEGF and TGF

  18. Pathological discrepancy between colposcopic directed cervical biopsy and Loop Electrosurgical-Excision Procedures (LEEPs in patients with biopsies proven high grade cervical intraepithelial neoplasia

    Directory of Open Access Journals (Sweden)

    Sitchuphong Noothong

    2017-10-01

    Conclusion: The prevalence of patients with CIN1 or less from LEEP specimens who previously had colposcopic biopsies proven CIN2 or 3 was 16.3%. CIN2 from biopsy was the statistically significant risk factor of CIN1 or less in LEEP specimens.

  19. An Electrosurgical Endoknife with a Water-Jet Function (Flushknife Proves Its Merits in Colorectal Endoscopic Submucosal Dissection Especially for the Cases Which Should Be Removed En Bloc

    Directory of Open Access Journals (Sweden)

    Yoji Takeuchi

    2013-01-01

    Full Text Available Background. Previously, we reported that the Flushknife (electrosurgical endoknife with a water-jet function could reduce the operation time of colorectal endoscopic submucosal dissection (ESD however, suitable situation for the Flushknife was obscure. This subgroup analysis of a prospective randomized controlled trial was aimed to investigate the suitable situation for the Flushknife. Methods. A total of 48 superficial colorectal neoplasms that underwent ESD using either the Flexknife or the Flushknife in a referral center were enrolled. The differences of operation time between the Flexknife and the Flushknife groups in each subgroup (tumor size, location, and macroscopic type were analyzed. Results. Median (95% CI operation time calculated using survival curves was significantly shorter in the Flushknife group than in the Flexknife group (55.5 min [41, 78] versus 74.0 [57, 90] min; , Hazard Ratio HR: 0.53; 95% CI (0.29–0.97. In particular, the HR in patients with laterally spreading tumors-nongranular type (LST-NG in the Flushknife group was significantly smaller than in the Flexknife group (HR: 0.1650.17; 95% CI (0.04–0.66. There was a trend of decreasing HRs according to larger lesion size. Conclusions. The Flushknife proved its merits in colorectal ESD especially for the lesions which should be removed en bloc (LST-NG and large lesion.

  20. Benign core biopsy of probably benign breast lesions 2 cm or larger: correlation with excisional biopsy and long-term follow-up

    International Nuclear Information System (INIS)

    Jung, Hyun Kyung; Moon, Hee Jung; Kim, Min Jung; Kim, Eun Kyung

    2014-01-01

    To evaluate the accuracy of benign core biopsy of probably benign breast lesions (category 3) 2 cm or larger on the basis of excisional biopsy and long-term follow-up. We retrospectively reviewed 146 category 3 lesions in 146 patients 2 cm or larger which were diagnosed as benign by ultrasound (US)-guided core biopsy. Patients were initially diagnosed as benign at core needle biopsy and then followed up with excisional biopsy (surgical excision, n=91; US-guided vacuum assisted excision, n=35) or breast ultrasonography (n=20). Of the 126 patients who underwent surgical excision or US-guided vacuum-assisted excision, 114 patients were diagnosed with benign lesions, 10 patients with borderline lesions (benign phyllodes tumor), and two patients with malignant phyllodes tumors. The probabilities of lesions being benign, borderline and malignant were 91.8% (134/146), 6.8% (10/146), and 1.4% (2/146), respectively. Of 13 patients who had growing masses on follow-up ultrasonography, three (23.1%) were non-benign (two benign phyllodes tumors and one malignant phyllodes tumor). US-guided core needle biopsy of probably benign breast mass 2 cm or larger was accurate (98.6%) enough to rule out malignancy. But, it was difficult to rule out borderline lesions even when they were diagnosed as benign.

  1. [Selective biopsy of the sentinel lymph node in patients with breast cancer and previous excisional biopsy: is there a change in the reliability of the technique according to time from surgery?].

    Science.gov (United States)

    Sabaté-Llobera, A; Notta, P C; Benítez-Segura, A; López-Ojeda, A; Pernas-Simon, S; Boya-Román, M P; Bajén, M T

    2015-01-01

    To assess the influence of time on the reliability of sentinel lymph node biopsy (SLNB) in breast cancer patients with previous excisional biopsy (EB), analyzing both the sentinel lymph node detection and the lymph node recurrence rate. Thirty-six patients with cT1/T2 N0 breast cancer and previous EB of the lesion underwent a lymphoscintigraphy after subdermal periareolar administration of radiocolloid, the day before SLNB. Patients were classified into two groups, one including 12 patients with up to 29 days elapsed between EB and SLNB (group A), and another with the remaining 24 in which time between both procedures was of 30 days or more (group B). Scintigraphic and surgical detection of the sentinel lymph node, histological status of the sentinel lymph node and of the axillary lymph node dissection, if performed, and lymphatic recurrences during follow-up, were analyzed. Sentinel lymph node visualization at the lymphoscintigraphy and surgical detection were 100% in both groups. Histologically, three patients showed macrometastasis in the sentinel lymph node, one from group A and two from group B. None of the patients, not even those with malignancy of the sentinel lymph node, relapsed after a medium follow-up of 49.5 months (24-75). Time elapsed between EB and SLNB does not influence the reliability of this latter technique as long as a superficial injection of the radiopharmaceutical is performed, proving a very high detection rate of the sentinel lymph node without evidence of lymphatic relapse during follow-up. Copyright © 2014 Elsevier España, S.L.U. and SEMNIM. All rights reserved.

  2. One-Session Management of Cervical Intraepithelial Neoplasia: A Solution for Developing Countries. A Prospective, Randomized Trial of LEEP versus Laser Excisional Conization

    Science.gov (United States)

    Santos; Galdos; Alvarez; Velarde; Barriga; Dyer; Estrada; Almonte

    1996-04-01

    Six hundred thirty-nine patients with CIN on referral Pap were evaluated cytocolposcopically at the first visit and decided whether to be treated the same day or not. One hundred ninety-two patients (30%) were considered negative. Follow-up evidenced later appearance of CIN in five of them. One hundred fifty-three (24%) were candidates for delayed treatment due to conditions contraindicating same-day treatment. Two hundred ninety-four patients (46%) were randomly allocated in LEEP (149) or excisional laser (145) arms, and treated the same day under local anesthesia. Both arms were comparable. There were three microinvasive carcinomas diagnosed in the surgical specimen. LEEP was faster and produced less bleeding than laser, although required a mean of four slices to remove the lesion. Arterial hypertension after anesthetic infiltration was detected in 26% of cases. Two intraoperative and two delayed bleeders required surgery. The size of lesion and surgical defect were larger than those reported in the literature. Margins were involved in 8 patients (2.7%). Only 4.7% (7/149) of patients randomized to LEEP and 3.4% (5/145) with excisional laser had persistent or recurrent CIN on follow-up. Factors predisposing to failure included depth of surgical defect, grade of lesion, and operator's expertise. With this approach, 69% of patients referred for cytology of CIN were adequately managed in the first visit, which contrasts to classical management that reaches the state of treatment in 30% of patients. LEEP appears to be faster, less costly, and requires less expertise. Its use in conjunction with adequate screening is recommended for developing countries.

  3. Safety and efficacy of radioactive seed localization with I-125 prior to lumpectomy and/or excisional biopsy

    International Nuclear Information System (INIS)

    Sung, Janice S.; King, Valencia; Thornton, Cynthia M.; Brooks, Jennifer D.; Fry, Charles W.; El-Tamer, Mahmoud; Dauer, Lawrence T.; Brogi, Edi; St Germain, Jean M.; Morris, Elizabeth A.

    2013-01-01

    Purpose: To evaluate the safety and efficacy of pre-operative I-125 radioactive seed localization (RSL) as an alternative to wire localization (WL). Methods: A waiver was granted by the institutional review board for this HIPAA compliant study. Review of 356 consecutive single site nonpalpable mammographic and ultrasound guided I-125 RSLs done between November 2011 and April 2012 was conducted. Preoperative mammograms and specimen radiographs were reviewed for seed-target distance, lesion location, and target/seed removal. During a brief surgical training period, 35 of 356 women had both RSL and wire localization (WL) of the same lesion. Chi-square and single sample t-tests were used to compare margin status and duration of procedures. Results: Of the 356 RSLs, 303 (85.1%) were performed ≥1 day before surgery. Mammographic guidance was used in 330 (93%) and ultrasound in 26 (7%). Mean seed to target distance was 1 mm (range 0–20 mm); all targeted lesions were retrieved. In 31 women in whom mammographic guidance was used for both RSL and WL, median procedure time was not significantly different (RSL 9.0 min; WL 7.0 min; p = 0.91), and median seed migration distance was <1 mm (range 0–15 mm). No difference was detected between margin status with RSL alone versus WL (p = 0.40 and p = 0.65 for positive and <1 mm margins, respectively). Two adverse events occurred requiring an additional wire/surgery. Conclusion: RSL ≥ 1 day before surgery is a safe effective procedure for pre-operative localization, with few adverse events and surgical outcomes comparable to those achieved with wire localization

  4. Th erapeutic potential of d-Th erapeutic potential of d-δ-tocotrienol rich fraction -tocotrienol rich fraction on excisional skin wounds in diabetic rats

    Directory of Open Access Journals (Sweden)

    Bijo Elsy

    2017-10-01

    Full Text Available Introduction: Long-standing hyperglycemia in addition to many of its associated complications also hampers normal wound healing which may be further aggravated in the presence of infection and oxidative stress. Therefore, antioxidant supplementation appears to be strategically relevant for wound healing. This study is designed to explore the therapeutic potential of d-δ-tocotrienol rich fraction (d-δ-TRF on skin wound healing in both healthy and diabetic rats. Materials and Methods: Diabetes was induced through single subcutaneous injection of alloxan at the dose of 100 mg/kg at hip region. 24 albino rats were divided into four groups; healthy control, diabetic control, healthy treated and diabetic treated. d-δ-TRF was administered to treated groups (200 mg/kg, orally, daily for 3 weeks. Full thickness excisional skin wounds were. Wound area was studied by assessing the morphological, histomorphological and histological features at weekly intervals and biochemical analyses were performed at the end of 3rd week. Results: The findings of present study revealed that d-δ-TRF accelerated the skin wound healing by means of early regeneration of both epidermal and dermal components; enhancement of serum protein synthesis, improvement of antioxidant status, maintenance of glycemic condition and controlling serum creatinine levels in diabetic rats. Conclusion: It is concluded that d-δ-TRF has significant therapeutic potency on the healing of skin wounds in both healthy and diabetics.

  5. Transforming growth factor-beta stimulates wound healing and modulates extracellular matrix gene expression in pig skin. I. Excisional wound model.

    Science.gov (United States)

    Quaglino, D; Nanney, L B; Kennedy, R; Davidson, J M

    1990-09-01

    The effect of transforming growth factor-beta 1 (TGF-beta 1) on matrix gene expression has been investigated during the process of wound repair, where the formation of new connective tissue represents a critical step in restoring tissue integrity. Split-thickness excisional wounds in the pig were studied by in situ hybridization in order to obtain subjective findings on the activity and location of cells involved in matrix gene expression after the administration of recombinant TGF-beta 1. Data focus on the stimulatory role of this growth factor in granulation tissue formation, on the enhanced mRNA content of collagen types I and III, fibronectin, TGF-beta 1 itself, and on the reduction in stromelysin mRNA, suggesting that increased matrix formation measured after treatment with TGF-beta 1 is due to fibroplasia regulated by the abundance of mRNAs for several different structural, matrix proteins as well as inhibition of proteolytic phenomena elicited by metalloproteinases. These studies reveal elastin mRNA early in the repair process, and elastin mRNA expression is enhanced by administration of TGF-beta 1. Moreover, we show that TGF-beta 1 was auto-stimulating in wounds, accounting, at least in part, for the persistent effects of single doses of this multipotential cytokine.

  6. The SINS trial: A randomised controlled trial of excisional surgery versus imiquimod 5% cream for nodular and superficial basal cell carcinoma

    Directory of Open Access Journals (Sweden)

    Armstrong Sarah J

    2010-04-01

    Full Text Available Abstract Background Basal cell carcinoma is the commonest human cancer. Despite increasing incidence it remains poorly researched. While not life threatening it can cause significant cosmetic disfigurement. Imiquimod, a cream which enhances the body's immune response, may help deal with the number of cases that occur in low-risk sites, especially when good cosmetic results and home use without surgery are needed. This study aims 1. To compare excisional surgery with imiquimod cream for nodular or superficial basal cell carcinoma in low risk sites, with respect to 3 year clinical clearance, cost-effectiveness and cosmetic results. 2. To ascertain if certain phenotypic features and gene polymorphisms predict tumour responsiveness to treatment. Methods/Design Five hundred participants with low risk nodular or superficial basal cell carcinoma will be recruited from hospitals to this multi-centre, randomised, parallel group, controlled phase III trial. Treatment in the imiquimod group is for 6 weeks for superficial basal cell carcinoma and 12 weeks for nodular basal cell carcinoma. Both treatment groups are followed up in clinic for 3 years. Primary outcome variable: the proportion of participants with clinical evidence of success (no recurrence at 3 years. The primary outcome will be compared between the two treatment groups. Secondary outcomes include: i clinical success at 1, 2 and 5 years, ii time to first recurrence, iii cosmetic appearance of lesion site after treatment, iv level of pain, and v cost-effectiveness. Safety and tolerability data will also be reported. Discussion This study protocol describes a pragmatic randomised controlled trial which it is hoped will address the above uncertainties. Three-year results will be available towards the end of 2010. Trial registration Meta-register: NCT00066872, Eudract No. 2004-004506-24, ISRCTN48755084.

  7. Emergency procedures

    International Nuclear Information System (INIS)

    Abd Nasir Ibrahim; Azali Muhammad; Ab Razak Hamzah; Abd Aziz Mohamed; Mohammad Pauzi Ismail

    2004-01-01

    The following subjects are discussed - Emergency Procedures: emergency equipment, emergency procedures; emergency procedure involving X-Ray equipment; emergency procedure involving radioactive sources

  8. Radiosurgery in the conservative treatment of the preinvader lesions of he uterine cervix

    International Nuclear Information System (INIS)

    Fernandez Gonzalez, Olga L; Perez Morales, Vivian; Lopez Camejo, Israel

    2009-01-01

    We performed a prospective descriptive and analytical study aimed at evaluating the behavior of the procedure Loop Electrosurgical Excision as conservative treatment of cervical pre-invasive lesions in the neck pathology consultations General Teaching Hospital of Moron in the period on 1 January 2005 to 31 December 2006. The universe consisted of all female carriers of pre-invasive cervical lesions for which excisional biopsy was performed with electrosurgery. With the result that the frequency of use of surgical Electro Asa was 73.4%, the most common age was 35-39 years, the most frequent reason for consultation was altered cytology, began sexual relations with fewer than 17 years, had a history of both parties and having three or more sexual partners. From the results of the biopsy specimens without previous biopsy was the largest percent NIC II. While in postconization biopsy, the result was the most common carcinoma in situ. According to the results of statistical significance concluded: electrosurgical excisional biopsy reduce complications and gives us greater confidence in the results of biopsies and decreasing hospital costs with their use. (Author)

  9. Topical photodynamic therapy following excisional wounding of human skin increases production of transforming growth factor-β3 and matrix metalloproteinases 1 and 9, with associated improvement in dermal matrix organization.

    Science.gov (United States)

    Mills, S J; Farrar, M D; Ashcroft, G S; Griffiths, C E M; Hardman, M J; Rhodes, L E

    2014-07-01

    Animal studies report photodynamic therapy (PDT) to improve healing of excisional wounds; the mechanism is uncertain and equivalent human studies are lacking. To explore the impact of methyl aminolaevulinate (MAL)-PDT on clinical and microscopic parameters of human cutaneous excisional wound healing, examining potential modulation through production of transforming growth factor (TGF)-β isoforms. In 27 healthy older men (60-77 years), a 4-mm punch biopsy wound was created in skin of the upper inner arm and treated with MAL-PDT three times over 5 days. An identical control wound to the contralateral arm was untreated and both wounds left to heal by secondary intention. Wounds were re-excised during the inflammatory phase (7 days, n = 10), matrix remodelling (3 weeks, n = 8) and cosmetic outcome/dermal structure (9 months, n = 9). Production of TGF-β1, TGF-β3 and matrix metalloproteinases (MMPs) was assessed by immunohistochemistry alongside microscopic measurement of wound size/area and clinical assessment of wound appearance. MAL-PDT delayed re-epithelialization at 7 days, associated with increased inflammation. However, 3 weeks postwounding, treated wounds were smaller with higher production of MMP-1 (P = 0·01), MMP-9 (P = 0·04) and TGF-β3 (P = 0·03). TGF-β1 was lower than control at 7 days and higher at 3 weeks (both P = 0·03). At 9 months, MAL-PDT-treated wounds showed greater, more ordered deposition of collagen I, collagen III and elastin (all P < 0·05). MAL-PDT increases MMP-1, MMP-9 and TGF-β3 production during matrix remodelling, ultimately producing scars with improved dermal matrix architecture. © 2014 British Association of Dermatologists.

  10. Quantization Procedures

    International Nuclear Information System (INIS)

    Cabrera, J. A.; Martin, R.

    1976-01-01

    We present in this work a review of the conventional quantization procedure, the proposed by I.E. Segal and a new quantization procedure similar to this one for use in non linear problems. We apply this quantization procedures to different potentials and we obtain the appropriate equations of motion. It is shown that for the linear case the three procedures exposed are equivalent but for the non linear cases we obtain different equations of motion and different energy spectra. (Author) 16 refs

  11. Standard Guidelines of Care: Performing Procedures in Patients on or Recently Administered with Isotretinoin.

    Science.gov (United States)

    Mysore, Venkataram; Mahadevappa, Omprakash H; Barua, Shyamanta; Majid, Imran; Viswanath, Vishalakshi; Bhat, Ramesh M; Talwar, Suresh; Thurakkal, Salim; Aurangabadkar, Sanjeev J; Chatterjee, Manas; Ganjoo, Anil

    2017-01-01

    Currently, the standard protocol regarding the performance of procedures on patients receiving or having recently received isotretinoin (13- cis -retinoic acid) states that the procedures should not be performed. The recommendations in standard books and drug insert require discontinuation of isotretinoin for 6 months before performing cosmetic procedures, including waxing, dermabrasion, chemical peels, laser procedures, or incisional and excisional cold-steel surgery. These recommendations have been followed for over two decades despite little evidence for the stated increased risk of scarring. The Association of Cutaneous Surgeons (I) constituted a task force to review the evidence and to recommend consensus guidelines regarding the safety of skin procedures, including resurfacing, energy-device treatments, and dermatosurgical procedures in patients with concurrent or recent isotretinoin administration. Data were extracted from the literature through a PubMed search using the keywords "isotretinoin," "safety," "scarring," "keloids," "hypertrophic scarring," and "pigmentation." The evidence was then labeled and circulated to all members of task force for review. The task force is of the opinion that there is insufficient evidence to support the current protocol of avoiding and delaying treatments in the patient group under consideration and recommends that the current practice should be discontinued. The task force concludes that performing procedures such as laser hair removal, fractional lasers for aging and acne scarring, lasers for pigmented skin lesions, fractional radio-frequency microneedling, superficial and medium-depth peels, microdermabrasion, dermaroller, biopsies, radio-frequency ablation, and superficial excisions is safe in patients with concurrent or recent isotretinoin administration.

  12. A pragmatic multicentre randomised controlled trial comparing stapled haemorrhoidopexy with traditional excisional surgery for haemorrhoidal disease: the eTHoS study.

    Science.gov (United States)

    Watson, Angus Jm; Cook, Jonathan; Hudson, Jemma; Kilonzo, Mary; Wood, Jessica; Bruhn, Hanne; Brown, Steven; Buckley, Brian; Curran, Finlay; Jayne, David; Loudon, Malcolm; Rajagopal, Ramesh; McDonald, Alison; Norrie, John

    2017-11-01

    Haemorrhoids are a benign anorectal condition and are highly prevalent in the UK population. Treatments involve clinic-based procedures and surgery. The surgical procedures available include stapled haemorrhoidopexy (SH) and traditional haemorrhoidectomy (TH), and over 25,000 operations are performed for haemorrhoids annually in the UK. The disease is therefore important both to patients and to health service commissioners. Debate remains as to which of these surgical procedures is the most clinically effective and cost-effective. The aim of this study was to compare the clinical effectiveness and cost-effectiveness of SH with that of TH. A large, open two-arm parallel-group pragmatic multicentre randomised controlled trial involving 32 UK hospitals and a within-trial cost-benefit analysis. A discrete choice experiment was conducted to estimate benefits (willingness to pay). Patients with grades II-IV haemorrhoids who had not previously undergone SH or TH were included in the study. Participants were randomised to receive either SH or TH. Randomisation was minimised at 1 : 1, in accordance with baseline EuroQol-5 Dimensions, three-level version (EQ-5D-3L) score, haemorrhoid grade, sex and centre, via an automated system. The primary outcome was area under the quality-of-life curve measured using the EQ-5D-3L descriptive system over 24 months, and the primary economic outcome was the incremental cost-effectiveness ratio. Secondary outcomes included disease-specific quality of life, recurrence, complications, further interventions and costs. Between January 2011 and August 2014, 777 patients were randomised (389 to receive SH and 388 to receive TH). There were 774 participants included in the analysis as a result of one post-randomisation exclusion in the SH arm and two in the TH arm. SH was less painful than TH in the short term. Surgical complications were similar in both arms. EQ-5D-3L score was higher for the SH arm in the first 6 weeks after surgery, but

  13. Environmental procedures

    International Nuclear Information System (INIS)

    1992-01-01

    The European Bank has pledged in its Agreement to place environmental management at the forefront of its operations to promote sustainable economic development in central and eastern Europe. The Bank's environmental policy is set out in the document titled, Environmental Management: The Bank's Policy Approach. This document, Environmental Procedures, presents the procedures which the European Bank has adopted to implement this policy approach with respect to its operations. The environmental procedures aim to: ensure that throughout the project approval process, those in positions of responsibility for approving projects are aware of the environmental implications of the project, and can take these into account when making decisions; avoid potential liabilities that could undermine the success of a project for its sponsors and the Bank; ensure that environmental costs are estimated along with other costs and liabilities; and identify opportunities for environmental enhancement associated with projects. The review of environmental aspects of projects is conducted by many Bank staff members throughout the project's life. This document defines the responsibilities of the people and groups involved in implementing the environmental procedures. Annexes contain Environmental Management: The Bank's Policy Approach, examples of environmental documentation for the project file and other ancillary information

  14. Radiochemical procedures

    International Nuclear Information System (INIS)

    Lyon, W.S.

    1982-01-01

    The modern counting instrumentation has largely obviated the need for separation processes in the radiochemical analysis but problems in low-level radioactivity measurement, environmental-type analyses, and special situations caused in the last years a renaissance of the need for separation techniques. Most of the radiochemical procedures, based on the classic works of the Manhattan Project chemists of the 1940's, were published in the National Nuclear Energy Series (NNES). Improvements such as new solvent extraction and ion exchange separations have been added to these methods throughout the years. Recently the Los Alamos Group have reissued their collected Radiochemical Procedures containing a short summary and review of basic inorganic chemistry - 'Chemistry of the Elements on the Basis of Electronic Configuration'. (A.L.)

  15. Clinical use of a 15-W diode laser in small animal surgery: results in 30 varied procedures

    Science.gov (United States)

    Crowe, Dennis T.; Swalander, David; Hittenmiller, Donald; Newton, Jenifer

    1999-06-01

    The use of a 15-watt diode laser (CeramOptec)in 30 surgical procedures in dogs and cats was reviewed. Ease of use, operator safety, hemostasis control, wound healing, surgical time, complication rate, and pain control were observed and recorded. Procedures performed were partial pancreatectomy, nasal carcinoma ablation, medial meniscus channeling, perianal and anorectal mass removal (5), hemangioma and hemangiopericytoma removal from two legs, benign skin mass removal (7), liver lobectomy, partial prostatectomy, soft palate resection, partial arytenoidectomy, partial ablation of a thyroid carcinoma, photo-vaporization of the tumor bed following malignant tumor resection (4), neurosheath tumor removal from the tongue, tail sebaceous cyst resection, malignant mammary tumor and mast cell tumor removal. The laser was found to be very simple and safe to use. Hemostasis was excellent in all but the liver and prostate surgeries. The laser was particularly effective in preventing hemorrhage during perianal, anal, and tongue mass removal. It is estimated that a time and blood loss savings of 50% over that of conventional surgery occurred with the use of the laser. All external wounds made by laser appeared to heal faster and with less inflammation than those made with a conventional or electrosurgical scalpel.

  16. Pretreatment procedures

    International Nuclear Information System (INIS)

    Anon.

    1989-01-01

    It is frequently in the patient's best interest that radiation treatments are initiated soon after the decision to treat is made. However, it is essential to good radiation therapy that the patient's treatment course be planned and beam-modifying devices be fabricated with utmost care prior to treatment. The objectives of the treatment, along with the treatment parameters and techniques necessary to achieve these objectives, must be discussed prior to initiating planning procedures. Determination of the target volume is made by the radiation oncologist; this is based on knowledge of the history of the tumor, the patterns of spread of the disease, and on diagnostic findings during the work-up of each patient. It is then necessary to obtain several measurements of the patient and also to identify the position of the target volume and of adjacent normal organs with respect to known external skin marks before the actual treatment planning is begun. Such localization can be done through several methods. The two most commonly used methods are radiographic and computed tomography (CT), both of which are discussed in this chapter. The measurements often include contours of the patient's external surface, usually in the axial plane of the central axis of the beam, and often in multiple levels within the region to be treated. Three dimensional localization and treatment planning requires thorough understanding of geometry as well as of patient positioning and immobilization. This chapter attempts to clarify some of these complicated but essential preparations for treatment

  17. Standard Guidelines of Care: Performing Procedures in Patients on or Recently Administered with Isotretinoin

    Science.gov (United States)

    Mysore, Venkataram; Mahadevappa, Omprakash H.; Barua, Shyamanta; Majid, Imran; Viswanath, Vishalakshi; Bhat, Ramesh M.; Talwar, Suresh; Thurakkal, Salim; Aurangabadkar, Sanjeev J.; Chatterjee, Manas; Ganjoo, Anil

    2017-01-01

    Background: Currently, the standard protocol regarding the performance of procedures on patients receiving or having recently received isotretinoin (13-cis-retinoic acid) states that the procedures should not be performed. The recommendations in standard books and drug insert require discontinuation of isotretinoin for 6 months before performing cosmetic procedures, including waxing, dermabrasion, chemical peels, laser procedures, or incisional and excisional cold-steel surgery. These recommendations have been followed for over two decades despite little evidence for the stated increased risk of scarring. Objective: The Association of Cutaneous Surgeons (I) constituted a task force to review the evidence and to recommend consensus guidelines regarding the safety of skin procedures, including resurfacing, energy-device treatments, and dermatosurgical procedures in patients with concurrent or recent isotretinoin administration. Materials and Methods: Data were extracted from the literature through a PubMed search using the keywords “isotretinoin,” “safety,” “scarring,” “keloids,” “hypertrophic scarring,” and “pigmentation.” The evidence was then labeled and circulated to all members of task force for review. Results: The task force is of the opinion that there is insufficient evidence to support the current protocol of avoiding and delaying treatments in the patient group under consideration and recommends that the current practice should be discontinued. The task force concludes that performing procedures such as laser hair removal, fractional lasers for aging and acne scarring, lasers for pigmented skin lesions, fractional radio-frequency microneedling, superficial and medium-depth peels, microdermabrasion, dermaroller, biopsies, radio-frequency ablation, and superficial excisions is safe in patients with concurrent or recent isotretinoin administration. PMID:29491653

  18. Standard guidelines of care: Performing procedures in patients on or recently administered with isotretinoin

    Directory of Open Access Journals (Sweden)

    Venkataram Mysore

    2017-01-01

    Full Text Available Background: Currently, the standard protocol regarding the performance of procedures on patients receiving or having recently received isotretinoin (13-cis-retinoic acid states that the procedures should not be performed. The recommendations in standard books and drug insert require discontinuation of isotretinoin for 6 months before performing cosmetic procedures, including waxing, dermabrasion, chemical peels, laser procedures, or incisional and excisional cold-steel surgery. These recommendations have been followed for over two decades despite little evidence for the stated increased risk of scarring. Objective: The Association of Cutaneous Surgeons (I constituted a task force to review the evidence and to recommend consensus guidelines regarding the safety of skin procedures, including resurfacing, energy-device treatments, and dermatosurgical procedures in patients with concurrent or recent isotretinoin administration. Materials and Methods: Data were extracted from the literature through a PubMed search using the keywords “isotretinoin,” “safety,” “scarring,” “keloids,” “hypertrophic scarring,” and “pigmentation.” The evidence was then labeled and circulated to all members of task force for review. Results: The task force is of the opinion that there is insufficient evidence to support the current protocol of avoiding and delaying treatments in the patient group under consideration and recommends that the current practice should be discontinued.The task force concludes that performing procedures such as laser hair removal, fractional lasers for aging and acne scarring, lasers for pigmented skin lesions, fractional radio-frequency microneedling, superficial and medium-depth peels, microdermabrasion, dermaroller, biopsies, radio-frequency ablation, and superficial excisions is safe in patients with concurrent or recent isotretinoin administration.

  19. HASL procedures manual

    International Nuclear Information System (INIS)

    Harley, J.H.

    1977-08-01

    Additions and corrections to the following sections of the HASL Procedures Manual are provided: General, Sampling, Field Measurements; General Analytical Chemistry, Chemical Procedures, Data Section, and Specifications

  20. Computer assisted procedure maintenance

    International Nuclear Information System (INIS)

    Bisio, R.; Hulsund, J. E.; Nilsen, S.

    2004-04-01

    The maintenance of operating procedures in a NPP is a tedious and complicated task. Through the whole life cycle of the procedures they will be dynamic, 'living' documents. Several aspects of the procedure must be considered in a revision process. Pertinent details and attributes of the procedure must be checked. An organizational structure must be created and responsibilities allotted for drafting, revising, reviewing and publishing procedures. Available powerful computer technology provides solutions within document management and computerisation of procedures. These solutions can also support the maintenance of procedures. Not all parts of the procedure life cycle are equally amenable to computerized support. This report looks at the procedure life cycle in todays NPPs and discusses the possibilities associated with introduction of computer technology to assist the maintenance of procedures. (Author)

  1. Computerized procedures system

    Science.gov (United States)

    Lipner, Melvin H.; Mundy, Roger A.; Franusich, Michael D.

    2010-10-12

    An online data driven computerized procedures system that guides an operator through a complex process facility's operating procedures. The system monitors plant data, processes the data and then, based upon this processing, presents the status of the current procedure step and/or substep to the operator. The system supports multiple users and a single procedure definition supports several interface formats that can be tailored to the individual user. Layered security controls access privileges and revisions are version controlled. The procedures run on a server that is platform independent of the user workstations that the server interfaces with and the user interface supports diverse procedural views.

  2. Human factoring administrative procedures

    International Nuclear Information System (INIS)

    Grider, D.A.; Sturdivant, M.H.

    1991-01-01

    In nonnuclear business, administrative procedures bring to mind such mundane topics as filing correspondence and scheduling vacation time. In the nuclear industry, on the other hand, administrative procedures play a vital role in assuring the safe operation of a facility. For some time now, industry focus has been on improving technical procedures. Significant efforts are under way to produce technical procedure requires that a validated technical, regulatory, and administrative basis be developed and that the technical process be established for each procedure. Producing usable technical procedures requires that procedure presentation be engineered to the same human factors principles used in control room design. The vital safety role of administrative procedures requires that they be just as sound, just a rigorously formulated, and documented as technical procedures. Procedure programs at the Tennessee Valley Authority and at Boston Edison's Pilgrim Station demonstrate that human factors engineering techniques can be applied effectively to technical procedures. With a few modifications, those same techniques can be used to produce more effective administrative procedures. Efforts are under way at the US Department of Energy Nuclear Weapons Complex and at some utilities (Boston Edison, for instance) to apply human factors engineering to administrative procedures: The techniques being adapted include the following

  3. Procedures in diagnostic radiology

    International Nuclear Information System (INIS)

    Doyle, T.; Hare, W.S.C.; Thomson, K.; Tess, B.

    1989-01-01

    This book outlines the various procedures necessary for the successful practice of diagnostic radiology. Topics covered are: general principles, imaging of the urinary and gastrointestinal tracts, vascular radiology, arthrography, and miscellaneous diagnostic radiologic procedures

  4. Procedural Media Representation

    OpenAIRE

    Henrysson, Anders

    2002-01-01

    We present a concept for using procedural techniques to represent media. Procedural methods allow us to represent digital media (2D images, 3D environments etc.) with very little information and to render it photo realistically. Since not all kind of content can be created procedurally, traditional media representations (bitmaps, polygons etc.) must be used as well. We have adopted an object-based media representation where an object can be represented either with a procedure or with its trad...

  5. Classification of radiological procedures

    International Nuclear Information System (INIS)

    1989-01-01

    A classification for departments in Danish hospitals which use radiological procedures. The classification codes consist of 4 digits, where the first 2 are the codes for the main groups. The first digit represents the procedure's topographical object and the second the techniques. The last 2 digits describe individual procedures. (CLS)

  6. The Use of a Fresh-Tissue Cadaver Model for the Instruction of Dermatological Procedures: A Laboratory Study for Training Medical Students.

    Science.gov (United States)

    Cervantes, Jose A; Costello, Collin M; Maarouf, Melody; McCrary, Hilary C; Zeitouni, Nathalie C

    2017-09-01

    A realistic model for the instruction of basic dermatologic procedural skills was developed, while simultaneously increasing medical student exposure to the field of dermatology. The primary purpose of the authors' study was to evaluate the utilization of a fresh-tissue cadaver model (FTCM) as a method for the instruction of common dermatologic procedures. The authors' secondary aim was to assess students' perceived clinical skills and overall perception of the field of dermatology after the lab. Nineteen first- and second-year medical students were pre- and post-tested on their ability to perform punch and excisional biopsies on a fresh-tissue cadaver. Students were then surveyed on their experience. Assessment of the cognitive knowledge gain and technical skills revealed a statistically significant improvement in all categories (p < .001). An analysis of the survey demonstrated that 78.9% were more interested in selecting dermatology as a career and 63.2% of participants were more likely to refer their future patients to a Mohs surgeon. An FTCM is a viable method for the instruction and training of dermatologic procedures. In addition, the authors conclude that an FTCM provides realistic instruction for common dermatologic procedures and enhances medical students' early exposure and interest in the field of dermatology.

  7. Procedure generation and verification

    International Nuclear Information System (INIS)

    Sheely, W.F.

    1986-01-01

    The Department of Energy has used Artificial Intelligence of ''AI'' concepts to develop two powerful new computer-based techniques to enhance safety in nuclear applications. The Procedure Generation System, and the Procedure Verification System, can be adapted to other commercial applications, such as a manufacturing plant. The Procedure Generation System can create a procedure to deal with the off-normal condition. The operator can then take correct actions on the system in minimal time. The Verification System evaluates the logic of the Procedure Generator's conclusions. This evaluation uses logic techniques totally independent of the Procedure Generator. The rapid, accurate generation and verification of corrective procedures can greatly reduce the human error, possible in a complex (stressful/high stress) situation

  8. Civil Procedure In Denmark

    DEFF Research Database (Denmark)

    Werlauff, Erik

    scientific activities conducted by the author, partly based on the author's experience as a member, through a number of years, of the Danish Standing Committee on Procedural Law (Retsplejeraadet), which on a continuous basis evaluates the need for civil procedural reforms in Denmark, and finally also based......The book contains an up-to-date survey of Danish civil procedure after the profound Danish procedural reforms in 2007. It deals with questions concerning competence and function of Danish courts, commencement and preparation of civil cases, questions of evidence and burden of proof, international...... procedural questions, including relations to the Brussels I Regulation and Denmark's participation in this Regulation via a parallel convention with the EU countries, impact on Danish civil procedure of the convention on human rights, preparation and pronouncement of judgment and verdict, questions of appeal...

  9. Spline-procedures

    International Nuclear Information System (INIS)

    Schmidt, R.

    1976-12-01

    This report contains a short introduction to spline functions as well as a complete description of the spline procedures presently available in the HMI-library. These include polynomial splines (using either B-splines or one-sided basis representations) and natural splines, as well as their application to interpolation, quasiinterpolation, L 2 -, and Tchebycheff approximation. Special procedures are included for the case of cubic splines. Complete test examples with input and output are provided for each of the procedures. (orig.) [de

  10. Procedural sedation analgesia

    OpenAIRE

    Sheta, Saad A

    2010-01-01

    The number of noninvasive and minimally invasive procedures performed outside of the operating room has grown exponentially over the last several decades. Sedation, analgesia, or both may be needed for many of these interventional or diagnostic procedures. Individualized care is important when determining if a patient requires procedural sedation analgesia (PSA). The patient might need an anti-anxiety drug, pain medicine, immobilization, simple reassurance, or a combination of these interve...

  11. Endoscopic Instruments and Electrosurgical Unit for Colonoscopic Polypectomy

    OpenAIRE

    Park, Hong Jun

    2016-01-01

    Colorectal polypectomy is an effective method for prevention of colorectal cancer. Many endoscopic instruments have been used for colorectal polypectomy, such as snares, forceps, endoscopic clips, a Coagrasper, retrieval net, injector, and electrosurgery generator unit (ESU). Understanding the characteristics of endoscopic instruments and their proper use according to morphology and size of the colorectal polyp will enable endoscopists to perform effective polypectomy. I reviewed the characte...

  12. The impact of electrosurgical heat on optical force feedback sensors

    NARCIS (Netherlands)

    Heijmans, J.A.C.; Vleugels, M.P.H.; Tabak, E.; Dool, T.C. van den; Oderwald, M.P.

    2008-01-01

    Electrosurgery enables cutting and coagulation (desiccation) of tissue for Minimally Invasive Surgery. Measurements performed by TNO with an infrared camera showed that the forceps of an endoscopic instrument can be over 300°C in temperature. During electro-surgery the surgeon relies on the power

  13. Handbook of radiologic procedures

    International Nuclear Information System (INIS)

    Hedgcock, M.

    1986-01-01

    This book is organized around radiologic procedures with each discussed from the points of view of: indications, contraindications, materials, method of procedures and complications. Covered in this book are: emergency radiology chest radiology, bone radiology, gastrointestinal radiology, GU radiology, pediatric radiology, computerized tomography, neuroradiology, visceral and peripheral angiography, cardiovascular radiology, nuclear medicine, lymphangiography, and mammography

  14. Decision-making Procedures

    DEFF Research Database (Denmark)

    Aldashev, Gani; Kirchsteiger, Georg; Sebald, Alexander Christopher

    2009-01-01

    define procedures as mechanisms that influence the probabilities of reaching different endnodes. We show that for such procedural games a sequential psychological equilibrium always exists. Applying this approach within a principal-agent context we show that the way less attractive jobs are allocated...

  15. Maintenance procedure upgrade programs

    International Nuclear Information System (INIS)

    Campbell, J.J.; Zimmerman, C.M.

    1988-01-01

    This paper describes a systematic approach to upgrading nuclear power plant maintenance procedures. The approach consists of four phases: diagnosis, program planning, program implementation, and program evaluation. Each phase is explained as a series of steps to ensure that all factors in a procedure upgrade program are considered

  16. Actor-Network Procedures

    NARCIS (Netherlands)

    Pavlovic, Dusko; Meadows, Catherine; Ramanujam, R.; Ramaswamy, Srini

    2012-01-01

    In this paper we propose actor-networks as a formal model of computation in heterogenous networks of computers, humans and their devices, where these new procedures run; and we introduce Procedure Derivation Logic (PDL) as a framework for reasoning about security in actor-networks, as an extension

  17. Analytical procedures. Pt. 1

    International Nuclear Information System (INIS)

    Weber, G.

    1985-01-01

    In analytical procedures (Boole procedures) there is certain to be a close relationship between the safety assessment and reliability assessment of technical facilities. The paper gives an overview of the organization of models, fault trees, the probabilistic evaluation of systems, evaluation with minimum steps or minimum paths regarding statistically dependent components and of systems liable to suffer different kinds of outages. (orig.) [de

  18. Play vs. Procedures

    DEFF Research Database (Denmark)

    Hammar, Emil

    Through the theories of play by Gadamer (2004) and Henricks (2006), I will show how the relationship between play and game can be understood as dialectic and disruptive, thus challenging understandings of how the procedures of games determine player activity and vice versa. As such, I posit some...... analytical consequences for understandings of digital games as procedurally fixed (Boghost, 2006; Flannagan, 2009; Bathwaite & Sharp, 2010). That is, if digital games are argued to be procedurally fixed and if play is an appropriative and dialectic activity, then it could be argued that the latter affects...... and alters the former, and vice versa. Consequently, if the appointed procedures of a game are no longer fixed and rigid in their conveyance of meaning, qua the appropriative and dissolving nature of play, then understandings of games as conveying a fixed meaning through their procedures are inadequate...

  19. HASL procedures manual

    International Nuclear Information System (INIS)

    1980-08-01

    Addition and corrections to the following sections of the HASL Procedures Manual are provided: Table of Contents; Bibliography; Fallout Collection Methods; Wet/Dry Fallout Collection; Fluoride in Soil and Sediment; Strontium-90; Natural Series; Alpha Emitters; and Gamma Emitters

  20. EML procedures manual

    International Nuclear Information System (INIS)

    Volchok, H.L.; de Planque, G.

    1982-01-01

    This manual contains the procedures that are used currently by the Environmental Measurements Laboratory of the US Department of Energy. In addition a number of analytical methods from other laboratories have been included. These were tested for reliability at the Battelle, Pacific Northwest Laboratory under contract with the Division of Biomedical and Environmental Research of the AEC. These methods are clearly distinguished. The manual is prepared in loose leaf form to facilitate revision of the procedures and inclusion of additional procedures or data sheets. Anyone receiving the manual through EML should receive this additional material automatically. The contents are as follows: (1) general; (2) sampling; (3) field measurements; (4) general analytical chemistry; (5) chemical procedures; (6) data section; (7) specifications

  1. Cosmetic Procedure Questions

    Science.gov (United States)

    ... for Every Season How to Choose the Best Skin Care Products In This Section Dermatologic Surgery What is dermatologic ... for Every Season How to Choose the Best Skin Care Products Cosmetic Procedure Questions Want to look younger? Start ...

  2. Modified arthroscopic Brostrom procedure.

    Science.gov (United States)

    Lui, Tun Hing

    2015-09-01

    The open modified Brostrom anatomic repair technique is widely accepted as the reference standard for lateral ankle stabilization. However, there is high incidence of intra-articular pathologies associated with chronic lateral ankle instability which may not be addressed by an isolated open Brostrom procedure. Arthroscopic Brostrom procedure with suture anchor has been described for anatomic repair of chronic lateral ankle instability and management of intra-articular lesions. However, the complication rates seemed to be higher than open Brostrom procedure. Modification of the arthroscopic Brostrom procedure with the use of bone tunnel may reduce the risk of certain complications. Copyright © 2015 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

  3. Assisted Medical Procedures (AMP)

    Data.gov (United States)

    National Aeronautics and Space Administration — DOCUMENTATION, DEVELOPMENT, AND PROGRESS The AMP was initially being developed as part the Advanced Integrated Clinical System (AICS)-Guided Medical Procedure System...

  4. Cosmetic Procedure Questions

    Science.gov (United States)

    ... Back Injectable Deoxycholic Acid Injectable Hyaluronic Acid Injectable Poly-l-lactic Acid Injectable Polymethylmethacrylate + Bovine Collagen Filler ... time of their procedure. 6. What are my pain management and anesthesia options? To help avoid the ...

  5. Special Blood Donation Procedures

    Science.gov (United States)

    ... Blood Products Special Blood Donation Procedures Precautions and Adverse Reactions During Blood Transfusion (See Overview of Blood Transfusion .) Plateletpheresis (platelet donation) In plateletpheresis, a donor gives only platelets rather than whole blood. Whole ...

  6. Dynamic alarm response procedures

    International Nuclear Information System (INIS)

    Martin, J.; Gordon, P.; Fitch, K.

    2006-01-01

    The Dynamic Alarm Response Procedure (DARP) system provides a robust, Web-based alternative to existing hard-copy alarm response procedures. This paperless system improves performance by eliminating time wasted looking up paper procedures by number, looking up plant process values and equipment and component status at graphical display or panels, and maintenance of the procedures. Because it is a Web-based system, it is platform independent. DARP's can be served from any Web server that supports CGI scripting, such as Apache R , IIS R , TclHTTPD, and others. DARP pages can be viewed in any Web browser that supports Javascript and Scalable Vector Graphics (SVG), such as Netscape R , Microsoft Internet Explorer R , Mozilla Firefox R , Opera R , and others. (authors)

  7. Radiochemical procedures and techniques

    International Nuclear Information System (INIS)

    Flynn, K.

    1975-04-01

    A summary is presented of the radiochemical procedures and techniques currently in use by the Chemistry Division Nuclear Chemistry Group at Argonne National Laboratory for the analysis of radioactive samples. (U.S.)

  8. Soil Sampling Operating Procedure

    Science.gov (United States)

    EPA Region 4 Science and Ecosystem Support Division (SESD) document that describes general and specific procedures, methods, and considerations when collecting soil samples for field screening or laboratory analysis.

  9. Bariatric Surgery Procedures

    Science.gov (United States)

    ... Meetings of Interest Online Education Job Board CME Policies CBN Fellowship Certificate Research Grant Program Resources All Resources Approved Procedures Patient Safety Vignettes Dr. Mason Historical Library Governing Documents Guidelines Access and Insurance Position and ...

  10. Nuclear materials management procedures

    International Nuclear Information System (INIS)

    Veevers, K.; Silver, J.M.; Quealy, K.J.; Steege, E. van der.

    1987-10-01

    This manual describes the procedures for the management of nuclear materials and associated materials at the Lucas Heights Research Laboratories. The procedures are designed to comply with Australia's nuclear non-proliferation obligations to the International Atomic Energy Agency (IAEA), bilateral agreements with other countries and ANSTO's responsibilities under the Nuclear Non-Proliferation (Safeguards) Act, 1987. The manual replaces those issued by the Australian Atomic Energy Commission in 1959, 1960 and 1969

  11. Procedural learning and dyslexia.

    Science.gov (United States)

    Nicolson, R I; Fawcett, A J; Brookes, R L; Needle, J

    2010-08-01

    Three major 'neural systems', specialized for different types of information processing, are the sensory, declarative, and procedural systems. It has been proposed (Trends Neurosci., 30(4), 135-141) that dyslexia may be attributable to impaired function in the procedural system together with intact declarative function. We provide a brief overview of the increasing evidence relating to the hypothesis, noting that the framework involves two main claims: first that 'neural systems' provides a productive level of description avoiding the underspecificity of cognitive descriptions and the overspecificity of brain structural accounts; and second that a distinctive feature of procedural learning is its extended time course, covering from minutes to months. In this article, we focus on the second claim. Three studies-speeded single word reading, long-term response learning, and overnight skill consolidation-are reviewed which together provide clear evidence of difficulties in procedural learning for individuals with dyslexia, even when the tasks are outside the literacy domain. The educational implications of the results are then discussed, and in particular the potential difficulties that impaired overnight procedural consolidation would entail. It is proposed that response to intervention could be better predicted if diagnostic tests on the different forms of learning were first undertaken. 2010 John Wiley & Sons, Ltd.

  12. Procedural sedation analgesia

    Directory of Open Access Journals (Sweden)

    Sheta Saad

    2010-01-01

    Full Text Available The number of noninvasive and minimally invasive procedures performed outside of the operating room has grown exponentially over the last several decades. Sedation, analgesia, or both may be needed for many of these interventional or diagnostic procedures. Individualized care is important when determining if a patient requires procedural sedation analgesia (PSA. The patient might need an anti-anxiety drug, pain medicine, immobilization, simple reassurance, or a combination of these interventions. The goals of PSA in four different multidisciplinary practices namely; emergency, dentistry, radiology and gastrointestinal endoscopy are discussed in this review article. Some procedures are painful, others painless. Therefore, goals of PSA vary widely. Sedation management can range from minimal sedation, to the extent of minimal anesthesia. Procedural sedation in emergency department (ED usually requires combinations of multiple agents to reach desired effects of analgesia plus anxiolysis. However, in dental practice, moderate sedation analgesia (known to the dentists as conscious sedation is usually what is required. It is usually most effective with the combined use of local anesthesia. The mainstay of success for painless imaging is absolute immobility. Immobility can be achieved by deep sedation or minimal anesthesia. On the other hand, moderate sedation, deep sedation, minimal anesthesia and conventional general anesthesia can be all utilized for management of gastrointestinal endoscopy.

  13. Anesthesia for radiologic procedures

    International Nuclear Information System (INIS)

    Forestner, J.E.

    1987-01-01

    Anesthetic techniques for neurodiagnostic studies and radiation therapy have been recently reviewed, but anesthetic involvement in thoracic and abdominal radiology has received little attention. Patient reactions to radiologic contrast media may be of concern to the anesthesiologist, who is often responsible for injecting these agents during diagnostic procedures, and thus is included in this discussion. Finally, the difficulties of administering anesthesia for magnetic resonance imaging (MRI) scans are outlined, in an effort to help anesthesiologist to anticipate problems with this new technologic development. Although there are very few indications for the use of general anesthesia for diagnostic radiologic studies in adults, most procedures performed with children, the mentally retarded, or the combative adult require either heavy sedation or general anesthesia. In selecting an anesthetic technique for a specific procedure, both the patient's disease process and the requirements of the radiologist must be carefully balanced

  14. Motive Criminal Procedure Evidence

    Directory of Open Access Journals (Sweden)

    В. В. Вапнярчук

    2015-03-01

    Full Text Available In the article the need for such a level of mental regulation of behavior of proving motivation. The latter refers to internal motivation conscious entity Criminal Procedure proof, due to specific needs, interests and goals that cause a person to act rishymist. Detailed attention is given to the first two determinants, namely the nature of needs and interests. In particular, analyzes highlighted in the literature variety of needs (physiological, ekzistentsionalni, social, prestige, cognitive, aesthetic and spiritual and the manifestation of some of them in the criminal procedural proof.

  15. Magnet‑retained Prophylactic Appliance for Post‑excisional ...

    African Journals Online (AJOL)

    Keloid is a cutaneous fibrous scar that represents disequilibrium in the dermal wound healing ... helix of right ear since 1½ years. There was history of first ear piercing of lobe of the ears at the age of 10 years ... produced as a result of aberration in the healing process. Pressure therapy, in combination with other forms of ...

  16. Breast Cancer from the Excisional Scar of a Benign Mass

    International Nuclear Information System (INIS)

    Kim, Min Jung; Kim, Eun Kyung; Lee, Ji Young; Youk, Ji Hyun; Park, Byeong Woo; Kim, Hae Ryoung; Oh, Ki Keun

    2007-01-01

    Burns and chronic inflammation are well-known circumstances in which malignant transformation may occur during wound healing. There are many reports of malignancies developing from a burn scar; however, there are only a few reports of malignancy arising from chronic inflammation or from the skin of a surgical scar following excision of a benign mass, in any part of the body. There are only twelve reported cases of breast cancer developing from a surgical scar, moreover, there have been no reports in the last 30 years. This case is a recent example of breast cancer developing in a surgical scar that showed subtle changes on sequential sonograms. The imaging findings of this case were subtle but the mass that had been shrinking developed an angular margin in one region. These findings, along with the penetrating vascularity revealed on Doppler, prompted us to proceed to a biopsy of the lesion. It was of critical importance to compare the size and the shape of the lesion with previous ultrasounds in order to exclude malignancy in any iatrogenically altered lesion. Based on this case, we conclude that whenever a subtle change is detected, at a surgical site, a biopsy should be performed. Breast cancer developing from a surgical scar is rare; this type of malignancy has been reported in only 12 cases to date. Herein, we report on a 52-year-old female who developed infiltrating ductal carcinoma in a surgical scar following excision of a benign mass. Two years previously, the patient underwent surgery and radiotherapy for invasive ductal carcinoma of the contralateral breast. The initial appearance of the scar was similar to fat necrosis; it was observed to be progressively shrinking on follow-up sonography. On the two year follow-up ultrasound, the appearance changed, an angular margin and vascularity at the periphery of the scar were noted. A biopsy and subsequent excision of the scar were performed; the diagnosis of infiltrating ductal carcinoma of the scar was confirmed

  17. 76 FR 62092 - Filing Procedures

    Science.gov (United States)

    2011-10-06

    ... INTERNATIONAL TRADE COMMISSION Filing Procedures AGENCY: International Trade Commission. ACTION: Notice of issuance of Handbook on Filing Procedures. SUMMARY: The United States International Trade Commission (``Commission'') is issuing a Handbook on Filing Procedures to replace its Handbook on Electronic...

  18. Electronic procedure distribution

    International Nuclear Information System (INIS)

    Slone, B.J. III; Richardson, C.E.

    1993-01-01

    Printed procedures can offer a mix of text and graphic information that improves readability and increases understanding. A typical procedure uses illustrations and graphics to clarify concepts, a variety of type styles and weights to make it easier to find different topics and sections, white space to improve readability, and familiar navigational clues such as page numbers and topic headers. Initially, electronic procedure systems had limited typeface options, often only a single typeface, with no capability for enhancing readability by varying type size bolding, italicizing, or underlining, and no ability to include graphics. Even recently, many text-only electronic procedures were originally created in a modern What-You-See-Is-What-You-Get (WYSI-WYG) document authoring system, only to be converted to pages and pages of plain type for electronic distribution. Given the choice of paper or on-line producers, most users have chosen paper for its readability. But current-generation electronic document systems that use formatted text and embedded graphics offer users vastly improved readability. Further, they are offering ever-better search tools to enable rapid location of material of interest

  19. The nuclear licensing procedure

    International Nuclear Information System (INIS)

    Wagner, H.

    1976-01-01

    To begin with, the present nuclear licensing procedure is illustrated by a diagram. The relationship between the state and the Laender, the various experts (GRS - IRS + LRA -, TUEV, DWD, university institutes, firms of consulting engineers, etc), participation of the public, e.g. publication of the relevant documents, questions, objections (made by individuals or by groups such as citizens' initiatives), public discussion, official notice, appeals against the decision, the right of immediate execution of the decision are shortly dealt with. Finally, ways to improve the licensing procedure are discussed, from the evaluation of the documents to be submitted, published, and examined by the authorities (and their experts) up to an improvement of the administrative procedure. An improved licensing procedure should satisfy the well-founded claims of the public for more transparency as well as the equally justifiable claims of industry and utilities in order to ensure that the citizens' legal right to have safe and adequate electric power is guaranteed. The updated energy programme established by the Federal Government is mentioned along with the effectiveness of dealing with nuclear problems on the various levels of a Land government. (orig.) [de

  20. OCRWM international procedures

    International Nuclear Information System (INIS)

    1986-03-01

    These international procedures provide guidance and assistance for the Office of Civilian Radioactive Waste Management (OCRWM) and for OCRWM Project Offices, contractors and subcontractors in conducting international activities. They supplement the relevant Department of Energy (DOE) orders (which are referenced), not supplant them

  1. Pneumomediastinum after odontologic procedure

    International Nuclear Information System (INIS)

    Olivella C, Fabio Alejandro; Bermudez G, Mary; Hidalgo M, Patricia; Sanchez M, Jully Mariana; Solarte R, Ivan; Uriza C, Felipe

    2005-01-01

    The sudden increase in alveolar pressure is a frequent cause of pneumomediastinum, but there are other reasons that could lead to it such as airway or esophagus trauma. The pneumomediastinum, which has been produced after dental procedures, is very rare and product deserves special attention by dentists and medical personnel in order to get its soon recognition and handling

  2. Educational Accounting Procedures.

    Science.gov (United States)

    Tidwell, Sam B.

    This chapter of "Principles of School Business Management" reviews the functions, procedures, and reports with which school business officials must be familiar in order to interpret and make decisions regarding the school district's financial position. Among the accounting functions discussed are financial management, internal auditing,…

  3. Robust procedures in chemometrics

    DEFF Research Database (Denmark)

    Kotwa, Ewelina

    properties of the analysed data. The broad theoretical background of robust procedures was given as a very useful supplement to the classical methods, and a new tool, based on robust PCA, aiming at identifying Rayleigh and Raman scatters in excitation-mission (EEM) data was developed. The results show...

  4. IXM gas sampling procedure

    International Nuclear Information System (INIS)

    Pingel, L.A.

    1995-01-01

    Ion Exchange Modules (IXMs) are used at the 105-KE and -KW Fuel Storage Basins to control radionuclide concentrations in the water. A potential safety concern relates to production of hydrogen gas by radiolysis of the water trapped in the ion exchange media of spent IXMs. This document provides a procedure for sampling the gases in the head space of the IXM

  5. 3. Procedures and Recursion

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 1; Issue 6. Algorithms Procedures and Recursion. R K Shyamasundar. Series Article Volume 1 ... Author Affiliations. R K Shyamasundar1. Computer Science Group, Tata Institute of Fundamental Research, Homi Bhabha Road Mumbai 400 005, India.

  6. The TOMAX-procedure

    NARCIS (Netherlands)

    Overgoor, M.L.E.

    2015-01-01

    Most patients with a low spinal lesion (LSL) have intact erectile function but no penile sensation, which can lead to frustration. To tackle this problem, we designed TOMAX, TOMAXimize sensation, sexuality and quality of life, a surgical procedure in which a functional "groin” nerve is connected to

  7. Experiments with Cloze Procedure

    Science.gov (United States)

    Evans, Gordon; Haastrup, Kirsten

    1976-01-01

    The Nordic Test Development Group prepared proficiency tests of English designed to provide reliable information on which to base decisions as to whether a candidate would be able to function in a job as described or whether he could be trained to do so. Two subtests used a modified cloze procedure. (Author/CFM)

  8. Formalizing physical security procedures

    NARCIS (Netherlands)

    Meadows, C.; Pavlovic, Dusko

    Although the problems of physical security emerged more than 10,000 years before the problems of computer security, no formal methods have been developed for them, and the solutions have been evolving slowly, mostly through social procedures. But as the traffic on physical and social networks is now

  9. Cervical dysplasia - series (image)

    Science.gov (United States)

    ... is performed using either a knife, laser, or electrocautery. LEEP, or the loop electrosurgical excision procedure is the term used for conization electrocautery. In this procedure, an electric current is run ...

  10. Cancer pancreatis, diagnostic procedures

    International Nuclear Information System (INIS)

    Graadal, Oe.; Schlichting, E.; Aasen, A.O.; Stadaas, J.O.

    1990-01-01

    151 patients treated for carcinoma of the pancreas at Ullevaal Hospital (Oslo University) during the period 1980-89 were studied. The most common initial symptom was abdominal pain. Other frequent debut symptoms were loss of weight and jaundice. ERCP and PTC were found to be the best diagnostic procedures. CT or ultrasonography were normal in 10-20% of the patients. Nearly all tumors of the pancreas were found by the ERCP procedure. Also angiography was used to evaluate operability of the pancreas tumor, but was found to be a very uncertain diagnostic method. This method will not be used in the future evaluation of patients with cancer of the pancreas. 13 refs., 1 fig., 2 tabs

  11. Subsea HIPPS design procedure

    International Nuclear Information System (INIS)

    Aaroe, R.; Lund, B.F.; Onshus, T.

    1995-01-01

    The paper is based on a feasibility study investigating the possibilities of using a HIPPS (High Integrity Pressure Protection System) to protect a subsea pipeline that is not rated for full wellhead shut-in pressure. The study was called the Subsea OPPS Feasibility Study, and was performed by SINTEF, Norway. Here, OPPS is an acronym for Overpressure Pipeline Protection System. A design procedure for a subsea HIPPS is described, based on the experience and knowledge gained through the ''Subsea OPPS Feasibility Study''. Before a subsea HIPPS can be applied, its technical feasibility, reliability and profitability must be demonstrated. The subsea HIPPS design procedure will help to organize and plan the design activities both with respect to development and verification of a subsea HIPPS. The paper also gives examples of how some of the discussed design steps were performed in the Subsea OPPS Feasibility Study. Finally, further work required to apply a subsea HIPPS is discussed

  12. Headache and endovascular procedures.

    Science.gov (United States)

    de Biase, Stefano; Longoni, Marco; Gigli, Gian Luigi; Agostoni, Elio

    2017-05-01

    The International Classification of Headache Disorders (ICHD-3 beta) includes headache attributed to intracranial endovascular procedures (EVPs). The aim of this review is to describe the clinical and pathophysiological aspects of headache related to vascular lesions and EVPs. Current studies regarding this issue are contradictory, although generally favouring headache improvement after EVPs. Further large studies are needed to adequately assess the effect of EVPs on headache.

  13. Internal Control Organization Procedure

    OpenAIRE

    Radu Dorin Lenghel

    2013-01-01

    Internal control represents the totality of policies and procedures adopted by management, which contribute: to the fulfilment of managerial objectives, to the prevention and detection of frauds or errors, to the accuracy and exhaustiveness of accounting entries, as well as to the preparation in due course of financial accounting information. Internal control represents a managerial instrument which assures the fulfilment of objectives of the entity, being an ongoing process in which administ...

  14. Analytical Procedures for Testability.

    Science.gov (United States)

    1983-01-01

    Beat Internal Classifications", AD: A018516. "A System of Computer Aided Diagnosis with Blood Serum Chemistry Tests and Bayesian Statistics", AD: 786284...6 LIST OF TALS .. 1. Truth Table ......................................... 49 2. Covering Problem .............................. 93 3. Primary and...quential classification procedure in a coronary care ward is evaluated. In the toxicology field "A System of Computer Aided Diagnosis with Blood Serum

  15. The TOMAX-procedure

    OpenAIRE

    Overgoor, M.L.E.

    2015-01-01

    Most patients with a low spinal lesion (LSL) have intact erectile function but no penile sensation, which can lead to frustration. To tackle this problem, we designed TOMAX, TOMAXimize sensation, sexuality and quality of life, a surgical procedure in which a functional "groin” nerve is connected to the non-functional “penile” nerve on one side to bypass the LSL. Our goal was to increase LSL patients’ sexual health by restoring penile sensation: we show that TOMAX can achieve dramatic improvem...

  16. Start-up procedure

    International Nuclear Information System (INIS)

    Marchl, A.; Krebs, W.D.; Aleite, W.

    1975-01-01

    The start-up procedure will be shown on a pressurized water reactor, although most of the activities will occur similarly in other reactor types. The commissioning time can be divided into 5 sections, the phases A to E together lasting 26 months. Subsequently there are a test run of one month and the handling-over of the plant to the operator. A survey of the commissioning sections with several important main events is shown. (orig./TK) [de

  17. Coal pillar design procedures

    CSIR Research Space (South Africa)

    York, G

    2000-03-01

    Full Text Available Final Project Report Coal pillar design procedures G. York, I. Canbulat, B.W. Jack Research agency: CSIR Mining Technology Project number: COL 337 Date: March 2000 2 Executive Summary Examination of collapsed pillar cases outside of the empirical... in strength occurs with increasing specimen size. 45 40 35 30 25 20 15 10 5 0 20 40 60 80 100 120 140 160 UNIAX IA L COMPR EHEN SIV E S TR ENG TH (M Pa ) CUBE SIZE (cm) Figure 1...

  18. Emergency procedures in London

    International Nuclear Information System (INIS)

    Cree, D.

    1984-01-01

    This chapter discusses the following: emergency services (fire brigade, ambulance and police) that would be involved in dealing with an accident to a nuclear fuel flask in transport through London, with special reference to procedures used by the Metropolitan Police; geographical area covered by Metropolitan Police; initiation of action; decision whether to evacuate the area of the accident; examples of action taken to deal with non-radiation accidents (in absence of any example of relevant radiation accident); specific instructions, or advice, to police relating to the movement of irradiated fuel; training exercises. (U.K.)

  19. Regulations and Procedures Manual

    Energy Technology Data Exchange (ETDEWEB)

    Young, Lydia J. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2011-07-25

    The purpose of the Regulations and Procedures Manual (RPM) is to provide LBNL personnel with a reference to University and Lawrence Berkeley National Laboratory (LBNL or Laboratory) policies and regulations by outlining normal practices and answering most policy questions that arise in the day-to-day operations of Laboratory organizations. Much of the information in this manual has been condensed from detail provided in LBNL procedure manuals, Department of Energy (DOE) directives, and Contract DE-AC02-05CH11231. This manual is not intended, however, to replace any of those documents. RPM sections on personnel apply only to employees who are not represented by unions. Personnel policies pertaining to employees represented by unions may be found in their labor agreements. Questions concerning policy interpretation should be directed to the LBNL organization responsible for the particular policy. A link to the Managers Responsible for RPM Sections is available on the RPM home page. If it is not clear which organization is responsible for a policy, please contact Requirements Manager Lydia Young or the RPM Editor.

  20. Regulations and Procedures Manual

    Energy Technology Data Exchange (ETDEWEB)

    Young, Lydia [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2010-09-30

    The purpose of the Regulations and Procedures Manual (RPM) is to provide Laboratory personnel with a reference to University and Lawrence Berkeley National Laboratory policies and regulations by outlining the normal practices and answering most policy questions that arise in the day-to-day operations of Laboratory departments. Much of the information in this manual has been condensed from detail provided in Laboratory procedure manuals, Department of Energy (DOE) directives, and Contract DE-AC02-05CH11231. This manual is not intended, however, to replace any of those documents. The sections on personnel apply only to employees who are not represented by unions. Personnel policies pertaining to employees represented by unions may be found in their labor agreements. Questions concerning policy interpretation should be directed to the department responsible for the particular policy. A link to the Managers Responsible for RPM Sections is available on the RPM home page. If it is not clear which department should be called, please contact the Associate Laboratory Director of Operations.

  1. Radiation dose electrophysiology procedures

    International Nuclear Information System (INIS)

    Hernandez-Armas, J.; Rodriguez, A.; Catalan, A.; Hernandez Armas, O.; Luque Japon, L.; Moral, S.; Barroso, L.; Rfuez-Hdez, R.

    2006-01-01

    The aim of this paper has been to measure and analyse some of the parameters which are directly related with the doses given to patients in two electrophysiology procedures: diagnosis and ablation with radiofrequency. 16 patients were considered in this study. 13 them had an ablation with radiofrequency at the Unit of Electrophysiology at the University Hospital of the Canaries, La Laguna., Tenerife. The results of skin doses, in the ablation cases, were higher than 2 Gy (threshold of some deterministic effects). The average value was 1.1 Gy. The personal doses, measured under the lead apron, for physician and nurses were 4 and 3 micro Sievert. These results emphasised the necessity of radiation protection measures in order to reduce, ad much as possible, the doses to patients. (Author)

  2. Decommissioning licensing procedure

    International Nuclear Information System (INIS)

    Perello, M.

    1979-01-01

    Decommissioning or closure of a nuclear power plant, defined as the fact that takes place from the moment that the plant stops producing for the purpose it was built, is causing preocupation. So this specialist meeting on Regulatory Review seems to be the right place for presenting and discusing the need of considering the decommissioning in the safety analysis report. The main goal of this paper related to the licensing procedure is to suggest the need of a new chapter in the Preliminary Safety Analysis Report (P.S.A.R.) dealing with the decommissioning of the nuclear power plant. Therefore, after a brief introduction the problem is exposed from the point of view of nuclear safety and finally a format of the new chapter is proposed. (author)

  3. Toddler test or procedure preparation

    Science.gov (United States)

    ... a test or procedure: Explain the procedure in language your child understands, using plain words. Avoid abstract terms. Make sure your child understands the exact body part involved in the test, and that the ...

  4. Preschooler test or procedure preparation

    Science.gov (United States)

    ... your child during and after the procedure with books, songs, counting, deep breathing, or blowing bubbles. PLAY ... can be present during the procedure. Ask if anesthesia can be used to reduce your child's discomfort. ...

  5. Automation of the testing procedure

    International Nuclear Information System (INIS)

    Haas, H.; Fleischer, M.; Bachner, E.

    1979-01-01

    For the judgement of technologies applied and the testing of specific components of the HTR primary circuit, complex test procedures and data evaluations are required. Extensive automation of these test procedures is indispensable. (orig.) [de

  6. Quantization Procedures; Sistemas de cuantificacion

    Energy Technology Data Exchange (ETDEWEB)

    Cabrera, J. A.; Martin, R.

    1976-07-01

    We present in this work a review of the conventional quantization procedure, the proposed by I.E. Segal and a new quantization procedure similar to this one for use in non linear problems. We apply this quantization procedures to different potentials and we obtain the appropriate equations of motion. It is shown that for the linear case the three procedures exposed are equivalent but for the non linear cases we obtain different equations of motion and different energy spectra. (Author) 16 refs.

  7. Application of safeguards procedures

    International Nuclear Information System (INIS)

    1977-01-01

    The earliest applications of safeguards procedures took place in a political and technical climate far different from that of today. In the early 1960's there was a fear of the proliferation possibilities which could arise as more and more countries acquired nuclear power plants. Today nuclear power is being produced in some 20 countries without resulting in nuclear weapons proliferation. The export of equipment and technology for the nuclear fuel cycle, however, has become the subject of current concern. In view of these developments, it is not surprising that techniques in the application of safeguards have also changed. In order to appreciate the nature of these changes, it is important to be aware of the original general attitude towards the technical problems of safeguards applications. Originally, the common attitude was that the objectives of safeguards were self-evident and the methods, while in need of development, were known at least in outline. Today, it has become evident that before a safeguards procedure can be applied, the objectives must first be carefully defined, and the criteria against which success in meeting those objectives can be measured must also be developed. In line with this change, a significant part of the effort of the safeguards inspectorate is concerned with work preliminary and subsequent to the actual inspection work in the field. Over the last two years, for example, a considerable part of the work of experienced safeguards staff has been spent in analysing the possibilities of diverting material at each facility to be safeguarded. These analyses are carried out in depth by a 'facility officer' and are subjected to constructive criticism by teams composed of staff responsible for similar types of facilities as well as other technical experts. The analyses consider the measures currently considered practicable, to meet the diversion possibilities and where necessary list the development work needed to overcome any present

  8. BWR emergency procedure guidelines

    International Nuclear Information System (INIS)

    Post, J.S.; Karner, E.F.; Stratman, R.A.

    1984-01-01

    This chapter describes plans for dealing with reactor accidents developed by the Boiling Water Reactor (BWR) Owners' Group in response to post-Three Mile Island US NRC requirements. The devised Emergency Procedure Guidelines (EPGs), applicable to all BWRs, are symptom-based rather than event-based. According to the EPGs, the operator does not need to identify what event is occurring in the plant in order to decide what action to take, but need only observe the symptoms (values and trends of key control parameters) which exist and take appropriate action to control these symptoms. The original objective was to provide reactor operator guidance in responding to a small break loss-of-coolant accident (LOCA), but subsequent revisions have included other types of reactor accidents. Topics considered include the reactor pressure vessel (RPV) control guideline, the primary containment control guideline, the secondary containment control guideline, the radioactivity release control guideline, multiple failures vs. the design basis, safe limits vs. technical specifications, the technical status, licensing, and implementation. The EPGs are based upon maintaining both adequate core cooling and primary containment integrity

  9. Automated emergency operating procedures

    International Nuclear Information System (INIS)

    Perez-Ramirez, G.; Nelson, P.F.

    1990-01-01

    This paper describes the development of a training tool for the symptom oriented emergency operating procedures used at the Laguna Verde Nuclear Power Plant. EOPs and operator training are intended to assist the operator for managing accident situations. A prototype expert system based on the EOPs has been developed for operator training. The demonstration expert system was developed using a commercial shell. The knowledge base consists of two parts. The specific operator actions to be executed for 5 selected accident sequences and the EOPs steps for the reactor pressure vessel control of the water level, pressure, and power. The knowledge is expressed in the form of IF-THEN production rules. A typical training session will display a set of conditions and will prompt the trainee to indicate the appropriate step to perform. This mode will guide the trainee through selected accident sequences. A second mode of the expert system will prompt the trainee for the current plant conditions and the expert system will respond with the EOPs which are required to be performed under these conditions. This allows the trainee to study What if situations

  10. Computer software review procedures

    International Nuclear Information System (INIS)

    Mauck, J.L.

    1993-01-01

    This article reviews the procedures which are used to review software written for computer based instrumentation and control functions in nuclear facilities. The utilization of computer based control systems is becoming much more prevalent in such installations, in addition to being retrofit into existing systems. Currently, the Nuclear Regulatory System uses Regulatory Guide 1.152, open-quotes Criteria for Programmable Digital Computer System Software in Safety-Related Systems of Nuclear Power Plantsclose quotes and ANSI/IEEE-ANS-7-4.3.2-1982, open-quotes Application Criteria for Programmable Digital Computer Systems in Safety Systems of Nuclear Power Generating Stationsclose quotes for guidance when performing reviews of digital systems. There is great concern about the process of verification and validation of these codes, so when inspections are done of such systems, inspectors examine very closely the processes which were followed in developing the codes, the errors which were detected, how they were found, and the analysis which went into tracing down the causes behind the errors to insure such errors were not propagated again in the future

  11. Analytical procedures. Pt. 4

    International Nuclear Information System (INIS)

    Rackwitz, R.

    1985-01-01

    The semi-analytical procedures are summarized under the heading 'first or second-order reliability method'. The asymptotic aggravation of the theory was repeatedly hinted at. In supporting structures the probability of outage of components always is also a function of the condition of all other components. It depends moreover on the stress affecting mostly all components. This fact causes a marked reduction of the effect of redundant component arrangements in the system. It moreover requires very special formulations. Although theoretically interesting and practically important developments will leave their mark on the further progress of the theory, the statements obtained by those approaches will continue to depend on how closely the chosen physical relationships and stoachstic models can come to the scatter quantities. Sensitivity studies show that these are partly aspects of substantially higher importance with a view to decision criteria than the refinement of the (probabilistic) method. Questions of relevance and reliability of data and their adequate treatment in reliability analyses seem to rank higher in order of sequence than exaggerated demands on methodics. (orig./HP) [de

  12. [Costing nuclear medicine diagnostic procedures].

    Science.gov (United States)

    Markou, Pavlos

    2005-01-01

    To the Editor: Referring to a recent special report about the cost analysis of twenty-nine nuclear medicine procedures, I would like to clarify some basic aspects for determining costs of nuclear medicine procedure with various costing methodologies. Activity Based Costing (ABC) method, is a new approach in imaging services costing that can provide the most accurate cost data, but is difficult to perform in nuclear medicine diagnostic procedures. That is because ABC requires determining and analyzing all direct and indirect costs of each procedure, according all its activities. Traditional costing methods, like those for estimating incomes and expenses per procedure or fixed and variable costs per procedure, which are widely used in break-even point analysis and the method of ratio-of-costs-to-charges per procedure may be easily performed in nuclear medicine departments, to evaluate the variability and differences between costs and reimbursement - charges.

  13. Radiation dose during angiographic procedures

    International Nuclear Information System (INIS)

    Lavoie, Ch.; Rasuli, P.

    2001-01-01

    The use of angiographic procedures is becoming more prevalent as new techniques and equipment are developed. There have been concerns in the scientific community about the level of radiation doses received by patients, and indirectly by staff, during some of these radiological procedures. The purpose of this study was to assess the level of radiation dose from angiographic procedures to patient at the Ottawa Hospital, General Campus. Radiation dose measurements, using Thermo-Luminescent Dosimeters (TLDs), were performed on more than 100 patients on various procedures. The results show that while the patient dose from the great majority of angiographic procedures is less than 2 Gy, a significant number of procedures, especially interventional procedures may have doses greater than 2 Gy and may lead to deterministic effects. (author)

  14. Administrative Procedure Act and mass procedures (illustrated by the nuclear licensing procedure)

    International Nuclear Information System (INIS)

    Naumann, R.

    1977-01-01

    The report deals with the administrative procedure law of 25.5.76 of the Fed. Government, esp. with its meaning for the administrative procedures for the permission for nuclear power plants, as fas ar so-called mass procedures are concerned. (UN) [de

  15. SAJS SAJS

    African Journals Online (AJOL)

    2009-05-25

    May 25, 2009 ... indicated for all patients with clinical evidence of significant ... BOWA is the intelligent electro-surgical unit for advanced procedures of all ... coated metal spiral and ergonomic hangle design with serrated oval cup design.

  16. Safeguards management inspection procedures

    International Nuclear Information System (INIS)

    Barth, M.J.; Dunn, D.R.

    1984-08-01

    The objective of this inspection module is to independently assess the contributions of licensee management to overall safeguards systems performance. The inspector accomplishes this objective by comparing the licensee's safeguards management to both the 10 CFR, parts 70 and 73, requirements and to generally accepted management practices. The vehicle by which this comparison is to be made consists of assessment questions and key issues which point the inspector to areas of primary concern to the NRC and which raise additional issues for the purpose of exposing management ineffectiveness. Further insight into management effectiveness is obtained through those assessment questions specifically directed toward the licensee's safeguards system performance. If the quality of the safeguards is poor, then the inspector should strongly suspect that management's role is ineffective and should attempt to determine management's influence (or lack thereof) on the underlying safeguards deficiencies. (The converse is not necessarily true, however.) The assessment questions in essence provide an opportunity for the inspector to identify, to single out, and to probe further, questionable management practices. Specific issues, circumstances, and concerns which point to questionable or inappropriate practices should be explicitly identified and referenced against the CFR and the assessment questions. The inspection report should also explain why the inspector feels certain management practices are poor, counter to the CFR, and/or point to ineffecive management. Concurrent with documenting the inspection results, the inspector should provide recommendations for alleviating observed management practices that are detrimental to effective safeguards. The recommendations could include: specific changes in the practices of the licensee, followup procedures on the part of NRC, and proposed license changes

  17. AGREED-UPON PROCEDURES, PROCEDURES FOR AUDITING EUROPEAN GRANTS

    Directory of Open Access Journals (Sweden)

    Daniel Petru VARTEIU

    2016-12-01

    The audit of EU-funded projects is an audit based on agreed-upon procedures, which are established by the Managing Authority or the Intermediate Body. Agreed-upon procedures can be defined as engagements made in accordance with ISRS 4400, applicable to agreed-upon procedures, where the auditor undertakes to carry out the agreed-upon procedures and issue a report on factual findings. The report provided by the auditor does not express any assurance. It allows users to form their own opinions about the conformity of the expenses with the project budget as well as the eligibility of the expenses.

  18. Aesthetic procedures in office practice.

    Science.gov (United States)

    Small, Rebecca

    2009-12-01

    Since the approval of botulinum toxin, dermal fillers, and lasers for cosmetic use, minimally invasive aesthetic procedures have rapidly become the treatments of choice for age-related facial changes. In the past 10 years, aesthetic procedures have increased nearly five-fold. Of the 10.2 million aesthetic treatments performed in 2008, 83 percent were minimally invasive procedures. Botulinum toxin and dermal filler injections, laser hair reduction, chemical peels, laser skin resurfacing, microdermabrasion, and intense pulsed light photorejuvenation were the most commonly performed procedures in 2008. These procedures are effective and associated with minimal discomfort, and they have a low incidence of adverse effects and short recovery times. High patient and physician satisfaction have contributed to their growing popularity and availability in the primary care setting. As patient demand for aesthetic treatments increases, family physicians should be familiar with common minimally invasive aesthetic procedures when advising patients or incorporating aesthetic care into office practice.

  19. Characteristics of Mobile Payment Procedures

    OpenAIRE

    Kreyer, Nina; Pousttchi, Key; Turowski, Klaus

    2002-01-01

    Companies are not going to invest into the development of innovative applications or services unless these can be charged for appropriately. Thus, the existence of standardized and widely accepted mobile payment procedures is crucial for successful business-to-customer mobile commerce. The acceptance of mobile payment procedures depends on costs, security and convenience issues. For the latter, it is important that a procedure can be used over the different payment scenarios mobile commerce, ...

  20. Coding for urologic office procedures.

    Science.gov (United States)

    Dowling, Robert A; Painter, Mark

    2013-11-01

    This article summarizes current best practices for documenting, coding, and billing common office-based urologic procedures. Topics covered include general principles, basic and advanced urologic coding, creation of medical records that support compliant coding practices, bundled codes and unbundling, global periods, modifiers for procedure codes, when to bill for evaluation and management services during the same visit, coding for supplies, and laboratory and radiology procedures pertinent to urology practice. Detailed information is included for the most common urology office procedures, and suggested resources and references are provided. This information is of value to physicians, office managers, and their coding staff. Copyright © 2013 Elsevier Inc. All rights reserved.

  1. Acquisition Policy and Procedures Program

    National Research Council Canada - National Science Library

    2001-01-01

    This Instruction establishes policies, responsibilities, and procedures for the procurement of goods and services to include supplies, equipment, publications, furniture, and information technology...

  2. Electronic Procedures for Medical Operations

    Science.gov (United States)

    2015-01-01

    Electronic procedures are replacing text-based documents for recording the steps in performing medical operations aboard the International Space Station. S&K Aerospace, LLC, has developed a content-based electronic system-based on the Extensible Markup Language (XML) standard-that separates text from formatting standards and tags items contained in procedures so they can be recognized by other electronic systems. For example, to change a standard format, electronic procedures are changed in a single batch process, and the entire body of procedures will have the new format. Procedures can be quickly searched to determine which are affected by software and hardware changes. Similarly, procedures are easily shared with other electronic systems. The system also enables real-time data capture and automatic bookmarking of current procedure steps. In Phase II of the project, S&K Aerospace developed a Procedure Representation Language (PRL) and tools to support the creation and maintenance of electronic procedures for medical operations. The goal is to develop these tools in such a way that new advances can be inserted easily, leading to an eventual medical decision support system.

  3. Pollutant Assessments Group procedures manual: Volume 2, Technical procedures

    Energy Technology Data Exchange (ETDEWEB)

    1992-03-01

    This is volume 2 of the manuals that describes the technical procedures currently in use by the Pollution Assessments Group. This manual incorporates new developments in hazardous waste assessment technology and administrative policy. Descriptions of the equipment, procedures and operations of such things as radiation detection, soil sampling, radionuclide monitoring, and equipment decontamination are included in this manual. (MB)

  4. Proof Rules for Recursive Procedures

    NARCIS (Netherlands)

    Hesselink, Wim H.

    1993-01-01

    Four proof rules for recursive procedures in a Pascal-like language are presented. The main rule deals with total correctness and is based on results of Gries and Martin. The rule is easier to apply than Martin's. It is introduced as an extension of a specification format for Pascal-procedures, with

  5. Laparoscopic reversal of Hartmann's procedure

    DEFF Research Database (Denmark)

    Svenningsen, Peter Olsen; Bulut, Orhan; Jess, Per

    2010-01-01

    of Hartmann's procedure as safely as in open surgery and with a faster recovery, shorter hospital stay and less blood loss despite a longer knife time. It therefore seems reasonable to offer patients a laparoscopic procedure at departments which are skilled in laparoscopic surgery and use it for standard...

  6. Developing Competency in Payroll Procedures

    Science.gov (United States)

    Jackson, Allen L.

    1975-01-01

    The author describes a sequence of units that provides for competency in payroll procedures. The units could be the basis for a four to six week minicourse and are adaptable, so that the student, upon completion, will be able to apply his learning to any payroll procedures system. (Author/AJ)

  7. Failure to Follow Written Procedures

    Science.gov (United States)

    2017-12-01

    Most tasks in aviation have a mandated written procedure to be followed specifically under the Code of Federal Regulations (CFR) Part 14, Section 43.13(a). However, the incidence of Failure to Follow Procedure (FFP) events continues to be a major iss...

  8. Procedure for taking physical inventories

    International Nuclear Information System (INIS)

    Anon.

    1981-01-01

    This session is intended to apprise one of the various aspects of procedures and routines that Exxon Nuclear uses with respect to its nuclear materials physical inventory program. The presentation describes how plant physical inventories are planned and taken. The description includes the planning and preparation for taking the inventory, the clean-out procedures for converting in-process material to measurable items, the administrative procedures for establishing independent inventory teams and for inventorying each inventory area, the verification procedures used to include previously measured tamper-safed items in the inventory, and lastly, procedures used to reconcile the inventory and calculate MUF (materials unaccounted for). The purpose of the session is to enable participants to: (1) understand the planning and pre-inventorty procedures and their importance; (2) understand the need for and the required intensity of clean-out procedures; (3) understand how inventory teams are formed, and how the inventory is conducted; (4) understand the distinction between inventory previously measured tamper-safed items and other materials not so characterized; (5) understand the reconciliation procedures; and (6) calculate a MUF given the book and inventory results

  9. Biomass Compositional Analysis Laboratory Procedures | Bioenergy | NREL

    Science.gov (United States)

    Biomass Compositional Analysis Laboratory Procedures Biomass Compositional Analysis Laboratory Procedures NREL develops laboratory analytical procedures (LAPs) for standard biomass analysis. These procedures help scientists and analysts understand more about the chemical composition of raw biomass

  10. Simplified Laboratory Runoff Procedure (SLRP): Procedure and Application

    National Research Council Canada - National Science Library

    Price, Richard

    2000-01-01

    The Simplified Laboratory Runoff Procedure (SLRP) was developed to provide a faster, less expensive approach to evaluate surface runoff water quality from dredged material placed in an upland environment...

  11. Pelvic denervation procedures for dysmenorrhea.

    Science.gov (United States)

    Ramirez, Christina; Donnellan, Nicole

    2017-08-01

    Chronic pelvic pain and dysmenorrhea are common conditions affecting reproductive-age women. Surgical pelvic denervation procedures may be a treatment option for women with midline dysmenorrhea, in which medical management is declined by the patient, ineffective at managing symptoms, or medically contraindicated. This review describes the surgical techniques and complications associated with pelvic denervation procedures as well as the current evidence for these procedures in women with primary dysmenorrhea and dysmenorrhea secondary to endometriosis. Presacral neurectomy is the preferred pelvic denervation procedure in patients with primary dysmenorrhea and midline chronic pelvic pain associated with endometriosis. In patients with endometriosis presacral neurectomy is a useful adjunct to excision or ablation of all endometrial lesions to improve postoperative pain relief. There is no additional patient benefit of performing combined presacral neurectomy and uterine nerve ablation procedures. Pelvic denervation procedures can be performed safely and quickly with a low risk of complication if the surgeon is knowledgeable and skilled in operating in the presacral space. Patients should be adequately counseled on expected success rates and potential complications associated with pelvic denervation procedures.

  12. Specified assurance level sampling procedure

    International Nuclear Information System (INIS)

    Willner, O.

    1980-11-01

    In the nuclear industry design specifications for certain quality characteristics require that the final product be inspected by a sampling plan which can demonstrate product conformance to stated assurance levels. The Specified Assurance Level (SAL) Sampling Procedure has been developed to permit the direct selection of attribute sampling plans which can meet commonly used assurance levels. The SAL procedure contains sampling plans which yield the minimum sample size at stated assurance levels. The SAL procedure also provides sampling plans with acceptance numbers ranging from 0 to 10, thus, making available to the user a wide choice of plans all designed to comply with a stated assurance level

  13. ANAESTHESIA FOR OPHTHALMIC SURGICAL PROCEDURES

    African Journals Online (AJOL)

    Objective: To review factors influencing the choice of anaesthesia for ophthalmic surgical procedures. ... as risk associated with general anaesthesia (8) they are more .... Wilson ME, Pandey SK, Thakur J. Paediatric cataract blindness in the ...

  14. Adequate procedures for specific exams

    International Nuclear Information System (INIS)

    Staevie, G.L.G.; Gattringer, D.K.; Dal Mas, C.R.; Tessman, M.

    1996-01-01

    Some ideal procedures for specific radiographic exams are briefly presented. The aim is to improve the quality standard, establishing a specific method for each exam in order to decrease films waste and reduce the patient dose exposure

  15. An Analytical Cost Estimation Procedure

    National Research Council Canada - National Science Library

    Jayachandran, Toke

    1999-01-01

    Analytical procedures that can be used to do a sensitivity analysis of a cost estimate, and to perform tradeoffs to identify input values that can reduce the total cost of a project, are described in the report...

  16. Soil Gas Sampling Operating Procedure

    Science.gov (United States)

    EPA Region 4 Science and Ecosystem Support Division (SESD) document that describes general and specific procedures, methods, and considerations when collecting soil gas samples for field screening or laboratory analysis.

  17. Construction inspection manual of procedures

    Science.gov (United States)

    2009-01-01

    This manual provides highway construction personnel with relevant, practical information in order to perform accurate inspections and provide relevant construction procedural information for the various roadway and structures items of work. It is the...

  18. Fusion Imaging for Procedural Guidance.

    Science.gov (United States)

    Wiley, Brandon M; Eleid, Mackram F; Thaden, Jeremy J

    2018-05-01

    The field of percutaneous structural heart interventions has grown tremendously in recent years. This growth has fueled the development of new imaging protocols and technologies in parallel to help facilitate these minimally-invasive procedures. Fusion imaging is an exciting new technology that combines the strength of 2 imaging modalities and has the potential to improve procedural planning and the safety of many commonly performed transcatheter procedures. In this review we discuss the basic concepts of fusion imaging along with the relative strengths and weaknesses of static vs dynamic fusion imaging modalities. This review will focus primarily on echocardiographic-fluoroscopic fusion imaging and its application in commonly performed transcatheter structural heart procedures. Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  19. Surface Environmental Surveillance Procedures Manual

    Energy Technology Data Exchange (ETDEWEB)

    Hanf, RW; Dirkes, RL

    1990-02-01

    This manual establishes the procedures for the collection of environmental samples and the performance of radiation surveys and other field measurements. Responsibilities are defined for those personnel directly involved in the collection of samples and the performance of field measurements.

  20. FFTF reactor plant procedures plan

    International Nuclear Information System (INIS)

    1972-01-01

    The document presented defines the plan to be used to coordinate the preparation, review, approval, and issuance of the operating procedure documents required to ensure safe and efficient operation of FFTF

  1. Adolescent test or procedure preparation

    Science.gov (United States)

    ... someone else) during the procedure Playing hand-held video games Using guided imagery Trying other distractions, such as ... effects the test may cause. Older teens may benefit from videos that show adolescents of the same age explaining ...

  2. Environmental protection and procedural law

    International Nuclear Information System (INIS)

    Mutschler, U.

    1978-01-01

    For the power industry which is 'independent of licensing', the Ule/Laubinger statement as well as its discussion on the 52th German legal experts' day are of considerable importance. It is therefore absolutely necessary to critically investigate the statements of this expert's opinion and the considerations on which they are based. This investigation is limited to those licensing procedures which in the terminology of experts, are 'similar to the plan approval procedure'. This applies mainly to the procedures according to paragraph 4 ff of the Federal Act on the Protection Against Nuisances and paragraph 7 of the Atomic Energy Law: Preliminaries publication of documents, inspection of files, public hearing, taking of evidence, persons with special responsibilities, administrative proceedings, actions by associations. The deficiencies in the execution of environmental procedural law is briefly mentioned. The notes in the article refer only to air pollution. (orig./HP) [de

  3. Urinary incontinence - vaginal sling procedures

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/007376.htm Urinary incontinence - vaginal sling procedures To use the sharing features ... are types of surgeries that help control stress urinary incontinence . This is urine leakage that happens when you ...

  4. Safety analysis procedures for PHWR

    International Nuclear Information System (INIS)

    Min, Byung Joo; Kim, Hyoung Tae; Yoo, Kun Joong

    2004-03-01

    The methodology of safety analyses for CANDU reactors in Canada, a vendor country, uses a combination of best-estimate physical models and conservative input parameters so as to minimize the uncertainty of the plant behavior predictions. As using the conservative input parameters, the results of the safety analyses are assured the regulatory requirements such as the public dose, the integrity of fuel and fuel channel, the integrity of containment and reactor structures, etc. However, there is not the comprehensive and systematic procedures for safety analyses for CANDU reactors in Korea. In this regard, the development of the safety analyses procedures for CANDU reactors is being conducted not only to establish the safety analyses system, but also to enhance the quality assurance of the safety assessment. In the first phase of this study, the general procedures of the deterministic safety analyses are developed. The general safety procedures are covered the specification of the initial event, selection of the methodology and accident sequences, computer codes, safety analysis procedures, verification of errors and uncertainties, etc. Finally, These general procedures of the safety analyses are applied to the Large Break Loss Of Coolant Accident (LBLOCA) in Final Safety Analysis Report (FSAR) for Wolsong units 2, 3, 4

  5. Collected radiochemical and geochemical procedures

    Energy Technology Data Exchange (ETDEWEB)

    Kleinberg, J [comp.

    1990-05-01

    This revision of LA-1721, 4th Ed., Collected Radiochemical Procedures, reflects the activities of two groups in the Isotope and Nuclear Chemistry Division of the Los Alamos National Laboratory: INC-11, Nuclear and radiochemistry; and INC-7, Isotope Geochemistry. The procedures fall into five categories: I. Separation of Radionuclides from Uranium, Fission-Product Solutions, and Nuclear Debris; II. Separation of Products from Irradiated Targets; III. Preparation of Samples for Mass Spectrometric Analysis; IV. Dissolution Procedures; and V. Geochemical Procedures. With one exception, the first category of procedures is ordered by the positions of the elements in the Periodic Table, with separate parts on the Representative Elements (the A groups); the d-Transition Elements (the B groups and the Transition Triads); and the Lanthanides (Rare Earths) and Actinides (the 4f- and 5f-Transition Elements). The members of Group IIIB-- scandium, yttrium, and lanthanum--are included with the lanthanides, elements they resemble closely in chemistry and with which they occur in nature. The procedures dealing with the isolation of products from irradiated targets are arranged by target element.

  6. Measuring variability of procedure progression in proceduralized scenarios

    International Nuclear Information System (INIS)

    Kim, Yochan; Park, Jinkyun; Jung, Wondea

    2012-01-01

    Highlights: ► The VPP measure was developed to quantify how differently operators follow the procedures. ► Sources that cause variability of ways to follow a given procedure were identified. ► The VPP values for the scenarios are positively related to the scenario performance time. ► The VPP measure is meaningful for explaining characteristics of several PSFs. -- Abstract: Various performance shaping factors (PSFs) have been presented to explain the contributors to unsafe acts in a human failure event or predict a human error probability of new human performance. However, because most of these parameters of an HRA depend on the subjective knowledge and experience of HRA analyzers, the results of an HRA insufficiently provide unbiased standards to explain human performance variations or compare collected data with other data from different analyzers. To secure the validity of the HRA results, we propose a quantitative measure, which represents the variability of procedure progression (VPP) in proceduralized scenarios. A VPP measure shows how differently the operators follow the steps of the procedures. This paper introduces the sources of the VPP measure and relevance to PSFs. The assessment method of the VPP measure is also proposed, and the application examples are shown with a comparison of the performance time. Although more empirical studies should be conducted to reveal the relationship between the VPP measure and other PSFs, it is believed that the VPP measure provides evidence to quantitatively evaluate human performance variations and to cross-culturally compare the collected data.

  7. Program Baseline Change Control Procedure

    International Nuclear Information System (INIS)

    1993-02-01

    This procedure establishes the responsibilities and process for approving initial issues of and changes to the technical, cost, and schedule baselines, and selected management documents developed by the Office of Civilian Radioactive Waste Management (OCRWM) for the Civilian Radioactive Waste Management System. This procedure implements the OCRWM Baseline Management Plan and DOE Order 4700.1, Chg 1. It streamlines the change control process to enhance integration, accountability, and traceability of Level 0 and Level I decisions through standardized Baseline Change Proposal (BCP) forms to be used by the Level 0, 1, 2, and 3 Baseline Change Control Boards (BCCBs) and to be tracked in the OCRWM-wide Configuration Information System (CIS) Database.This procedure applies to all technical, cost, and schedule baselines controlled by the Energy System Acquisition Advisory Board (ESAAB) BCCB (Level 0) and, OCRWM Program Baseline Control Board (PBCCB) (Level 1). All baseline BCPs initiated by Level 2 or lower BCCBs, which require approval from ESAAB or PBCCB, shall be processed in accordance with this procedure. This procedure also applies to all Program-level management documents controlled by the OCRWM PBCCB

  8. Designing Flightdeck Procedures: Literature Resources

    Science.gov (United States)

    Feldman, Jolene; Barshi, Immanuel; Degani, Asaf; Loukopoulou, Loukia; Mauro, Robert

    2017-01-01

    This technical publication contains the titles, abstracts, summaries, descriptions, and/or annotations of available literature sources on procedure design and development, requirements, and guidance. It is designed to provide users with an easy access to available resources on the topic of procedure design, and with a sense of the contents of these sources. This repository of information is organized into the following publication sources: Research (e.g., journal articles, conference proceedings), Manufacturers' (e.g., operation manuals, newsletters), and Regulatory and/or Government (e.g., advisory circulars, reports). An additional section contains synopses of Accident/Incident Reports involving procedures. This work directly supports a comprehensive memorandum by Barshi, Mauro, Degani, & Loukopoulou (2016) that summarizes the results of a multi-year project, partially funded by the FAA, to develop technical reference materials that support guidance on the process of developing cockpit procedures (see "Designing Flightdeck Procedures" https://ntrs.nasa.gov/archive/nasa/casi.ntrs.nasa.gov/20160013263.pdf). An extensive treatment of this topic is presented in a forthcoming book by the same authors.

  9. New procedure for departure formalities

    CERN Multimedia

    HR & GS Departments

    2011-01-01

    As part of the process of simplifying procedures and rationalising administrative processes, the HR and GS Departments have introduced new personalised departure formalities on EDH. These new formalities have applied to students leaving CERN since last year and from 17 October 2011 this procedure will be extended to the following categories of CERN personnel: Staff members, Fellows and Associates. It is planned to extend this electronic procedure to the users in due course. What purpose do departure formalities serve? The departure formalities are designed to ensure that members of the personnel contact all the relevant services in order to return any necessary items (equipment, cards, keys, dosimeter, electronic equipment, books, etc.) and are aware of all the benefits to which they are entitled on termination of their contract. The new departure formalities on EDH have the advantage of tailoring the list of services that each member of the personnel must visit to suit his individual contractual and p...

  10. Design Procedure for Hybrid Ventilation

    DEFF Research Database (Denmark)

    Heiselberg, Per; Tjelflaat, Per Olaf

    Mechanical and natural ventilation systems have developed separately during many years. The natural next step in this development is development of ventilation concepts that utilises and combines the best features from each system into a new type of ventilation system - Hybrid Ventilation....... Buildings with hybrid ventilation often include other sustainable technologies and an energy optimisation requires an integrated approach in the design of the building and its mechanical systems. Therefore, the hybrid ventilation design procedure differs from the design procedure for conventional HVAC....... The first ideas on a design procedure for hybrid ventilation is presented and the different types of design methods, that is needed in different phases of the design process, is discussed....

  11. Acute Procedural Pain in Children

    DEFF Research Database (Denmark)

    Kristensen, Helle Nygård; Lundbye-Christensen, Søren; Haslund-Thomsen, Helle

    2018-01-01

    INTRODUCTION: Hospitalized children often describe needle-related procedures as the worst pain possible and such procedures may be emotionally traumatic. The use of hospital clowns related to painful medical procedures in children may offer pain relief, but this has not been systematically...... evaluated. The objective of this study was to assess the effect of a therapeutic clown in comparison to standard care on the experience of pain for children receiving venipuncture. METHODS: A sample of 116 children aged 4-15 years consecutively admitted to the hospital was allocated to either......: Without the clown present, the mean pain score (2.7±2.8) was not significantly different between the two age groups. Children aged 7-15 years had lower pain scores when the clown was present compared to the control group (P=0.025). Children aged 4-6 years had higher pain scores with the clown present...

  12. MITG test procedure and results

    International Nuclear Information System (INIS)

    Eck, M.E.; Mukunda, M.

    1983-01-01

    Elements and modules for Radioisotope Thermoelectric Generator have been performance tested since the inception of the RTG program. These test articles seldom resembled flight hardware and often lacked adequate diagnostic instrumentation. Because of this, performance problems were not identified in the early stage of program development. The lack of test data in an unexpected area often hampered the development of a problem solution. A procedure for conducting the MITG Test was developed in an effort to obtain data in a systematic, unambiguous manner. This procedure required the development of extensive data acquisition software and test automation. The development of a facility to implement the test procedure, the facility hardware and software requirements, and the results of the MITG testing are the subject of this paper

  13. Radiation control standards and procedures

    Energy Technology Data Exchange (ETDEWEB)

    1956-12-14

    This manual contains the Radiation Control Standards'' and Radiation Control Procedures'' at Hanford Operations which have been established to provide the necessary control radiation exposures within Irradiation Processing Department. Provision is also made for including, in the form of Bulletins'', other radiological information of general interest to IPD personnel. The purpose of the standards is to establish firm radiological limits within which the Irradiation Processing Department will operate, and to outline our radiation control program in sufficient detail to insure uniform and consistent application throughout all IPD facilities. Radiation Control Procedures are intended to prescribe the best method of accomplishing an objective within the limitations of the Radiation Control Standards. A procedure may be changed at any time provided the suggested changes is generally agreeable to management involved, and is consistent with department policies and the Radiation Control Standards.

  14. MR diagnostics after Ross procedure

    International Nuclear Information System (INIS)

    Steffens, J.C.; Link, J.; Harringer, W.; Haverich, A.; Heller, M.

    1996-01-01

    Purpose: To determine the ability of MRI to diagnose morphological and functional changes in patients after Ross procedure. Material and methods: During one year, 5 patients after Ross procedure were studied by MRI. T 1 -weighted spin-echo sequences in different orientations as well as cine sequences and a VENC-sequence were used. Results: In all patients the morphology including the postoperative changes could be visualised by MRI. The cine sequences provided functional information on valvular and ventricular function. VENC-MR yielded an exact quantification of the regurgitant fraction. Conclusion: MRI is capable of providing all important diagnostic information in patients after Ross procedure such as valvular and ventricular function and valvular and outflow tract morphology in a single examination. (orig.) [de

  15. Transversal of Procedure Elements in a Computerized Procedure System

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Yeonsub [KHNP Central Research Institute, Daejeon (Korea, Republic of)

    2014-05-15

    APR1400 MCR(Main Control Room) has introduced CPS(Computerized Procedure System). APR400 CPS is framed with overview pane, step detail pane, and monitoring pane. The overview shows the step in one dimensional array. Diagram in the step detail pane is called as flowlogic diagram. The flowlogic diagram has advantage of being intuitive and not being segmented so that the interfaces are easy to follow and understand. While developing CPS software or training operators these interfaces, however, there is still areas to refine behaviors of flowlogic diagram. If flowlogic diagram has contingency instructions, it is sometime difficult to interpret it properly. Therefore this paper is trying to explain behavior of flowlogic diagram in view of procedure elements. Procedure execution can be called as transversal of steps and instructions in flowlogic diagram. Both hierarchy of procedures elements and flowlogic diagram provides useful framework to test transversal with completeness. Navigation button behaviors are interpreted in view of flowlogic diagram. The framework and flowlogic diagram can be further applied to improve CPS user interfaces.

  16. Procedures monitoring and MAAP analysis

    International Nuclear Information System (INIS)

    May, R.S.

    1991-01-01

    Numerous studies of severe accidents in light water reactors have shown that operator response can play a crucial role in the predicted outcomes of dominant accident scenarios. MAAP provides the capability to specify certain operator actions as input data. However, making reasonable assumptions about the nature and timing of operator response requires substantial knowledge about plant practices and procedures and what they imply for the event being analyzed. The appearance of knowledge based software technology in the mid-1980s provided a natural format for representing and maintaining procedures as IF-THEN rules. The boiling water reactor (BWR) Emergency Operating Procedures Tracking System (EOPTS) was composed of a rule base of procedures and a dedicated inference engine (problem-solver). Based on the general approach and experience of EOPTS, the authors have developed a prototype procedures monitoring system that reads MAAP transient output files and evaluate the EOP messages and instructions that would be implied during each transient time interval. The prototype system was built using the NEXPERT OBJECT expert system development system, running on a 386-class personal computer with 4 MB of memory. The limited scope prototype includes a reduced set of BWR6 EOPs procedures evaluation on a coarse time interval, a simple text-based user interface, and a summary-report generator. The prototype, which is limited to batch-mode analysis of MAAP output, is intended to demonstrate the concept and aid in the design of a production system, which will involve a direct link to MAAP and interactive capabilities

  17. Interventional chest procedures in pregnancy.

    LENUS (Irish Health Repository)

    Morgan, Ross K

    2012-02-01

    Interventional pulmonology encompasses diagnostic and therapeutic bronchoscopic procedures, and pleural interventions. In the last 10 years older techniques have been refined and exciting new technologies have extended the reach and application of the instruments used. The main areas within pulmonary medicine for which these interventions have a role are malignant and nonmalignant airway disease, pleural effusion, pneumothorax, and artificial airways. There are no data from well-designed prospective trials to guide recommendations for interventional pulmonary procedures in pregnancy. The recommendations provided in this article are based on critical review of reported case series, opinion from recognized experts, and personal observations.

  18. Interventional chest procedures in pregnancy.

    LENUS (Irish Health Repository)

    Morgan, Ross K

    2011-03-01

    Interventional pulmonology encompasses diagnostic and therapeutic bronchoscopic procedures, and pleural interventions. In the last 10 years older techniques have been refined and exciting new technologies have extended the reach and application of the instruments used. The main areas within pulmonary medicine for which these interventions have a role are malignant and nonmalignant airway disease, pleural effusion, pneumothorax, and artificial airways. There are no data from well-designed prospective trials to guide recommendations for interventional pulmonary procedures in pregnancy. The recommendations provided in this article are based on critical review of reported case series, opinion from recognized experts, and personal observations.

  19. FFTF operations procedures preparation guide. Revision 2

    International Nuclear Information System (INIS)

    1976-12-01

    The Guide is intended to provide guidelines for the initial preparation of FFTF Operating Procedures. The Procedures Preparation Guide was developed from the plan presented and approved in the FFTF Reactor Plant Procedures Plan, PC-1, Revision 3

  20. Guide to Alabama Court Procedures.

    Science.gov (United States)

    Alabama Administrative Office of Courts, Montgomery.

    Designed to assist the public in understanding the judicial system and judicial process in Alabama, this handbook (1) presents an overview of Alabama's courts and their jurisdictions, (2) identifies the officers of the courts and the contributions each makes to the judicial process, and (3) narrates in general terms the procedures most common to…

  1. On Procedural Freedom of Choice

    NARCIS (Netherlands)

    Arlegi, R.; Dimitrov, D.A.

    2004-01-01

    Numerous works in the last decade have analyzed the question of how to compare opportunity sets as a way to measure and evaluate individual freedom of choice.This paper defends that, in many contexts, external procedural aspects that are associated to an opportunity set should be taken into account

  2. Core calculational techniques and procedures

    International Nuclear Information System (INIS)

    Romano, J.J.

    1977-10-01

    Described are the procedures and techniques employed by B and W in core design analyses of power peaking, control rod worths, and reactivity coefficients. Major emphasis has been placed on current calculational tools and the most frequently performed calculations over the operating power range

  3. Environmental Impact Assessment: A Procedure.

    Science.gov (United States)

    Stover, Lloyd V.

    Prepared by a firm of consulting engineers, this booklet outlines the procedural "whys and hows" of assessing environmental impact, particularly for the construction industry. Section I explores the need for environmental assessment and evaluation to determine environmental impact. It utilizes a review of the National Environmental Policy Act and…

  4. International evaluation procedure for Supergrants

    OpenAIRE

    2010-01-01

    Sergey Ivanets, director of the department of international integration at the Ministry of Education and Science, talks about the specifics of the evaluation procedures for inviting leading scientists (Decree of the Government of the Russian Federation dated April 9, 2010, N 220: "On Measures for Attracting Leading Scientists into Russian Higher Professional Educational Institutions")

  5. Cognitive Procedures and Hyperbolic Discounting

    NARCIS (Netherlands)

    Nir, A.

    2004-01-01

    "Hyperbolic discount functions are characterized by a relatively high discount rate over short horizons and a relatively low discount rate over long horizons" (Laibson 1997).We suggest two cognitive procedures where individuals perceive future utility as decreasing at a decreasing rate as a function

  6. Safety procedures for radiography works

    International Nuclear Information System (INIS)

    Abd Nasir Ibrahim; Azali Muhammad; Ab Razak Hamzah; Abd Aziz Mohamed; Mohammad Pauzi Ismail

    2004-01-01

    The following subjects are discussed - Work preparation: before exposure, during exposure, after work completion. Radiographic work at the open site: types of open sites, establishment of radiographic boundary, storage of radiographic equipment at sites. Safety procedures for radiography works; radiographic works in exposure room

  7. Postoperative Complications of Beger Procedure

    Directory of Open Access Journals (Sweden)

    Nayana Samejima Peternelli

    2015-01-01

    Full Text Available Introduction. Chronic pancreatitis (CP is considered an inflammatory disease that may cause varying degrees of pancreatic dysfunction. Conservative and surgical treatment options are available depending on dysfunction severity. Presentation of Case. A 36-year-old male with history of heavy alcohol consumption and diagnosed CP underwent a duodenal-preserving pancreatic head resection (DPPHR or Beger procedure after conservative treatment failure. Refractory pain was reported on follow-up three months after surgery and postoperative imaging uncovered stones within the main pancreatic duct and intestinal dilation. The patient was subsequently subjected to another surgical procedure and intraoperative findings included protein plugs within the main pancreatic duct and pancreaticojejunal anastomosis stricture. A V-shaped enlargement and main pancreatic duct dilation in addition to the reconstruction of the previous pancreaticojejunal anastomosis were performed. The patient recovered with no further postoperative complications in the follow-up at an outpatient clinic. Discussion. Main duct and pancreaticojejunal strictures are an unusual complication of the Beger procedure but were identified intraoperatively as the cause of patient’s refractory pain and explained intraductal protein plugs accumulation. Conclusion. Patients that undergo Beger procedures should receive close outpatient clinical follow-up in order to guarantee postoperative conservative treatment success and therefore guarantee an early detection of postoperative complications.

  8. Procedural learning during declarative control.

    Science.gov (United States)

    Crossley, Matthew J; Ashby, F Gregory

    2015-09-01

    There is now abundant evidence that human learning and memory are governed by multiple systems. As a result, research is now turning to the next question of how these putative systems interact. For instance, how is overall control of behavior coordinated, and does learning occur independently within systems regardless of what system is in control? Behavioral, neuroimaging, and neuroscience data are somewhat mixed with respect to these questions. Human neuroimaging and animal lesion studies suggest independent learning and are mostly agnostic with respect to control. Human behavioral studies suggest active inhibition of behavioral output but have little to say regarding learning. The results of two perceptual category-learning experiments are described that strongly suggest that procedural learning does occur while the explicit system is in control of behavior and that this learning might be just as good as if the procedural system was controlling the response. These results are consistent with the idea that declarative memory systems inhibit the ability of the procedural system to access motor output systems but do not prevent procedural learning. (c) 2015 APA, all rights reserved).

  9. Current procedural terminology; a primer.

    Science.gov (United States)

    Hirsch, Joshua A; Leslie-Mazwi, Thabele M; Nicola, Gregory N; Barr, Robert M; Bello, Jacqueline A; Donovan, William D; Tu, Raymond; Alson, Mark D; Manchikanti, Laxmaiah

    2015-04-01

    In 1966, The American Medical Association (AMA) working with multiple major medical specialty societies developed an iterative coding system for describing medical procedures and services using uniform language, the Current Procedural Terminology (CPT) system. The current code set, CPT IV, forms the basis of reporting most of the services performed by healthcare providers, physicians and non-physicians as well as facilities allowing effective, reliable communication among physician and other providers, third parties and patients. This coding system and its maintenance has evolved significantly since its inception, and now goes well beyond its readily perceived role in reimbursement. Additional roles include administrative management, tracking new and investigational procedures, and evolving aspects of 'pay for performance'. The system also allows for local, regional and national utilization comparisons for medical education and research. Neurointerventional specialists use CPT category I codes regularly--for example, 36,215 for first-order cerebrovascular angiography, 36,216 for second-order vessels, and 37,184 for acute stroke treatment by mechanical means. Additionally, physicians add relevant modifiers to the CPT codes, such as '-26' to indicate 'professional charge only,' or '-59' to indicate a distinct procedural service performed on the same day. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  10. Procedural Personas for Player Decision Modeling and Procedural Content Generation

    DEFF Research Database (Denmark)

    Holmgård, Christoffer

    2016-01-01

    ." These methods for constructing procedural personas are then integrated with existing procedural content generation systems, acting as critics that shape the output of these systems, optimizing generated content for different personas and by extension, different kinds of players and their decision making styles......How can player models and artificially intelligent (AI) agents be useful in early-stage iterative game and simulation design? One answer may be as ways of generating synthetic play-test data, before a game or level has ever seen a player, or when the sampled amount of play test data is very low....... This thesis explores methods for creating low-complexity, easily interpretable, generative AI agents for use in game and simulation design. Based on insights from decision theory and behavioral economics, the thesis investigates how player decision making styles may be defined, operationalised, and measured...

  11. Pediatric procedural sedation and analgesia

    Directory of Open Access Journals (Sweden)

    Meredith James

    2008-01-01

    Full Text Available Procedural sedation and analgesia (PSA is an evolving field in pediatric emergency medicine. As new drugs breach the boundaries of anesthesia in the Pediatric Emergency Department, parents, patients, and physicians are finding new and more satisfactory methods of sedation. Short acting, rapid onset agents with little or no lingering effects and improved safety profiles are replacing archaic regimens. This article discusses the warning signs and areas of a patient′s medical history that are particularly pertinent to procedural sedation and the drugs used. The necessary equipment is detailed to provide the groundwork for implementing safe sedation in children. It is important for practitioners to familiarize themselves with a select few of the PSA drugs, rather than the entire list of sedatives. Those agents most relevant to PSA in the pediatric emergency department are presented.

  12. Investigative procedures in thyroid cancer

    International Nuclear Information System (INIS)

    Samuel, A.M.

    1999-01-01

    One of the main objectives of the procedures is to establish the likelihood of malignancy in the thyroid gland prior to surgery and detect metastases after surgery. Thyroid imaging is discussed in the context of (a) its role in the diagnosis of the primary disease (b) in the investigation of post-operative residual disease and (c) its role in the follow-up of patients after radioiodine therapy

  13. New procedures in nuclear medicine

    International Nuclear Information System (INIS)

    Spencer, R.P.

    1989-01-01

    The authors review the recent emergence of functional studies in nuclear medicine in this critical and informative text. The new procedures are presented in terms of their underlying physiology, indications, contraindications, methodology, results, interpretation and relationship to other evaluations. The volume includes discussions on the central nervous system, interventional studies, cardiac studies, bone densitometry, plus radiolabeled antibodies, radiolabeling of blood elements and flow and distribution

  14. Surface Environmental Surveillance Procedures Manual

    Energy Technology Data Exchange (ETDEWEB)

    RW Hanf; TM Poston

    2000-09-20

    Environmental surveillance data are used in assessing the impact of current and past site operations on human health and the environment, demonstrating compliance with applicable local, state, and federal environmental regulations, and verifying the adequacy of containment and effluent controls. SESP sampling schedules are reviewed, revised, and published each calendar year in the Hanford Site Environmental Surveillance Master Sampling Schedule. Environmental samples are collected by SESP staff in accordance with the approved sample collection procedures documented in this manual.

  15. Operating procedures and safety culture

    International Nuclear Information System (INIS)

    Carnino, A.

    1993-01-01

    The development of new technologies in recent years has led to a tremendous increase in the information to be mastered by operators in industrial processes. The information at operators disposal both in routine situations and accidental ones needs to be well prepared and organized to ensure reliability and safety. The man-machine interface should give operators all the necessary and clear indications on the process status and evolution so that the operators can operate the installation through adequate procedures. Procedures represent the real interface and mode of action of the operators on the machine, and they are of prime importance. Although they are by essence quite different, the routine, accident, and emergency procedures have in common one attribute: They all require a good safety culture both in their development and their implementation. From the definition given by the members of the International Nuclear Safety Advisory Group (INSAG), open-quotes Safety culture is that assembly of characteristics and attitudes in organizations and individuals which establishes that, as an overriding priority, nuclear plant safety issues receive the attention warranted by their significance,close quotes one can see that two aspects are embedded, a collective attitude that in fact is reflected in the managerial framework and an individual one that is linked to personnel behavior and work practices

  16. Computer managed emergency operating procedures

    International Nuclear Information System (INIS)

    Salamun, I.; Mavko, B.; Stritar, A.

    1994-01-01

    New computer technology is a very effective tool for developing a new design of nuclear power plant control room. It allows designer possibility to create a tool for managing with large database of power plant parameters and displaying them in different graphic forms and possibility of automated execution of well known task. The structure of Emergency Operating Procedures (EOP) is very suitable for programming and for creating expert system. The Computerized Emergency Operating Procedures (CEOP) described in this paper can be considered as an upgrading of standard EOP approach. EmDiSY (Emergency Display System - computer code name for CEOP) main purpose is to supply the operator with necessary information, to document all operator actions and to execute well known tasks. It is a function oriented CEOP that gives operator guidance on how to verify the critical safety functions and how to restore and maintain these functions where they are degraded. All knowledge is coded and stored in database files. The knowledge base consists from stepping order for verifying plant parameters, desired values of parameters, conditions for comparison and links between procedures and actions. Graphical shell allows users to read database, to follow instruction and to find out correct task. The desired information is concentrated in one screen and allows users to focus on a task. User is supported in two ways: desired parameter values are displayed on the process picture and automated monitoring critical safety function status trees are all time in progress and available to the user. (author). 4 refs, 4 figs

  17. INADMISSIBLE EVIDENCE IN CIVIL PROCEDURE

    Directory of Open Access Journals (Sweden)

    Mihajlo Dika

    2016-01-01

    Full Text Available This paper examines the exclusion of specific means of evidence as instruments for determining the object of evidence, as well as the taking of evidence in the framework of the Croatian civil procedure law. The introduction lays the grounds for classifying and qualifying exclusion of evidence (general, special; absolute, relative; removable, irremovable; direct, indirect, after which greater attention is paid to the so called absolute and relative type; exclusionary evidence of the direct relative type pertaining to the establishing of facts, and evidence dismissals. With regard to the indirect relative type, the paper examines exclusionary evidence concerning the object of evidence. The remainder of the paper focuses on illegally obtained evidence, while outlining the constitutional, statutory, judicature and doctrinaire premises of bearing for such evidence. Subsequently, the question of evidence obtained in violation of the Constitutional guarantee of respect and legal protection of private and family life, dignity, reputation and honour, as well as evidence obtained by breach of the Constitutional guarantee of freedom and secrecy of correspondence and all other forms of communication, and in violation of the right to safety and privacy of personal data, are discussed too. In addition, the paper analyses the institutions of preclusion of evidence and the so called informative evidence. Concluding, the author points to a lacking regulation of inadmissible evidence within the Croatian civil procedure law, underlining the need to determine de lege ferenda legal requirements with a view to operationalizing inadmissible evidence within the Croatian civil procedure law.

  18. 18 CFR 301.3 - Filing procedures.

    Science.gov (United States)

    2010-04-01

    ... FOR SALES FROM UTILITIES TO BONNEVILLE POWER ADMINISTRATION UNDER NORTHWEST POWER ACT § 301.3 Filing procedures. (a) Bonneville's ASC review procedures. The procedures established by Bonneville's Administrator... Bonneville's ASC review procedures. (b) Exchange Period. The Exchange Period will be equal to the term of...

  19. An improved ashing procedure for biologic sample

    Energy Technology Data Exchange (ETDEWEB)

    Zongmei, Wu [Zhejiang Province Enviromental Radiation Monitoring Centre (China)

    1992-07-01

    The classical ashing procedure in muffle was modified for biologic samples. In the modified procedure the door of muffle was open in the duration of ashing process, the ashing was accelerated and the ashing product quality was comparable to that the classical procedure. The modified procedure is suitable for ashing biologic samples in large batches.

  20. An improved ashing procedure for biologic sample

    International Nuclear Information System (INIS)

    Wu Zongmei

    1992-01-01

    The classical ashing procedure in muffle was modified for biologic samples. In the modified procedure the door of muffle was open in the duration of ashing process, the ashing was accelerated and the ashing product quality was comparable to that the classical procedure. The modified procedure is suitable for ashing biologic samples in large batches

  1. Series expansion of the modified Einstein Procedure

    Science.gov (United States)

    Seema Chandrakant Shah-Fairbank

    2009-01-01

    This study examines calculating total sediment discharge based on the Modified Einstein Procedure (MEP). A new procedure based on the Series Expansion of the Modified Einstein Procedure (SEMEP) has been developed. This procedure contains four main modifications to MEP. First, SEMEP solves the Einstein integrals quickly and accurately based on a series expansion. Next,...

  2. Revised Unfilling Procedure for Solid Lithium Lenses

    International Nuclear Information System (INIS)

    Leveling, A.

    2003-01-01

    A procedure for unfilling used lithium lenses to has been described in Pbar Note 664. To date, the procedure has been used to disassemble lenses 20, 21, 17, 18, and 16. As a result of this work, some parts of the original procedure were found to be time consuming and ineffective. Modifications to the original procedure have been made to streamline the process and are discussed in this note. The revised procedure is included in this note.

  3. Efficiency of performing pulmonary procedures in a shared endoscopy unit: procedure time, turnaround time, delays, and procedure waiting time.

    Science.gov (United States)

    Verma, Akash; Lee, Mui Yok; Wang, Chunhong; Hussein, Nurmalah B M; Selvi, Kalai; Tee, Augustine

    2014-04-01

    The purpose of this study was to assess the efficiency of performing pulmonary procedures in the endoscopy unit in a large teaching hospital. A prospective study from May 20 to July 19, 2013, was designed. The main outcome measures were procedure delays and their reasons, duration of procedural steps starting from patient's arrival to endoscopy unit, turnaround time, total case durations, and procedure wait time. A total of 65 procedures were observed. The most common procedure was BAL (61%) followed by TBLB (31%). Overall procedures for 35 (53.8%) of 65 patients were delayed by ≥ 30 minutes, 21/35 (60%) because of "spillover" of the gastrointestinal and surgical cases into the time block of pulmonary procedure. Time elapsed between end of pulmonary procedure and start of the next procedure was ≥ 30 minutes in 8/51 (16%) of cases. In 18/51 (35%) patients there was no next case in the room after completion of the pulmonary procedure. The average idle time of the room after the end of pulmonary procedure and start of next case or end of shift at 5:00 PM if no next case was 58 ± 53 minutes. In 17/51 (33%) patients the room's idle time was >60 minutes. A total of 52.3% of patients had the wait time >2 days and 11% had it ≥ 6 days, reason in 15/21 (71%) being unavailability of the slot. Most pulmonary procedures were delayed due to spillover of the gastrointestinal and surgical cases into the block time allocated to pulmonary procedures. The most common reason for difficulty encountered in scheduling the pulmonary procedure was slot unavailability. This caused increased procedure waiting time. The strategies to reduce procedure delays and turnaround times, along with improved scheduling methods, may have a favorable impact on the volume of procedures performed in the unit thereby optimizing the existing resources.

  4. PRINCIPLES AND PROCEDURES ON FISCAL

    Directory of Open Access Journals (Sweden)

    Morar Ioan Dan

    2011-07-01

    Full Text Available Fiscal science advertise in most analytical situations, while the principles reiterated by specialists in the field in various specialized works The two components of taxation, the tax system relating to the theoretical and the practical procedures relating to tax are marked by frequent references and invocations of the underlying principles to tax. This paper attempts a return on equity fiscal general vision as a principle often invoked and used to justify tax policies, but so often violated the laws fiscality . Also want to emphasize the importance of devising procedures to ensure fiscal equitable treatment of taxpayers. Specific approach of this paper is based on the notion that tax equity is based on equality before tax and social policies of the executive that would be more effective than using the other tax instruments. I want to emphasize that if the scientific approach to justify the unequal treatment of the tax law is based on the various social problems of the taxpayers, then deviates from the issue of tax fairness justification explaining the need to promote social policies usually more attractive to taxpayers. Modern tax techniques are believed to be promoted especially in order to ensure an increasing level of high efficiency at the expense of the taxpayers obligations to ensure equality before the law tax. On the other hand, tax inequities reaction generates multiple recipients from the first budget plan, but finalities unfair measures can not quantify and no timeline for the reaction, usually not known. But while statistics show fluctuations in budgetary revenues and often find in literature reviews and analysis relevant to a connection between changes in government policies, budget execution and outcome. The effects of inequality on tax on tax procedures and budgetary revenues are difficult to quantify and is among others to this work. Providing tax equity without combining it with the principles of discrimination and neutrality

  5. Instrument Calibration and Certification Procedure

    Energy Technology Data Exchange (ETDEWEB)

    Davis, R. Wesley [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2016-05-31

    The Amptec 640SL-2 is a 4-wire Kelvin failsafe resistance meter, designed to reliably use very low-test currents for its resistance measurements. The 640SL-1 is a 2-wire version, designed to support customers using the Reynolds Industries type 311 connector. For both versions, a passive (analog) dual function DC Milliameter/Voltmeter allows the user to verify the actual 640SL output current level and the open circuit voltage on the test leads. This procedure includes tests of essential performance parameters. Any malfunction noticed during calibration, whether specifically tested for or not, shall be corrected before calibration continues or is completed.

  6. Inspection system performance test procedure

    International Nuclear Information System (INIS)

    Jensen, C.E.

    1995-01-01

    This procedure establishes requirements to administer a performance demonstration test. The test is to demonstrate that the double-shell tank inspection system (DSTIS) supplied by the contractor performs in accordance with the WHC-S-4108, Double-Shell Tank Ultrasonic Inspection Performance Specification, Rev. 2-A, January, 1995. The inspection system is intended to provide ultrasonic (UT) and visual data to determine integrity of the Westinghouse Hanford Company (WHC) site underground waste tanks. The robotic inspection system consists of the following major sub-systems (modules) and components: Mobile control center; Deployment module; Cable management assembly; Robot mechanism; Ultrasonic testing system; Visual testing system; Pneumatic system; Electrical system; and Control system

  7. Procedure for taking physical inventories

    International Nuclear Information System (INIS)

    Boston, R.A.

    1984-01-01

    Physical inventories are taken periodically to meet Company, State and IAEA requirements. Those physical inventories may be verified by IAEA and/or State inspectors. This presentation describes in an introductory but detailed manner the approaches and procedures used in planning, preparing, conducting, reconciling and reporting physical inventories for the Model Plant. Physical inventories are taken for plant accounting purposes to provide an accurate basis for starting and closing the plant material balance. Physical inventories are also taken for safeguards purposes to provide positive assurance that the nuclear materials of concern are indeed present and accounted for

  8. Capital Investment Procedures for FEMYSO

    OpenAIRE

    Oluduro, Francis Oladele; Duru, Longinus; Al Jaafar, Mofid

    2008-01-01

    Date: 2008-06-05 Level: Bachelor Thesis in Business Administration EF0703, 15 ECTS Credits. Authors: Longinus Duru (Stockholm), Francis O.Oluduro (Västerås) and Mofid Al Jaafar (Västerås) Title: Capital Investment Procedures for FEMYSO Problem Area: Undertaking an investment by FEMYSO involves weighing up the risk against the returns but still capital investment decision are still one of the most undertaken decisions by organization managers because it involves commitment of huge amount of mo...

  9. Forthcoming indefinite contract review procedure

    CERN Multimedia

    Human Resources Department

    2011-01-01

    The vacancy notices for posts opened with a view to the award of an indefinite contract will be published in early April 2011. In the meantime, the list of posts to be opened this spring is available at the following address: Indefinite contract posts - spring 2011 A second exercise will take place in autumn 2011 and, as of 2012, the indefinite contract award procedure will only be held once a year, in autumn. For more information please consult: https://hr-recruit.web.cern.ch/hr-recruit/staff/IndefiniteContracts.asp  

  10. Waste segregation procedures and benefits

    International Nuclear Information System (INIS)

    Fish, J.D.; Massey, C.D.; Ward, S.J.

    1990-01-01

    Segregation is a critical first step in handling hazardous and radioactive materials to minimize the generation of regulated wastes. In addition, segregation can significantly reduce the complexity and the total cost of managing waste. Procedures at Sandia National Laboratories, Albuquerque require that wastes be segregated, first, by waste type (acids, solvents, low level radioactive, mixed, classified, etc.). Higher level segregation requirements, currently under development, are aimed at enhancing the possibilities for recovery, recycle and reapplication; reducing waste volumes; reducing waste disposal costs, and facilitating packaging storage, shipping and disposal. 2 tabs

  11. Vasoplegic syndrome during Whipple procedure.

    Science.gov (United States)

    Anandaswamy, Tejesh C; Rajappa, Geetha C; Krishnamachar, Harish

    2017-02-01

    Vasoplegic syndrome is an unusual cause of refractory hypotension under general anesthesia. It is commonly described in the setting of cardiac surgery, but rarely seen in noncardiac setting. We describe successful management of vasoplegic syndrome during Whipple procedure with vasopressin infusion. A high index of suspicion and prompt treatment with vasopressin can be lifesaving in patients with risk factors for vasoplegic syndrome who present with severe refractory hypotension and who respond poorly to fluid administration and routine vasopressor infusion. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Entangled entanglement: A construction procedure

    Energy Technology Data Exchange (ETDEWEB)

    Uchida, Gabriele, E-mail: Gabriele.Uchida@univie.ac.at [University of Vienna, Faculty of Computer Science, Währinger Strasse 29, 1090 Vienna (Austria); Bertlmann, Reinhold A., E-mail: Reinhold.Bertlmann@univie.ac.at [University of Vienna, Faculty of Physics, Boltzmanngasse 5, 1090 Vienna (Austria); Hiesmayr, Beatrix C., E-mail: Beatrix.Hiesmayr@univie.ac.at [University of Vienna, Faculty of Physics, Boltzmanngasse 5, 1090 Vienna (Austria)

    2015-10-30

    The familiar Greenberger–Horne–Zeilinger (GHZ) states can be rewritten by entangling the Bell states for two qubits with a third qubit state, which is dubbed entangled entanglement. We show that in a constructive way we obtain all eight independent GHZ states that form the simplex of entangled entanglement, the magic simplex. The construction procedure allows a generalization to higher dimensions both, in the degrees of freedom (considering qudits) as well as in the number of particles (considering n-partite states). Such bases of GHZ-type states exhibit a cyclic geometry, a Merry Go Round, that is relevant for experimental and quantum information theoretic applications.

  13. Radiation risk of diagnostical procedures

    International Nuclear Information System (INIS)

    Pohlit, W.

    1986-01-01

    The environmental radiation burden of man in Germany is about 1 mGy (Milligray) per year. This is, of course, also valid for children. Due to diagnostical procedures this burden is increased to about 1.3 mGy. The question arises wether this can be neglected, or important consequences have to be drawn. To give a clear answer, the action of ionizing radiation in living cells and in organisms is explained in detail. Many of the radiation actions at the DNA can soon be repaired by the cell, if the radiation dose was small. Some damage, however will remain irreparable for the cell and consequently leads to cell death, to mutations or to cell transformation. The number of these lesion increases or decreases linearily with radiation dose. Therefore, it must be expected that the risk of tumour induction is increased to above the normal background even by the smallest doses. This small but not negligible risk has to be compared with other risks of civilization or with other medical risks. But also the benefit and the efficacy of diagnostic procedures have to be considered. (orig./HSCH) [de

  14. Procedure to describe clavicular motion.

    Science.gov (United States)

    Gutierrez Delgado, Guivey; De Beule, Matthieu; Ortega Cardentey, Dolgis R; Segers, Patrick; Iznaga Benítez, Arsenio M; Rodríguez Moliner, Tania; Verhegghe, Benedict; Palmans, Tanneke; Van Hoof, Tom; Van Tongel, Alexander

    2017-03-01

    For many years, researchers have attempted to describe shoulder motions by using different mathematical methods. The aim of this study was to describe a procedure to quantify clavicular motion. The procedure proposed for the kinematic analysis consists of 4 main processes: 3 transcortical pins in the clavicle, motion capture, obtaining 3-dimensional bone models, and data processing. Clavicular motion by abduction (30° to 150°) and flexion (55° to 165°) were characterized by an increment of retraction of 27° to 33°, elevation of 25° to 28°, and posterior rotation of 14° to 15°, respectively. In circumduction, clavicular movement described an ellipse, which was reflected by retraction and elevation. Kinematic analysis shows that the articular surfaces move by simultaneously rolling and sliding on the convex surface of the sternum for the 3 movements of abduction, flexion, and circumduction. The use of 3 body landmarks in the clavicle and the direct measurement of bone allowed description of the osteokinematic and arthrokinematic movement of the clavicle. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  15. Geologic mapping procedure: Final draft

    International Nuclear Information System (INIS)

    1987-09-01

    Geologic mapping will provide a baseline record of the subsurface geology in the shafts and drifts of the Exploratory Shaft Facility (ESF). This information will be essential in confirming the specific repository horizon, selecting representative locations for the in situ tests, providing information for construction and decommissioning seal designs, documenting the excavation effects, and in providing information for performance assessment, which relates to the ultimate suitability of the site as a nuclear waste repository. Geologic mapping will be undertaken on the walls and roof, and locally on the floor within the completed At-Depth Facility (ADF) and on the walls of the two access shafts. Periodic mapping of the exposed face may be conducted during construction of the ADF. The mapping will be oriented toward the collection and presentation of geologic information in an engineering format and the portrayal of detailed stratigraphic information which may be useful in confirmation of drillhole data collected as part of the surface-based testing program. Geologic mapping can be considered as a predictive tool as well as a means of checking design assumptions. This document provides a description of the required procedures for geologic mapping for the ESF. Included in this procedure is information that qualified technical personnel can use to collect the required types of geologic descriptions, at the appropriate level of detail. 5 refs., 3 figs., 1 tab

  16. Surface Environmental Surveillance Procedures Manual

    International Nuclear Information System (INIS)

    Hanf, Robert W.; Poston, Ted M.

    2000-01-01

    Shows and explains certain procedures needed for surface environmental surveillance. Hanford Site environmental surveillance is conducted by the Pacific Northwest National Laboratory (PNNL) for the U.S. Department of Energy (DOE) under the Surface Environmental Surveillance Project (SESP). The basic requirements for site surveillance are set fourth in DOE Order 5400.1, General Environmental Protection Program Requirements. Guidance for the SESP is provided in DOE Order 5484.1, Environmental Protection, Safety, and Health Protection Information Reporting Requirements and DOE Order 5400.5, Radiation Protection of the Public and Environment. Guidelines for environmental surveillance activities are provided in DOE/EH-0173T, Environmental Regulatory Guide for Radiological Effluent Monitoring and Environmental Surveillance. An environmental monitoring plan for the Hanford Site is outlined in DOE/RL 91-50 Rev. 2, Environmental Monitoring Plan, United States Department of Energy, Richland Operations Office. Environmental surveillance data are used in assessing the impact of current and past site operations on human health and the environment, demonstrating compliance with applicable local, state, and federal environmental regulations, and verifying the adequacy of containment and effluent controls. SESP sampling schedules are reviewed, revised, and published each calendar year in the Hanford Site Environmental Surveillance Master Sampling Schedule. Environmental samples are collected by SESP staff in accordance with the approved sample collection procedures documented in this manual. Personnel training requirements are documented in SESP-TP-01 Rev.2, Surface Environmental Surveillance Project Training Program.

  17. CMOS gate array characterization procedures

    Science.gov (United States)

    Spratt, James P.

    1993-09-01

    Present procedures are inadequate for characterizing the radiation hardness of gate array product lines prior to personalization because the selection of circuits to be used, from among all those available in the manufacturer's circuit library, is usually uncontrolled. (Some circuits are fundamentally more radiation resistant than others.) In such cases, differences in hardness can result between different designs of the same logic function. Hardness also varies because many gate arrays feature large custom-designed megacells (e.g., microprocessors and random access memories-MicroP's and RAM's). As a result, different product lines cannot be compared equally. A characterization strategy is needed, along with standardized test vehicle(s), methodology, and conditions, so that users can make informed judgments on which gate arrays are best suited for their needs. The program described developed preferred procedures for the radiation characterization of gate arrays, including a gate array evaluation test vehicle, featuring a canary circuit, designed to define the speed versus hardness envelope of the gate array. A multiplier was chosen for this role, and a baseline multiplier architecture is suggested that could be incorporated into an existing standard evaluation circuit chip.

  18. [Procedural learning disorder: neuropsychological characteristics].

    Science.gov (United States)

    Crespo-Eguílaz, N; Narbona, J

    This research aims at neurocognitive delineation of the core features of procedural learning disorder (PLD), otherwise labeled as motor coordination disorder or non-verbal learning disorder. A sample of 209 correlative outpatients (73% males), aged 6-12 years, all of them having QI ranging from 81 to 120, was clustered into the following neurobehavioural groups: PLD (n = 16), PLD plus attention deficit hyperactivity disorder (ADHD) (n = 37), ADHD combined type (n = 47), ADHD predominantly inattentive type (n = 23), specific language impairment (n = 68), and semantic-pragmatic language impairment (n = 18). Two additional groups of patients were included for some comparisons: children with periventricular leukomalacia (PVL) without learning disability (n = 8) or associating PLD (n = 17). A set of behavioural scales and neurocognitive tests was used to evaluate verbal and non-verbal IQ, attention, impulsivity control, visuo-motor coordination, declarative memory, procedural memory and learning, formal and functional dimensions of language, peer relationships and academic achievement. Parametric analysis were used to test the differences and similarities of neurobehavioural variables between groups. Our results allow us to conclude that PLD implies a difficult acquisition of automatized motor, cognitive and communicative abilities required in school work and peer social relationships. PLD is different from autistic spectrum disorders. It is frequently associated to inattentive ADHD. Operational criteria for diagnosis of PLD are proposed, according to our results. A bilateral posterior parietal dysfunction is a plausible explanation of its physiopathology. Preserved general intelligence and formal linguistic abilities are the clues for intervention designs.

  19. Antibiotic prophylaxis in obstetric procedures.

    Science.gov (United States)

    van Schalkwyk, Julie; Van Eyk, Nancy

    2010-09-01

    To review the evidence and provide recommendations on antibiotic prophylaxis for obstetrical procedures. Outcomes evaluated include need and effectiveness of antibiotics to prevent infections in obstetrical procedures. Published literature was retrieved through searches of Medline and The Cochrane Library on the topic of antibiotic prophylaxis in obstetrical procedures. Results were restricted to systematic reviews, randomized controlled trials/controlled clinical trials, and observational studies. Searches were updated on a regular basis and articles published from January 1978 to June 2009 were incorporated in the guideline. Current guidelines published by the American College of Obstetrics and Gynecology were also incorporated. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. The evidence obtained was reviewed and evaluated by the Infectious Diseases Committee of the Society of Obstetricians and Gynaecologists of Canada under the leadership of the principal authors, and recommendations were made according to guidelines developed by the Canadian Task Force on Preventive Health Care (Table 1). Implementation of this guideline should reduce the cost and harm resulting from the administration of antibiotics when they are not required and the harm resulting from failure to administer antibiotics when they would be beneficial. SUMMARY STATEMENTS: 1. Available evidence does not support the use of prophylactic antibiotics to reduce infectious morbidity following operative vaginal delivery. (II-1) 2. There is insufficient evidence to argue for or against the use of prophylactic antibiotics to reduce infectious morbidity for manual removal of the placenta. (III) 3. There is insufficient evidence to argue for or against the use of

  20. Physiotherapy following elective orthopaedic procedures.

    Science.gov (United States)

    De Kleijn, P; Blamey, G; Zourikian, N; Dalzell, R; Lobet, S

    2006-07-01

    As haemophilic arthropathy and chronic synovitis are still the most important clinical features in people with haemophilia, different kinds of invasive and orthopaedic procedures have become more common during the last decades. The availability of clotting factor has made arthroplasty of one, or even multiple joints possible. This article highlights the role of physiotherapy before and after such procedures. Synovectomies are sometimes advocated in people with haemophilia to stop repetitive cycles of intra-articular bleeds and/or chronic synovitis. The synovectomy itself, however, does not solve the muscle atrophy, loss of range of motion (ROM), instability and poor propriocepsis, often developed during many years. The key is in taking advantage of the subsequent, relatively safe, bleed-free period to address these important issues. Although the preoperative ROM is the most important variable influencing the postoperative ROM after total knee arthroplasty, there are a few key points that should be considered to improve the outcome. Early mobilization, either manual or by means of a continuous passive mobilization machine, can be an optimal solution during the very first postoperative days. Muscle isometric contractions and light open kinetic chain exercises should also be started in order to restore the quadriceps control. Partial weight bearing can be started shortly after, because of quadriceps inhibition and to avoid excessive swelling. The use of continuous clotting factor replacement permits earlier and intensive rehabilitation during the postoperative period. During the rehabilitation of shoulder arthroplasty restoring the function of the rotator cuff is of utmost importance. Often the rotator cuff muscles are inhibited in the presence of pain and loss of ROM. Physiotherapy also assists in improving pain and maintaining ROM and strength. Functional weight-bearing tasks, such as using the upper limbs to sit and stand, are often discouraged during the first 6

  1. Procedure for preparation of dispersions

    International Nuclear Information System (INIS)

    1978-01-01

    Procedure for the preparation of a water based dispersion of cerium oxide, characterised in that a suspension of cerium (IV) hydroxide is formed with an acid, where the acid is in the state of a disaggregation of aggregated crystalline cerium hydroxide, the suspension being preheated for a specified time and to a specified temperature, so that the pH value becomes constant, and whereby the quantity of acid in the suspension is such that the constant pH value is lower than 5.4, so that a conditioned suspension may be obtained, and water may be mixed with the conditioned suspension for making a water based dispersion of cerium oxide. (G.C.)

  2. Geometric procedures for civil engineers

    CERN Document Server

    Tonias, Elias C

    2016-01-01

    This book provides a multitude of geometric constructions usually encountered in civil engineering and surveying practice.  A detailed geometric solution is provided to each construction as well as a step-by-step set of programming instructions for incorporation into a computing system. The volume is comprised of 12 chapters and appendices that may be grouped in three major parts: the first is intended for those who love geometry for its own sake and its evolution through the ages, in general, and, more specifically, with the introduction of the computer. The second section addresses geometric features used in the book and provides support procedures used by the constructions presented. The remaining chapters and the appendices contain the various constructions. The volume is ideal for engineering practitioners in civil and construction engineering and allied areas.

  3. Radiological Work Planning and Procedures

    CERN Document Server

    Kurtz, J E

    2000-01-01

    Each facility is tasked with maintaining personnel radiation exposure as low as reasonably achievable (ALARA). A continued effort is required to meet this goal by developing and implementing improvements to technical work documents (TWDs) and work performance. A review of selected TWDs from most facilities shows there is a need to incorporate more radiological control requirements into the TWD. The Radioactive Work Permit (RWP) provides a mechanism to place some of the requirements but does not provide all the information needed by the worker as he/she is accomplishing the steps of the TWD. Requiring the engineers, planners and procedure writers to put the radiological control requirements in the work steps would be very easy if all personnel had a strong background in radiological work planning and radiological controls. Unfortunately, many of these personnel do not have the background necessary to include these requirements without assistance by the Radiological Control organization at each facility. In add...

  4. Procedures for maintenance and repairs

    International Nuclear Information System (INIS)

    Pickel, E.

    1981-01-01

    After a general review of the operation experience in the history of more than 12 operating years, the organization in the plant will be shown with special aspect to quality assurance, capacity of the workshops and connected groups as radiation protection, chemical laboratories etc. The number, time intervals and manpower effort for the repeating tests will be discussed. Reasons and examples for back-fitting activities in the plant are given. Besides special repair and maintenance procedures as repair of the steam generators, in-service inspection of the reactor pressure vessel, repair of a feed-water pipe and repair of the core structure in the pressure vessel, the general system to handle maintenance and repair-work in the KWO-plant will be shown. This includes also the detailed planning of the annual refueling and revision of the plant. (orig./RW)

  5. Preparation, property of the complex of carboxymethyl chitosan grafted copolymer with iodine and application of it in cervical antibacterial biomembrane

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Yu [School of Materials Science and Engineering, Beijing Institute of Technology, Beijing 100081 (China); Yang, Yumin; Liao, Qingping [Zhejiang Sanchuang Biological Technology Co., Ltd., Jiaxing, Zhejiang Province 314031 (China); Yang, Wei [School of Materials Science and Engineering, Beijing Institute of Technology, Beijing 100081 (China); Ma, Wanfeng [Zhejiang Sanchuang Biological Technology Co., Ltd., Jiaxing, Zhejiang Province 314031 (China); Zhao, Jian [Department of Gynaecology and Obstetrics, The First Hospital of Peking University, Beijing 100034 (China); Zheng, Xionggao [School of Materials Science and Engineering, Beijing Institute of Technology, Beijing 100081 (China); Yang, Yang [Zhejiang Sanchuang Biological Technology Co., Ltd., Jiaxing, Zhejiang Province 314031 (China); Chen, Rui [Department of Gynaecology and Obstetrics, The First Hospital of Peking University, Beijing 100034 (China)

    2016-10-01

    Cervical erosion is one of the common diseases of women. The loop electrosurgical excisional procedure (LEEP) has been used widely in the treatment of the cervical diseases. However, there are no effective wound dressings for the postoperative care to protect the wound area from further infection, leading to increased secretion and longer healing time. Iodine is a widely used inorganic antibacterial agent with many advantages. However, the carrier for stable iodine complex antibacterial agents is lack. In the present study, a novel iodine carrier, Carboxymethyl chitosan-g-(poly(sodium acrylate)-co-polyvinylpyrrolidone) (CMCTS-g-(PAANa-co-PVP), was prepared by graft copolymerization of sodium acrylate (AANa) and N-vinylpyrrolidone (NVP) to a carboxymethyl chitosan (CMCTS) skeleton. The obtained structure could combine prominent property of poly(sodium acrylate) (PAANa) anionic polyelectrolyte segment and good complex property of polyvinylpyrrolidone (PVP) segment to iodine. The bioactivity of CMCTS could also be kept. The properties of the complex, CMCTS-g-(PAANa-co-PVP)-I{sub 2}, were studied. The in vitro experiment shows that it has broad-spectrum bactericidal effects to virus, fungus, gram-positive bacteria and gram-negative bacteria. A CMCTS-g-(PAANa-co-PVP)-I{sub 2} complex contained cervical antibacterial biomembrane (CABM) was prepared. The iodine release from the CABM is pH-dependent. The clinic trial results indicate that CABM has better treatment effectiveness than the conventional treatment in the postoperative care of the LEEP operation. - Highlights: • The multifunctional iodine complexing carrier CMCTS-g-(PAANa-co-PVP) was prepared. • CMCTS-g-(PAANa-co-PVP)-I{sub 2} with high antibacterial property and bio-safety was studied. • By compositing it with CMCTS and gelatin further, CABM with multifunction was deduced. • The releasing properties of the activated iodine from CABM showed pH sensitivity. • CABM showed good treating effect for

  6. Management of cryotherapy-ineligible women in a “screen-and-treat” cervical cancer prevention program targeting HIV-infected women in Zambia: Lessons from the field

    Science.gov (United States)

    Pfaendler, Krista S.; Mwanahamuntu, Mulindi H.; Sahasrabuddhe, Vikrant V.; Mudenda, Victor; Stringer, Jeffrey S.A.; Parham, Groesbeck P.

    2009-01-01

    Objective We demonstrate the feasibility of implementing a referral and management system for cryotherapy-ineligible women in a “screen-and-treat” cervical cancer prevention program targeting HIV-infected women in Zambia. Methods We established criteria for patient referral, developed a training program for loop electrosurgical excision procedure (LEEP) providers, and adapted LEEP to a resource-constrained setting. Results We successfully trained 15 nurses to perform visual inspection with acetic acid (VIA) followed by immediate cryotherapy. Women with positive tests but ineligible for cryotherapy were referred for further evaluation. We trained four Zambian physicians to evaluate referrals, perform punch biopsy, LEEP, and manage intra-operative and post-operative complications. From January 2006 through October 2007, a total of 8823 women (41.5% HIV seropositive) were evaluated by nurses in outlying prevention clinics; of these, 1477 (16.7%) were referred for physician evaluation based on established criteria. Of the 875 (59.2% of 1147 referred) that presented for evaluation, 748 (8.4% of total screened) underwent histologic evaluation in the form of punch biopsy or LEEP. Complications associated with LEEP included anesthesia reaction (n=2) which spontaneously resolved, intra-operative (n=12) and post-operative (n=2) bleeding managed by local measures, and post-operative infection (n=12) managed with antibiotics. Conclusion With adaptations for a resource-constrained environment, we have demonstrated that performing LEEP is feasible and safe, with low rates of complications that can be managed locally. It is important to establish referral and management systems using LEEP-based excisional evaluation for women with cryotherapy-ineligible lesions in VIA-based “screen-and-treat” protocols nested within HIV-care programs in resource-constrained settings. PMID:18556050

  7. Management of cryotherapy-ineligible women in a "screen-and-treat" cervical cancer prevention program targeting HIV-infected women in Zambia: lessons from the field.

    Science.gov (United States)

    Pfaendler, Krista S; Mwanahamuntu, Mulindi H; Sahasrabuddhe, Vikrant V; Mudenda, Victor; Stringer, Jeffrey S A; Parham, Groesbeck P

    2008-09-01

    We demonstrate the feasibility of implementing a referral and management system for cryotherapy-ineligible women in a "screen-and-treat" cervical cancer prevention program targeting HIV-infected women in Zambia. We established criteria for patient referral, developed a training program for loop electrosurgical excision procedure (LEEP) providers, and adapted LEEP to a resource-constrained setting. We successfully trained 15 nurses to perform visual inspection with acetic acid (VIA) followed by immediate cryotherapy. Women with positive tests but ineligible for cryotherapy were referred for further evaluation. We trained four Zambian physicians to evaluate referrals, perform punch biopsy, LEEP, and manage intra-operative and post-operative complications. From January 2006 through October 2007, a total of 8823 women (41.5% HIV seropositive) were evaluated by nurses in outlying prevention clinics; of these, 1477 (16.7%) were referred for physician evaluation based on established criteria. Of the 875 (59.2% of 1147 referred) that presented for evaluation, 748 (8.4% of total screened) underwent histologic evaluation in the form of punch biopsy or LEEP. Complications associated with LEEP included anesthesia reaction (n=2) which spontaneously resolved, intra-operative (n=12) and post-operative (n=2) bleeding managed by local measures, and post-operative infection (n=12) managed with antibiotics. With adaptations for a resource-constrained environment, we have demonstrated that performing LEEP is feasible and safe, with low rates of complications that can be managed locally. It is important to establish referral and management systems using LEEP-based excisional evaluation for women with cryotherapy-ineligible lesions in VIA-based "screen-and-treat" protocols nested within HIV-care programs in resource-constrained settings.

  8. Headache following intracranial neuroendovascular procedures.

    Science.gov (United States)

    Baron, Eric P; Moskowitz, Shaye I; Tepper, Stewart J; Gupta, Rishi; Novak, Eric; Hussain, Muhammad Shazam; Stillman, Mark J

    2012-05-01

    Predicting who will develop post-procedure headache (PPH) following intracranial endovascular procedures (IEPs) would be clinically useful and potentially could assist in reducing the excessive diagnostic testing so often obtained in these patients. Although limited safety data exist, the use of triptans or dihydroergotamine (DHE) often raise concern when used with pre/post-coiled aneurysms. We sought to determine risk factors for PPH following IEP, to evaluate the utility of diagnostic testing in patients with post-coil acute headache (HA), and to record whether triptans and DHE have been used safely in this clinical setting. We conducted a retrospective chart review of adult patients undergoing IEPs. Bivariate analyses were conducted to compare patients who did and did not develop PPH. We reviewed records pertaining to 372 patients, of whom 263 underwent intracranial coil embolizations, 21 acrylic glue embolizations, and 88 stent placements. PPH occurred in 72% of coil patients, 33% of glue patients, and 14% of stent patients. Significant risk factors for post-coil HA were female gender, any pre-coil HA history, smoking, and anxiety/depression. A pre-stent history of HA exceeding 1 year's duration, and smoking were risk factors for post-stent HA. A pre-glue history of HA exceeding 1 year was the only risk factor for post-glue HA. In the small subgroup available for study, treatment with triptans or DHE was not associated with adverse events in pre/post-coiled aneurysms. Diagnostic testing was low yield. Occurrence of PPH was common after IEPs and especially so with coiling and in women, smokers, and those with anxiety/depression, and was often of longer duration than allowed by current International Classification of Headache Disorders-II criteria. The yield of diagnostic testing was low, and in a small subgroup treatment with triptans or DHE did not cause adverse events in pre/post-coiled aneurysms. Prospective studies are needed to confirm these findings.

  9. Long terms results of Draf 3 procedure

    NARCIS (Netherlands)

    Georgalas, C.; Hansen, F.; Videler, W. J. M.; Fokkens, W. J.

    2011-01-01

    To assess the effectiveness and factors associated with restenosis after Draf type III (Endoscopic Modified Lothrop) frontal sinus drainage procedure. Retrospective analysis of prospectively collected data. A hundred and twenty two consecutive patients undergoing Draf III procedure for recalcitrant

  10. Procedure Integrated Development Environment (PRIDE), Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — NASA captures and distributes operational knowledge in the form of procedures. These procedures are created and accessed by a range of people performing many...

  11. Procedures For Microbial-Ecology Laboratory

    Science.gov (United States)

    Huff, Timothy L.

    1993-01-01

    Microbial Ecology Laboratory Procedures Manual provides concise and well-defined instructions on routine technical procedures to be followed in microbiological laboratory to ensure safety, analytical control, and validity of results.

  12. Typical NRC inspection procedures for model plant

    International Nuclear Information System (INIS)

    Blaylock, J.

    1984-01-01

    A summary of NRC inspection procedures for a model LEU fuel fabrication plant is presented. Procedures and methods for combining inventory data, seals, measurement techniques, and statistical analysis are emphasized

  13. TMACS Test Procedure TP011: Panalarm Interface

    International Nuclear Information System (INIS)

    Seghers, R.; Washburn, S.J.

    1994-01-01

    The TMACS Software Test Procedures translate the project's acceptance criteria into test steps. The TMACS Test Plan (WHC-SD-WM-TP-148) is fulfilled when all Test Cases are approved. This Test Procedure tests the TMACS Panalarm Interface functions

  14. XML Syntax for Clinical Laboratory Procedure Manuals

    OpenAIRE

    Saadawi, Gilan; Harrison, James H.

    2003-01-01

    We have developed a document type description (DTD) in Extensable Markup Language (XML)1 for clinical laboratory procedures. Our XML syntax can adequately structure a variety of procedure types across different laboratories and is compatible with current procedure standards. The combination of this format with an XML content management system and appropriate style sheets will allow efficient procedure maintenance, distributed access, customized display and effective searching across a large b...

  15. Procedural Attack! Procedural Generation for Populated Virtual Cities: A Survey

    Directory of Open Access Journals (Sweden)

    Werner Gaisbauer

    2017-06-01

    Full Text Available On the one hand, creating rich virtual worlds "by hand" like in the game Grand Theft Auto V is hugely expensive and limited to large studios. On the other hand, procedural content generation (PCG allows tiny teams to create huge worlds like Hello Games did with only four people (in the beginning for the recently released game No Man's Sky. Following in the footsteps of Hello Games, this paper tries to equip the reader with an overview about the state-of-the-art of how to build such a virtual world, i.e., a populated virtual city with buildings, streets, parks, vegetation, humans, and vehicles, using just PCG assets. Each PCG asset that is envisioned to bring the city to life is grouped and discussed in detail and the latest research trends in PCG are presented together with open questions. Using the above-mentioned PCG assets, instead of months, a city can be built in a mere couple of minutes by a user without much experience in designing 3D assets. The city can then be used for many applications like games, virtual reality (VR, or film.

  16. 40 CFR 791.30 - Hearing procedures.

    Science.gov (United States)

    2010-07-01

    ... officer may deem necessary to an understanding and determination of the dispute. The hearing officer shall... 40 Protection of Environment 31 2010-07-01 2010-07-01 true Hearing procedures. 791.30 Section 791... (CONTINUED) DATA REIMBURSEMENT Hearing Procedures § 791.30 Hearing procedures. (a) Representation by counsel...

  17. 49 CFR 195.214 - Welding procedures.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 3 2010-10-01 2010-10-01 false Welding procedures. 195.214 Section 195.214... PIPELINE Construction § 195.214 Welding procedures. (a) Welding must be performed by a qualified welder in accordance with welding procedures qualified under Section 5 of API 1104 or Section IX of the ASME Boiler and...

  18. 46 CFR 154.665 - Welding procedures.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 5 2010-10-01 2010-10-01 false Welding procedures. 154.665 Section 154.665 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CERTAIN BULK DANGEROUS CARGOES SAFETY STANDARDS... Construction § 154.665 Welding procedures. Welding procedure tests for cargo tanks for a design temperature...

  19. 49 CFR 192.225 - Welding procedures.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 3 2010-10-01 2010-10-01 false Welding procedures. 192.225 Section 192.225... BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS Welding of Steel in Pipelines § 192.225 Welding procedures. (a) Welding must be performed by a qualified welder in accordance with welding procedures...

  20. 40 CFR 1065.10 - Other procedures.

    Science.gov (United States)

    2010-07-01

    ... importance of pursuing changes to the procedures: (i) Whether supplemental emission standards or other... procedures, such as those of the California Air Resources Board or the International Organization for... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Other procedures. 1065.10 Section 1065...

  1. TMACS Test Procedure TP009: Acromag Driver

    International Nuclear Information System (INIS)

    Washburn, S.J.

    1994-01-01

    The TMACS Software Project Test Procedures translate the project's acceptance criteria into test steps. Software releases are certified when the affected Test Procedures are successfully performed and the customers authorize installation of these changes. This Test Procedure tests the TMACS Acromag Software Driver (Bridge Code)

  2. Environmental Measurements Laboratory (EML) procedures manual

    International Nuclear Information System (INIS)

    Chieco, N.A.; Bogen, D.C.; Knutson, E.O.

    1990-11-01

    Volume 1 of this manual documents the procedures and existing technology that are currently used by the Environmental Measurements Laboratory. A section devoted to quality assurance has been included. These procedures have been updated and revised and new procedures have been added. They include: sampling; radiation measurements; analytical chemistry; radionuclide data; special facilities; and specifications. 228 refs., 62 figs., 37 tabs. (FL)

  3. 39 CFR 5.2 - Committee procedure.

    Science.gov (United States)

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Committee procedure. 5.2 Section 5.2 Postal Service UNITED STATES POSTAL SERVICE THE BOARD OF GOVERNORS OF THE U.S. POSTAL SERVICE COMMITTEES (ARTICLE V) § 5.2 Committee procedure. Each committee establishes its own rules of procedure, consistent with...

  4. WSSDA's Guide to Parliamentary Procedures. Revised

    Science.gov (United States)

    Randolph, Mary

    2004-01-01

    This guide to parliamentary procedures is presented by the Washington State School Directors' Association (WSSDA) for use by local school boards within the State of Washington. Parliamentary law and parliamentary procedure is the key to order and to provide justice and fairness to all. Through both formal and informal parliamentary procedures,…

  5. Intake Procedures in College Counseling Centers.

    Science.gov (United States)

    Pappas, James P.; And Others

    Intake procedures is the common subject of four papers presented in this booklet. James P. Pappas discusses trends, a decision theory model, information and issues in his article "Intake Procedures in Counseling Centers--Trends and Theory." In the second article "The Utilization of Standardized Tests in Intake Procedures or 'Where's the Post…

  6. Objective Truth Institution in Criminal Procedure

    Directory of Open Access Journals (Sweden)

    Voltornist O. A.

    2012-11-01

    Full Text Available The article deals with the category of objective truth in criminal procedure, its importance for correct determination of criminal court procedure aims. The author analyzes also the bill draft offered by the RF Committee of Inquiry “On amending in the RF Criminal Procedure Code due to the implementation ofobjective truth institution in criminal procedure”

  7. TMACS Test Procedure TP007: System administration

    International Nuclear Information System (INIS)

    Scanlan, P.; Washburn, S.; Seghers, R.

    1994-01-01

    The TMACS Software Project Test Procedures translate the project's acceptance criteria into test steps. Software releases are certified when the affected Test Procedures are successfully performed and the customers authorize installation of these changes. This Test Procedure tests the TMACS System Administration functions

  8. MITS Feed and Withdrawal Subsystem: operating procedures

    International Nuclear Information System (INIS)

    Brown, W.S.

    1980-01-01

    This document details procedures for the operation of the MITS (Machine Interface Test System) Feed and Withdrawal Subsystem (F and W). Included are fill with UF 6 , establishment of recycle and thruput flows, shutdown, UF 6 makeup, dump to supply container, Cascade dump to F and W, and lights cold trap dump, all normal procedures, plus an alternate procedure for trapping light gases

  9. 32 CFR 635.35 - Procedures.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 4 2010-07-01 2010-07-01 true Procedures. 635.35 Section 635.35 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND CRIMINAL INVESTIGATIONS LAW ENFORCEMENT REPORTING Victim and Witness Assistance Procedures § 635.35 Procedures. (a) As required by Federal law, Army personnel...

  10. 21 CFR 211.150 - Distribution procedures.

    Science.gov (United States)

    2010-04-01

    ...: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR FINISHED PHARMACEUTICALS Holding and Distribution § 211.150 Distribution procedures. Written procedures shall be established, and followed, describing the... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Distribution procedures. 211.150 Section 211.150...

  11. 40 CFR 205.54 - Test procedures.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Test procedures. 205.54 Section 205.54 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) NOISE ABATEMENT PROGRAMS TRANSPORTATION EQUIPMENT NOISE EMISSION CONTROLS Medium and Heavy Trucks § 205.54 Test procedures. The procedures described...

  12. TMACS Test Procedure TP002: Trending

    International Nuclear Information System (INIS)

    Scanlan, P.K.

    1994-01-01

    The TMACS Software Project Test Procedures translate the project's acceptance criteria into test steps. Software releases are certified when the affected Test Procedures are successfully performed and the customers authorize installation of these changes. This Test Procedure tests the TMACS Trending functions

  13. 28 CFR 79.73 - Appeals procedures.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Appeals procedures. 79.73 Section 79.73 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) CLAIMS UNDER THE RADIATION EXPOSURE COMPENSATION ACT Procedures § 79.73 Appeals procedures. (a) An appeal must be in writing and must be received by...

  14. Modified Arthroscopic Brostrom Procedure With Bone Tunnels.

    Science.gov (United States)

    Lui, Tun Hing

    2016-08-01

    The open anatomic repair of the anterior talofibular and calcaneofibular ligaments (modified Brostrom procedure) is widely accepted as the standard surgical stabilization procedure for lateral ankle instability that does not respond to conservative measures. Arthroscopic Brostrom procedures with a suture anchor have been reported to achieve both anatomic repair of the lateral ankle ligaments and management of the associated intra-articular lesions. However, the complication rates are higher than open Brostom procedures. Many of these complications are associated with the use of a suture anchor. We report a modified arthroscopic Brostrom procedure in which the anterolateral ankle capsule is anchored to the lateral malleolus through small bone tunnels instead of suture anchors.

  15. Photogrammetry procedures applied to anthropometry.

    Science.gov (United States)

    Okimoto, Maria Lúcialeite Ribeiro; Klein, Alison Alfred

    2012-01-01

    This study aims to evaluate the reliability and establish procedures for the use of digital photogrammetry in anthropometric measurements of the human hand. The methodology included the construction of a platform to allow the placement of the hand always equivalent to a distance of the camera lens and to annul the effects of parallax. We developed a software to perform the measurements from the images and built up a subject of proof in a cast from a negative mold, this object was subjected to measurements with digital photogrammetry using the data collection platform in caliper and the Coordinate Measuring Machine (MMC). The results of the application of photogrammetry in the data collection segment hand, allow us to conclude that photogrammetry is an effective presenting precision coefficient below 0.940. Within normal and acceptable values, given the magnitude of the data used in anthropometry. It was concluded photogrammetry then be reliable, accurate and efficient for carrying out anthropometric surveys of population, and presents less difficulty to collect in-place.

  16. Training review criteria and procedures

    International Nuclear Information System (INIS)

    1986-07-01

    The industry, through commitment to the INPO-managed Training Accreditation Program, is implementing what is referred to as performance-based training, or the Systems Approach to Training (SAT). The NRC considers the following five elements as essential to these training programs: Systematic analysis of the jobs to be performed; learning objectives that are derived from the analysis and that describe desired performance after training; Training design and implementation based on the learning objectives; Evaluation of trainee mastery of the objectives during training; and evaluation and revision of the training based on the performance of trained personnel in the job setting. As indicated in the ''Commission Policy Statement on Training and Qualifications of Nuclear Power Plant Personnel'' of March 20, 1985,''the NRC will continue to closely monitor the process [INPO Accreditation] and its results, and ''It remains the continuing responsibility of the NRC to independently evaluate applicants' and licensees' implementation of improvement programs....'' These procedures provide a systematic means for implementing two of the NRC monitoring functions identified in the Commission Policy Statement: ''Continuing evaluation of industry training and qualification program effectiveness,''; and ''Monitoring plant and industry trends and events involving personnel errors.''

  17. Radiological Work Planning and Procedures

    International Nuclear Information System (INIS)

    KURTZ, J.E.

    2000-01-01

    Each facility is tasked with maintaining personnel radiation exposure as low as reasonably achievable (ALARA). A continued effort is required to meet this goal by developing and implementing improvements to technical work documents (TWDs) and work performance. A review of selected TWDs from most facilities shows there is a need to incorporate more radiological control requirements into the TWD. The Radioactive Work Permit (RWP) provides a mechanism to place some of the requirements but does not provide all the information needed by the worker as he/she is accomplishing the steps of the TWD. Requiring the engineers, planners and procedure writers to put the radiological control requirements in the work steps would be very easy if all personnel had a strong background in radiological work planning and radiological controls. Unfortunately, many of these personnel do not have the background necessary to include these requirements without assistance by the Radiological Control organization at each facility. In addition, there seems to be confusion as to what should be and what should not be included in the TWD

  18. Imaging of cartilage repair procedures

    International Nuclear Information System (INIS)

    Sanghvi, Darshana; Munshi, Mihir; Pardiwala, Dinshaw

    2014-01-01

    The rationale for cartilage repair is to prevent precocious osteoarthritis in untreated focal cartilage injuries in the young and middle-aged population. The gamut of surgical techniques, normal postoperative radiological appearances, and possible complications have been described. An objective method of recording the quality of repair tissue is with the magnetic resonance observation of cartilage repair tissue (MOCART) score. This scoring system evaluates nine parameters that include the extent of defect filling, border zone integration, signal intensity, quality of structure and surface, subchondral bone, subchondral lamina, and records presence or absence of synovitis and adhesions. The five common techniques of cartilage repair currently offered include bone marrow stimulation (microfracture or drilling), mosaicplasty, synthetic resorbable scaffold grafts, osteochondral allograft transplants, and autologous chondrocyte implantation (ACI). Complications of cartilage repair procedures that may be demonstrated on magnetic resonance imaging (MRI) include plug loosening, graft protuberance, graft depression, and collapse in mosaicplasty, graft hypertrophy in ACI, and immune response leading to graft rejection, which is more common with synthetic grafts and cadaveric allografts

  19. Remote handling procedures in JET

    International Nuclear Information System (INIS)

    Raimondi, T.; Huguet, M.

    1976-01-01

    Remote maintenance will be needed in the second phase of operation due to the structural activation produced by deuterium-tritium discharges. Priority will be given to tasks which require frequent intervention, but efforts will be made also to tackle larger operations such as replacement of an octant. Owing to the variety and unpredictability of the operations which may be required, general purpose telemanipulator and TV systems will be used, mounted on versatile articulated supports capable of reaching the various parts of the machine. An experimental programme is planned to test the envisaged equipment and develop procedures for carrying out the various tasks as they are more clearly identified. Design of peripheral equipment for easy accessibility, choice of simple connection methods, development of auxiliary tools, as well as careful programming of the operations, will be essential for successful remote maintenance. The effort put into these areas will, however, also result in considerable time saving during the assembly and maintenance in non-active conditions. Preliminary feasibility tests of some difficult operations have already been done with a force-reflecting servo-manipulator and two TV sets for front and side viewing. Leak identification and precision welding for vacuum tightness were demonstrated

  20. Probabilistic safety analysis procedures guide

    International Nuclear Information System (INIS)

    Papazoglou, I.A.; Bari, R.A.; Buslik, A.J.

    1984-01-01

    A procedures guide for the performance of probabilistic safety assessment has been prepared for interim use in the Nuclear Regulatory Commission programs. The probabilistic safety assessment studies performed are intended to produce probabilistic predictive models that can be used and extended by the utilities and by NRC to sharpen the focus of inquiries into a range of tissues affecting reactor safety. This guide addresses the determination of the probability (per year) of core damage resulting from accident initiators internal to the plant and from loss of offsite electric power. The scope includes analyses of problem-solving (cognitive) human errors, a determination of importance of the various core damage accident sequences, and an explicit treatment and display of uncertainties for the key accident sequences. Ultimately, the guide will be augmented to include the plant-specific analysis of in-plant processes (i.e., containment performance) and the risk associated with external accident initiators, as consensus is developed regarding suitable methodologies in these areas. This guide provides the structure of a probabilistic safety study to be performed, and indicates what products of the study are essential for regulatory decision making. Methodology is treated in the guide only to the extent necessary to indicate the range of methods which is acceptable; ample reference is given to alternative methodologies which may be utilized in the performance of the study

  1. Crisis management and warning procedures

    Directory of Open Access Journals (Sweden)

    Valérie November

    2009-03-01

    territoriale du risque s’avère nécessaire.Based on two flood events that recently affected new housing areas in very different political, organisational and hydrological contexts, this article examines the practices of actors involved in emergency and crisis situations in Switzerland. In both cases, the actors are identified – through their role and their position in the various procedures related to crisis management – and an inventory is made of the documents used. The study examines how the flood events were managed, identifies the organisational changes that followed the crises, and determines how the risk was conceived and to what extent it was formalised by the different actors both before and after the floods. Finally new forecasting and warning procedures that were set up following the events are described. The study shows that floods have a decisive impact on the production of knowledge, but that this phenomenon varies according to the actors. Events such as floods also sometimes reveal the existence of "latent" knowledge, or knowledge that is available but has not yet been integrated into institutional procedures. In terms of both forecasting and crisis management, these events also provide the opportunity to test information channels and to identify and correct any problems relating to organisation, cooperation or the reliability of means of communication. Among other things, the risks and crises related to flooding modify the dynamics and policies of the local area as a result of readjustments in the networks of actors. The introduction of emergency and crisis management measures appears more effective, however, than the reorganisation of planning and development procedures, a process which generally takes a lot longer. Nevertheless, since the recollection of events tends to fade with time, it is important that risks find a more concrete form of spatial expression on the landscape.

  2. DACS upgrade acceptance test procedure

    International Nuclear Information System (INIS)

    Zuehlke, A.C.

    1994-01-01

    The readiness of the Data Acquisition and Control System (DACS) to provide monitoring and control of the mixer pump, directional drive system, and the instrumentation associated with the SY-101 tank and support systems, and the proper functioning of the DACS with new Model 984-785 Programmable Logic Controllers (PLCs), new MODBUS PLUS version 2.01 software for the PLCs, and version 3.72 of the GENESIS software will be systematically evaluated by performance of this procedure. The DACS, which is housed in a trailer located just outside of the north fence at the SY tank farm, receives input signals from a variety of sensors located in and around the SY-101 tanks. These sensors provide information such as: tank vapor space and ventilation system H 2 concentration; tank waste temperature; tank pressure; waste density; operating pump parameters such as speed, flow, rotational position, discharge pressure, and internal temperature; strain (for major equipment); and waste level. The output of these sensors is conditioned and transmitted to the DACS computers where these signals are displayed, recorded, and monitored for out-of-specification conditions. If abnormal conditions are detected, then, in certain situations, the DACS automatically generates alarms and causes the system to abort pump operations

  3. Developing, adopting and adapting operating procedures

    International Nuclear Information System (INIS)

    Rabouhams, J.

    1986-01-01

    This lecture specifies all the dispositions which have been taken by EDF Nuclear and Fossil Generation Department - according to the fact that availability and safety largely depend on the quality of the procedures and their easy handling - in order to develop, adopt and adapt the operating procedures. The following points are treated: General organization of procedures for plant operation during normal and abnormal conditions; Personnel and extend of responsibility involved into the development of procedures (research center, training center, specialized services, nuclear station, etc.); Validation of the procedures by means of full-scope simulators; Modifications of the procedures taking into account operation experience in material and human fields; Development of simulation softs in order to perform the procedures in abnormal situations; Evolution of operating technics and future skills. (orig.)

  4. Surgeon-patient communication during awake procedures.

    Science.gov (United States)

    Smith, Claire S; Guyton, Kristina; Pariser, Joseph J; Siegler, Mark; Schindler, Nancy; Langerman, Alexander

    2017-06-01

    Surgeons are increasingly performing procedures on awake patients. Communication during such procedures is complex and underexplored in the literature. Surgeons were recruited from the faculty of 2 hospitals to participate in an interview regarding their approaches to communication during awake procedures. Three researchers used the constant comparative method to transcribe, code, and review interviews until saturation was reached. Twenty-three surgeons described the advantages and disadvantages of awake procedures, their communication with the awake patient, their interactions with staff and with trainees, the environment of awake procedures, and how communication in this context is taught and learned. Surgeons recognized communication during awake procedures as important and reported varied strategies for ensuring patient comfort in this context. However, they also acknowledged challenges with multiparty communication during awake procedures, especially in balancing commitments to teaching with their duty to comfort the patient. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Human Reliability Analysis For Computerized Procedures

    International Nuclear Information System (INIS)

    Boring, Ronald L.; Gertman, David I.; Le Blanc, Katya

    2011-01-01

    This paper provides a characterization of human reliability analysis (HRA) issues for computerized procedures in nuclear power plant control rooms. It is beyond the scope of this paper to propose a new HRA approach or to recommend specific methods or refinements to those methods. Rather, this paper provides a review of HRA as applied to traditional paper-based procedures, followed by a discussion of what specific factors should additionally be considered in HRAs for computerized procedures. Performance shaping factors and failure modes unique to computerized procedures are highlighted. Since there is no definitive guide to HRA for paper-based procedures, this paper also serves to clarify the existing guidance on paper-based procedures before delving into the unique aspects of computerized procedures.

  6. Multiple position borehole extensometer procedure: Final draft

    International Nuclear Information System (INIS)

    1986-08-01

    The purpose of the Multiple Position Borehole Extensometer Procedure is to provide detailed information for MPBXs installed at the salt Deaf Smith County ESF. This procedure includes design of equipment, installation, instructions, instrument locations, measurement requirements, support requirements, quality assurance procedures, and data acquisition requirements. Data reduction procedures are also discussed; however, the relevance of the data is discussed elsewhere in the appropriate test plans. Sufficient detail is provided in this procedure to allow for integrating the requirements of this procedure into both the facility construction and overall underground testing programs; identifying necessary equipment for procurement; determining data acquisition requirements as input to Automatic Data Acquisition System (ADAS) design; providing step-by-step procedures for training personnel as well as for directing field operations; establishing quality assurance (QA) checkpoints and implementation methods; and defining data reduction methods and providing the anticipated accuracy of the system. 11 refs., 14 figs

  7. Writer`s guide for technical procedures

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-12-01

    A primary objective of operations conducted in the US Department of Energy (DOE) complex is safety. Procedures are a critical element of maintaining a safety envelope to ensure safe facility operation. This DOE Writer`s Guide for Technical Procedures addresses the content, format, and style of technical procedures that prescribe production, operation of equipment and facilities, and maintenance activities. The DOE Writer`s Guide for Management Control Procedures and DOE Writer`s Guide for Emergency and Alarm Response Procedures are being developed to assist writers in developing nontechnical procedures. DOE is providing this guide to assist writers across the DOE complex in producing accurate, complete, and usable procedures that promote safe and efficient operations that comply with DOE orders, including DOE Order 5480.19, Conduct of Operations for DOE Facilities, and 5480.6, Safety of Department of Energy-Owned Nuclear Reactors.

  8. INITIATION AND CONDUCT OF ADMINISTRATIVE PROCEDURE

    Directory of Open Access Journals (Sweden)

    Milan Stipic

    2013-12-01

    Full Text Available General administrative procedure act contains legal norms that are valid for all identical cases. In addition to the general, there are special administrative procedures, customized to the specific administrative areas. Procedure initiation is regulated. Administrative procedure can be initiated at the request of the proponent and ex officio. When the official determines that the conditions for the conduct of administrative procedure are met, before making a decision, all the facts and circumstances relevant to the resolution of administrative matter have to be identified. When there are no legal requirements for the initiation of procedures, the official shall make a decision to reject the application of the party. The procedure is initiated ex officio when stipulated by law or when protection of public interest requires it. When initiating procedure ex officio, the public authority shall take into consideration the petition or other information that indicate the need to protect the public interest. In such cases the applicant is not a party, and the official is obliged to notify the applicant, if initiation of procedures is not accepted ex officio. Based on the notification, the applicant has a right to complain, including the situation when there is no response within the prescribed period of 30 days. Public authority may, therefore it is not obliged to, initiate administrative procedure by public announcement only in a situation where the parties are unknown, while it is obliged to initiate procedure by public announcement when this method of initiating the procedure is prescribed by law. Initiation of procedure with public announcement occurs in rare cases. Due to the application of efficiency and cost-effectiveness principle, two or more administrative procedures can be merged into one procedure by a conclusion. The condition for this is that the rights or obligations of the parties are based on the same legal basis and on the same or

  9. Loop electrosurgical excision of the cervix and the subsequent risk of preterm delivery

    DEFF Research Database (Denmark)

    Nøhr, Bugge; Tabor, Ann; Frederiksen, Kirsten

    2007-01-01

    , with the original aim of investigating the role of human papillomavirus in the natural history of cervical neoplasia. The study included 11,088 women aged 20-29. The cohort was invited for 2 follow-up examinations in 1993-1995 and 1999-2000, respectively. At all 3 examinations, the women answered questions about...

  10. The mediation procedure in Romania

    Directory of Open Access Journals (Sweden)

    Alexandrina Zaharia

    2009-06-01

    Full Text Available The mediation activity as an alternative way of solving conflicts occupies an important place in modernsociety. Currently, the mediation reached its maturity worldwide being adopted without reservations.The future of solving conflicts is undoubtedly closely related to mediation. XXth century is the century of solvingconflicts amiably outside the court room. In Romania and the mediation profession were regulated by the Law no.192/2006, on the basis of the idea that mediation is one of the major themes of the reform strategy of the judicialsystem 2005-2007. By adopting the mentioned law it was followed the idea of reducing the volume of activitycourts, and therefore, relieve them of as many cases, with the direct effect on the quality of justice. Mediation is avoluntary process in which the parties with a neutral and impartial third party, without power of decision - themediator - who is qualified to assist the parties to negotiate, facilitating the communication between them andhelping them to reach a unanimous effective and sustainable agreement. The parties may resort to mediation beforeor after triggering a trial. Mediation can be applied, in principle, on any type of conflict. However, theRomanian legislator has established special stipulations on conflict mediation in criminal, civil and familylaw. Although not expressly provided, the stipulations regarding the civil conflicts and also apply to commercialconflicts. Therefore, the mediation is applicable to most types of lawsuits, except those relating to personalrights. As a "win- win" principle, the mediation does not convert any of the parties defeated or victorious; allthose involved have gained by applying this procedure.

  11. Vaginal hysterectomy, an outpatient procedure.

    Science.gov (United States)

    Engh, Marie Ellström; Hauso, Wenche

    2012-11-01

    To report our experience of treating women undergoing vaginal hysterectomy in an outpatient setting and to identify risk factors for hospital admission and women dissatisfied with care. Prospective observational report. department of obstetrics and gynecology, university hospital in Norway. 150 women who underwent vaginal hysterectomy at the outpatient clinic from February 2009 to April 2010. Perioperative data were collected prospectively and case notes were searched for complications. On the first postoperative day all women were contacted by telephone by a nurse. A visual analogue scale (VAS) was used to monitor pain and nausea during the stay at the outpatient clinic and the day after surgery. VAS was also used to specify the women's degree of satisfaction with care the day after surgery. The number of women who could be discharged from the outpatient unit and had a satisfaction score of ≥7 the day after surgery. Of the 150 women, 84% could be discharged after a mean observation period of 276 min (SD ± 80 min). The mean satisfaction score was 9.0, SD ± 1.4, and 92.6% of the women reported ≥7 points in the satisfaction score. No women with serious complications were sent home. Using a multivariable logistic regression model only pain at discharge was found as significant (p= 0.009) for admittance to hospital. Vaginal hysterectomy is a feasible outpatient procedure and the majority of women were satisfied with the care they received. © 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.

  12. PC based temporary shielding administrative procedure (TSAP)

    International Nuclear Information System (INIS)

    Olsen, D.E.; Pederson, G.E.; Hamby, P.N.

    1995-01-01

    A completely new Administrative Procedure for temporary shielding was developed for use at Commonwealth Edison's six nuclear stations. This procedure promotes the use of shielding, and addresses industry requirements for the use and control of temporary shielding. The importance of an effective procedure has increased since more temporary shielding is being used as ALARA goals become more ambitious. To help implement the administrative procedure, a personal computer software program was written to incorporate the procedural requirements. This software incorporates the useability of a Windows graphical user interface with extensive help and database features. This combination of a comprehensive administrative procedure and user friendly software promotes the effective use and management of temporary shielding while ensuring that industry requirements are met

  13. PC based temporary shielding administrative procedure (TSAP)

    Energy Technology Data Exchange (ETDEWEB)

    Olsen, D.E.; Pederson, G.E. [Sargent & Lundy, Chicago, IL (United States); Hamby, P.N. [Commonwealth Edison Co., Downers Grove, IL (United States)

    1995-03-01

    A completely new Administrative Procedure for temporary shielding was developed for use at Commonwealth Edison`s six nuclear stations. This procedure promotes the use of shielding, and addresses industry requirements for the use and control of temporary shielding. The importance of an effective procedure has increased since more temporary shielding is being used as ALARA goals become more ambitious. To help implement the administrative procedure, a personal computer software program was written to incorporate the procedural requirements. This software incorporates the useability of a Windows graphical user interface with extensive help and database features. This combination of a comprehensive administrative procedure and user friendly software promotes the effective use and management of temporary shielding while ensuring that industry requirements are met.

  14. Civil rights reference of administrative procedures

    International Nuclear Information System (INIS)

    Held, J.

    1984-01-01

    The book deals with the constitutional obligations which substantive civil rights demand from administrative procedures. The Federal Constitutional Court distinguishes between protection of civil rights in, and by, administrative and judicial procedures. The author analyses the example of the decision of the Federal Constitutional Court concerning the atomic power plant of Muelheim-Kaerlich. In the licensing procedure pursuant to the Atomic Energy Act, the civil rights of persons concerned are guaranteed by the governmental obligation to its protection. (CW) [de

  15. Procedures minimally invasive image-guided

    International Nuclear Information System (INIS)

    Mora Guevara, Alejandro

    2011-01-01

    A literature review focused on minimally invasive procedures, has been performed at the Department of Radiology at the Hospital Calderon Guardia. A multidisciplinary team has been raised for decision making. The materials, possible complications and the available imaging technique such as ultrasound, computed tomography, magnetic resonance imaging, have been determined according to the procedure to be performed. The revision has supported medical interventions didactically enjoying the best materials, resources and conditions for a successful implementation of procedures and results [es

  16. Can proceduralization support coping with the unexpected?

    Energy Technology Data Exchange (ETDEWEB)

    Norros, Leena; Savioja, Paula; Liinasuo, Marja; Wahlstrom, Mikael [VTT Technical Research Centre of Finland, Vuorimiehentie (Finland)

    2014-08-15

    Operations of safety critical industries unquestionably require a diversity of technical and organizational control measures to increase stability and predictability of the complex sociotechnical systems. Nevertheless, experiences from recent severe accidents and results of safety research have questioned the effectiveness of the prevailing safety management strategy that mainly relies on standardization and designed-in defenses. This paper discusses the identified need to balance between stability and flexibility in a concrete safety issue, i.e., proceduralization. The main research problem of our study is whether procedure guided practice can offer sufficient support for flexibility of operating activity. We shall frame our study with the help of a model that explains different aspects of procedures. We then elaborate how these different aspects were considered empirically in our 3-phase study. In the first study we interviewed 62 main control room operators and asked how they consider procedures to support balancing. In the second study we observed in detail 12 NPP operator crews' activity in a simulated loss-of-coolant accident. In a third study we inquired 5 procedure designers about their conceptions concerning procedure guidance in operator work. Drawing on either interview or behavioral data we analyzed the personnel's stance to the flexibility and stability balancing, and how the conceptions portray in the practices of procedure usage. Our results demonstrate that the operators are aware of the need for balancing flexibility and stability and consider successful balancing to represent 'good' professional action. In actual action many operators, however, tend towards more straightforward following of procedures. Designers also see the capability for balancing stability and flexibility as a key operator competence but describe actual acting simply as procedure-following. According to the documents of the nuclear community, procedure

  17. Unexpected effects of computer presented procedures

    International Nuclear Information System (INIS)

    Blackman, H.S.; Nelson, W.R.

    1988-01-01

    Results from experiments conducted at the Idaho National Engineering Laboratory have been presented regarding the computer presentation of procedural information. The results come from the experimental evaluation of an expert system which presented procedural instructions to be performed by a nuclear power plant operator. Lessons learned and implications from the study are discussed as well as design issues that should be considered to avoid some of the pitfalls in computer presented or selected procedures

  18. Can proceduralization support coping with the unexpected?

    International Nuclear Information System (INIS)

    Norros, Leena; Savioja, Paula; Liinasuo, Marja; Wahlstrom, Mikael

    2014-01-01

    Operations of safety critical industries unquestionably require a diversity of technical and organizational control measures to increase stability and predictability of the complex sociotechnical systems. Nevertheless, experiences from recent severe accidents and results of safety research have questioned the effectiveness of the prevailing safety management strategy that mainly relies on standardization and designed-in defenses. This paper discusses the identified need to balance between stability and flexibility in a concrete safety issue, i.e., proceduralization. The main research problem of our study is whether procedure guided practice can offer sufficient support for flexibility of operating activity. We shall frame our study with the help of a model that explains different aspects of procedures. We then elaborate how these different aspects were considered empirically in our 3-phase study. In the first study we interviewed 62 main control room operators and asked how they consider procedures to support balancing. In the second study we observed in detail 12 NPP operator crews' activity in a simulated loss-of-coolant accident. In a third study we inquired 5 procedure designers about their conceptions concerning procedure guidance in operator work. Drawing on either interview or behavioral data we analyzed the personnel's stance to the flexibility and stability balancing, and how the conceptions portray in the practices of procedure usage. Our results demonstrate that the operators are aware of the need for balancing flexibility and stability and consider successful balancing to represent 'good' professional action. In actual action many operators, however, tend towards more straightforward following of procedures. Designers also see the capability for balancing stability and flexibility as a key operator competence but describe actual acting simply as procedure-following. According to the documents of the nuclear community, procedure

  19. Payment Procedures for Electronic Government Services

    OpenAIRE

    Pousttchi, Key; Wiedemann, Dietmar Georg

    2005-01-01

    In this paper, we analyse payment procedures for their suitability for electronic government. We provide an overview of the payment procedures currently available on the market, compare the situation in electronic government with the situation in electronic commerce and analyze what we can transfer. Based on functional requirements we propose a scheme that allows public agencies to examine the appropriateness of any given payment procedure for electronic government.

  20. Nuclear Waste Fund cash management procedures

    International Nuclear Information System (INIS)

    1988-04-01

    The Nuclear Waste Policy Act if 1982 (NWPA) provided for the Office of Radioactive Waste Management (OCRWM) to adopt financial and accounting methods comparable to those used by private industry, including borrowing and investing authority. This document describes the procedures OCRWM follows to meet its borrowing and investing authority under the NWPA. These procedures are a supplement to, and are, therefore, not intended to supersede, existing Departmental policies and procedures

  1. Unexpected effects of computer presented procedures

    International Nuclear Information System (INIS)

    Blackman, H.S.; Nelson, W.R.

    1988-01-01

    Results from experiments conducted at the Idaho National Engineering Laboratory will be presented regarding the computer presentation of procedural information. The results come from the experimental evaluation of an expert system which presented procedural instructions to be performed by a nuclear power plant operator. Lessons learned and implications from the study will be discussed as well as design issues that should be considered to avoid some of the pitfalls in computer presented or selected procedures. 1 ref., 1 fig

  2. Robotic vascular resections during Whipple procedure.

    Science.gov (United States)

    Allan, Bassan J; Novak, Stephanie M; Hogg, Melissa E; Zeh, Herbert J

    2018-01-01

    Indications for resection of pancreatic cancers have evolved to include selected patients with involvement of peri-pancreatic vascular structures. Open Whipple procedures have been the standard approach for patients requiring reconstruction of the portal vein (PV) or superior mesenteric vein (SMV). Recently, high-volume centers are performing minimally invasive Whipple procedures with portovenous resections. Our institution has performed seventy robotic Whipple procedures with concomitant vascular resections. This report outlines our technique.

  3. Robotic vascular resections during Whipple procedure

    OpenAIRE

    Allan, Bassan J.; Novak, Stephanie M.; Hogg, Melissa E.; Zeh, Herbert J.

    2018-01-01

    Indications for resection of pancreatic cancers have evolved to include selected patients with involvement of peri-pancreatic vascular structures. Open Whipple procedures have been the standard approach for patients requiring reconstruction of the portal vein (PV) or superior mesenteric vein (SMV). Recently, high-volume centers are performing minimally invasive Whipple procedures with portovenous resections. Our institution has performed seventy robotic Whipple procedures with concomitant vas...

  4. Conception, definition, measuring procedure of grain size

    International Nuclear Information System (INIS)

    Yanagisawa, Kazuaki

    1976-12-01

    The conception, definition, measuring procedure of ''Grain Size'' were surveyed. A concept ''grain diameter'' was introduced after deriving a calculation formula for the grain diameter for using the Comparison (simple) and Intercept(detailed) procedure. As an example and putting into practice, the grain diameter determination was carried out by means of the Comparison procedure for a UO 2 pellet used in a densification experiment. (auth.)

  5. Implementation of procedures to NPP Krsko INTRANEK

    International Nuclear Information System (INIS)

    Gradisar, D.; Krajnc, M.; Kocnar, R.; Spiler, J.

    1999-01-01

    Part of NEK documentation has already been presented on NEK Intranet such as USAR, Technical Specifications, QA Plan as well as some frequently used series of drawings. At the time being the process of presentation of all procedures (thereinafter INTRANEK procedures) is in progress. The purpose of this project is the presentation of 1600 procedures with average size of 30 pages what is more than 48000 pages altogether. ADOBE PDF (Portable Document Format) has been chosen as the most suitable format for the presentation of procedures on INTRANEK. PDF format meets the following criteria: the outlook of a document page is always the same as an original one and cannot be changed without control. In addition to this, full text search is available as well as easy jump from procedure to procedure. Some changes of working process on internal procedures have to be made before the project start, which determine the responsibility of individual users in the process. The work flow, which enables easy daily maintenance, has been prepared, the rules of both procedure numbering as well as folder contents/name have been set and the server selected. The project was managed and implemented with the extensive use of compute-aided management, document distribution and control, databases, electronics mail and Intranet tools. The results of practical implementation of NEK procedures and our experience with INTRANEK are presented in this paper.(author)

  6. Radiation Exposure from Medical Exams and Procedures

    Science.gov (United States)

    Fact Sheet Adopted: January 2010 Health Physics Society Specialists in Radiation Safety Radiation Exposure from Medical Exams and Procedures Ionizing radiation is used daily in hospitals and clinics ...

  7. Procedural Pain Management for Children Receiving Physiotherapy

    OpenAIRE

    von Baeyer, Carl L.; Tupper, Susan M.

    2010-01-01

    Purpose: This article provides an overview of literature relevant to the prevention and relief of pain and distress during physiotherapy procedures, with guidance for physiotherapists treating children.

  8. Information Security - Data Loss Prevention Procedure

    Science.gov (United States)

    The purpose of this procedure is to extend and provide specificity to the Environmental Protection Agency (EPA) Information Security Policy regarding data loss prevention and digital rights management.

  9. Management of the Bohunice RPVs annealing procedures

    International Nuclear Information System (INIS)

    Repka, M.

    1994-01-01

    The program of annealing regeneration procedure of RPVs units 1 and 2 of NPP V-1 (EBO) realization in the year 1993, is the topic of this paper. In the paper the following steps are described in detail: the preparation works, the annealing procedure realization schedule and safety management: starting with zero conditions, assembling of annealing apparatus, annealing procedure, cooling down and disassembling procedure of annealing apparatus. At the end the programs of annealing of both RPVs including the dosimetry measurements are discussed and evaluated. (author). 3 figs

  10. Robot-assisted procedures in pediatric neurosurgery.

    Science.gov (United States)

    De Benedictis, Alessandro; Trezza, Andrea; Carai, Andrea; Genovese, Elisabetta; Procaccini, Emidio; Messina, Raffaella; Randi, Franco; Cossu, Silvia; Esposito, Giacomo; Palma, Paolo; Amante, Paolina; Rizzi, Michele; Marras, Carlo Efisio

    2017-05-01

    OBJECTIVE During the last 3 decades, robotic technology has rapidly spread across several surgical fields due to the continuous evolution of its versatility, stability, dexterity, and haptic properties. Neurosurgery pioneered the development of robotics, with the aim of improving the quality of several procedures requiring a high degree of accuracy and safety. Moreover, robot-guided approaches are of special interest in pediatric patients, who often have altered anatomy and challenging relationships between the diseased and eloquent structures. Nevertheless, the use of robots has been rarely reported in children. In this work, the authors describe their experience using the ROSA device (Robotized Stereotactic Assistant) in the neurosurgical management of a pediatric population. METHODS Between 2011 and 2016, 116 children underwent ROSA-assisted procedures for a variety of diseases (epilepsy, brain tumors, intra- or extraventricular and tumor cysts, obstructive hydrocephalus, and movement and behavioral disorders). Each patient received accurate preoperative planning of optimal trajectories, intraoperative frameless registration, surgical treatment using specific instruments held by the robotic arm, and postoperative CT or MR imaging. RESULTS The authors performed 128 consecutive surgeries, including implantation of 386 electrodes for stereo-electroencephalography (36 procedures), neuroendoscopy (42 procedures), stereotactic biopsy (26 procedures), pallidotomy (12 procedures), shunt placement (6 procedures), deep brain stimulation procedures (3 procedures), and stereotactic cyst aspiration (3 procedures). For each procedure, the authors analyzed and discussed accuracy, timing, and complications. CONCLUSIONS To the best their knowledge, the authors present the largest reported series of pediatric neurosurgical cases assisted by robotic support. The ROSA system provided improved safety and feasibility of minimally invasive approaches, thus optimizing the surgical

  11. Procedural pain in neonatal units in Kenya.

    Science.gov (United States)

    Kyololo, O'Brien Munyao; Stevens, Bonnie; Gastaldo, Denise; Gisore, Peter

    2014-11-01

    To determine the nature and frequency of painful procedures and procedural pain management practices in neonatal units in Kenya. Cross-sectional survey. Level I and level II neonatal units in Kenya. Ninety-five term and preterm neonates from seven neonatal units. Medical records of neonates admitted for at least 24 h were reviewed to determine the nature and frequency of painful procedures performed in the 24 h period preceding data collection (6:00 to 6:00) as well as the pain management interventions (eg, morphine, breastfeeding, skin-to-skin contact, containment, non-nutritive sucking) that accompanied each procedure. Neonates experienced a total of 404 painful procedures over a 24 h period (mean=4.3, SD 2.0; range 1-12); 270 tissue-damaging (mean=2.85, SD 1.1; range 1-6) and 134 non-tissue-damaging procedures (mean=1.41, SD 1.2; range 0-6). Peripheral cannula insertion (27%) and intramuscular injections (22%) were the most common painful procedures. Ventilated neonates and neonates admitted in level II neonatal units had a higher number of painful procedures than those admitted in level I units (mean 4.76 vs 2.96). Only one procedure had a pain intensity score documented; and none had been performed with any form of analgesia. Neonates in Kenya were exposed to numerous tissue-damaging and non-tissue-damaging procedures without any form of analgesia. Our findings suggest that education is needed on how to assess and manage procedural pain in neonatal units in Kenya. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  12. Parliamentary Pastries: Learning Parliamentary Procedure through Cookies

    Science.gov (United States)

    Toupence, Rachelle H.

    2008-01-01

    Parliamentary procedure is an integral part of the business of many recreation organizations, but students often perceive it to be difficult and irrelevant to their professional preparation. The activity uses the creation of a cookie recipe to practice the basic meeting business functions in parliamentary procedure. The cookie meeting is an active…

  13. 29 CFR 1614.305 - Consideration procedures.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 4 2010-07-01 2010-07-01 false Consideration procedures. 1614.305 Section 1614.305 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION FEDERAL SECTOR EQUAL EMPLOYMENT OPPORTUNITY Related Processes § 1614.305 Consideration procedures. (a) Once a petition is filed...

  14. 32 CFR 623.4 - Accounting procedures.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Accounting procedures. 623.4 Section 623.4... ARMY MATERIEL § 623.4 Accounting procedures. (a) Loan document format. (1) When the lending accountable... property accounting purposes. (3) Loans will be processed by accountable property officers according to...

  15. W-087 Acceptance test procedure. Revision 1

    International Nuclear Information System (INIS)

    Joshi, A.W.

    1997-01-01

    This Acceptance Test Procedure/Operational Test Procedure (ATP/OTP) has been prepared to demonstrate that the Electrical/Instrumentation and Mechanical systems function as required by project criteria and to verify proper operation of the integrated system including the interlocks

  16. Acceptance test procedure for Project W-280

    International Nuclear Information System (INIS)

    Stites, C.G.

    1994-01-01

    This Document is the Acceptance Test Procedure for 200 Area C and SY Tank Farm Lighting Upgrade. This Acceptance Test Procedure has been prepared to demonstrate that the Tank Farm Lighting Systems function correctly as required by project criteria and as intended by design

  17. 25 CFR 225.21 - Negotiation procedures.

    Science.gov (United States)

    2010-04-01

    ... setting forth the duration of the minerals agreement; (3) A statement providing indemnification to the... accounting and mineral valuation procedures; (8) Provisions establishing operating and management procedures... refusal by the Indian mineral owner in the event of a proposed assignment; (10) Bond requirements; (11...

  18. 9 CFR 381.311 - Recall procedure.

    Science.gov (United States)

    2010-01-01

    ... CERTIFICATION POULTRY PRODUCTS INSPECTION REGULATIONS Canning and Canned Products § 381.311 Recall procedure... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Recall procedure. 381.311 Section 381.311 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE AGENCY...

  19. Towards a procedure for metaphor identification

    NARCIS (Netherlands)

    Steen, G.J.

    2002-01-01

    This article aims to demonstrate the possibility of a stepwise procedure for metaphor identification. It is situated against the background of a more encompassing and complete five-step procedure for deriving conceptual metaphorical mappings from linguistic metaphors. The mainly cognitive linguistic

  20. 21 CFR 60.44 - Hearing procedures.

    Science.gov (United States)

    2010-04-01

    ... RESTORATION Due Diligence Hearings § 60.44 Hearing procedures. The due diligence hearing shall be conducted in accordance with this part, supplemented by the nonconflicting procedures in part 16. During the due diligence... requesting a hearing under part 16. The standard of due diligence set forth in § 60.36 will apply in the due...

  1. 48 CFR 410.002 - Procedures.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Procedures. 410.002 Section 410.002 Federal Acquisition Regulations System DEPARTMENT OF AGRICULTURE COMPETITION AND ACQUISITION PLANNING MARKET RESEARCH 410.002 Procedures. Market research must include obtaining information on...

  2. Procedural lawmaking at the International Criminal Tribunals

    NARCIS (Netherlands)

    Sluiter, G.; Darcy, S.; Powderly, J.

    2011-01-01

    This chapter examines the role played by the judges in creating the procedural rules which govern the functioning of the ad hoc Tribunals. Noting that the bench had been tasked with devising its own rules of procedure and evidence, it queries whether judicial lawmaking in this context at the

  3. MITS Feed and Withdrawal Subsystem: operating procedures

    International Nuclear Information System (INIS)

    Brown, W.S.

    1980-01-01

    This procedure details the steps involved in establishing closed loop flows, providing UF 6 vapor to the FEED header of the Sampling Subsystem and returning it through the PRODUCT and TAILS headers via the F and W recycle valves. It is essentially a Startup Procedure

  4. W-087 Acceptance test procedure. Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    Joshi, A.W.

    1997-06-10

    This Acceptance Test Procedure/Operational Test Procedure (ATP/OTP) has been prepared to demonstrate that the Electrical/Instrumentation and Mechanical systems function as required by project criteria and to verify proper operation of the integrated system including the interlocks.

  5. Procedure to Generate the MPACT Multigroup Library

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kang Seog [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2015-12-17

    The CASL neutronics simulator MPACT is under development for the neutronics and T-H coupled simulation for the light water reactor. The objective of this document is focused on reviewing the current procedure to generate the MPACT multigroup library. Detailed methodologies and procedures are included in this document for further discussion to improve the MPACT multigroup library.

  6. 48 CFR 17.504 - Ordering procedures.

    Science.gov (United States)

    2010-10-01

    ... METHODS AND CONTRACT TYPES SPECIAL CONTRACTING METHODS Interagency Acquisitions Under the Economy Act 17.504 Ordering procedures. (a) Before placing an Economy Act order for supplies or services with another...; see also 6.302 for procedures to follow where using other than full and open competition.) The...

  7. 77 FR 51943 - Procedures for Safety Investigations

    Science.gov (United States)

    2012-08-28

    ... rule, Procedures for Safety Investigations, which published July 27, 2012 in the Federal Register, 77... DEFENSE NUCLEAR FACILITIES SAFETY BOARD 10 CFR Part 1708 Procedures for Safety Investigations AGENCY: Defense Nuclear Facilities Safety Board. ACTION: Proposed rule; extension of comment period...

  8. 22 CFR 226.71 - Closeout procedures.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Closeout procedures. 226.71 Section 226.71 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ADMINISTRATION OF ASSISTANCE AWARDS TO U.S. NON-GOVERNMENTAL ORGANIZATIONS After-the-Award Requirements § 226.71 Closeout procedures. (a) Recipients shall...

  9. CT4 - Cost-Optimum Procedures

    DEFF Research Database (Denmark)

    Thomsen, Kirsten Engelund; Wittchen, Kim Bjarne

    This report collects the status in European member states regarding implementation of the cos optimum procedure for setting energy performance requirements to new and existing buildings.......This report collects the status in European member states regarding implementation of the cos optimum procedure for setting energy performance requirements to new and existing buildings....

  10. Procedures for mastitis diagnosis and control.

    Science.gov (United States)

    Sears, P M; González, R N; Wilson, D J; Han, H R

    1993-11-01

    Procedures for mastitis diagnosis and control include culturing individual cow and bulk tank milk samples, antibiotic susceptibility testing, and evaluation of somatic cell count reports and clinical mastitis treatment records. Integrated use of such procedures is necessary for effective mastitis diagnosis and control.

  11. Multimodality imaging to guide cardiac interventional procedures

    NARCIS (Netherlands)

    Tops, Laurens Franciscus

    2010-01-01

    In recent years, a number of new cardiac interventional procedures have been introduced. Catheter ablation procedures for atrial fibrillation (AF) have been refined and are now considered a good treatment option in patients with drug-refractory AF. In cardiac pacing, cardiac resynchronization

  12. Matching procedure for the sixth Painleve equation

    International Nuclear Information System (INIS)

    Guzzetti, Davide

    2006-01-01

    In the framework of the isomonodromy deformation method, we present a constructive procedure to obtain the critical behaviour of Painleve VI transcendents and solve the connection problem. This procedure yields two- and one-parameter families of solutions, including trigonometric and logarithmic behaviours, and three classes of solutions with Taylor expansion at a critical point

  13. 5 CFR 339.303 - Examination procedures.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Examination procedures. 339.303 Section... QUALIFICATION DETERMINATIONS Medical Examinations § 339.303 Examination procedures. (a) When an agency orders or offers a medical examination under this subpart, it must inform the applicant or employee in writing of...

  14. 22 CFR 92.60 - Examination procedures.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Examination procedures. 92.60 Section 92.60... and Letters Rogatory § 92.60 Examination procedures. (a) Explaining interrogatory to witness. If the... examination of a witness propound such inquiries as may be necessary to satisfy himself whether the witness is...

  15. 47 CFR 13.209 - Examination procedures.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 1 2010-10-01 2010-10-01 false Examination procedures. 13.209 Section 13.209 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL RADIO OPERATORS Examination System § 13.209 Examination procedures. (a) Each examination for a commercial radio operator license must be administered at a...

  16. 37 CFR 1.809 - Examination procedures.

    Science.gov (United States)

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Examination procedures. 1.809... Biological Material § 1.809 Examination procedures. (a) The examiner shall determine pursuant to § 1.104 in... deposited biological material sufficient to specifically identify it and to permit examination; and (4) The...

  17. 22 CFR 92.37 - Authentication procedure.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Authentication procedure. 92.37 Section 92.37... Notarial Acts § 92.37 Authentication procedure. (a) The consular officer must compare the foreign official...) Where the State law requires the consular officer's certificate of authentication to show that the...

  18. 46 CFR 296.40 - Billing procedures.

    Science.gov (United States)

    2010-10-01

    ... OPERATORS MARITIME SECURITY PROGRAM (MSP) Billing and Payment Procedures § 296.40 Billing procedures. Submission of voucher. For contractors operating under more than one MSP Operating Agreement, the contractor may submit a single monthly voucher applicable to all its MSP Operating Agreements. Each voucher...

  19. Procedures for ground-water investigations

    International Nuclear Information System (INIS)

    1992-12-01

    This manual was developed by the Pacific Northwest Laboratory (PNL) to document the procedures used to carry out and control the technical aspects of ground-water investigations at the PNL. Ground-water monitoring procedures are developed and used in accordance with the PNL Quality Assurance Program

  20. 8 CFR 270.2 - Enforcement procedures.

    Science.gov (United States)

    2010-01-01

    ... Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY IMMIGRATION REGULATIONS PENALTIES FOR DOCUMENT FRAUD § 270.2 Enforcement procedures. (a) Procedures for the filing of complaints. Any person or entity... charges for document fraud committed by refugees at the time of entry. The Service shall not issue a...

  1. 40 CFR 7.90 - Grievance procedures.

    Science.gov (United States)

    2010-07-01

    ...) Exception. Recipients with fewer than fifteen (15) full-time employees need not comply with this section... Recipients § 7.90 Grievance procedures. (a) Requirements. Each recipient shall adopt grievance procedures... significantly impair the recipient's ability to provide benefits or services. ...

  2. 10 CFR 474.4 - Test procedures.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 3 2010-01-01 2010-01-01 false Test procedures. 474.4 Section 474.4 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION ELECTRIC AND HYBRID VEHICLE RESEARCH, DEVELOPMENT, AND DEMONSTRATION PROGRAM; PETROLEUM-EQUIVALENT FUEL ECONOMY CALCULATION § 474.4 Test procedures. (a) The electric vehicle energy...

  3. 40 CFR 68.52 - Operating procedures.

    Science.gov (United States)

    2010-07-01

    ...) CHEMICAL ACCIDENT PREVENTION PROVISIONS Program 2 Prevention Program § 68.52 Operating procedures. (a) The... for safely conducting activities associated with each covered process consistent with the safety information for that process. Operating procedures or instructions provided by equipment manufacturers or...

  4. Grid - a fast threshold tracking procedure

    DEFF Research Database (Denmark)

    Fereczkowski, Michal; Dau, Torsten; MacDonald, Ewen

    2016-01-01

    A new procedure, called “grid”, is evaluated that allows rapid acquisition of threshold curves for psychophysics and, in particular, psychoacoustic, experiments. In this method, the parameterresponse space is sampled in two dimensions within a single run. This allows the procedure to focus more e...

  5. 12 CFR 411.405 - Penalty procedures.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Penalty procedures. 411.405 Section 411.405 Banks and Banking EXPORT-IMPORT BANK OF THE UNITED STATES NEW RESTRICTIONS ON LOBBYING Penalties and Enforcement § 411.405 Penalty procedures. Agencies shall impose and collect civil penalties pursuant to the...

  6. 44 CFR 208.52 - Reimbursement procedures.

    Science.gov (United States)

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Reimbursement procedures. 208... Reimbursement Claims and Appeals § 208.52 Reimbursement procedures. (a) General. A Sponsoring Agency must present a claim for reimbursement to DHS in such manner as the Assistant Administrator specifies . (b...

  7. 28 CFR 527.31 - Procedures.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Procedures. 527.31 Section 527.31 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INMATE ADMISSION, CLASSIFICATION, AND TRANSFER TRANSFERS Transfer of Inmates to State Agents for Production on State Writs § 527.31 Procedures...

  8. 27 CFR 44.227 - Customs procedure.

    Science.gov (United States)

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Customs procedure. 44.227..., WITHOUT PAYMENT OF TAX, OR WITH DRAWBACK OF TAX Drawback of Tax § 44.227 Customs procedure. The customs... having inspected the articles and supervised the lading thereof on the export carrier, the customs...

  9. Comparison of transition-matrix sampling procedures

    DEFF Research Database (Denmark)

    Yevick, D.; Reimer, M.; Tromborg, Bjarne

    2009-01-01

    We compare the accuracy of the multicanonical procedure with that of transition-matrix models of static and dynamic communication system properties incorporating different acceptance rules. We find that for appropriate ranges of the underlying numerical parameters, algorithmically simple yet high...... accurate procedures can be employed in place of the standard multicanonical sampling algorithm....

  10. Procedural Due Process Rights in Student Discipline.

    Science.gov (United States)

    Pressman, Robert; Weinstein, Susan

    To assist administrators in understanding procedural due process rights in student discipline, this manual draws together hundreds of citations and case summaries of federal and state court decisions and provides detailed commentary as well. Chapter 1 outlines the general principles of procedural due process rights in student discipline, such as…

  11. 45 CFR 708.7 - Hearing procedures.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Hearing procedures. 708.7 Section 708.7 Public Welfare Regulations Relating to Public Welfare (Continued) COMMISSION ON CIVIL RIGHTS COLLECTION BY SALARY OFFSET FROM INDEBTED CURRENT AND FORMER EMPLOYEES § 708.7 Hearing procedures. (a) If an employee timely...

  12. 50 CFR 85.21 - Application procedures.

    Science.gov (United States)

    2010-10-01

    ... 50 Wildlife and Fisheries 6 2010-10-01 2010-10-01 false Application procedures. 85.21 Section 85... Application for Grants § 85.21 Application procedures. (a) Eligible applicants will submit their proposals to..., Missouri, Ohio, and Wisconsin Division of Federal Aid, U.S. Fish and Wildlife Service, Bishop Henry Whipple...

  13. 32 CFR 162.6 - Procedures.

    Science.gov (United States)

    2010-07-01

    ... Department of Defense OFFICE OF THE SECRETARY OF DEFENSE DEFENSE CONTRACTING PRODUCTIVITY ENHANCING CAPITAL INVESTMENT (PECI) § 162.6 Procedures. The following procedures shall be followed by the DoD Components in the... documentation, pre-investment analysis, financing, and post-investment accountability of PECI projects, when DoD...

  14. 5 CFR 179.304 - Notification procedures.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Notification procedures. 179.304 Section 179.304 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS CLAIMS COLLECTION STANDARDS Administrative Offset § 179.304 Notification procedures. Before collecting any debt...

  15. 5 CFR 179.308 - Accelerated procedures.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Accelerated procedures. 179.308 Section 179.308 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS CLAIMS COLLECTION STANDARDS Administrative Offset § 179.308 Accelerated procedures. OPM may make an administrative...

  16. 40 CFR 73.12 - Rounding Procedures.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 16 2010-07-01 2010-07-01 false Rounding Procedures. 73.12 Section 73.12 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) SULFUR DIOXIDE ALLOWANCE SYSTEM Allowance Allocations § 73.12 Rounding Procedures. (a) Calculation...

  17. 32 CFR 145.6 - Procedures.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 1 2010-07-01 2010-07-01 false Procedures. 145.6 Section 145.6 National Defense... THE OFFICE OF SPECIAL COUNSEL OF THE MERIT SYSTEMS PROTECTION BOARD § 145.6 Procedures. (a... corrective or disciplinary action considered appropriate because of facts disclosed by such an investigation...

  18. 28 CFR 550.31 - Procedures.

    Science.gov (United States)

    2010-07-01

    ... the allotted time period. An inmate may rebut this presumption during the disciplinary process. (b... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Procedures. 550.31 Section 550.31... Urine Surveillance § 550.31 Procedures. (a) Staff of the same sex as the inmate tested shall directly...

  19. Assessment procedures results of training in biology

    Directory of Open Access Journals (Sweden)

    Elena A. Galkina

    2018-04-01

    Full Text Available The article describes the procedures for evaluating the results of training in biology. The mechanisms for monitoring the learning outcomes of a biology teacher are presented. Examples of algorithms for procedures for evaluating learning outcomes in biology are demonstrated.

  20. The benefits of using customized procedure packs.

    Science.gov (United States)

    Baines, R; Colquhoun, G; Jones, N; Bateman, R

    2001-01-01

    Discrete item purchasing is the traditional approach for hospitals to obtain consumable supplies for theatre procedures. Although most items are relatively low cost, the management and co-ordination of the supply chain, raising orders, controlling stock, picking and delivering to each operating theatre can be complex and costly. Customized procedure packs provide a solution.

  1. Occupational exposures from selected interventional radiological procedures

    International Nuclear Information System (INIS)

    Janeczek, J.; Beal, A.; James, D.

    2001-01-01

    The number of radiology and cardiology interventional procedures has significantly increased in recent years due to better diagnostic equipment resulting in an increase in radiation dose to the staff and patients. The assessment of staff doses was performed for cardiac catheterization and for three other non-cardiac procedures. The scattered radiation distribution resulting from the cardiac catheterization procedure was measured prior to the staff dose measurements. Staff dose measurements included those of the left shoulder, eye, thyroid and hand doses of the cardiologist. In non-cardiac procedures doses to the hands of the radiologist were measured for nephrostomy, fistulogram and percutaneous transluminal angioplasty procedures. Doses to the radiologist or cardiologist were found to be relatively high if correct protection was not observed. (author)

  2. Deterministic effects of interventional radiology procedures

    International Nuclear Information System (INIS)

    Shope, Thomas B.

    1997-01-01

    The purpose of this paper is to describe deterministic radiation injuries reported to the Food and Drug Administration (FDA) that resulted from therapeutic, interventional procedures performed under fluoroscopic guidance, and to investigate the procedure or equipment-related factors that may have contributed to the injury. Reports submitted to the FDA under both mandatory and voluntary reporting requirements which described radiation-induced skin injuries from fluoroscopy were investigated. Serious skin injuries, including moist desquamation and tissues necrosis, have occurred since 1992. These injuries have resulted from a variety of interventional procedures which have required extended periods of fluoroscopy compared to typical diagnostic procedures. Facilities conducting therapeutic interventional procedures need to be aware of the potential for patient radiation injury and take appropriate steps to limit the potential for injury. (author)

  3. Sentinel node biopsy (SNB) in malignant melanoma as same day procedure vs delayed procedure

    DEFF Research Database (Denmark)

    Rødgaard, Jes Christian; Kramer, Stine; Stolle, Lars B

    2013-01-01

    The aim of this study was to compare a delayed sentinel node biopsy (dSNB) procedure with a same-day procedure (sSNB) in malignant melanoma. In March 2012, Aarhus University Hospital went from the dSNB to the sSNB procedure defined by lymphoscintigraphy (LS) and sentinel node biopsy (SNB) perform......, essential to keep the morbidity and economic costs low, while keeping the quality of the procedure high....

  4. An XML Representation for Crew Procedures

    Science.gov (United States)

    Simpson, Richard C.

    2005-01-01

    NASA ensures safe operation of complex systems through the use of formally-documented procedures, which encode the operational knowledge of the system as derived from system experts. Crew members use procedure documentation on the ground for training purposes and on-board space shuttle and space station to guide their activities. Investigators at JSC are developing a new representation for procedures that is content-based (as opposed to display-based). Instead of specifying how a procedure should look on the printed page, the content-based representation will identify the components of a procedure and (more importantly) how the components are related (e.g., how the activities within a procedure are sequenced; what resources need to be available for each activity). This approach will allow different sets of rules to be created for displaying procedures on a computer screen, on a hand-held personal digital assistant (PDA), verbally, or on a printed page, and will also allow intelligent reasoning processes to automatically interpret and use procedure definitions. During his NASA fellowship, Dr. Simpson examined how various industries represent procedures (also called business processes or workflows), in areas such as manufacturing, accounting, shipping, or customer service. A useful method for designing and evaluating workflow representation languages is by determining their ability to encode various workflow patterns, which depict abstract relationships between the components of a procedure removed from the context of a specific procedure or industry. Investigators have used this type of analysis to evaluate how well-suited existing workflow representation languages are for various industries based on the workflow patterns that commonly arise across industry-specific procedures. Based on this type of analysis, it is already clear that existing workflow representations capture discrete flow of control (i.e., when one activity should start and stop based on when other

  5. Judicial civil procedure dragging out in Kosovo

    Directory of Open Access Journals (Sweden)

    Rrustem Qehaja

    2016-03-01

    Full Text Available This article tends to deal with one of the most worrying issues in the judicial system of Kosovo the problem of judicial civil procedure dragging out. The article analyses the reasons of these dragging outs of the judicial civil procedure focusing on the context of one of the basic procedural principles in civil procedure-the principle of economy or efficiency in the courts. Dragging out of civil procedure in Kosovo has put in question not only the basic principles of civil procedure, but it also challenges the general principles related to human rights and freedoms sanctioned not only by the highest legal act of the country, but also with international treaties. The article tends to give a reflection to the most important reasons that effect and influence in these dragging outs of civil procedure, as well as, at the same time aims to give the necessary alternatives to pass through them by identifying dilemmas within the judicial practice. As a result, the motives of this scientific paper are exactly focused at the same time on identifying the dilemmas, as well as presenting ideas, to overstep them, including the judicial practice of the European Court of Human Rights on Article 6 of the European Convention on Human Rights, by which it is given the possibility to offering people efficient and within a reasonable time legal protection of their rights before national courts. For these reasons, the paper elaborates this issue based on both, the legal theory and judicial practice.

  6. Interim Reliability Evaluation Program procedures guide

    International Nuclear Information System (INIS)

    Carlson, D.D.; Gallup, D.R.; Kolaczkowski, A.M.; Kolb, G.J.; Stack, D.W.; Lofgren, E.; Horton, W.H.; Lobner, P.R.

    1983-01-01

    This document presents procedures for conducting analyses of a scope similar to those performed in Phase II of the Interim Reliability Evaluation Program (IREP). It documents the current state of the art in performing the plant systems analysis portion of a probabilistic risk assessment. Insights gained into managing such an analysis are discussed. Step-by-step procedures and methodological guidance constitute the major portion of the document. While not to be viewed as a cookbook, the procedures set forth the principal steps in performing an IREP analysis. Guidance for resolving the problems encountered in previous analyses is offered. Numerous examples and representative products from previous analyses clarify the discussion

  7. Radiation safety in nuclear medicine procedures

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Sang Geon; Kim, Ja Hae; Song, Ho Chun [Dept. of Nuclear Medicine, Medical Radiation Safety Research Center, Chonnam National University Hospital, Gwangju (Korea, Republic of)

    2017-03-15

    Since the nuclear disaster at the Fukushima Daiichi Nuclear Power Plant in 2011, radiation safety has become an important issue in nuclear medicine. Many structured guidelines or recommendations of various academic societies or international campaigns demonstrate important issues of radiation safety in nuclear medicine procedures. There are ongoing efforts to fulfill the basic principles of radiation protection in daily nuclear medicine practice. This article reviews important principles of radiation protection in nuclear medicine procedures. Useful references, important issues, future perspectives of the optimization of nuclear medicine procedures, and diagnostic reference level are also discussed.

  8. Smoke as a pictorial procedure: Fumage

    Directory of Open Access Journals (Sweden)

    José Antonio Pérez Esteban

    2013-01-01

    Full Text Available I propose a new definition for fumage and address in a brief approach —from the chemical point of view— the nature of smoke. From this base, I study the possible supports, potential tools for application in artistic purposes, visual possibilities, attachment procedure and narrative connotations related to its use. Next, I analyze its connections with the related heat engraving art. To finish and justifying the new definition which claims the contemporaneity of the procedure, I bring a list of artists who have used and, mainly, who are using this procedure in their artistic proposals.

  9. Radiation safety in nuclear medicine procedures

    International Nuclear Information System (INIS)

    Cho, Sang Geon; Kim, Ja Hae; Song, Ho Chun

    2017-01-01

    Since the nuclear disaster at the Fukushima Daiichi Nuclear Power Plant in 2011, radiation safety has become an important issue in nuclear medicine. Many structured guidelines or recommendations of various academic societies or international campaigns demonstrate important issues of radiation safety in nuclear medicine procedures. There are ongoing efforts to fulfill the basic principles of radiation protection in daily nuclear medicine practice. This article reviews important principles of radiation protection in nuclear medicine procedures. Useful references, important issues, future perspectives of the optimization of nuclear medicine procedures, and diagnostic reference level are also discussed

  10. Health Code Number (HCN) Development Procedure

    Energy Technology Data Exchange (ETDEWEB)

    Petrocchi, Rocky; Craig, Douglas K.; Bond, Jayne-Anne; Trott, Donna M.; Yu, Xiao-Ying

    2013-09-01

    This report provides the detailed description of health code numbers (HCNs) and the procedure of how each HCN is assigned. It contains many guidelines and rationales of HCNs. HCNs are used in the chemical mixture methodology (CMM), a method recommended by the department of energy (DOE) for assessing health effects as a result of exposures to airborne aerosols in an emergency. The procedure is a useful tool for proficient HCN code developers. Intense training and quality assurance with qualified HCN developers are required before an individual comprehends the procedure to develop HCNs for DOE.

  11. Reliability of application of inspection procedures

    Energy Technology Data Exchange (ETDEWEB)

    Murgatroyd, R A

    1988-12-31

    This document deals with the reliability of application of inspection procedures. A method to ensure that the inspection of defects thanks to fracture mechanics is reliable is described. The Systematic Human Error Reduction and Prediction Analysis (SHERPA) methodology is applied to every task performed by the inspector to estimate the possibility of error. It appears that it is essential that inspection procedures should be sufficiently rigorous to avoid substantial errors, and that the selection procedures and the training period for inspectors should be optimised. (TEC). 3 refs.

  12. Reliability of application of inspection procedures

    International Nuclear Information System (INIS)

    Murgatroyd, R.A.

    1988-01-01

    This document deals with the reliability of application of inspection procedures. A method to ensure that the inspection of defects thanks to fracture mechanics is reliable is described. The Systematic Human Error Reduction and Prediction Analysis (SHERPA) methodology is applied to every task performed by the inspector to estimate the possibility of error. It appears that it is essential that inspection procedures should be sufficiently rigorous to avoid substantial errors, and that the selection procedures and the training period for inspectors should be optimised. (TEC)

  13. Excisional treatment of renal hydatid cyst mimicking renal tumor with diode laser technique: A case report.

    Science.gov (United States)

    Uçar, Murat; Karagözlü Akgül, Ahsen; Çelik, Fatih; Kılıç, Nizamettin

    2016-08-01

    Cystic echinococcosis, which is one of the most important helminthic infestations, is a serious life-threatening health problem in developing countries. Hydatid cyst of the kidney is a rare condition in children that can be treated with medical therapy or surgical treatment in some resistant cases. Here, we present a case of renal hydatid cyst that was treated with laparoscopic excision with diode laser. A 15-year-old female patient was admitted with abdominal pain. Abdominal ultrasonography revealed a 32 × 23 × 19-mm solid mass with cystic component at lower pole of right kidney. An indirect hemagglutination (IHA) test for echinococcosis granulosus was positive at a 1:320 titer. Other laboratory tests were within normal limits. The patient received albendazole therapy for 3 months. The follow-up magnetic resonance imaging showed a solitary lesion with exophytic extensions that contained large separations. No contrast enhancement could be detected after gadolinium injection. As no regression could be detected radiologically, surgical treatment was planned. Laparoscopic renal lower pole mass cyst excision with diode laser was performed (Figure). The patient was hospitalized for 1 day without any blood transfusion. Histopathological examination was consistent with hydatid cyst of the kidney. Diagnosis of hydatid cyst of the kidney is generally made incidentally and can be misdiagnosed as a primary kidney tumor. Radiological studies may be insufficient for accurate diagnosis. In our case, laparoscopic excision of cyst and histopathological examination confirmed the diagnosis of cyst hydatid. At the postoperative second month the ultrasonography of kidneys were normal. For patients from endemic areas, hydatid cyst should always be included in the differential diagnosis. Laparoscopic excision of renal hydatid cysts with diode laser is a feasible and safe technique for resistant cases. Copyright © 2016 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  14. Cost Effectiveness of Stapled Haemorrhoidopexy and Traditional Excisional Surgery for the Treatment of Haemorrhoidal Disease.

    Science.gov (United States)

    Kilonzo, Mary M; Brown, Steven R; Bruhn, Hanne; Cook, Jonathan A; Hudson, Jemma; Norrie, John; Watson, Angus J M; Wood, Jessica

    2017-08-25

    Our objective was to compare the cost effectiveness of stapled haemorrhoidopexy (SH) and traditional haemorrhoidectomy (TH) in the treatment of grade II-IV haemorrhoidal disease from the perspective of the UK national health service. An economic evaluation was conducted alongside an open, two-arm, parallel-group, pragmatic, multicentre, randomised controlled trial conducted in several hospitals in the UK. Patients were randomised into either SH or TH surgery between January 2011 and August 2014 and were followed up for 24 months. Intervention and subsequent resource use data were collected using case review forms and questionnaires. Benefits were collected using the EQ-5D-3L (EuroQoL-five dimensions-three levels) instrument. The primary economic outcome was incremental cost measured in pounds (£), year 2016 values, relative to the incremental benefit, which was estimated using quality-adjusted life-years (QALYs). Cost and benefits accrued in the second year were discounted at 3.5%. The base-case analysis was based on imputed data. Uncertainty was explored using univariate sensitivity analyses. Participants (n = 777) were randomised to SH (n = 389) or TH (n = 388). The mean cost of SH was £337 (95% confidence interval [CI] 251-423) higher than that of TH and the mean QALYs were -0.070 (95% CI -0.127 to -0.011) lower than for TH. The base-case cost-utility analysis indicated that SH has zero probability of being cost effective at both the £20,000 and the £30,000 threshold. Results from the sensitivity analyses were similar to those from the base-case analysis. The evidence suggests that, on average, the total mean costs over the 24-month follow-up period were significantly higher for the SH arm than for the TH arm. The QALYs were also, on average, significantly lower for the SH arm. These results were supported by the sensitivity analyses. Therefore, in terms of cost effectiveness, TH is a superior surgical treatment for the management of grade II-IV haemorrhoids when compared with SH.

  15. Helicopter Flight Procedures for Community Noise Reduction

    Science.gov (United States)

    Greenwood, Eric

    2017-01-01

    A computationally efficient, semiempirical noise model suitable for maneuvering flight noise prediction is used to evaluate the community noise impact of practical variations on several helicopter flight procedures typical of normal operations. Turns, "quick-stops," approaches, climbs, and combinations of these maneuvers are assessed. Relatively small variations in flight procedures are shown to cause significant changes to Sound Exposure Levels over a wide area. Guidelines are developed for helicopter pilots intended to provide effective strategies for reducing the negative effects of helicopter noise on the community. Finally, direct optimization of flight trajectories is conducted to identify low noise optimal flight procedures and quantify the magnitude of community noise reductions that can be obtained through tailored helicopter flight procedures. Physically realizable optimal turns and approaches are identified that achieve global noise reductions of as much as 10 dBA Sound Exposure Level.

  16. 7 CFR 1210.325 - Procedure.

    Science.gov (United States)

    2010-01-01

    ... Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE WATERMELON RESEARCH AND PROMOTION PLAN Watermelon Research and Promotion Plan National Watermelon Promotion Board § 1210.325 Procedure...

  17. 21 CFR 314.530 - Withdrawal procedures.

    Science.gov (United States)

    2010-04-01

    ... Serious or Life-Threatening Illnesses § 314.530 Withdrawal procedures. (a) For new drugs approved under... benefit; (2) The applicant fails to perform the required postmarketing study with due diligence; (3) Use...

  18. 46 CFR 221.85 - Hearing procedures.

    Science.gov (United States)

    2010-10-01

    ... § 221.85 Hearing procedures. (a) The Hearing Officer shall conduct a fair and impartial proceeding in... the authentication of any written exhibit or statement. (c) At the close of the Party's presentation...

  19. The interaction of criminal procedure and outcome.

    Science.gov (United States)

    Laxminarayan, Malini; Pemberton, Antony

    2014-01-01

    Procedural quality is an important aspect of crime victims' experiences in criminal proceedings and consists of different dimensions. Two of these dimensions are procedural justice (voice) and interpersonal justice (respectful treatment). Social psychological research has suggested that both voice and respectful treatment are moderated by the impact of outcomes of justice procedures on individuals' reactions. To add to this research, we extend this assertion to the criminal justice context, examining the interaction between the assessment of procedural quality and outcome favorability with victim's trust in the legal system and self-esteem. Hierarchical regression analyses reveal that voice, respectful treatment and outcome favorability are predictive of trust in the legal system and self-esteem. Further investigation reveals that being treated with respect is only related to trust in the legal system when outcome favorability is high. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Supporting Information Synthesis Procedure: Graphene oxide (GO ...

    Indian Academy of Sciences (India)

    SS

    Synthesis Procedure: Graphene oxide (GO) was prepared by a modified Hummers method using expandable .... anode material for Li ion batteries, J. Solid State Electrochem. ... coupling, doping and nonadiabatic effects, Solid State Commun.

  1. Analytical Chemistry Laboratory (ACL) procedure compendium

    International Nuclear Information System (INIS)

    1993-01-01

    This volume contains the interim change notice for the safety operation procedure for hot cell. It covers the master-slave manipulators, dry waste removal, cell transfers, hoists, cask handling, liquid waste system, and physical characterization of fluids

  2. Use of picture books to explain procedures.

    Science.gov (United States)

    2016-10-06

    A small study conducted at a Swedish hospital on the effect of giving picture books and picture sheets to prepare children for their procedures before and during day surgery is explored in this article.

  3. 49 CFR 244.17 - Procedures.

    Science.gov (United States)

    2010-10-01

    ... Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION REGULATIONS ON SAFETY INTEGRATION PLANS GOVERNING RAILROAD CONSOLIDATIONS, MERGERS, AND ACQUISITIONS OF CONTROL Safety Integration Plans § 244.17 Procedures. (a) Each applicant shall file one...

  4. MITS Data Acquisition Subsystem Acceptance Test procedure

    International Nuclear Information System (INIS)

    Allison, R.

    1980-01-01

    This is an acceptance procedure for the Data Acquisition Subsystem of the Machine Interface Test System (MITS). Prerequisites, requirements, and detailed step-by-step instruction are presented for inspecting and performance testing the subsystem

  5. MITS Feed and Withdrawal Subsystem: operating procedures

    International Nuclear Information System (INIS)

    Brown, W.S.

    1980-01-01

    This procedure details the steps required to provide continuous feed flow and withdrawal of process product and waste flows in support of thruput operation in the cascade or its elements. It particularly requires operator attention to safety considerations

  6. Radiation exposure during cardiac catheterization procedures

    International Nuclear Information System (INIS)

    Kicken, P.J.H.; Huyskens, C.J.; Michels, H.R.

    1988-01-01

    For some time there has been an increased interest in more information about radiation exposure during cardiac catheterization because of: relatively high doses to workers and patient; rapid increase of numbers of examinations; introduction of new procedure-types (e.g. Percutaneous Transluminal Coronary Angiography, PTCA) and introduction of new techniques (e.g. Digital Subtraction Angiography, DSA). This paper reports about a study on the exposure to medical personnel and patient in two major hospitals in the Netherlands. The Total number of cardiac catheterization procedures in both hospitals amounts to circa 3000 per year (approximately 10% of all cardiac procedures c.q. 20% of all PTCA procedures in the Netherlands). This study is related to 1300 cardiac examinations

  7. 48 CFR 1503.500-71 - Procedures.

    Science.gov (United States)

    2010-10-01

    ... for: (1) A written code of business ethics and conduct and an ethics training program for all employees; (2) Periodic reviews of company business practices, procedures, policies and internal controls...

  8. Phenomenological Research Method, Design and Procedure: A ...

    African Journals Online (AJOL)

    Phenomenological Research Method, Design and Procedure: A Phenomenological Investigation of the Phenomenon of Being-in-Community as Experienced by Two Individuals Who Have Participated in a Community Building Workshop.

  9. Transesophageal echocardiography in NeoChord procedure

    Directory of Open Access Journals (Sweden)

    Pittarello Demetrio

    2015-01-01

    Full Text Available Background: Transapical off-pump mitral valve intervention with neochord implantation for degenerative mitral valve disease have been recently introduced in the surgical practice. The procedure is performed under 2D-3D transesophageal echocardiography guidance. Methods: The use of 3D real-time transesophageal echocardiography provides more accurate information than 2D echocardiography only in all the steps of the procedure. In particular 3D echocardiography is mandatory for preoperative assessment of the morphology of the valve, for correct positioning of the neochord on the diseased segment , for the final tensioning of the chordae and for the final evaluation of the surgical result. Result and Conclusion: This article is to outline the technical aspects of the transesophageal echocardiography guidance of the NeoChord procedure showing that the procedure can be performed only with a close and continuous interaction between the anesthesiologist and the cardiac surgeon.

  10. Procedures for health risk assessment in Europe

    NARCIS (Netherlands)

    Seeley, M.R.; Tonner-Navarro, L.E.; Beck, B.D.; Deskin, R.; Feron, V.J.; Johanson, G.; Bolt, H.M.

    2001-01-01

    This report compares cancer classification systems, health risk assessment approaches, and procedures used for establishing occupational exposure limits (OELs), in various European countries and scientific organizations. The objectives were to highlight and compare key aspects of these processes and

  11. Caustic addition system operability test procedure

    Energy Technology Data Exchange (ETDEWEB)

    Parazin, R.E.

    1994-11-01

    This test procedure provides instructions for performing operational testing of the major components of the 241-AN-107 Caustic Addition System by WHC and Kaiser personnel at the Rotating Equipment Shop run-in pit (Bldg. 272E).

  12. The Accelerated Procedure for Electrical Work (TPA)

    CERN Document Server

    Coelingh, G J

    2000-01-01

    The accelerated procedure for electrical work [in French: Travaux électriques selon Procédure Accélérée (TPA)] was introduced in October 1996. It allows the contractor to carry out minor electrical installation jobs (about 350 a year) independently. The special features of the TPA are that the number of hours to be worked is limited to 16 and the cost to less than 1000 CHF. This procedure has substantial advantages for both the requesters and ST division. Firstly, the requester benefits from direct contact with the contractor, prompt action and simplified invoicing. In addition, ST division, relieved of ordinary minor work, can concentrate on larger-scale projects and can take advantage of a simplified system of administration. The author sets out the course of the procedure, its advantages and drawbacks, the statistics and the results of a satisfaction questionnaire. This procedure could be adapted and extended to other operations linked to future contracts.

  13. Caustic addition system operability test procedure

    International Nuclear Information System (INIS)

    Parazin, R.E.

    1994-11-01

    This test procedure provides instructions for performing operational testing of the major components of the 241-AN-107 Caustic Addition System by WHC and Kaiser personnel at the Rotating Equipment Shop run-in pit (Bldg. 272E)

  14. Occurrence of pneumomediastinum due to dental procedures.

    Science.gov (United States)

    Aslaner, Mehmet Ali; Kasap, Gül Nihal; Demir, Cihat; Akkaş, Meltem; Aksu, Nalan M

    2015-01-01

    The occurrence of pneumomediastinum and massive subcutaneous emphysema due to dental procedures is quite rare. We present a case of pneumomediastinum and massive subcutaneous emphysema that occurred during third molar tooth extraction with air-turbine handpiece.

  15. Small Optics Laser Damage Test Procedure

    Energy Technology Data Exchange (ETDEWEB)

    Wolfe, Justin [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2017-10-19

    This specification defines the requirements and procedure for laser damage testing of coatings and bare surfaces designated for small optics in the National Ignition Facility (NIF) at Lawrence Livermore National Laboratory (LLNL).

  16. 32 CFR 191.6 - Procedures.

    Science.gov (United States)

    2010-07-01

    .... (7) Develop procedures for and implement a program to eliminate sexual harassment in Component work places, consistent with DoD Policy on Sexual Harassment memorandums, and to ensure compliance with the...

  17. April 2006. 32 Major Orthopaedic Procedures

    African Journals Online (AJOL)

    user

    2006-04-01

    Apr 1, 2006 ... Major Orthopaedic Procedures: 17 Year Trends. Biruk Lambisso Wamisho1 ... financial and logistic constraints with poor compliance of ... Modern orthopaedic surgery is very expensive. A highly ..... Case management. Tribury.

  18. Electronic Procedures for Medical Operations, Phase II

    Data.gov (United States)

    National Aeronautics and Space Administration — Electronic procedures are currently being used to document the steps in performing medical operations for the Space Shuttle and/or the International Space Station...

  19. 14 CFR 25.1585 - Operating procedures.

    Science.gov (United States)

    2010-01-01

    ...) Non-normal procedures for malfunction cases and failure conditions involving the use of special... envelopes, determined under § 25.251 must be furnished. The buffet onset envelopes presented may reflect the...

  20. The status of penile enhancement procedures.

    Science.gov (United States)

    Vardi, Yoram; Gruenwald, Ilan

    2009-11-01

    Most men who request surgical penile enhancement have a normal-sized and fully functional penis but visualize their penises as small (psychological dysmorphism). This fact by itself leads to controversy regarding the true indications for penile enhancement procedures in men without micropenis. One of the typical aspects of penile enhancement is the lack of true methodological evaluation of the more commonly performed procedures. Even recently, only few solid scientific studies are available which can shed some light on results and outcome of these controversial procedures. Although some additional data has emerged during the past year, there is still no consensus in regard to indications and surgical techniques used for penile augmentation or penile girth enhancement. There is further need for more studies to provide a better overview of the value and worthiness of these procedures.

  1. The uniqueness of the regularization procedure

    International Nuclear Information System (INIS)

    Brzezowski, S.

    1981-01-01

    On the grounds of the BPHZ procedure, the criteria of correct regularization in perturbation calculations of QFT are given, together with the prescription for dividing the regularized formulas into the finite and infinite parts. (author)

  2. 48 CFR 432.006-4 - Procedures.

    Science.gov (United States)

    2010-10-01

    ... REQUIREMENTS CONTRACT FINANCING 432.006-4 Procedures. (a) Immediately upon submittal of the referral described... decision making process. (c) The OIG will determine the need for and the extent of an investigation. (d...

  3. The meaning of the administrative procedure

    Directory of Open Access Journals (Sweden)

    Martín Loo Gutiérrez

    2017-06-01

    Full Text Available The article seeks to present a substantive notion of the ‘administrative procedure’, that is, an understanding that departs from the merely procedural or formal meaning that has been consolidated in Chile from the definition adopted by the Administrative Procedures Act (“lbpa” and analyses the institutional purposes that have been assigned to the administrative procedure by foreign literature. The paper develops an explanation about the origins of this formal understanding and exposes the doctrine that has been consolidated in Europe to explain the institution from a substantial point of view. It is argued that this substantive notion can also be constructed in Chile from a systematic reading of some of the provisions of the law on administrative procedures.

  4. An Examination of Disciplinary Procedures with Children

    Science.gov (United States)

    Forehand, Rex; And Others

    1976-01-01

    Experiment 1 examined the effect of negative attention and repeated demands on the noncompliant behavior of children. Experiment 2 studied the relative effectiveness of negative attention, isolation, ignoring, and a combination of procedures in reducing noncompliance in children. (GO)

  5. Procedural and Logic Programming: A Comparison.

    Science.gov (United States)

    Watkins, Will; And Others

    1988-01-01

    Examines the similarities and fundamental differences between procedural programing and logic programing by comparing LogoWriter and PROLOG. Suggests that PROLOG may be a good first programing language for students to learn. (MVL)

  6. Magnetic fusion energy. Disaster operation procedures

    International Nuclear Information System (INIS)

    1986-06-01

    In a major disaster such as an earthquake, toxic chemical release, or fire, these Disaster Operations Procedures can be used, in combination with good judgment, to minimize the risk of injury to personnel and of property damage in our laboratory, shop, and office areas. These emergency procedures apply to all personnel working within MFE/Zone-11 area including visitors, program contract personnel, and construction contract personnel

  7. Efficient Reanalysis Procedures in Structural Topology Optimization

    DEFF Research Database (Denmark)

    Amir, Oded

    This thesis examines efficient solution procedures for the structural analysis problem within topology optimization. The research is motivated by the observation that when the nested approach to structural optimization is applied, most of the computational effort is invested in repeated solutions...... on approximate reanalysis. For cases where memory limitations require the utilization of iterative equation solvers, we suggest efficient procedures based on alternative termination criteria for such solvers. These approaches are tested on two- and three-dimensional topology optimization problems including...

  8. OCRWM baseline management procedure for document identifiers

    International Nuclear Information System (INIS)

    1993-03-01

    This procedure establishes a uniform numbering system (document identifier) for all Program and project technical, cost, and schedule baselines, and selected management and procurement documents developed for and controlled by the Office of Civilian Radioactive Waste Management (OCRWM) for the Civilian Radioactive Waste Management System (CRWMS). The document identifier defined in this procedure is structured to ensure that the relational integrity between configuration items (CIs) and their associated documentation and software is maintained, traceable, categorical, and retrievable for the life of the program

  9. Minimally invasive aesthetic procedures in young adults

    OpenAIRE

    Wollina, Uwe; Goldman, Alberto

    2011-01-01

    Uwe Wollina1, Alberto Goldman21Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany; 2Clinica Goldman, Porto Alegre, Rio Grande du Sul, BrazilAbstract: Age is a significant factor in modifying specific needs when it comes to medical aesthetic procedures. In this review we will focus on young adults in their third decade of life and review minimally invasive aesthetic procedures other than cosmetics and cosmeceuticals. Correction of asy...

  10. Glove Perforations During Interventional Radiological Procedures

    International Nuclear Information System (INIS)

    Leena, R. V.; Shyamkumar, N. K.

    2010-01-01

    Intact surgical gloves are essential to avoid contact with blood and other body fluids. The objective of this study was to estimate the incidence of glove perforations during interventional radiological procedures. In this study, a total of 758 gloves used in 94 interventional radiological procedures were examined for perforations. Eleven perforations were encountered, only one of which was of occult type. No significant difference in the frequency of glove perforation was found between the categories with varying time duration.

  11. PENILE ENHANCEMENT PROCEDURES: UROLOGICAL AND ETHICOLEGAL ISSUES

    OpenAIRE

    Marco Vella

    2012-01-01

    Phalloplasty procedures for most men requiring penile augmentation surgery are cosmetic procedures; generally the patients have a normal-sized and fully functional penis but they think that their penis is too small. There are not well defined indications for penile enhancement surgery and, except for the treatment of “micropenis”, there are not established guidelines and the outcome measures for success are still unclear. All penile enhancement techniques often do not reach the...

  12. Quality procedure management for improved nuclear safety

    International Nuclear Information System (INIS)

    Forzano, P.; Castagna, P.

    1995-01-01

    Emergency Operating Procedures and Accident Management Procedures are the next step in the computerization of NPP control rooms. Different improvements are presently conceivable for this operator aid tool, and research activities are in development. Undergoing activities regard especially formal aspects of knowledge representation, Human-Machine interface and procedure life cycle management. These aspects have been investigated deeply by Ansaldo, and partially incorporated in the DIAM prototype. Nuclear Power Plant Procedures can be seen from essentially two viewpoints: the process and the information management. From the first point of view, it is important to supply the knowledge apt to solve problems connected with the control of the process, from the second one the focus of attention is on the knowledge representation, its structure, elicitation and maintenance, and formal quality assurance. These two aspects of procedure representation can be considered and solved separately. In particular, methodological, formal and management issues require long and tedious activities, that in most cases constitute a great barrier for procedures development and upgrade. To solve these problems, Ansaldo is developing DIAM, a wide integrated tool for procedure management to support in procedure writing, updating, usage, and documentation. One of the most challenging features of DIAM is AUTO-LAY, a CASE sub-tool that, in a complete automatical way, structures parts or complete flow diagram. This is the feature that is partial present in some other CASE products, that, anyway, do not allow complex graph handling and isomorphism between video and paper representation. AUTO-LAY has the unique prerogative to draw graphs of any complexity to section them in pages, and to automatically compose a document. This has been recognized in the literature as the most important a second-generation CASE improvement. (Author) 9 Figs., 5 Refs

  13. Procedures for sampling radium-contaminated soils

    International Nuclear Information System (INIS)

    Fleischhauer, H.L.

    1985-10-01

    Two procedures for sampling the surface layer (0 to 15 centimeters) of radium-contaminated soil are recommended for use in remedial action projects. Both procedures adhere to the philosophy that soil samples should have constant geometry and constant volume in order to ensure uniformity. In the first procedure, a ''cookie cutter'' fashioned from pipe or steel plate, is driven to the desired depth by means of a slide hammer, and the sample extracted as a core or plug. The second procedure requires use of a template to outline the sampling area, from which the sample is obtained using a trowel or spoon. Sampling to the desired depth must then be performed incrementally. Selection of one procedure over the other is governed primarily by soil conditions, the cookie cutter being effective in nongravelly soils, and the template procedure appropriate for use in both gravelly and nongravelly soils. In any event, a minimum sample volume of 1000 cubic centimeters is recommended. The step-by-step procedures are accompanied by a description of the minimum requirements for sample documentation. Transport of the soil samples from the field is then addressed in a discussion of the federal regulations for shipping radioactive materials. Interpretation of those regulations, particularly in light of their application to remedial action soil-sampling programs, is provided in the form of guidance and suggested procedures. Due to the complex nature of the regulations, however, there is no guarantee that our interpretations of them are complete or entirely accurate. Preparation of soil samples for radium-226 analysis by means of gamma-ray spectroscopy is described

  14. Factors Affecting Patient Satisfaction During Endoscopic Procedures

    International Nuclear Information System (INIS)

    Qureshi, M. O.; Shafqat, F.; Ahmed, S.; Niazi, T. K.; Khokhar, N. K.

    2013-01-01

    Objective: To assess the quality and patient satisfaction in Endoscopy Unit of Shifa International Hospital. Study Design: Cross-sectional survey. Place and Duration of Study: Division of Gastroenterology, Shifa International Hospital, Islamabad, Pakistan, from July 2011 to January 2012. Methodology: Quality and patient satisfaction after the endoscopic procedure was assessed using a modified GHAA-9 questionnaire. Data was analyzed using SPSS version 16. Results: A total of 1028 patients were included with a mean age of 45 A+- 14.21 years. Out of all the procedures, 670 (65.17%) were gastroscopies, 181 (17.60%) were flexible sigmoidoscopies and 177 (17.21%) were colonoscopies. The maximum unsatisfactory responses were on the waiting time before the procedure (13.13 %), followed by unsatisfactory explanation of the procedure and answers to questions (7.58%). Overall, unsatisfied impression was 4.86%. The problem rate was 6.22%. Conclusion: The quality of procedures and level of satisfaction of patients undergoing a gastroscopy or colonoscopy was generally good. The factors that influence the satisfaction of these patients are related to communication between doctor and patient, doctor's manner and waiting time for the procedure. Feedback information in an endoscopy unit may be useful in improving standards, including the performance of endoscopists. (author)

  15. A Computerized Procedure linked to Virtual Equipment

    International Nuclear Information System (INIS)

    Jung, Yeon Sub; Song, Tae Young

    2011-01-01

    Digital, information, and communication technologies have change human's behavior. This is because human has limitation to memorize and process information. Human has to access other information and real time information for important decisions. Those technologies are playing important roles. Nuclear power plants cannot be exception. Many accidents in nuclear power plants result from absent or incorrect information. The information for nuclear personnel is context sensitive. They don't have enough time to verify the context sensitive information. Therefore they skip the information, as resulting in incident. Nuclear personnel are usually carrying static paper procedures during local task performance. The procedure guides them steps to follow. There is, however, no dynamic and context sensitive information in the paper. The effect of the work is evaluated once while getting permission of the work. Afterward they are not informed. The static paper is generally simplified, so that it does not show detail of equipment being manipulated. Particularly novice workers feel difficult to understand the procedure due to lack of detail. Pictures of equipment inserted in the procedure are not enough for comprehension. A computerized procedure linked with virtual equipment is one of the best solutions to increase the detail of procedure. Virtual equipment, however, has still limitation not to provide real time information, because the virtual equipment is not synchronized with real plants

  16. Complex intravenous anesthesia in interventional procedures

    International Nuclear Information System (INIS)

    Xie Zonggui; Hu Yuanming; Huang Yunlong; You Yong; Wu Juan; Huang Zengping; Li Jian

    2006-01-01

    Objective: To evaluate the value and safety of Diprivan and Fentany intravenous administration of analgesia in interventional procedures. Methods: Diprivan with Fentany intravenous administration for analgesia was used in eighty interventional procedures of sixty-five patients, without tracheal tube insertion. Vital signs including HR, BP, arterial oxygen saturation (SpO 2 ) and patients' reaction to operating were recorded. Results: Intravenous anesthesia was cared out successfully in eighty interventional procedures, with patients under sleeping condition during the operation, together with no pain and no agony memory of the procedure. The amount of Diprivan was 500±100 mg and Fentany was 0.2±0.025 mg. Mean arterial pressure and SpO 2 were 11.4±2.2 kPa, 10.6±2.1 kPa and 98±1.0, 96±1.5 respectively before and after ten minutes of the operation, with no significant difference. Conclusions: Diprivan with Fentany intravenous administration for interventional procedure analgesia possess good safety, painless and no agony memory of the procedure; therefor ought to be recommended. (authors)

  17. Vision based flight procedure stereo display system

    Science.gov (United States)

    Shen, Xiaoyun; Wan, Di; Ma, Lan; He, Yuncheng

    2008-03-01

    A virtual reality flight procedure vision system is introduced in this paper. The digital flight map database is established based on the Geographic Information System (GIS) and high definitions satellite remote sensing photos. The flight approaching area database is established through computer 3D modeling system and GIS. The area texture is generated from the remote sensing photos and aerial photographs in various level of detail. According to the flight approaching procedure, the flight navigation information is linked to the database. The flight approaching area vision can be dynamic displayed according to the designed flight procedure. The flight approaching area images are rendered in 2 channels, one for left eye images and the others for right eye images. Through the polarized stereoscopic projection system, the pilots and aircrew can get the vivid 3D vision of the flight destination approaching area. Take the use of this system in pilots preflight preparation procedure, the aircrew can get more vivid information along the flight destination approaching area. This system can improve the aviator's self-confidence before he carries out the flight mission, accordingly, the flight safety is improved. This system is also useful in validate the visual flight procedure design, and it helps to the flight procedure design.

  18. Laparoscopic Whipple procedure: review of the literature.

    Science.gov (United States)

    Gagner, Michel; Palermo, Mariano

    2009-01-01

    Laparoscopic pancreatic surgery represents one of the most advanced applications for laparoscopic surgery currently in use. In the past, minimally invasive techniques were only used for diagnostic laparoscopy, staging of pancreatic cancer, and palliative procedures for unresectable pancreatic cancer. With new advances in technology and instrumentation, some sophisticated procedures are currently available, such as the Whipple procedure, one of the most sophisticated applications of minimally invasive surgery. A review of the literature shows that 146 laparoscopic Whipple procedures have been published worldwide since 1994. The authors analyzed blood loss, mean operating time, hospital stay, conversion rate, mean age, mortality rate, lymph nodes in the pathologic findings, follow up, and complications. Mean age was 59.1 years; mean operating time was 439 min. The average blood loss for the reviewed literature was 143 mL; median hospital stay was 18 days; conversion rate was 46%; number of lymph nodes in the pathologic findings was 19; and mortalities related to the procedure was low, 2 patients (1.3%) and the complication rate was 16% (23/46 patients). Complications included 2 hemorrhages, 4 bowel obstructions, 1 stress ulcer, 1 delay of gastric emptying, 4 pneumonias, and 11 leaks. This review demonstrates that the laparoscopic Whipple procedure is not only feasible but also safe, with low mortality and acceptable rates of complications.

  19. The impact of a medical procedure service on patient safety, procedure quality and resident training opportunities.

    Science.gov (United States)

    Tukey, Melissa H; Wiener, Renda Soylemez

    2014-03-01

    At some academic hospitals, medical procedure services are being developed to provide supervision for residents performing bedside procedures in hopes of improving patient safety and resident education. There is limited knowledge of the impact of such services on procedural complication rates and resident procedural training opportunities. To determine the impact of a medical procedure service (MPS) on patient safety and resident procedural training opportunities. Retrospective cohort analysis comparing characteristics and outcomes of procedures performed by the MPS versus the primary medical service. Consecutive adults admitted to internal medicine services at a large academic hospital who underwent a bedside medical procedure (central venous catheterization, thoracentesis, paracentesis, lumbar puncture) between 1 July 2010 and 31 December 2011. The primary outcome was a composite rate of major complications. Secondary outcomes included resident participation in bedside procedures and use of "best practice" safety process measures. We evaluated 1,707 bedside procedures (548 by the MPS, 1,159 by the primary services). There were no differences in the composite rate of major complications (1.6 % vs. 1.9 %, p = 0.71) or resident participation in bedside procedures (57.0 % vs. 54.3 %, p = 0.31) between the MPS and the primary services. Procedures performed by the MPS were more likely to be successfully completed (95.8 % vs. 92.8 %, p = 0.02) and to use best practice safety process measures, including use of ultrasound guidance when appropriate (96.8 % vs. 90.0 %, p = 0.0004), avoidance of femoral venous catheterization (89.5 vs. 82.7 %, p = 0.02) and involvement of attending physicians (99.3 % vs. 57.0 %, p < 0.0001). Although use of a MPS did not significantly affect the rate of major complications or resident opportunities for training in bedside procedures, it was associated with increased use of best practice safety process measures.

  20. Image-guided procedures in brain biopsy.

    Science.gov (United States)

    Fujita, K; Yanaka, K; Meguro, K; Narushima, K; Iguchi, M; Nakai, Y; Nose, T

    1999-07-01

    Image-guided procedures, such as computed tomography (CT)-guided stereotactic and ultrasound-guided methods, can assist neurosurgeons in localizing the relevant pathology. The characteristics of image-guided procedures are important for their appropriate use, especially in brain biopsy. This study reviewed the results of various image-guided brain biopsies to ascertain the advantages and disadvantages. Brain biopsies assisted by CT-guided stereotactic, ultrasound-guided, Neuronavigator-guided, and the combination of ultrasound and Neuronavigator-guided procedures were carried out in seven, eight, one, and three patients, respectively. Four patients underwent open biopsy without a guiding system. Twenty of 23 patients had a satisfactory diagnosis after the initial biopsy. Three patients failed to have a definitive diagnosis after the initial procedure, one due to insufficient volume sampling after CT-guided procedure, and two due to localization failure by ultrasound because the lesions were nonechogenic. All patients who underwent biopsy using the combination of ultrasound and Neuronavigator-guided methods had a satisfactory result. The CT-guided procedure provided an efficient method of approaching any intracranial target and was appropriate for the diagnosis of hypodense lesions, but tissue sampling was sometimes not sufficient to achieve a satisfactory diagnosis. The ultrasound-guided procedure was suitable for the investigation of hyperdense lesions, but was difficult to localize nonechogenic lesions. The combination of ultrasound and Neuronavigator methods improved the diagnostic accuracy even in nonechogenic lesions such as malignant lymphoma. Therefore, it is essential to choose the most appropriate guiding method for brain biopsy according to the radiological nature of the lesions.

  1. Avoiding Psychological Pitfalls in Aesthetic Medical Procedures.

    Science.gov (United States)

    Wang, Qiuyu; Cao, Chuan; Guo, Rui; Li, Xiaoge; Lu, Lele; Wang, Wenping; Li, Shirong

    2016-12-01

    To assess the prevalence of body dysmorphic disorder (BDD) in an aesthetic surgery setting in the region of Southwest China, and to ascertain the differences in terms of body images between patients in the aesthetic setting and general Chinese population. This study tracked patient satisfaction with their body image changes while undergoing aesthetic medical procedures to identify whether the condition of patients who were presenting with BDD symptoms or their psychological symptoms could be improved by enhancing their appearance. Additionally, this study explored whether there was improvement in quality of life (QoL) and self-esteem after aesthetic medical procedures. A total of 106 female patients who were undergoing aesthetic medical procedures for the first time (plastic surgery, n = 26; minimally invasive aesthetic treatment, n = 42; and aesthetic dermatological treatment, n = 38) were classified as having body dysmorphic disorder symptoms or not having body dysmorphic disorder symptoms, based on the body dysmorphic disorder examination (BDDE), which was administered preoperatively. These patients were followed up for 1 month after the aesthetic procedures. The multidimensional body self-relations questionnaire-appearance scales (MBSRQ-AS) and rosenberg self-esteem scale (RSE-S) were used to assess patients' preoccupation with appearance and self-esteem pre-procedure and 1 month post-procedure. Additionally, 100 female healthy control participants were recruited as a comparative group into this study and they were also assessed using BDDE, MBSRQ-AS, and RSE-S. A total of 14.2 % of 106 aesthetic patients and 1 % of 100 healthy controls were diagnosed with BDD to varying extents. BDDE scores were 72.83 (SD ± 30.7) and 68.18 (SD ± 31.82), respectively, before and after the procedure for the aesthetic patient group and 43.44 (SD ± 15.65) for the healthy control group (F = 34.28; p aesthetic patients (pre-procedure) and female adult norms from

  2. The Influence of Parent Preprocedural Anxiety on Child Procedural Pain: Mediation by Child Procedural Anxiety

    OpenAIRE

    Bearden, Donald J.; Feinstein, Amanda; Cohen, Lindsey L.

    2012-01-01

    Objective Data suggest parents’ preprocedural anxiety is related to children's acute procedural anxiety and pain. This study examined the temporal relations among these constructs to determine whether children's anxiety mediates the relation between parents' anticipatory anxiety and children's procedural pain. Methods A total of 90 preschoolers receiving immunizations, their parents, and the nurses rated children's procedural anxiety and pain. Parents provided ratings of their own preprocedur...

  3. Increasing nursing treatment for pediatric procedural pain.

    Science.gov (United States)

    Bice, April A; Gunther, Mary; Wyatt, Tami

    2014-03-01

    Procedural pain management is an underused practice in children. Despite the availability of efficacious treatments, many nurses do not provide adequate analgesia for painful interventions. Complementary therapies and nonpharmacologic interventions are additionally essential to managing pain. Owing to the increasing awareness of inadequate nursing utilization of pharmacologic measures for procedural pain, this paper focuses only on analgesic treatments. The aim of this review was to examine how varying degrees of quality improvement affect nursing utilization of treatments for routine pediatric procedural pain. A comprehensive search of databases including Cinahl, Medline/Pubmed, Web of Science, Google Scholar, Psycinfo, and Cochrane Library was performed. Sixty-two peer-reviewed research articles were examined. Ten articles focusing on quality improvement in pediatric pain management published in English from 2001 to 2011 were included. Three themes emerged: 1) increasing nursing knowledge; 2) nursing empowerment; and 3) protocol implementation. Research critique was completed with the use of guidelines and recommendations from Creswell (2009) and Garrard (2011). The literature reveals that nurses still think that pediatric pain management is essential. Quality improvement increases nursing utilization of procedural pain treatments. Although increasing nursing knowledge improves pediatric pain management, it appears that nursing empowerment and protocol implementation increase nursing compliance more than just education alone. Nurses providing pain management can enhance their individual practice with quality improvement measures that may increase nursing adherence to institutional and nationally recommended pediatric procedural pain management guidelines. Copyright © 2014 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  4. Complications with Outpatient Angiography and Interventional Procedures

    International Nuclear Information System (INIS)

    Young, Noel; Chi, Ka-Kit; Ajaka, Joe; McKay, Lesa; O'Neill, Diane; Wong, Kai Ping

    2002-01-01

    Purpose: To prospectively identify the complications, and rates of complication, in outpatient angiography and interventional procedures. Methods: There were 1050 consecutive patients, 646 men and 404 women, aged 17-89 years, with a total of 1239 procedures studied in a 2-year period, 1997 to 1999. Results: There were 560 cases of aorto-femoral angiography,resulting in 124 complications (22%), with pain or hematoma in 110.There were 206 cases of neck and cerebral angiography, resulting in 51 complications (25%), with pain and hematoma in 34, transient ischemic attack in 2 and cerebrovascular accident in 1. There were 197 interfentional procedures, with 177 being balloon dilatations, resulting in 68 complications (35%), with 2 having hematomas and 1 having hematoma/abscess requiring active treatment. There were 276 cases having various 'other' procedures (e.g., renal angiography),resulting in 65 complications (24%), with pain and hematoma in 61. No procedure-related death occurred. Eighteen cases (1.5%) had significant complications, with contrast allergy in eight. Conclusion: Outpatient angiography and intervention are relatively safe, with low significant complication rates

  5. Performance audit procedures for opacity monitors

    International Nuclear Information System (INIS)

    Plaisance, S.J.; Peeler, J.W.

    1987-04-01

    This manual contains monitor-specific performance audit procedures and data forms for use in conducting audits of installed opacity continuous emission monitoring systems (CEMS). General auditing procedures and acceptance limits for various audit criteria are discussed. Practical considerations and common problems encountered in conducting audits are delineated, and recommendations are included to optimize the successful completion of performance audits. Performance audit procedures and field-data forms were developed for six common opacity CEMS: (1) Lear Siegler, Inc. Model RM-41; (2) Lear Siegler, Inc. Model RM-4; (3) Dynatron Model 1100; (4) Thermo Electron, Inc. Model 400; (5) Thermo Electron, Inc. Model 1000A; and (6) Enviroplan Model D-R280 AV. Generic audit procedures are included for use in evaluating opacity CEMS with multiple transmissometers and combiner devices. In addition, several approaches for evaluating the zero-alignment or clear-path zero response are described. The zero-alignment procedures are included since the factor is fundamental to the accuracy of opacity monitoring data, even though the zero-alignment checks cannot usually be conducted during a performance audit

  6. PENILE ENHANCEMENT PROCEDURES: UROLOGICAL AND ETHICOLEGAL ISSUES

    Directory of Open Access Journals (Sweden)

    Marco Vella

    2012-04-01

    Full Text Available Phalloplasty procedures for most men requiring penile augmentation surgery are cosmetic procedures; generally the patients have a normal-sized and fully functional penis but they think that their penis is too small. There are not well defined indications for penile enhancement surgery and, except for the treatment of “micropenis”, there are not established guidelines and the outcome measures for success are still unclear. All penile enhancement techniques often do not reach the expected result and the grade of patient’s satisfaction is frequently poor. Phalloplasty procedures for psychological dysmorfism are not approved by any scientific society and the majority of these procedures are performed in private settings. The ethical and medicolegal problems resulting from a penis enhancement can be various and numerous, but few of them are reported in literature. After phalloplasty an attribution of professional responsibility and request of reimbursement is not rare. In this contribution the authors summarize a panorama of several urological and medico-legal aspects related to phalloplasty procedures.

  7. Guidelines for procedural pain in the newborn

    Science.gov (United States)

    Lago, Paola; Garetti, Elisabetta; Merazzi, Daniele; Pieragostini, Luisa; Ancora, Gina; Pirelli, Anna; Bellieni, Carlo Valerio

    2009-01-01

    Despite accumulating evidence that procedural pain experienced by newborn infants may have acute and even long-term detrimental effects on their subsequent behaviour and neurological outcome, pain control and prevention remain controversial issues. Our aim was to develop guidelines based on evidence and clinical practice for preventing and controlling neonatal procedural pain in the light of the evidence-based recommendations contained in the SIGN classification. A panel of expert neonatologists used systematic review, data synthesis and open discussion to reach a consensus on the level of evidence supported by the literature or customs in clinical practice and to describe a global analgesic management, considering pharmacological, non-pharmacological, behavioural and environmental measures for each invasive procedure. There is strong evidence to support some analgesic measures, e.g. sucrose or breast milk for minor invasive procedures, and combinations of drugs for tracheal intubation. Many other pain control measures used during chest tube placement and removal, screening and treatment for ROP, or for postoperative pain, are still based not on evidence, but on good practice or expert opinions. Conclusion: These guidelines should help improving the health care professional's awareness of the need to adequately manage procedural pain in neonates, based on the strongest evidence currently available. PMID:19484828

  8. Formal Verification of Computerized Procedure with Colored Petri Nets

    International Nuclear Information System (INIS)

    Kim, Yun Goo; Shin, Yeong Cheol

    2008-01-01

    Computerized Procedure System (CPS) supports nuclear power plant operators in performing operating procedures which are instructions to guide in monitoring, decision making and controlling nuclear power plants. Computerized Procedure (CP) should be loaded to CPS. Due to its execution characteristic, computerized procedure acts like a software in CPS. For example, procedure flows are determined by operator evaluation and computerized procedure logic which are pre-defined. So the verification of Computerized Procedure logic and execution flow is needed before computerized procedures are installed in the system. Formal verification methods are proposed and the modeling of operating procedures with Coloured Petri Nets(CP-nets) is presented

  9. Radiation doses to patients in haemodynamic procedures

    Energy Technology Data Exchange (ETDEWEB)

    Canadillas-Perdomo, B; Catalan-Acosta, A; Hernandez-Armas, J [Servicio de Fisica Medica, Hospital Universitario de Canarias, La Laguna, Tenerife (Spain); Perez-Martin, C [Servicio de Ingenieria Biomedica, Hospital Universitario de Canarias, La Laguna, Tenerife (Spain); Armas-Trujillo, D de [Servicio de Cardiologia, Hospital Universitario de Canarias, La Laguna, Tenerife (Spain)

    2001-03-01

    Interventional radio-cardiology gives high doses to patients due to high values of fluoroscopy times and large series of radiographic images. The main objective of the present work is the determination of de dose-area product (DAP) in patients of three different types of cardiology procedures with X-rays. The effective doses were estimated trough the organ doses values measured with thermoluminescent dosimeters (TLDs-100), suitable calibrated, placed in a phantom type Rando which was submitted to the same radiological conditions corresponding to the procedures made on patients. The values for the effective doses in the procedures CAD Seldinger was 6.20 mSv on average and 1.85mSv for pacemaker implants. (author)

  10. Uranium hexafluoride: handling procedures and container criteria

    International Nuclear Information System (INIS)

    1977-04-01

    The U.S. Energy Research and Development Administration's (ERDA) procedures for packaging, measuring, and transferring uranium hexafluoride (UF 6 ) have been undergoing continual review and revision for several years to keep them in phase with developing agreements for the supply of enriched uranium. This report, first issued in 1966, was reissued in 1967 to make editorial changes and to provide for minor revisions in procedural information. In 1968 and 1972, Revisions 2 and 3, respectively, were issued as part of the continuing effort to present updated information. This document, Revision 4, includes primarily revisions to UF 6 cylinders, valves, and methods of use. This revision supersedes all previous issues of this report. The procedures will normally apply in all transactions involving receipt or shipment of UF 6 by ERDA, unless stipulated otherwise by contracts or agreements with ERDA or by notices published in the Federal Register

  11. Development of symptoms-oriented operating procedures

    International Nuclear Information System (INIS)

    Colquhoun, R.

    1984-01-01

    Until recently, the formal treatment of control room procedures for upset conditions in nuclear power plants has been event-oriented. This orientation was not so much a reflection of power plant operating practice as it was a reflection of design-oriented thinking - design-basis events, therefore event-oriented procedures. Event orientation is not common in other professions. In the medical profession, for example, the stabilization of vital functions through a symptoms-oriented approach has priority over diagnosis and prognosis. The American nuclear power industry has initiated programs for the development and application of a symptoms-oriented approach for handling upset conditions. Canadian programs have independently paralleled the US programs. This article describes the rationale and current applications of the Canadian programs and identifies the relevance of a generic symptoms-based emergency procedure to current operating practices

  12. The Econometric Procedures of Specific Transaction Identification

    Directory of Open Access Journals (Sweden)

    Doszyń Mariusz

    2017-06-01

    Full Text Available The paper presents the econometric procedures of identifying specific transactions, in which atypical conditions or attributes may occur. These procedures are based on studentized and predictive residuals of the accordingly specified econometric models. The dependent variable is a unit transactional price, and explanatory variables are both the real properties’ attributes and accordingly defined artificial binary variables. The utility of the proposed method has been verified by means of a real market data base. The proposed procedures can be helpful during the property valuation process, making it possible to reject real properties that are specific (both from the point of view of the transaction conditions and the properties’ attributes and, consequently, to select an appropriate set of similar attributes that are essential for the valuation process.

  13. Radiation doses to patients in haemodynamic procedures

    International Nuclear Information System (INIS)

    Canadillas-Perdomo, B.; Catalan-Acosta, A.; Hernandez-Armas, J.; Perez-Martin, C.; Armas-Trujillo, D. de

    2001-01-01

    Interventional radio-cardiology gives high doses to patients due to high values of fluoroscopy times and large series of radiographic images. The main objective of the present work is the determination of de dose-area product (DAP) in patients of three different types of cardiology procedures with X-rays. The effective doses were estimated trough the organ doses values measured with thermoluminescent dosimeters (TLDs-100), suitable calibrated, placed in a phantom type Rando which was submitted to the same radiological conditions corresponding to the procedures made on patients. The values for the effective doses in the procedures CAD Seldinger was 6.20 mSv on average and 1.85mSv for pacemaker implants. (author)

  14. Minimally invasive aesthetic procedures in young adults

    Directory of Open Access Journals (Sweden)

    Wollina U

    2011-03-01

    Full Text Available Uwe Wollina1, Alberto Goldman21Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany; 2Clinica Goldman, Porto Alegre, Rio Grande du Sul, BrazilAbstract: Age is a significant factor in modifying specific needs when it comes to medical aesthetic procedures. In this review we will focus on young adults in their third decade of life and review minimally invasive aesthetic procedures other than cosmetics and cosmeceuticals. Correction of asymmetries, correction after body modifying procedures, and facial sculpturing are important issues for young adults. The implication of aesthetic medicine as part of preventive medicine is a major ethical challenge that differentiates aesthetic medicine from fashion.Keywords: acne scars, ice pick scars, boxcar scars, fillers 

  15. Yahtzee: an anonymized group level matching procedure.

    Science.gov (United States)

    Jones, Jason J; Bond, Robert M; Fariss, Christopher J; Settle, Jaime E; Kramer, Adam D I; Marlow, Cameron; Fowler, James H

    2013-01-01

    Researchers often face the problem of needing to protect the privacy of subjects while also needing to integrate data that contains personal information from diverse data sources. The advent of computational social science and the enormous amount of data about people that is being collected makes protecting the privacy of research subjects ever more important. However, strict privacy procedures can hinder the process of joining diverse sources of data that contain information about specific individual behaviors. In this paper we present a procedure to keep information about specific individuals from being "leaked" or shared in either direction between two sources of data without need of a trusted third party. To achieve this goal, we randomly assign individuals to anonymous groups before combining the anonymized information between the two sources of data. We refer to this method as the Yahtzee procedure, and show that it performs as predicted by theoretical analysis when we apply it to data from Facebook and public voter records.

  16. Procedure and apparatus for back projection

    International Nuclear Information System (INIS)

    1977-01-01

    (1) The procedure is for back projection in the form of a tomographic picture of a member, characterised in that the strip pictures are written onto the signal plate by a conversion pick-up unit; and that to the address inputs of the pick-up unit voltages are applied that represent a rotating coordinate system. (2) Procedure following claim 1 characterised by the fact that the voltages are respectively applied as sawtooth waveform horizontal and vertical television deflections. (3) Procedure following claims 1 and 2, characterised that in order to correct the television deflection voltages for the effect of a fan shaped radiation beam, first one and then the other of the amplitudes is modulated. (G.C.)

  17. Eye bank procedures: donor selection criteria.

    Science.gov (United States)

    Sousa, Sidney Júlio de Faria E; Sousa, Stella Barretto de Faria E

    2018-01-01

    Eye banks use sterile procedures to manipulate the eye, antiseptic measures for ocular surface decontamination, and rigorous criteria for donor selection to minimize the possibility of disease transmission due to corneal grafting. Donor selection focuses on analysis of medical records and specific post-mortem serological tests. To guide and standardize procedures, eye bank associations and government agencies provide lists of absolute and relative contraindications for use of the tissue based on donor health history. These lists are guardians of the Hippocratic principle "primum non nocere." However, each transplantation carries risk of transmission of potentially harmful agents to the recipient. The aim of the procedures is not to eliminate risk, but limit it to a reasonable level. The balance between safety and corneal availability needs to be maintained by exercising prudence without disproportionate rigor.

  18. FRENCH CARDS - NEW PROCEDURE FOR INITIAL APPLICATION

    CERN Multimedia

    Human Resources Division

    2002-01-01

    The Human Resources Division would like to remind members of personnel that they are obliged to submit an application form for a French card as soon as they have a permanent address in either Switzerland or in France and they are actually living there. Following the rationalization of our administrative procedures, as of October 1st, 2002, the initial application procedure for a French card will now be as follows: The member of personnel should complete an application form. If necessary, an application form must also be completed for family members. These forms must then be transferred via e-mail to the appropriate Divisional Administrative Officer (DAO) who will forward them to the Cards Service. In parallel, the member of personnel should submit the necessary supporting documents to the Cards Service. The application form (Word format only), the procedural details, the necessary supporting documents as well as the conditions of issue are available here.   Human Resources Division Tel. 74469

  19. Assessment of Competence in EVAR Procedures

    DEFF Research Database (Denmark)

    Strøm, M; Lönn, L; Bech, B

    2017-01-01

    OBJECTIVE/BACKGROUND: To develop a procedure specific global rating scale for assessment of operator competence in endovascular aortic repair (EVAR). METHODS: A Delphi approach was used to achieve expert consensus. A panel of 32 international experts (median 300 EVAR procedures, range 200...... suggested by the panel and reduced to seven pivotal assessment items that reached consensus, Cronbach's alpha = 0.82. The seven item rating scale covers key elements of competence in EVAR stent placement and deployment. Each item has well defined grades with explicit anchors at unacceptable, acceptable......, and superior performance on a 5 point Likert scale. CONCLUSION: The Delphi methodology allowed for international consensus on a new procedure specific global rating scale for assessment of competence in EVAR. The resulting scale, EndoVascular Aortic Repair Assessment of Technical Expertise (EVARATE...

  20. Licensing procedure and requirements in the FRG

    International Nuclear Information System (INIS)

    Brosche, D.

    1981-01-01

    The investigations of the different dynamic stresses of pressure suppression systems after the Wuergassen incident in 1972 and their theoretical and experimental solutions required an extraordinary effort from all participants of the licensing procedures. As a consequence of these new problems a lot of mathematical models and computer codes had been developed and a lot of experimental work had been performed. Numerous highly qualified scientists and engineers had been involved for a long time in the licensing procedures and innumerable discussions had been necessary. These investigations and discussions had a great influence on the licensing procedures and on the project running. Too pessimistic assumptions and wrong interpretations of experiments led to fictitious problems and a lot of time and money was necessary to overcome these difficulties. Finally at 1977 it could be proved that the construction was able to control stresses so that additional investigations were not necessary. (orig./HP)

  1. Still special? Harvesting procedures for industrial hemp

    Directory of Open Access Journals (Sweden)

    Hans-Jörg Gusovius

    2016-01-01

    Full Text Available A multitude of different harvesting procedures is available after the re-approval of hemp growing in Germany about 20 years ago. Established, but as well recent machine developments enable the supply of raw materials for further processing or as food and feed materials. The necessary specialization level results in high but, compared to other established crops, not exceeding procedural costs. In this study, harvesting procedures and technologies are analyzed that are currently used under Northern European cultivation conditions. However, technological enhancements are still needed in order to improve the competitiveness of fibre hemp in the crop rotation as well as of hemp-based semi-finished and finished products.

  2. Aerial photogrammetry procedure optimized for micro uav

    Directory of Open Access Journals (Sweden)

    T. Anai

    2014-06-01

    Full Text Available This paper proposes the automatic aerial photogrammetry procedure optimized for Micro UAV that has ability of autonomous flight. The most important goal of our proposed method is the reducing the processing cost for fully automatic reconstruction of DSM from a large amount of image obtained from Micro UAV. For this goal, we have developed automatic corresponding point generation procedure using feature point tracking algorithm considering position and attitude information, which obtained from onboard GPS-IMU integrated on Micro UAV. In addition, we have developed the automatic exterior orientation and registration procedure from the automatic generated corresponding points on each image and position and attitude information from Micro UAV. Moreover, in order to reconstruct precise DSM, we have developed the area base matching process which considering edge information. In this paper, we describe processing flow of our automatic aerial photogrammetry. Moreover, the accuracy assessment is also described. Furthermore, some application of automatic reconstruction of DSM will be desired.

  3. Procedures for ground-water investigations

    International Nuclear Information System (INIS)

    1989-09-01

    This manual was developed by the Pacific Northwest Laboratory (PNL) to document the procedures used to carry out and control the technical aspects of ground-water investigations at the PNL. Ground-water investigations are carried out to fulfill the requirements for the US Department of Energy (DOE) to meet the requirements of DOE Orders. Investigations are also performed for various clients to meet the requirements of the Resource Conservation and Recovery Act of 1976 (RCRA) and the Comprehensive Environmental Response, Compensation and Liability Act of 1980 (CERCLA). National standards including procedures published by the American Society for Testing and Materials (ASTM) and the US Geological Survey were utilized in developing the procedures contained in this manual

  4. A procedure for building product models

    DEFF Research Database (Denmark)

    Hvam, Lars; Riis, Jesper; Malis, Martin

    2001-01-01

    This article presents a procedure for building product models to support the specification processes dealing with sales, design of product variants and production preparation. The procedure includes, as the first phase, an analysis and redesign of the business processes, which are to be supported...... with product models. The next phase includes an analysis of the product assortment, and the set up of a so-called product master. Finally the product model is designed and implemented using object oriented modelling. The procedure is developed in order to ensure that the product models constructed are fit...... for the business processes they support, and properly structured and documented, in order to facilitate that the systems can be maintained continually and further developed. The research has been carried out at the Centre for Industrialisation of Engineering, Department of Manufacturing Engineering, Technical...

  5. Exposure of Medical Staff during Interventional Procedures

    International Nuclear Information System (INIS)

    Osvay, M.; Turak, O.

    2013-01-01

    The medical staff during interventional procedures receives significant doses on their hands, or parts of their body not covered with protective shielding equipment, as they are close to X-rays field. It can be stated, that interventional radiology and cardiology have one of the highest doses among the X-ray diagnostic procedures. The radiologist use X-ray machine directly in the interventional procedures. The occupational dose is measured only by one Kodak film badge worn under the lead apron for the estimation of the effective dose in Hungary. Our lecture presents the results of dose measurements on eye lens, hands, knees using LiF thermoluminescent dosemeters on the medical staff of two Hungarian hospitals. Results suggest that wearing only one film badge (or other dosemeter system) under the lead apron does not provide proper information on the real occupational dose of medical staff.(author)

  6. The Closing of the Insolvency Procedure

    Directory of Open Access Journals (Sweden)

    Cornelia Lefter

    2007-12-01

    Full Text Available The achievment of the balance between the offer and the demand in a market economy makes that some merchants win and others lose. Losing in business is a normal risk, usually assumed by any merchant. But when the merchant record losses, the issue is of engaging his responsibility before all those that may be damaged due to his negative results. Faced to this reality, the commercial legislation, by way of the collective procedure, has tried to found the most adequate means to reduce up to the maximum the negative influences that the losses beared by a merchant may have on his creditors. According to this, from the new law of the collective procedure (Law no. 85/2006 there have been analized those cases of closing the procedure and their effects which raised already problems in practice and aroused interesting doctrinal controversies.

  7. 40 CFR Appendix C to Part 61 - Quality Assurance Procedures

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 8 2010-07-01 2010-07-01 false Quality Assurance Procedures C Appendix...—Quality Assurance Procedures Procedure 1—Determination of Adequate Chromatographic Peak Resolution In this....” Procedure 2—Procedure for Field Auditing GC Analysis Responsibilities of audit supervisor and analyst at the...

  8. Bio-Oil Analysis Laboratory Procedures | Bioenergy | NREL

    Science.gov (United States)

    Bio-Oil Analysis Laboratory Procedures Bio-Oil Analysis Laboratory Procedures NREL develops laboratory analytical procedures (LAPs) for the analysis of raw and upgraded pyrolysis bio-oils. These standard procedures have been validated and allow for reliable bio-oil analysis. Procedures Determination

  9. Martius procedure revisited for urethrovaginal fistula

    Directory of Open Access Journals (Sweden)

    N P Rangnekar

    2000-01-01

    Full Text Available Background: Urethrovaginal fistula is a dreadful com-plication of obstetric trauma due to prolonged labour or obstetric intervention commonly seen in developing coun-tries. Due to prolonged ischaemic changes, the fistula is resistant to healing. The strategic location of the fistula leads to postoperative impairment of continence mecha-nism. Anatomical repair was previously the commonest mode of surgical management, but was associated with a miserable cumulative cure rate ranging from 16-60%. Hence we tried to study the efficacy of Martius procedure in the management of urethrovaginal fistula. Material and Methods: We studied the outcome of 12 urethrovaginal fistulae, all caused by obstetric trauma, treated surgically with Martius procedure in 8 and with anatomical repair in 4, retrospectively. 9 patients had re-current fistulae while I patient had multiple fistulae. Pa-tients were followed up for the period ranging from 6 months to 4′/2 years for fistula healing, continence and postoperative complications like dvspareunia. Results: Cumulative cure rate ofMartius procedure was 87.5% with no postoperative stress incontinence, while fistula healing rate of anatomical repair was only 25% (I patient out of 4 which was also complicated by Intrin-sic Sphincter Deficiency (ISD. In case of recurrent fistu-lae the success rate of anatomical repair was 0% compared to 83.33% with Martius procedure. Conclusions: Martius procedure has shown much bet-ter overall cure rate compared to anatomical repair be-cause - a it provides better reinforcement to urethral suture line, b it provides better blood supply and lymph drainage to the ischaemic fistulous area, c provides sur-face for epithelialization and, d helps to maintain conti-nence. Hence we recommend Martius procedure as a surgical modality for the treatment of urethrovaginal fis-tula.

  10. Procedure of safe handling with cytostatic drugs

    Directory of Open Access Journals (Sweden)

    Kodžo Dragan

    2003-01-01

    Full Text Available Working group for safe handling with cytostatic drugs has been formed by the Ministry of Health, and it consists of professionals from IORS, Federal Bureau of Weights and Measures, Industrial Medicine, Institute of Hematology, Military Medical Academy, and Crown Agents. The aim of this working group is to prepare procedures for safe handling with cytostatic drugs, as well as program for educational seminar for nurses, medical technicians, and pharmaceutical technicians. The procedures will serve as a guide of good practice of oncology health care, and will refer to all actions that health care professionals carry out from the moment of drugs arrival to the pharmacy to the moment of their application. In the first segment of this procedure, general rules are given for working with cytotoxic agents, control for risky exposures, safe system of work, control of working environment, monitoring of the employees' health condition adequate protection in the working environment, protective equipment of the employees (gloves, mask, cap, eyeglasses, shoe covers, coats and chambers for vertical laminary air stream. Storing of cytostatics, procedure in case of accident, and waste handling and removal are also described in this segment. Fifty-three standard operational procedures are described in detail in the second segment. Training scheme for preparation of chemotherapy is given in the third segment - education related to various fields and practical part, which would be carried out through workshops, and at the end of the course participants would pass a test and obtain certificate. After the procedures for safe handling with cytostatics are legally regulated employer will have to provide minimum of protective equipment, special rooms for the drugs dissolving, chambers with laminar airflow, 6 hours working time, rotation of the staff working with drugs dissolving in intervals of every five years, higher efficiency, better health control. In conclusion

  11. Patients' satisfaction with the Nuss procedure

    International Nuclear Information System (INIS)

    Ishimaru, Tetsuya; Iwanaka, Tadashi; Uchida, Hiroo; Kawashima, Hiroshi; Gotoh, Chikashi; Satoh, Kaori; Yoshida, Mariko; Kitano, Yoshihiro

    2009-01-01

    The purpose of this study is to investigate the satisfaction of patients who have already finished bar removal. Fifty-four patients with pectus excavatum underwent the Nuss procedure between July 2000 and December 2007 and the bar was removed in 41 of them at our hospital. A telephone questionnaire was administered to their parents or the patients (12 years old or older). The questions were as follows: self-assessment of the present thoracic form on a 5-point scale, whether it was good to have undergone the Nuss procedure (Y/N), whether the patient will recommend this procedure to another patient (Y/N). Thirty-nine patients responded to the questionnaire. Median age at the bar insertion was 83 months (range: 63-189 months). The bar was removed about 2 years after the initial operation. The median period after removal was 29 months ( range: 2-65 months). The mean point for the thoracic form was 4.2 (5 points: 20, 4 points: 11, 3 points: 5, 2 points: 3). Thirty-eight patients answered that they were satisfied with this procedure. Thirty-four patients answered that they would recommend this procedure to another patient. Eight patients reported that redepression occurred after bar removal. Six of them are under observation because their thoracic deformity is mild. Patients' satisfaction with the Nuss procedure was high. However, our study shows the possibility of post-removal recurrence. There seems to be a tendency for patients to assess their thoracic form more strictly than the doctors. (author)

  12. Algorithm for Video Summarization of Bronchoscopy Procedures

    Directory of Open Access Journals (Sweden)

    Leszczuk Mikołaj I

    2011-12-01

    Full Text Available Abstract Background The duration of bronchoscopy examinations varies considerably depending on the diagnostic and therapeutic procedures used. It can last more than 20 minutes if a complex diagnostic work-up is included. With wide access to videobronchoscopy, the whole procedure can be recorded as a video sequence. Common practice relies on an active attitude of the bronchoscopist who initiates the recording process and usually chooses to archive only selected views and sequences. However, it may be important to record the full bronchoscopy procedure as documentation when liability issues are at stake. Furthermore, an automatic recording of the whole procedure enables the bronchoscopist to focus solely on the performed procedures. Video recordings registered during bronchoscopies include a considerable number of frames of poor quality due to blurry or unfocused images. It seems that such frames are unavoidable due to the relatively tight endobronchial space, rapid movements of the respiratory tract due to breathing or coughing, and secretions which occur commonly in the bronchi, especially in patients suffering from pulmonary disorders. Methods The use of recorded bronchoscopy video sequences for diagnostic, reference and educational purposes could be considerably extended with efficient, flexible summarization algorithms. Thus, the authors developed a prototype system to create shortcuts (called summaries or abstracts of bronchoscopy video recordings. Such a system, based on models described in previously published papers, employs image analysis methods to exclude frames or sequences of limited diagnostic or education value. Results The algorithm for the selection or exclusion of specific frames or shots from video sequences recorded during bronchoscopy procedures is based on several criteria, including automatic detection of "non-informative", frames showing the branching of the airways and frames including pathological lesions. Conclusions

  13. Transvaginal mesh procedures for pelvic organ prolapse.

    Science.gov (United States)

    Walter, Jens-Erik

    2011-02-01

    To provide an update on transvaginal mesh procedures, newly available minimally invasive surgical techniques for pelvic floor repair. The discussion is limited to minimally invasive transvaginal mesh procedures. PubMed and Medline were searched for articles published in English, using the key words "pelvic organ prolapse," transvaginal mesh," and "minimally invasive surgery." Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. Searches were updated on a regular basis, and articles were incorporated in the guideline to May 2010. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. The quality of evidence was rated using the criteria described in the Report of the Canadian Task Force on the Preventive Health Care. Recommendations for practice were ranked according to the method described in that report (Table 1). Counselling for the surgical treatment of pelvic organ prolapse should consider all benefits, harms, and costs of the surgical procedure, with particular emphasis on the use of mesh. 1. Patients should be counselled that transvaginal mesh procedures are considered novel techniques for pelvic floor repair that demonstrate high rates of anatomical cure in uncontrolled short-term case series. (II-2B) 2. Patients should be informed of the range of success rates until stronger evidence of superiority is published. (II-2B) 3. Training specific to transvaginal mesh procedures should be undertaken before procedures are performed. (III-C) 4. Patients should undergo thorough preoperative counselling regarding (a) the potential serious adverse sequelae of transvaginal mesh repairs, including mesh exposure, pain, and dyspareunia; and (b) the limited data available

  14. Clinical considerations for regenerative endodontic procedures.

    Science.gov (United States)

    Geisler, Todd M

    2012-07-01

    The management of a tooth with incomplete root maturation and a necrotic pulp is an endodontic and a restorative challenge. Apexification procedures alone leave the tooth in a weakened state and at risk for reinfection. Regenerative endodontic procedures potentially offer advantages, including the possibility of hard tissue deposition and continued root development. Case studies have reported regeneration of human pulplike tissues in vivo, but there is no protocol that reliably regenerates pulplike tissue. This article summarizes historical, current, and future regenerative treatment approaches. Copyright © 2012 Elsevier Inc. All rights reserved.

  15. A procedure for preparing alkali metal hydrides

    International Nuclear Information System (INIS)

    Lemieux, R.U.; Sanford, C.E.; Prescott, J.F.

    1976-01-01

    A plain low cost, procedure for the continuous, low temperature preparation of sodium or potassium hydrides using cheap reagents is presented. Said invention is especially concerned with a process of purifying of a catalytic exchange liquid used for deuterium enrichment, in which an alkali metal hydride is produced as intermediate product. The procedure for producing the sodium and potassium hydrides consists in causing high pressure hydrogen to be absorbed by a mixture of at least a lower monoalkylamine and an alkylamide of an alkali metal from at least one of said amines [fr

  16. Skin resurfacing procedures: new and emerging options.

    Science.gov (United States)

    Loesch, Mathew M; Somani, Ally-Khan; Kingsley, Melanie M; Travers, Jeffrey B; Spandau, Dan F

    2014-01-01

    The demand for skin resurfacing and rejuvenating procedures has progressively increased in the last decade and has sparked several advances within the skin resurfacing field that promote faster healing while minimizing downtime and side effects for patients. Several technological and procedural skin resurfacing developments are being integrated into clinical practices today allowing clinicians to treat a broader range of patients' skin types and pathologies than in years past, with noteworthy outcomes. This article will discuss some emerging and developing resurfacing therapies and treatments that are present today and soon to be available.

  17. Year 2000 TWRS Maintenance procedure review report

    International Nuclear Information System (INIS)

    ADAMS, M.R.

    1999-01-01

    A concern exists that some equipment in use might contain microprocessors that are dependent upon a time date function. The majority of the software programming for microprocessors has only utilized a 2 digit identifier for the year. With the approach of the year 2000, (Y2K), there is concern that the date function will not be correctly recognized and some functions will not operate properly. TWRS maintenance procedures have been reviewed to identify equipment components that may not be Y2K compliant. Engineering judgment was utilized to eliminate procedures and equipment that is obviously not impacted by Y2K

  18. Dosimetric evaluation of mammary tomosynthesis procedures

    International Nuclear Information System (INIS)

    Silva, Rayre Janaína Vieira; Perini, Ana Paula; Santos, William de Souza; Vedovato, Uly P.; Neves, Lucio Pereira

    2017-01-01

    This work presents the results of the research on the evaluation of radiation doses usually applied in mammary procedures, using the Monte Carlo method. A virtual environment was created, to mimic the procedures room, including the room, its components, patient and source. The spectrum was obtained from the literature. The percentage of energy deposited compared to energy deposited in the breast was determined, and the scattered radiation was absorbed in specific areas. The regions of the head and neck were the most affected by scattered radiation. (author)

  19. DOT-7A packaging test procedure

    International Nuclear Information System (INIS)

    Kelly, D.L.

    1995-01-01

    This test procedure documents the steps involved with performance testing of Department of Transportation Specification 7A (DOT-7A) Type A packages. It includes description of the performance tests, the personnel involved, appropriate safety considerations, and the procedures to be followed while performing the tests. Westinghouse Hanford Company (WHC) is conducting the evaluation and testing discussed herein for the Department of Energy-Headquarters, Division of Quality Verification and Transportation Safety (EH-321). Please note that this report is not in WHC format. This report is being submitted through the Engineering Documentation System so that it may be used for reference and information purposes

  20. Evaluation procedure for radioactive waste treatment processes

    International Nuclear Information System (INIS)

    Whitty, W.J.

    1979-11-01

    An aspect of the Los Alamos Scientific Laboratory's nuclear waste management R and D programs has been to develop an evaluation procedure for radioactive waste treatment processes. This report describes the process evaluation method. Process worth is expressed as a numerical index called the Figure-of-Merit (FOM), which is computed using a hierarchial, linear, additive, scoring model with constant criteria weights and nonlinear value functions. A numerical example is used to demonstrate the procedure and to point out some of its strengths and weaknesses. Potential modifications and extensions are discussed, and an extensive reference list is included

  1. CONCORDAT PROCEDURE. LEGISLATIVE AND JURISPRUDENTIAL HIGHLIGHTS

    Directory of Open Access Journals (Sweden)

    Mihaela Tofan

    2014-11-01

    Full Text Available Insolvency Code has revived theoreticians’ and practitioners’ discussions, equally. The voluntary arrangements procedure is considered a legal solution for the prevention and recovery from commercial actors’ financial difficulty. The current legal framework establishes a number of imperative conditions for the implementation of this procedure, but in many cases, the application of the current regulation generated different conclusions. In less than half a year, since the entry into force of the law, the practice for each court varied. The paper synthesizes separate opinions and proposes solutions for shaping a more precise legal framework.

  2. Guide for External Beam Radiotherapy. Procedures 2007

    International Nuclear Information System (INIS)

    Ardiet, Jean-Michel; Bourhis, Jean; Eschwege, Francois; Gerard, Jean-Pierre; Martin, Philippe; Mazeron, Jean-Jacques; Barillot, Isabelle; Bey, Pierre; Cosset, Jean-Marc; Thomas, Olivier; Bolla, Michel; Bourguignon, Michel; Godet, Jean-Luc; Krembel, David; Valero, Marc; Bara, Christine; Beauvais-March, Helene; Derreumaux, Sylvie; Vidal, Jean-Pierre; Drouard, Jean; Sarrazin, Thierry; Lindecker-Cournil, Valerie; Robin, Sun Hee Lee; Thevenet, Nicolas; Depenweiller, Christian; Le Tallec, Philippe; Ortholan, Cecile; Aimone, Nicole; Baldeschi, Carine; Cantelli, Andree; Estivalet, Stephane; Le Prince, Cyrille; QUERO, Laurent; Costa, Andre; Gerard, Jean-Pierre; Ardiet, Jean-Michel; Bensadoun, Rene-Jean; Bourhis, Jean; Calais, Gilles; Lartigau, Eric; Ginot, Aurelie; Girard, Nicolas; Mornex, Francoise; Bolla, Michel; Chauvet, Bruno; Maingon, Philippe; Martin, Etienne; Azria, David; Gerard, Jean-Pierre; Grehange, Gilles; Hennequin, Christophe; Peiffert, Didier; Toledano, Alain; Belkacemi, Yazid; Courdi, Adel; Belliere, Aurelie; Peignaux, Karine; Mahe, Marc; Bondiau, Pierre-Yves; Kantor, Guy; Lepechoux, Cecile; Carrie, Christian; Claude, Line

    2007-01-01

    In order to optimize quality and security in the delivery of radiation treatment, the French SFRO (Societe francaise de radiotherapie oncologique) is publishing a Guide for Radiotherapy. This guide is realized according to the HAS (Haute Autorite de sante) methodology of 'structured experts consensus'. This document is made of two parts: a general description of external beam radiation therapy and chapters describing the technical procedures of the main tumors to be irradiated (24). For each procedure, a special attention is given to dose constraints in the organs at risk. This guide will be regularly updated

  3. Radioimmunoassay procedure using a stabilized complex

    International Nuclear Information System (INIS)

    Sultanian, I.V.; Irani, J.H.

    1978-01-01

    An improved radioimmunoassay procedure involves the use of a stabilized complex of labelled antigen and antibody which has an extended shelf life as compared to the same complex absent the stabilizers. Since the time needed to incubate the mixture of labelled antigen and antibody is eliminated, the time for completing the assay is considerably shortened and simplified. The components for carrying out the procedure are packaged in a kit basically including standard antigen for generation of a standard curve, a stabilized labelled antigen-antibody complex and reference serum, if used. A plurality of stabilizers are used in the complex to provide a shelf life of six weeks or more. 10 claims

  4. Reforming China’s Criminal Procedure Law

    OpenAIRE

    Winckler, Hugo

    2014-01-01

    Sources:- Wang Jianxun, “The provisions of the reform of criminal procedural law legalising secret investigations are a step backwards,” Caijing wang, 5 September 2011.- Chen Youxi, “The legalisation of secret investigations is an important violation of political integrity,” Zhongguo wangluo dianshitai – CNTV web site, Opinion section, 27 November 2011.- Wu Zhehua, “Chen Weidong discusses reform of the criminal procedure law: Behind each article there is a story,” Zhongguoguangbo wang, 8 Marc...

  5. Procedure guideline for thyroid scintigraphy (version 3)

    International Nuclear Information System (INIS)

    Dietlein, M.; Schicha, H.; Eschner, W.; Deutsche Gesellschaft fuer Medizinische Physik; Koeln Univ.; Leisner, B.; Allgemeines Krankenhaus St. Georg, Hamburg; Reiners, C.; Wuerzburg Univ.

    2007-01-01

    The version 3 of the procedure guideline for thyroid scintigraphy is an update of the procedure guideline previously published in 2003. The interpretation of the scintigraphy requires the knowledge of the patients' history, the palpation of the neck, the laboratory parameters and of the sonography. The interpretation of the technetium-99m uptake requires the knowledge of the TSH-level. As a consequence of the improved alimentary iodine supply the 99m Tc-uptake has decreased; 100 000 counts per scintigraphy should be acquired. For this, an imaging time of 10 minutes is generally needed using a high resolution collimator for thyroid imaging. (orig.)

  6. Mediation –Voluntary or Mandatory Procedure

    Directory of Open Access Journals (Sweden)

    Angelica ROSU

    2010-03-01

    Full Text Available Part of modifications brought through 370/2009 Act to the 192/2006 Law concerning mediation and structure of mediator profession have been interpreted as establishing a preliminary mediation procedure before intimating the courts of law, in civil and commercial matters. This interpretation is in excess of operative legal provisions. Although the law in modified form stipulates the compulsoriness of judicial authorities and other jurisdictional bodies to inform the parties about the possibility and the dvantages of using mediation procedure and the obligation to guide the parties to resort at mediation, this circumstances does not affect the mediation particular voluntary nature.

  7. Year 2000 TWRS Maintenance procedure review report

    Energy Technology Data Exchange (ETDEWEB)

    ADAMS, M.R.

    1999-02-24

    A concern exists that some equipment in use might contain microprocessors that are dependent upon a time date function. The majority of the software programming for microprocessors has only utilized a 2 digit identifier for the year. With the approach of the year 2000, (Y2K), there is concern that the date function will not be correctly recognized and some functions will not operate properly. TWRS maintenance procedures have been reviewed to identify equipment components that may not be Y2K compliant. Engineering judgment was utilized to eliminate procedures and equipment that is obviously not impacted by Y2K.

  8. The association between cervical dysplasia, a short cervix, and preterm birth.

    Science.gov (United States)

    Miller, Emily S; Sakowicz, Allie; Grobman, William A

    2015-10-01

    We sought to determine whether cervical dysplasia in the absence of an excisional procedure is associated with an increased risk of preterm birth (PTB) and whether that risk is independent of the presence of a short cervix. This is a cohort study including women with a singleton pregnancy who underwent routine cervical length assessment between 18-23 6/7 weeks of gestation, stratified by cervical dysplasia (ie, no prior dysplasia, prior dysplasia but no excisional procedure, or prior excisional procedure). The frequency of a short cervix (≤2.5 cm) and PTB were compared between groups and multivariable analyses were performed to identify whether: (1) dysplasia alone or a prior excisional procedure was associated with PTB; and (2) whether these factors remained independently associated with PTB after adjusting for the presence of a short cervix. Of the 18,528 women who met inclusion criteria, 3023 (16.3%) had prior dysplasia alone and 1356 (7.3%) had a prior excisional procedure. The frequency of a short cervix for women without dysplasia, with prior dysplasia alone, or with a prior excisional procedure was 0.8%, 1.0%, and 2.2%, respectively (P cervix. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Summative Mass Analysis of Algal Biomass - Integration of Analytical Procedures: Laboratory Analytical Procedure (LAP)

    Energy Technology Data Exchange (ETDEWEB)

    Laurens, Lieve M. L.

    2016-01-13

    This procedure guides the integration of laboratory analytical procedures to measure algal biomass constituents in an unambiguous manner and ultimately achieve mass balance closure for algal biomass samples. Many of these methods build on years of research in algal biomass analysis.

  10. Considerable variability of procedural sedation and analgesia practices for gastrointestinal endoscopic procedures in Europe

    NARCIS (Netherlands)

    Vaessen, Hermanus H B; Knape, Johannes T A

    2016-01-01

    Background/Aims: The use of moderate to deep sedation for gastrointestinal endoscopic procedures has increased in Europe considerably. Because this level of sedation is a risky medical procedure, a number of international guidelines have been developed. This survey aims to review if, and if so

  11. Comparing the operators' behavior in conducting emergency operating procedures with the complexity of procedural steps

    International Nuclear Information System (INIS)

    Park, Jin Kyun; Jung, Won Dea

    2003-01-01

    Many kinds of procedures have been used to reduce the operators' workload throughout various industries. However, significant portion of accidents or incidents was caused by procedure related human errors that are originated from non-compliance of procedures. According to related studies, several important factors for non-compliance behavior have been identified, and one if them is the complexity of procedures. This means that comparing the change of the operators' behavior with the complexity of procedures may be meaningful for investigating plausible reasons for the operators' non-compliance behavior. In this study, emergency training records were collected using a full scope simulator in order to obtain data related to the operators' non-compliance behavior. And then, collected data are compared with the complexity of procedural steps. As the result, two remarkable relationships are found, which indicate that the operators' behavior could be reasonably characterized by the complexity of procedural steps. Thus, these relationships can be used as meaningful clues not only to scrutinize the reason of non-compliance behavior but also to suggest appropriate remedies for the reduction of non-compliance behavior that can result in procedure related human errors

  12. Operating-procedure system at Savannah River Plant

    International Nuclear Information System (INIS)

    Tope, C.W.

    1981-05-01

    Three types of procedures are widely used at SRP: Du Pont Savannah Operating Logsheet, Du Pont Savannah Operating Procedure, and Plant Manual. This document briefly reviews originating of the procedures, their preparation, control, and indexing

  13. Endovascular thrombectomy and post-procedural headache.

    Science.gov (United States)

    Khan, Sabrina; Amin, Faisal Mohammad; Holtmannspötter, Markus; Hansen, Klaus; Florescu, Anna Maria; Fakhril-Din, Zainab; Petersen, Julie Falkenberg; Ghanizada, Hashmat; Ayata, Cenk; Gaist, David; Ashina, Messoud

    2017-12-01

    We investigated the prevalence of post-procedural headache in patients who have undergone thrombectomy for ischemic stroke, and correlated history of migraine with risk of peri-procedural complications. A total of 314 patients underwent thrombectomy at the Danish National Hospital from January 2012 to December 2014. Eligible subjects were phone-interviewed using a purpose-developed semi-structured questionnaire according to the International Classification of Headache Disorders 3, beta version criteria. Among 96 eligible subjects, there was a significant decrease in migraine (p = 0.022) within the first 3 months after EVT compared to 1 year before treatment, which was further evident at interview time (on average 1.6 years after EVT, p = 0.013). A minority of patients experienced headaches for the first time within 3 months of their EVT (migraine 2, TTH 9), which persisted at interview time for subjects with migraine. Out of 12 subjects with peri-procedural complications, 2 had a history of migraine with aura. Thrombectomy leads to a significant decrease in previously known migraine, and new onset of headache in a small subset of patients. A history of migraine does not appear to predispose to peri-procedural complications.

  14. 1983 EML Procedures Manual. 26th Edition

    International Nuclear Information System (INIS)

    Volchok, H.L.; de Planque, G.

    1983-01-01

    This document consists of page and section changes to the following HASL-300 procedures: fallout collection methods, radiochemical 90 Sr, atomic absorption-emission spectrophotometry of trace metals, precipitation and lake water samples, anions by ion chromatography, polynuclear aromatic hydrocarbons in sediments, Mn in saline precipitation samples, and Pb in saline precipitation samples

  15. Patient radiation doses from neuroradiology procedures

    Energy Technology Data Exchange (ETDEWEB)

    Garcia-Roman, M J; Abreu-Luis, J; Hernandez-Armas, J [Servicio de Fisica Medica, Hospital Universitario de Canarias, La Laguna, Tenerife (Spain); Prada-Martinez, E [Servicio de Radiodiagnostico, Hospital Universitario de Canarias, La Laguna, Tenerife (Spain)

    2001-03-01

    Following the presentation of radiation-induced deterministic effects by some patients undergoing neuroradiological procedures during successive sessions, such as temporary epilation, in the 'Hospital Universitario de Canarias', measurements were made of dose to patients. The maximum dose-area product measured by ionization chamber during these procedures was 39617 cGy.cm{sup 2} in a diagnostic of aneurysm and the maximum dose to the skin measured by thermoluminescent dosemeters (TLDs) was 462.53 mGy. This can justify certain deterministic effects but it is unlikely that the patients will suffer serious effects from this skin dose. Also, measurements were made of effective dose about two usual procedures, embolisation of tumour und embolisation of aneurysm. These procedures were reproduced with an anthropomorphic phantom Rando and doses were measured with TLDs. Effective doses obtained were 3.79 mSv and 4.11 mSv, respectively. The effective dose valued by the program EFFDOSE was less than values measured with TLDs. (author)

  16. 40 CFR 53.23 - Test procedures.

    Science.gov (United States)

    2010-07-01

    ... deviation about the mean and is expressed in concentration units. (2) Test procedure. (i) Allow sufficient... definition. Positive or negative response caused by a substance other than the one being measured. (2) Test...) Before testing for each interferent, allow the test analyzer to sample through the scrubber a test...

  17. 7 CFR 1207.325 - Procedure.

    Science.gov (United States)

    2010-01-01

    ... Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE POTATO RESEARCH AND PROMOTION PLAN Potato Research and Promotion Plan National Potato Promotion Board § 1207.325 Procedure. (a) Each State...

  18. Developmental Predictors of Fraction Concepts and Procedures

    Science.gov (United States)

    Jordan, Nancy C.; Hansen, Nicole; Fuchs, Lynn S.; Siegler, Robert S.; Gersten, Russell; Micklos, Deborah

    2013-01-01

    Developmental predictors of children's fraction concepts and procedures at the end of fourth grade were investigated in a 2-year longitudinal study. Participants were 357 children who started the study in third grade. Attentive behavior, language, nonverbal reasoning, number line estimation, calculation fluency, and reading fluency each…

  19. 7 CFR 356.8 - Return procedure.

    Science.gov (United States)

    2010-01-01

    ... receipt provided by Plant Protection and Quarantine, the seized property is authorized to be released. ... 7 Agriculture 5 2010-01-01 2010-01-01 false Return procedure. 356.8 Section 356.8 Agriculture Regulations of the Department of Agriculture (Continued) ANIMAL AND PLANT HEALTH INSPECTION SERVICE...

  20. 7 CFR 1221.108 - Procedure.

    Science.gov (United States)

    2010-01-01

    ... Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... INFORMATION ORDER Sorghum Promotion, Research, and Information Order Sorghum Promotion, Research, and Information Board § 1221.108 Procedure. (a) At a Board meeting, it will be considered a quorum when a simple...

  1. The need for culture sensitive diagnostic procedures

    NARCIS (Netherlands)

    Zandi, Tekleh; Havenaar, Johan M.; Limburg-Okken, Annechien G.; van Es, Hans; Sidali, Salah; Kadri, Nadia; van den Brink, Wim; Kahn, Rene S.

    Objective We examine the procedural validity of a standardized instrument for the diagnosis of psychotic disorders in Morocco. Method Twenty-nine patients from Casablanca, Morocco, with a psychotic or mood disorder were examined using the Comprehensive Assessment of Symptoms and History (CASH) an

  2. 40 CFR 53.43 - Test procedures.

    Science.gov (United States)

    2010-07-01

    ... sampling zone (see § 53.42(d)). To meet the maximum blockage limit of § 53.42(a) or for convenience, part... PM10 § 53.43 Test procedures. (a) Sampling effectiveness—(1) Technical definition. The ratio (expressed... evenly spaced isokinetic samplers in the sampling zone (see § 53.42(d)) of the wind tunnel. Collect...

  3. 12 CFR 268.710 - Compliance procedures.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 3 2010-01-01 2010-01-01 false Compliance procedures. 268.710 Section 268.710 Banks and Banking FEDERAL RESERVE SYSTEM (CONTINUED) BOARD OF GOVERNORS OF THE FEDERAL RESERVE SYSTEM... Women's Program Manager, the Hispanic Employment Program Coordinator, or the People with Disabilities...

  4. Procedures to establish National Rules of Behavior

    Science.gov (United States)

    The purpose of this procedure is to establish the EPA National Rules of Behavior to comply with OMB Circular A-130, regarding rules of behavior for users of information systems applicable to all users of EPA information and information systems for users.

  5. 9 CFR 124.42 - Hearing procedure.

    Science.gov (United States)

    2010-01-01

    ... Diligence Hearing § 124.42 Hearing procedure. (a) The presiding officer shall be appointed by the... hearing. (g) The due diligence hearing will be conducted in accordance with rules of practice adopted for... opportunity to participate as a party in the hearing. The standard of due diligence set forth in § 124.33 will...

  6. Implementing Distributed Algorithms using Remote Procedure Call

    NARCIS (Netherlands)

    Bal, H.E.; van Renesse, R.; Tanenbaum, A.S.

    1987-01-01

    Remote procedure call (RPC) is a simple yet powerful primitiv~ for communication and synchronization between distributed processes. A problem with RPC is that it tends to decrease the amount of parallelism in an application due to its synchronous nature. This paper shows how light-weight processes

  7. Readability of Invasive Procedure Consent Forms.

    Science.gov (United States)

    Eltorai, Adam E M; Naqvi, Syed S; Ghanian, Soha; Eberson, Craig P; Weiss, Arnold-Peter C; Born, Christopher T; Daniels, Alan H

    2015-12-01

    Informed consent is a pillar of ethical medicine which requires patients to fully comprehend relevant issues including the risks, benefits, and alternatives of an intervention. Given the average reading skill of US adults is at the 8th grade level, the American Medical Association (AMA) and the National Institutes of Health (NIH) recommend patient information materials should not exceed a 6th grade reading level. We hypothesized that text provided in invasive procedure consent forms would exceed recommended readability guidelines for medical information. To test this hypothesis, we gathered procedure consent forms from all surgical inpatient hospitals in the state of Rhode Island. For each consent form, readability analysis was measured with the following measures: Flesch Reading Ease Formula, Flesch-Kincaid Grade Level, Fog Scale, SMOG Index, Coleman-Liau Index, Automated Readability Index, and Linsear Write Formula. These readability scores were used to calculate a composite Text Readability Consensus Grade Level. Invasive procedure consent forms were found to be written at an average of 15th grade level (i.e., third year of college), which is significantly higher than the average US adult reading level of 8th grade (p readability guidelines for patient materials of 6th grade (p readability levels which makes comprehension difficult or impossible for many patients. Efforts to improve the readability of procedural consent forms should improve patient understanding regarding their healthcare decisions. © 2015 Wiley Periodicals, Inc.

  8. 78 FR 35812 - Revisions to Procedural Rules

    Science.gov (United States)

    2013-06-14

    ... also APWU Reply Comments at 2-5. The Public Representative believes that some changes in N-Case rules.... Id. at 2. The Public Representative asserts that N- Case procedures must assure meaningful public... special studies that explore related subjects. Each of these features of the proposed N-Case format is...

  9. 76 FR 37291 - Representation Case Procedures

    Science.gov (United States)

    2011-06-27

    ... communications must include the following words on the Subject Line--``Request to Attend Public Meeting Regarding... NATIONAL LABOR RELATIONS BOARD 29 CFR Parts 101, 102, 103 RIN 3142-AAO8 Representation Case Procedures AGENCY: National Labor Relations Board. ACTION: Proposed rule; notice of meeting. SUMMARY: The...

  10. 48 CFR 2910.002 - Procedures.

    Science.gov (United States)

    2010-10-01

    ... Section 2910.002 Federal Acquisition Regulations System DEPARTMENT OF LABOR ACQUISITION PLANNING MARKET RESEARCH 2910.002 Procedures. (a) In accordance with FAR 6.302-1(c), purchase descriptions must not specify... Contracts, should include product information concerning multiple sources based on research from www...

  11. WIMSD4 Version 101 and cataloged procedure

    International Nuclear Information System (INIS)

    Roth, M.J.; Taubman, C.J.; Lawrence, J.H.

    1982-06-01

    The changes made to WIMSD4 to produce Version 101 on the Harwell IBM 3033 and the Winfrith ICL 2976 computers are summarised. A detailed description of the amended catalogued procedure for executing WIMSD4 on the Harwell Computer is given. (author)

  12. [Conversional and endoscopic procedures following bariatric surgery].

    Science.gov (United States)

    Zorron, R; Bothe, C; Junghans, T; Pratschke, J; Benzing, C; Krenzien, F

    2016-10-01

    The Roux-en-Y gastric bypass (RYGB) is the therapy of choice in bariatric surgery. Sleeve gastrectomy and gastric banding are showing higher rates of treatment failure, reducing obesity-associated morbidity and body weight insufficiently. Moreover, gastroesophageal reflux disease (GERD) can occur refractory to medication. Therefore, a laparoscopic conversion to RYGB can be reasonable as long as specific conditions are fulfilled.Endoscopic procedures are currently being applied to revise bariatric procedures. Therapy failure following RYGB occurs in up to 20 % of cases. Transoral outlet reduction is the minimally invasive method of choice to reduce gastrojejunal anastomosis of the alimentary limb. The diameter of a gastric sleeve can be unwantedly enlarged as well; that can be reduced by placement of a longitudinal full-thickness suture.Severe hypoglycemic episodes can be present in patients following RYGB. Hypoglycemic episodes have to be diagnosed first and can be treated conventionally. Alternatively, a laparoscopic approach according to Branco-Zorron can be used for non-responders. Hypoglycemic episodes can thus be prevented and body weight reduction can be assured.Conversional and endoscopic procedures can be used in patients with treatment failure following bariatric surgery. Note that non-invasive approaches should have been applied intensively before a revisional procedure is performed.

  13. 78 FR 18285 - Direct Final Rulemaking Procedures

    Science.gov (United States)

    2013-03-26

    ... rules on which the agency does not expect adverse comment. If NHTSA decided a DFR is the appropriate... (i.e., with respect to those parts on which adverse comment was received). If the agency decided to... issued according to the following procedures. (a) Rules that the Administrator judges to be non...

  14. 5 CFR 317.302 - Conversion procedures.

    Science.gov (United States)

    2010-01-01

    ... conversion. (2) Pay. Upon conversion to the Senior Executive Service, an employee's SES rate will be... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Conversion procedures. 317.302 Section... IN THE SENIOR EXECUTIVE SERVICE Conversion to the Senior Executive Service § 317.302 Conversion...

  15. 2 CFR 215.71 - Closeout procedures.

    Science.gov (United States)

    2010-01-01

    ... 2 Grants and Agreements 1 2010-01-01 2010-01-01 false Closeout procedures. 215.71 Section 215.71 Grants and Agreements OFFICE OF MANAGEMENT AND BUDGET CIRCULARS AND GUIDANCE Reserved UNIFORM... being closed out. (d) The recipient shall promptly refund any balances of unobligated cash that the...

  16. A procedure for effective Dancoff factor calculation

    International Nuclear Information System (INIS)

    Milosevic, M.

    2001-01-01

    In this paper, a procedure for Dancoff factors calculation based on equivalence principle and its application in the SCALE-4.3 code system is described. This procedure is founded on principle of conservation of neutron absorption for resolved resonance range in a heterogeneous medium and an equivalent medium consisted of an infinite array of two-region pin cells, where the presence of other fuel rods is taken into account through a Dancoff factor. The neutron absorption in both media is obtained using a fine-group elastic slowing-down calculation. This procedure is implemented in a design oriented lattice physics code, which is applicable for any geometry where the method of collision probability is possible to apply to get a flux solution. Proposed procedure was benchmarked for recent exercise that represents a system with a fuel double heterogeneity, i.e., fuel in solid form (pellets) surrounded by fissile material in solution, and for a 5x5 irregular pressurised water reactor assembly, which requires different Dancoff factors. (author)

  17. ORNL Pocket Meter Program: internal operating procedures

    International Nuclear Information System (INIS)

    Berger, C.D.; Miller, J.H.; Dunsmore, M.R.

    1984-12-01

    The ORNL Pocket Meter Program is designed for auditing the approximate photon radiation exposure of Oak Ridge National Laboratory (ORNL) radiation workers. Although pocket meters are considered to be a secondary personnel dosimetry system at ORNL, they are valuable indicators of unplanned exposures if proper procedures are followed for testing, calibrating, deploying, wearing, processing, and recording data. 4 figures, 1 table

  18. General certification procedure of formation organizations

    CERN Document Server

    Int. At. Energy Agency, Wien

    2002-01-01

    This document presents the procedure dealing with the certification of formation organizations dispensing the formation and the risks prevention to the personnel of A or B category in nuclear facilities. This certification proves the organization ability to satisfy the ''F'' specification of the CEFRI. (A.L.B.)

  19. Loading procedures for shipment of irradiated fuel

    Energy Technology Data Exchange (ETDEWEB)

    Bates, E F; Feltz, D E; Sandel, P S; Schoenbucher, B [Texas A and M University (United States)

    1974-07-01

    The Nuclear Science Center at Texas A and M does not have proper equipment and facilities for transferring irradiated fuel from the reactor pool to the transport vehicle. To accomplish the transfer of 23 MTR type fuel elements procedures were developed using a modified fork lift and flex-lift obtained locally. The transfer was accomplished without incident and with negligible personnel exposure. (author)

  20. 23 CFR 650.313 - Inspection procedures.

    Science.gov (United States)

    2010-04-01

    ...) Quality control and quality assurance. Assure systematic quality control (QC) and quality assurance (QA) procedures are used to maintain a high degree of accuracy and consistency in the inspection program. Include... allow assessment of current bridge condition. Record the findings and results of bridge inspections on...