Sample records for hgi2 surgical probes

  1. Beer Law Constants and Vapor Pressures of HgI2 over HgI2(s,l) (United States)

    Su, Ching-Hua; Zhu, Shen; Ramachandran, N.; Burger, A.


    Optical absorption spectra of the vapor phase over HgI2(s,l) were measured at sample temperatures between 349 and 610 K for wavelengths between 200 and 600 nm. The spectra show the samples sublimed congruently into HGI2 without any observed Hg or I2 absorption spectra. The Beer's Law constants for 15 wavelengths between 200 and 440 nm were derived. From these constants the vapor pressure of HgI2, P, was found to be a function of temperature for the liquid and the solid beta-phases: ln P(atm) = -7700/T(K) + 12.462 (liquid phase) and ln P(atm) = -10150/T(K) + 17.026 (beta-phase). The expressions match the enthalpies of vaporization and sublimation of 15.30 and 20.17 kcal/mole respectively, for the liquid and the beta-phase HgI2. The difference in the enthalpies gives an enthalpy of fusion of 4.87 kcal/mole, and the intersection of the two expressions gives a melting point of 537 K.

  2. Synthesis and characterization of HgI2 nanoparticles for films nucleation (United States)

    Barthaburu, María Pérez; Galain, Isabel; Mombrú, Maia; Aguiar, Ivana; Olivera, Alvaro; Pereira, Heinkel Bentos; Fornaro, Laura


    With the aim of controlling the first steps in HgI2 film growth onto amorphous substrates, we employed HgI2 nanoparticles for nucleation. Hg(NO3)2 and NaI were used for obtaining HgI2 in water with and without citric or oxalic acid as capping agents. These samples were then subjected to a hydrothermal treatment at a constant temperature of 120 ºC during 2 h. All samples were washed, centrifuged and dried. This method presents a facile route for obtaining HgI2 nanoparticles and is easily scalable. HgI2 tetragonal phase was confirmed by powder X-ray diffraction. Nanoparticles were characterized in their size and morphology by transmission electron microscopy and the capping agent presence was studied by infrared spectroscopy. HgI2 nanoparticles synthesized in octadecene, previously reported, as well as nanoparticles obtained in the present work, were used for nucleation onto amorphous substrates. They were deposited onto floating silica glass by spin coating and the morphology of the layer was studied by atomic force microscopy. The results we obtained are the first involving HgI2 nucleation by spin coating, and are very promising for improving the film growth orientation and therefore the current applications of this material, as well as for opening new ones.

  3. Growth and characterization of HgI2, PbI2 and PbI2:HgI2 layered semiconductors

    Directory of Open Access Journals (Sweden)

    Manoel E.R.


    Full Text Available This paper presents a methodology for the preparation of a-HgI2 by Physical Vapor Transport and of PbI2 crystals using the Bridgman technique. The results of the growth of HgI2 diluted in PbI2 by the Bridgman technique are shown for the first time, its limit of solubility having been determined at 600 ppm of HgI2 in the PbI2 matrix. Optical absorption, photoluminescence and electrical conductivity measurements show that the crystals prepared are of good crystalline quality.

  4. HgI2 nanostructures obtained hydrothermally for application in ionizing radiation detection (United States)

    Pérez Barthaburu, María; Galain, Isabel; Aguiar, Ivana; Bentos Pereira, Heinkel; Fornaro, Laura


    The compound semiconductor HgI2 has been widely studied and employed as a material for ionizing radiation detection. Monocrystal growth is an intricate method for obtaining materials for this application. With the aim of finding a simpler and more effective way to develop ionizing radiation detectors, we employed HgI2 nanostructures subjected to a hydrothermal treatment and then pressed for this purpose. In the synthesis procedure, aqueous solutions of Hg(NO3)2 and NaI were mixed until their reaction completed and the suspension obtained was then placed in a homemade autoclave and heated at 120 °C for 2, 10 or 24 h. We confirmed the HgI2 tetragonal phase by powder XRD in all cases, independently of the synthesis conditions employed. Nanoparticles were characterized by their size and morphology by TEM. We used the HgI2 nanostructures to obtain a pellet by applying 0.7 GPa of pressure at room temperature. The pellet was then used to construct the detector, and we studied the electrical properties of the detector and its response to 241Am sources of different exposure rates. The resistivity and signal-to-noise ratio obtained are of the order of those reported for HgI2 detectors assembled with monocrystals. The results obtained in this work encourage us to work further on this topic, improving the method, scaling the detector’s size and studying its spectrometric grade.

  5. Photoelectronic properties of HgI2 crystals for nuclear radiation detection

    Indian Academy of Sciences (India)

    S L Sharma; H N Acharya


    Photoelectronic properties of red mercuric iodide single crystals, grown from its saturated solution in tetrahydrofuran, have been studied for the wavelength range 450-700 nm at temperatures 80, 110, 175, 235 and 300 K. Various aspects of the optical generation of charge carriers have been discussed. The computer simulation of the room temperature photoconductivity has generated the optimized values of the mobility-lifetime products (ee = 5.67 × 10-5 cm2/V, hh = 0.18 × 10-5 cm2/V), and surface recombination velocities (e = 3.2 × 105 cm/s, h = 4.5 × 105 cm/s) of the charge carriers in these crystals. The estimated values of the electron and hole drift lengths for typical electric fields suggest that, under the negative electrode illumination, THF -HgI2 crystals have high potential as regards to their use as phptodetectors in most of the scintillation spectrometers.

  6. Electrical properties of solid iodo mercurates resulting from the reaction of HgI2 with alcaline iodides (United States)

    Ponpon, J. P.; Amann, M.


    Potassium iodide solutions are currently used during the fabrication process of mercuric iodide based nuclear radiation detectors. However, KI treatment leaves the HgI2 surface covered with a residual compound (namely the potassium tri-iodo mercurate) which has a significant influence on the surface properties and stability of mercuric iodide devices and therefore on the detectors characteristics. Looking for other solutions to etch mercuric iodide, we found it interesting to investigate the electrical properties of the compounds which may form when etching HgI2 in NH4I, NaI, and RbI. For this purpose, solid iodo mercurates with the cations ammonium, sodium, and rubidium, have been prepared by reacting HgI2 with the solutions of interest. Study of the electrical properties of these samples and comparison with those of potassium tri-iodo mercurate ones, especially with respect to humidity, indicates noticeable stability differences in presence of water vapour. This could have interesting consequences on the surface cleaning of mercuric iodide.

  7. Influence of water and water vapour on the characteristics of KI treated HgI 2 detectors (United States)

    Ponpon, J. P.; Amann, M.; Sieskind, M.

    After being cleaned using a potassium iodide solution in water followed by a water rinse, the surface of mercuric iodide is covered by a chemical complex identified as being KHgI 3·H 2O. This compound can adsorb large quantities of water and its electrical properties are strongly sensitive to water and water vapour. The consequences on the manufacturing and storing conditions (especially the relative humidity), of mercuric iodide-based devices are therefore of great concern. They are illustrated by the study of the electrical and spectrometric properties of HgI 2 nuclear radiation detectors.

  8. Thermal radiation and low-temperature-vapour growth of HgI 2 crystal in production furnace (United States)

    Roux, A.; Fedoseyev, A.; Roux, B.


    Heat exchanges in a sealed ampoule in the LTVG (low temperature vapour growth) furnace have been modelled in order to compute temperature fields and control the growth of HgI 2 crystals from vapour phase at low temperatures. We use a coupled conductive-radiative model to determine the shapes of the source and the crystal at different equilibrium states (i.e. without growth rate). The model involves conductivity anisotropy in the crystal and radiative exchanges between grey and diffuse surfaces (source and crystal interfaces, Pyrex walls), which are considered as opaque. Internal buoyancy effect is not taken into account as the pressure inside the ampoule is very small. The source temperature is fixed. For different undercoolings, i.e. for different cold finger temperatures, the "equilibrium" isotherm between the source/gas and crystal/gas interface has been numerically obtained. This "equilibrium" isotherm, which is associated with the stop of the growing process, gives a crystal shape. This shape is compared with experimental results given by the ETH-Zürich group. The model would permit a better understanding and control of the future HgI 2 crystal growth experiment. The computations are performed using a finite element package (FIDAP).

  9. Conductive-radiative model for predicting the shape of HgI2 crystal grown in the LTVG furnace (United States)

    Roux, A.; Fedoseyev, A.; Roux, Bernard


    The modeling of heat exchanges in a sealed ampoule in the LTVG (Low Temperature Vapor Growth) furnace is focused upon, in order to compute temperature fields and control the growth of HgI2 crystals from vapor phase at low temperatures. A coupled conductive radiative model was used to determine the shape of the source and the crystal at different equilibrium states (that is, without growth rate). The model involves conductivity anisotropy in the crystal and radiative exchanges between grey and diffuse surfaces (source and crystal interfaces, pyrex walls), which are considered as opaque. Internal buoyancy effect is not taken into account as the pressure inside the ampoule is very small. The source temperature is fixed. For different undercoolings, that is, for different cold finger temperatures, the 'equilibrium' isotherm between the source/gas and crystal/gas interfaces was numerically obtained. This 'equilibrium' isotherm, which is associated with the stop of the growing process, gives a crystal shape. This shape is compared with experimental results given by the ETH-Zurich group. The model would permit a better understanding and control of the future HgI2 crystal growth experiment. The computations are performed using a finite element package (FIDAP).

  10. One-dimensional Zigzag Chain Composed of HgI2 Unit and 2,5-Bis(4-pyridyl)-1,3,4-thiadiazole: [HgI2(C12H8N4S)

    Institute of Scientific and Technical Information of China (English)

    CHEN Li-Juan; MENG Ze-Rong; ZHANG Quan-Zheng; WU Xiao-Yuan; LU Can-Zhong


    The title compound, [HgI2(C12H8N4S)], has been synthesized and characterized by single-crystal X-ray diffraction analysis. It crystallizes in monoclinic, space group P21/n with a =14.086(2), b = 6.0365(6), c = 20.286(2) (A), β = 108.818(5)°, V = 1632.7(3) (A)3, Mr = 694.67, Z = 4,Dc. = 2.826 g/cm3,μ - 13.331 mm1, F(000) = 1240, S = 1.108, the final R = 0.0438 and wR =0.0934 for 3085 observed reflections (I > 2σ(I)). The Hg(Ⅱ) atom is coordinated by two 2,5-bis(4-pyridyl)-1,3,4-thiadiazole (L) molecules and two iodine anions in a distorted tetrahedral coordination geometry. Mercury atoms are linked by the organic ligands to form a one-dimensional zigzag chain. It is noteworthy that such 1D zigzag chains are extended into a two-dimensional double layer framework through I…I interactions.

  11. Surgical guidance system using hand-held probe with accompanying positron coincidence detector

    Energy Technology Data Exchange (ETDEWEB)

    Majewski, Stanislaw; Weisenberger, Andrew G.


    A surgical guidance system offering different levels of imaging capability while maintaining the same hand-held convenient small size of light-weight intra-operative probes. The surgical guidance system includes a second detector, typically an imager, located behind the area of surgical interest to form a coincidence guidance system with the hand-held probe. This approach is focused on the detection of positron emitting biomarkers with gamma rays accompanying positron emissions from the radiolabeled nuclei.

  12. Utility of an intraoperabive gamma probe in the surgical management of secondary or tertiary hyperparathyroidism

    NARCIS (Netherlands)

    Jorna, Francisca H.; Jager, Pieter L.; Lemstra, Clara; Wiggers, Theo; Stegeman, Coen A.; Plukker, John T. M.


    BACKGROUND: In primary hyperparathyroidism the gamma probe is effective, but its role in secondary hyperparathyroidism is unclear. We investigated the utility of the probe in the surgical management of secondary and tertiary hyperparathyroidism. METHODS: The value of the probe in guiding resection o

  13. The Contributions of Gamma Probe to Lesion Detectability and Surgical Safety in Recurrent Thyroid Cancer at Risk

    Directory of Open Access Journals (Sweden)

    Salih Sinan Gültekin


    Full Text Available In patients, who underwent thyroid surgery or treated with I-131 radioiodine previously for differentiated thyroid cancer, a second surgical intervention carries higher risks due to distortion of the natural anatomy and development of fibrotic/cicatricial tissue. In addition, accurate assessment of current status about extent of the disease is important in terms of success of the surgery. In this case report, we present the positive contribution of intraoperative gamma probe used for lesion detectability and for surgical safety in a patient operated for several times and administered high cumulative dose of radioiodine therapy for diffentiated thyroid carcinoma previously.

  14. Design and testing of microfabricated surgical tools for large animal probe insertion

    Energy Technology Data Exchange (ETDEWEB)

    Jorgensen, Shelly [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)


    Neural probes provide therapeutic stimulation for neuropsychiatric disorders or record neural activity to investigate the workings of the brain. Researchers utilize 6 mm long temporary silicon stiffeners attached with biodissolvable adhesive to insert flexible neural probes into rat brains, but increasing the probe length fivefold makes inserting large animal probes a significant challenge because of an increased potential for buckling. This study compared the insertion success rates of 6 mm and 30 mm long silicon stiffeners that were 80 μm wide and 30 μm thick, and ascertained the material thickness and modulus of elasticity that would provide successful insertion for a 30 mm probe. Using a microdrive, stiffeners were inserted into an agarose brain phantom at controlled insertion speeds while being video-recorded. Twenty-five percent of the 30 mm silicon stiffeners fully inserted at speeds approximately four times higher than the target rate of 0.13 mm/s, while 100 percent of the 6 mm silicon stiffeners inserted successfully at target speed. Critical buckling loads (Pcr) were calculated for the 6 mm and 30 mm silicon stiffeners, and for 30 mm diamond and tungsten stiffeners, with thicknesses varying from 30-80 μm. Increasing the thickness of the material by 10 μm, 20 μm and 30 μm improved the Pcr by 2.4, 4.7 and 8.2 times, respectively, independent of the material, and substituting diamond for silicon multiplied the buckling capacity by 5.0 times. Stiffeners made of silicon for large animal probe insertion are not strong enough to withstand buckling upon insertion without a significant increase in thickness. Replacing silicon with diamond and increasing the thickness of the stiffener to 50 μm would afford a stiffener with the same Pcr capacity as the 6 mm silicon stiffener that had a 100 percent insertion success rate. Experiments should continue with diamond to determine a minimum thickness that will ensure successful

  15. Evaluation of diabetic foot osteomyelitis using probe to bone test and magnetic resonance imaging and their impact on surgical intervention

    Directory of Open Access Journals (Sweden)

    Fatma Zaiton


    Conclusion: PTB test is a simple, minimally invasive, low cost test and can be done at outpatient clinic. Its sensitivity and specificity are good when compared to those of MRI, but when we need to diagnose associated soft tissue infection and planning the surgical management MRI was the image of choice.

  16. Taking label-free optical spectroscopy techniques into the operating theatre: biopsy needles and surgical guidance probes (Conference Presentation) (United States)

    Leblond, Frédéric


    Recent advances will be described relating to the development and clinical translation of optical spectroscopy techniques designed to guide surgical interventions in brain and prostate oncology applications. The use of molecular imaging guidance systems can enable true intra-operative tissue identification, increasing the effectiveness of cancer surgery and potentially positively impacting patient survival. Surgical resection is a fundamental cancer treatment, but its effectiveness is reduced by the inability to rapidly and accurately identify cancer margins. We will introduce a portable intraoperative label-free multimodal optical spectroscopy system combining intrinsic fluorescence, diffuse reflectance, and Raman spectroscopy that can identify cancer in situ during surgery. We will show that this on-line guidance system can detect primary cancer such as glioma as well as metastatic melanoma and cancer of the lung and colon with an accuracy, sensitivity, and specificity of 97%, 100%, and 93% respectively. Moreover, a method will be presented, along with preliminary tissue classification results, based on the interrogation of whole human prostates from prostatectomies. The development and in vivo validation of an optical brain needle biopsy instrument will be presented demonstrating its ability to detect bulk tumor using Raman spectroscopy with the goal of reducing the number of non-diagnostic samples during a procedure. The extraction of tissue can cause life-threatening hemorrhage because of significant blood vessel injury during the procedure. We will demonstrate that a sub-diffuse optical tomography technique integrated with a commercial biopsy needle can detect the presence of blood vessels to limit the hemorrhage risk.

  17. Lithography process for patterning HgI2 photonic devices (United States)

    Mescher, Mark J.; James, Ralph B.; Hermon, Haim


    A photolithographic process forms patterns on HgI.sub.2 surfaces and defines metal sublimation masks and electrodes to substantially improve device performance by increasing the realizable design space. Techniques for smoothing HgI.sub.2 surfaces and for producing trenches in HgI.sub.2 are provided. A sublimation process is described which produces etched-trench devices with enhanced electron-transport-only behavior.

  18. Development of surgical gamma probes with TlBr semiconductors and CsI(Tl) scintillators crystals; Desenvolvimento de sondas cirurgicas radioguiadas com semicondutores de TlBr e com cristais cintiladores de CsI (Tl)

    Energy Technology Data Exchange (ETDEWEB)

    Costa, Fabio Eduardo da


    Radio guided surgery, using probes with radiation detectors, has been prominence in the medical area in the last decade. This technique consists in injecting a radioactive substance to concentrate in tumour and assist the localization during the surgical procedure. The radio guided surgeries allowing the identification of lymph node has revolutioned the behavior of tumour in initial stadium when are being spread by lymphatic way. The conditions imposed to the surgery due the proximity between some lymph nodes, demands of the probes, a small diameters and capacity of individual identification of these lymph nodes radiolabelled by a specific tracer. The international market supplies these probes with CdTe semiconductors and scintillators, but there is some time lack a promptly technical assistance in the Brazilian market. This work developed probes with national technology, using CsI(Tl) scintillators crystals and, in substitution to CdTe crystals semiconductors, the TlBr crystal, that is a new semiconductor detector in a world-wide development, with advantages in relation to the CdTe. Both crystals have been grown in IPEN. All the necessary electronics, specially, the preamplifier, that was also a restrictive factor for development of these types of probe in the country, have been developed with components found in the national market. Systematic measures of spatial resolution, spatial selectivity, maximum sensitivity and quality of the shielding have been carried the probes development. The results have shown that the probes, one with the CsI(Tl) crystal and another with TlBr semiconductor presented the requested performance in the international literature for radio guided probes. (author)

  19. Abortion - surgical (United States)

    Suction curettage; Surgical abortion; Elective abortion - surgical; Therapeutic abortion - surgical ... Surgical abortion involves dilating the opening to the uterus (cervix) and placing a small suction tube into the uterus. ...

  20. Identification of sentinel lymph node in breast cancer by lymphoscintigraphy and surgical gamma probe with peritumoral injection of scintimammographic agent ''{sup 99m}Tc MIBI''

    Energy Technology Data Exchange (ETDEWEB)

    Aras, G.; Arican, P.; Cam, R.; Kuecuek, N.OE.; Ibis, E.; Tuezuener, A.; Soylu, A [Ankara Univ. (Turkey). Medical Faculty


    The purpose of this study was to evaluate the efficacy of lymphoscintigraphy and the surgical gamma probe (SGP) with peritumoral injection of {sup 99m}Tc MIBI in sentinel lymph node (SLN) detection in breast cancer regardless of whether metastatic or not. Thirty patients with T1/T2 breast cancer had peritumoral injections of {sup 99m}Tc MIBI (74 MBq/0.2 ml at 4 different locations) at 2, 6 and 24 hours before surgery. Anterior, anterolateral, and lateral spot images were taken at 10, 30, 45, 60 and 120 minutes. Counts were collected from the injection site, affected breast tissue, internal mammaries, axillary and supraclavicular regions, and the contralateral side. Peritumoral blue dye was also injected at surgery. The first lymph nodes with counts twice the background tissue and/or with blue dye uptake were surgically isolated, and histopathological evaluations were made. Modified radical mastectomy was performed on all patients. Twenty-three out of thirty patients had lymph nodes in scintigrams and the sentinel lymph nodes were identified with SGP in 25/30 patients. Lymphoscintigraphy and subsequent SGP detection with peritumoral injection of {sup 99m}Tc MIBI can be used for identifying SLN in breast cancer. (author)

  1. Surgical Assisting (United States)

    ... Insert and remove Foley urinary bladder catheter Place pneumatic tourniquet Confirm procedure with surgeon Drape patient within ... Technology and Surgical Assisting (NBSTSA) offers the CertifiedSurgical First Assistant (CSFA) credential, and the National Surgical Assistant ...

  2. Mobile Probing and Probes

    DEFF Research Database (Denmark)


    Mobile probing is a method, developed for learning about digital work situations, as an approach to discover new grounds. The method can be used when there is a need to know more about users and their work with certain tasks, but where users at the same time are distributed (in time and space......). Mobile probing was inspired by the cultural probe method, and was influenced by qualitative interview and inquiry approaches. The method has been used in two subsequent projects, involving school children (young adults at 15-17 years old) and employees (adults) in a consultancy company. Findings point...... to mobile probing being a flexible method for uncovering the unknowns, as a way of getting rich data to the analysis and design phases. On the other hand it is difficult to engage users to give in depth explanations, which seem easier in synchronous dialogs (whether online or face2face). The development...

  3. Mobile Probing and Probes

    DEFF Research Database (Denmark)


    Mobile probing is a method, which has been developed for learning about digital work situations, as an approach to discover new grounds. The method can be used when there is a need to know more about users and their work with certain tasks, but where users at the same time are distributed (in time...... and space). Mobile probing was inspired by the cultural probe method, and was influenced by qualitative interview and inquiry approaches. The method has been used in two subsequent projects, involving school children (young adults at 15-17 years old) and employees (adults) in a consultancy company. Findings...... point to mobile probing being a flexible method for uncovering the unknowns, as a way of getting rich data to the analysis and design phases. On the other hand it is difficult to engage users to give in depth explanations, which seem easier in synchronous dialogs (whether online or face2face...

  4. Mobile Probing and Probes

    DEFF Research Database (Denmark)


    Mobile probing is a method, which has been developed for learning about digital work situations, as an approach to discover new grounds. The method can be used when there is a need to know more about users and their work with certain tasks, but where users at the same time are distributed (in time...... and space). Mobile probing was inspired by the cultural probe method, and was influenced by qualitative interview and inquiry approaches. The method has been used in two subsequent projects, involving school children (young adults at 15-17 years old) and employees (adults) in a consultancy company. Findings...... point to mobile probing being a flexible method for uncovering the unknowns, as a way of getting rich data to the analysis and design phases. On the other hand it is difficult to engage users to give in depth explanations, which seem easier in synchronous dialogs (whether online or face2face...

  5. Mobile Probing and Probes

    DEFF Research Database (Denmark)


    to mobile probing being a flexible method for uncovering the unknowns, as a way of getting rich data to the analysis and design phases. On the other hand it is difficult to engage users to give in depth explanations, which seem easier in synchronous dialogs (whether online or face2face). The development...

  6. Surgical Navigation

    DEFF Research Database (Denmark)

    Azarmehr, Iman; Stokbro, Kasper; Bell, R. Bryan


    were identified in the field of traumatology. Treatment of complex orbital fractures was considerably improved by the use of SN compared with traditionally treated control groups. Conclusions: SN seems to be a very promising addition to the surgical toolkit. Planning details of the surgical procedure...... in a 3-dimensional virtual environment and execution with real-time guidance can significantly improve precision. Among factors to be considered are the financial investments necessary and the learning curve....

  7. Probe Storage

    NARCIS (Netherlands)

    Gemelli, Marcellino; Abelmann, Leon; Engelen, Johan B.C.; Khatib, Mohammed G.; Koelmans, Wabe W.; Zaboronski, Olog; Campardo, Giovanni; Tiziani, Federico; Laculo, Massimo


    This chapter gives an overview of probe-based data storage research over the last three decades, encompassing all aspects of a probe recording system. Following the division found in all mechanically addressed storage systems, the different subsystems (media, read/write heads, positioning, data chan

  8. Cultural probes

    DEFF Research Database (Denmark)

    Madsen, Jacob Østergaard


    The aim of this study was thus to explore cultural probes (Gaver, Boucher et al. 2004), as a possible methodical approach, supporting knowledge production on situated and contextual aspects of occupation.......The aim of this study was thus to explore cultural probes (Gaver, Boucher et al. 2004), as a possible methodical approach, supporting knowledge production on situated and contextual aspects of occupation....

  9. Endocavity Ultrasound Probe Manipulators. (United States)

    Stoianovici, Dan; Kim, Chunwoo; Schäfer, Felix; Huang, Chien-Ming; Zuo, Yihe; Petrisor, Doru; Han, Misop


    We developed two similar structure manipulators for medical endocavity ultrasound probes with 3 and 4 degrees of freedom (DoF). These robots allow scanning with ultrasound for 3-D imaging and enable robot-assisted image-guided procedures. Both robots use remote center of motion kinematics, characteristic of medical robots. The 4-DoF robot provides unrestricted manipulation of the endocavity probe. With the 3-DoF robot the insertion motion of the probe must be adjusted manually, but the device is simpler and may also be used to manipulate external-body probes. The robots enabled a novel surgical approach of using intraoperative image-based navigation during robot-assisted laparoscopic prostatectomy (RALP), performed with concurrent use of two robotic systems (Tandem, T-RALP). Thus far, a clinical trial for evaluation of safety and feasibility has been performed successfully on 46 patients. This paper describes the architecture and design of the robots, the two prototypes, control features related to safety, preclinical experiments, and the T-RALP procedure.

  10. 21 CFR 882.4725 - Radiofrequency lesion probe. (United States)


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Radiofrequency lesion probe. 882.4725 Section 882...) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4725 Radiofrequency lesion probe. (a) Identification. A radiofrequency lesion probe is a device connected to a radiofrequency (RF...

  11. Mobile probes

    DEFF Research Database (Denmark)


    A project investigating the effectiveness of a collection of online resources for teachers' professional development used mobile probes as a data collection method. Teachers received questions and tasks on their mobile in a dialogic manner while in their everyday context as opposed to in an inter......A project investigating the effectiveness of a collection of online resources for teachers' professional development used mobile probes as a data collection method. Teachers received questions and tasks on their mobile in a dialogic manner while in their everyday context as opposed...... to in an interview. This method provided valuable insight into the contextual use, i.e. how did the online resource transfer to the work practice. However, the research team also found that mobile probes may provide the scaffolding necessary for individual and peer learning at a very local (intra-school) community...... level. This paper is an initial investigation of how the mobile probes process proved to engage teachers in their efforts to improve teaching. It also highlights some of the barriers emerging when applying mobile probes as a scaffold for learning....

  12. Conductivity Probe (United States)


    The Thermal and Electrical Conductivity Probe (TECP) for NASA's Phoenix Mars Lander took measurements in Martian soil and in the air. The needles on the end of the instrument were inserted into the Martian soil, allowing TECP to measure the propagation of both thermal and electrical energy. TECP also measured the humidity in the surrounding air. The needles on the probe are 15 millimeters (0.6 inch) long. The Phoenix Mission is led by the University of Arizona, Tucson, on behalf of NASA. Project management of the mission is by NASA's Jet Propulsion Laboratory, Pasadena, Calif. Spacecraft development is by Lockheed Martin Space Systems, Denver.

  13. Pollution Probe. (United States)

    Chant, Donald A.

    This book is written as a statement of concern about pollution by members of Pollution Probe, a citizens' anti-pollution group in Canada. Its purpose is to create public awareness and pressure for the eventual solution to pollution problems. The need for effective government policies to control the population explosion, conserve natural resources,…

  14. Cirugía radioguiada: extirpación de metástasis de un carcinoma papilar de tiroides Probe-guided surgery: metastases of a papillary thyroid carcinoma. Surgical Excision

    Directory of Open Access Journals (Sweden)

    A. R. Kowadlo


    Full Text Available Paciente de sexo masculino operado de Carcinoma Papilar Tiroideo (variedad folicular con recurrencia tumoral luego de tiroidectomía, linfadenectomía y Dosis Terapéutica de Iodo 131. Bajo tratamiento con hormonas tiroideas a dosis inhibitorias de TSH, persistencia de valores elevados de Tiroglobulina Plasmática e imágenes detectables en la Ecografía y Resonancia Magnética Nuclear ( RMN. Por la Dosis Terapéutica se sospechaba que las mismas concentrarían radioyodo. Se planificó por lo tanto cirugía radioguiada, según el protocolo del Instituto Gustave Roussy (modificado. Dosis Terapéutica de Iodo 131; al 4º día Rastreo Corporal Total en Cámara Gamma (RCT; al 5º día cirugía con sonda exploradora (gamma probe y a las 48 hs. poscirugía nuevo RCT. El procedimiento fue exitoso, pudiendo extirparse adenopatías metastásicas con la desaparición en el RCT posquirúrgico de las imágenes que fijaban francamente radioyodo en el preoperatorio. Los vlores de Tiroglobulina plasmática descendieron francamente con terapia hormonal de reemplazo, a los sesenta y noventa días postratamiento.A male patient with papillary thyroid cancer -folliculary variety- is chosen to be presented. After thyroidectomy, lymfhadenectomy and therapeutic dose of radioiodine treatments, cancer relapse was observed. After thyrotrophyn supressive therapy with l-thyroxine, a high serum thyroglobulin concentration was observed. The Ultrasonography ( US and Magnetic Resonance (MR images showed visible node structures in the neck. This node structures were probably going to concentrate I-131 as seen in the first whole body scan after therapeutic dose. Therefore a radio-guided surgery was planned as the best choice. (Institute Gustave Roussy protocol. A therapeutic dose of radioiodine (I-131 was given and up to the 4th day a whole body scan was performed. In the 5th day a gamma- probe-guided surgery was performed as well, and localized metastatic foci in the

  15. Development of an autofluorescent probe for brain cancer: probe characterization thanks to phantom studies (United States)

    Leh, B.; Charon, Y.; Duval, M.-A.; Lefebvre, F.; Linden, S.; Menard, L.; Siebert, R.


    Glioblastoma are brain tumors currently incurable, however, optimized treatment gives better prognosis and quality of life. In case of surgical treatment, there is still need to help surgeons to determine whether a tissue is tumorous or not. Within the framework of the design of a new autofluorescence probe for this issue, optically calibrated gel phantoms have been developed using "tumorous" inclusions in a "healthy" environment. Depending on "tumor" shape, size and localization, the sensitivity of the probe is evaluated. The probe sensitivity for fluorescence spectroscopy will be presented. The probe configuration is also taken into account and compared to simulated results.

  16. Stereotactic limbic leucotomy: surgical technique (United States)

    Richardson, Alan


    The requirements for modern psychosurgery are safety and accuracy. Stereotactic techniques give the geometric accuracy and stimulation gives physiological information, which is important in determining lesion sites or at least lesion symmetry. The process whereby focal brain destruction is produced is ideally by a freezing probe, but equally effectively by coagulation. A number of small lesions is thus required. This at present is unavoidable if side effects are to be obviated. Careful continuing assessment of results is necessary to validate any surgical procedure. ImagesFig. 1Fig. 2Fig. 3Fig. 4 PMID:4618905

  17. Micro-surgical endodontics. (United States)

    Eliyas, S; Vere, J; Ali, Z; Harris, I


    Non-surgical endodontic retreatment is the treatment of choice for endodontically treated teeth with recurrent or residual disease in the majority of cases. In some cases, surgical endodontic treatment is indicated. Successful micro-surgical endodontic treatment depends on the accuracy of diagnosis, appropriate case selection, the quality of the surgical skills, and the application of the most appropriate haemostatic agents and biomaterials. This article describes the armamentarium and technical procedures involved in performing micro-surgical endodontics to a high standard.

  18. Surgical innovation as sui generis surgical research. (United States)

    Lotz, Mianna


    Successful innovative 'leaps' in surgical technique have the potential to contribute exponentially to surgical advancement, and thereby to improved health outcomes for patients. Such innovative leaps often occur relatively spontaneously, without substantial forethought, planning, or preparation. This feature of surgical innovation raises special challenges for ensuring sufficient evaluation and regulatory oversight of new interventions that have not been the subject of controlled investigatory exploration and review. It is this feature in particular that makes early-stage surgical innovation especially resistant to classification as 'research', with all of the attendant methodological and ethical obligations--of planning, regulation, monitoring, reporting, and publication--associated with such a classification. This paper proposes conceptual and ethical grounds for a restricted definition according to which innovation in surgical technique is classified as a form of sui generis surgical 'research', where the explicit goal of adopting such a definition is to bring about needed improvements in knowledge transfer and thereby benefit current and future patients.

  19. A subcutaneous channeling probe for implanting long leads (United States)

    Lund, G. F.; Simmonds, R. C.; Williams, B. A.


    The channeling probe described in the present paper was designed to overcome surgical problems of the type that were encountered when a multichannel radio transmitter had to be implanted in a cow. The probe was made of a flexible but sufficiently stiff 9.5-mm-diam nylon rod, consisting of 46-cm sections for convenience in sterilization and surgical handling. Stainless steel sleaves reinforced the threaded connecting joints. At one end, arrowhead-shaped channeling heads could be attached to produce wide channels for large sensors. The other end was tapered for narrow channels. Postoperative problems were not encountered in the use of this probe in cows, sheep, and dogs.

  20. Hernia Surgical Mesh Implants (United States)

    ... Prosthetics Hernia Surgical Mesh Implants Hernia Surgical Mesh Implants Share Tweet Linkedin Pin it More sharing options ... majority of tissue used to produce these mesh implants are from a pig (porcine) or cow (bovine) ...

  1. Urogynecologic Surgical Mesh Implants (United States)

    ... Prosthetics Urogynecologic Surgical Mesh Implants Urogynecologic Surgical Mesh Implants Share Tweet Linkedin Pin it More sharing options ... majority of tissue used to produce these mesh implants are from a pig (porcine) or cow (bovine). ...

  2. American Pediatric Surgical Association (United States)

    American Pediatric Surgical Association Search for: Login Resources + For Members For Professionals For Training Program Directors For Media For ... Surgical Outcomes Surveys & Results Publications Continuing Education + ExPERT Pediatric Surgery NaT Annual Meeting CME MOC Requirements Residents / ...

  3. Optimizing surgical f

    Directory of Open Access Journals (Sweden)

    Sabry Mohamed Amin


    Conclusions: In our study both dexmedetomidine and esmolol were effective in reducing MABP, and lowering the heart rate providing dry surgical field and ensured good surgical condition during cochlear implant surgery in pediatric patients.

  4. Abortion - surgical - aftercare (United States)

    ... this page: // Abortion - surgical - aftercare To use the sharing features on ... please enable JavaScript. You have had a surgical abortion. This is a procedure that ends pregnancy by ...

  5. NASA SMART Probe: Breast Cancer Application (United States)

    Mah, Robert W.; Norvig, Peter (Technical Monitor)


    There is evidence in breast cancer and other malignancies that the physiologic environment within a tumor correlates with clinical outcome. We are developing a unique percutaneous Smart Probe to be used at the time of needle biopsy of the breast. The Smart Probe will simultaneously measure multiple physiologic parameters within a breast tumor. Direct and indirect measurements of tissue oxygen levels, blood flow, pH, and tissue fluid pressure will be analyzed in real-time. These parameters will be interpreted individually and collectively by innovative neural network techniques using advanced intelligent software. The goals are 1) develop a pecutaneous Smart Probe with multiple sensor modalities and applying advanced Information Technologies to provide real time diagnostic information of the tissue at tip of the probe, 2) test the percutaneous Smart Probe in women with benign and malignant breast masses who will be undergoing surgical biopsy, 3) correlate probe sensor data with benign and malignant status of breast masses, 4) determine whether the probe can detect physiologic differences within a breast tumor, and its margins, and in adjacent normal breast tissue, 5) correlate probe sensor data with known prognostic factors for breast caner, including tumor size, tumor grade, axillary lymph node metastases, estrogen receptor and progesterone receptor status.

  6. Proximal Probes Facility (United States)

    Federal Laboratory Consortium — The Proximal Probes Facility consists of laboratories for microscopy, spectroscopy, and probing of nanostructured materials and their functional properties. At the...

  7. Surgical Lasers In Gynecology (United States)

    Schellhas, Helmut F.; Barnes, Alfonso E.


    Multipurpose surgical CO2 lasers marketed in the USA have been developed to be applicable to a variety of surgical procedures in many surgical fields. They are all suited for endoscopic surgical procedures and can be fitted to all standard surgical microscopes. They all can adjust the focal length of the laser beam to the different standard focal lengths of the surgical microscope which for instance in laryngoscopy is 400 mm and in colposcopy 300 mm. One laser instrument can even change the spot size in a given focal distance which is very advantageous for some microsurgical procedures (Merrimack Laboratories 820). All multipurpose surgical CO2 laser systems provide a multi-articulated surgical arm for free-hand surgery. The surgical arms are cumbersome to use but they are adapted to the surgeons needs with ingenuity. The practicality of the multi-articulated surgical arms depends mostly on the distance of the handpiece from the surgical console which now is also overbridged by the laser tube in most surgical laser system. The spot size of the beam is variable in most handpieces by interchangeable lenses which modify the focal distance of the beam and the power density. Another common feature in all systems is a coaxial He-Ne pilot light which provides a red spot which unfortunately becomes invisible in a bleeding surgical field. Most surgical laser systems have a spacial mode of TEM 00 which is essential for incisional surgery. The continuous mode of beam delivery is used for incisional surgery and also for most endoscopic procedures.

  8. Probe tip heating assembly (United States)

    Schmitz, Roger William; Oh, Yunje


    A heating assembly configured for use in mechanical testing at a scale of microns or less. The heating assembly includes a probe tip assembly configured for coupling with a transducer of the mechanical testing system. The probe tip assembly includes a probe tip heater system having a heating element, a probe tip coupled with the probe tip heater system, and a heater socket assembly. The heater socket assembly, in one example, includes a yoke and a heater interface that form a socket within the heater socket assembly. The probe tip heater system, coupled with the probe tip, is slidably received and clamped within the socket.

  9. Manual of Surgical Instruments

    Directory of Open Access Journals (Sweden)

    Olga Lidia Sánchez Sarría


    Full Text Available Surgical instruments are the group of tools used in surgical procedures. They are very expensive and sophisticated. Consequently, a standardized and meticulous care is essential; they should go through the decontamination, cleaning and sterilization process. These instruments are designed in order to provide surgeons with tools that help them to perform a basic surgical procedure; there are multiple variations and the design depends on their function. This paper aims at showing all surgical instruments that can be used in an operating room during surgery and are not generally included in the medical literature.

  10. Mobile Game Probes

    DEFF Research Database (Denmark)

    Borup Lynggaard, Aviaja


    This paper will examine how probes can be useful for game designers in the preliminary phases of a design process. The work is based upon a case study concerning pervasive mobile phone games where Mobile Game Probes have emerged from the project. The new probes are aimed towards a specific target...... group and the goal is to specify the probes so they will cover the most relevant areas for our project. The Mobile Game Probes generated many interesting results and new issues occurred, since the probes came to be dynamic and favorable for the process in new ways....

  11. Surgical ethics and the challenge of surgical innovation. (United States)

    Angelos, Peter


    Surgical ethics as a specific discipline is relatively new to many. Surgical ethics focuses on the ethical issues that are particularly important to the care of surgical patients. Informed consent for surgical procedures, the level of responsibility that surgeons feel for their patients' outcomes, and the management of surgical innovation are specific issues that are important in surgical ethics and are different from other areas of medicine. The future of surgical progress is dependent on surgical innovation, yet the nature of surgical innovation raises specific concerns that challenge the professionalism of surgeons. These concerns will be considered in the following pages.

  12. Recognizing surgical patterns

    NARCIS (Netherlands)

    Bouarfa, L.


    In the Netherlands, each year over 1700 patients die from preventable surgical errors. Numerous initiatives to improve surgical practice have had some impact, but problems persist. Despite the introduction of checklists and protocols, patient safety in surgery remains a continuing challenge. This is

  13. Surgical medical record

    DEFF Research Database (Denmark)

    Bulow, S.


    A medical record is presented on the basis of selected linguistic pearls collected over the years from surgical case records Udgivelsesdato: 2008/12/15......A medical record is presented on the basis of selected linguistic pearls collected over the years from surgical case records Udgivelsesdato: 2008/12/15...

  14. Properties of Ultrasound Probes


    Rusina, M.


    This work deals with the measurement properties of ultrasound probes. Ultrasound probes and their parameters significantly affect the quality of the final image. In this work there are described the possibility of measuring the spatial resolution, sensitivity of the probe and measuring the length of the dead zone. Ultrasound phantom ATS Multi Purpose Phantom Type 539 was used for measurements.

  15. Surgical ethics: surgical virtue and more. (United States)

    Vercler, Christian J


    The encounter between a patient and her surgeon is unique for several reasons. The surgeon inflicts pain upon a patient for the patient's own good. An operative intervention is irreducibly personal, such that the decisions about and performance of operations are inseparable from the idiosyncrasies of the individual surgeon. Furthermore, there is a chasm of knowledge between the patient and surgeon that is difficult to cross. Hence, training in the discipline of surgery includes the inculcation of certain virtues and practices to safeguard against abuses of this relationship and to make sure that the best interests of the patient are prioritized. The stories in this issue are evidence that in contemporary practice this is not quite enough, as surgeons reflect on instances they felt were ethically challenging. Common themes include the difficulty in communicating surgical uncertainty, patient-surgeon relationships, ethical issues in surgical training, and the impact of the technological imperative on caring for dying patients.

  16. Multiscale Surgical Telerobots

    Energy Technology Data Exchange (ETDEWEB)

    Miles, R R; Seward, K P; Benett, W J; Tendick, F; Bentley, L; Stephan, P L


    A project was undertaken to improve robotic surgical tools for telerobotic minimally invasive surgery. The major objectives were to reduce the size of the tools to permit new surgical procedures in confined spaces such as the heart and to improve control of surgical tools by locating positional sensors and actuators at the end effector rather than external to the patient as is currently the state of the technology. A new compact end-effector with wrist-like flexibility was designed. Positional sensors based on MEMS microfabrication techniques were designed.

  17. Nuclear probes and intraoperative gamma cameras. (United States)

    Heller, Sherman; Zanzonico, Pat


    Gamma probes are now an important, well-established technology in the management of cancer, particularly in the detection of sentinel lymph nodes. Intraoperative sentinel lymph node as well as tumor detection may be improved under some circumstances by the use of beta (negatron or positron), rather than gamma detection, because the very short range (∼ 1 mm or less) of such particulate radiations eliminates the contribution of confounding counts from activity other than in the immediate vicinity of the detector. This has led to the development of intraoperative beta probes. Gamma camera imaging also benefits from short source-to-detector distances and minimal overlying tissue, and intraoperative small field-of-view gamma cameras have therefore been developed as well. Radiation detectors for intraoperative probes can generally be characterized as either scintillation or ionization detectors. Scintillators used in scintillation-detector probes include thallium-doped sodium iodide, thallium- and sodium-doped cesium iodide, and cerium-doped lutecium orthooxysilicate. Alternatives to inorganic scintillators are plastic scintillators, solutions of organic scintillation compounds dissolved in an organic solvent that is subsequently polymerized to form a solid. Their combined high counting efficiency for beta particles and low counting efficiency for 511-keV annihilation γ-rays make plastic scintillators well-suited as intraoperative beta probes in general and positron probes in particular Semiconductors used in ionization-detector probes include cadmium telluride, cadmium zinc telluride, and mercuric iodide. Clinical studies directly comparing scintillation and semiconductor intraoperative probes have not provided a clear choice between scintillation and ionization detector-based probes. The earliest small field-of-view intraoperative gamma camera systems were hand-held devices having fields of view of only 1.5-2.5 cm in diameter that used conventional thallium

  18. Guide to Surgical Specialists (United States)

    ... have expertise in the following areas of responsibility: neonatal surgery (specialized knowledge in the surgical repair of ... and non-operative management of certain types of pain. Common conditions managed by neurologic surgeons include disorders ...

  19. Surgical Critical Care Initiative (United States)

    Federal Laboratory Consortium — The Surgical Critical Care Initiative (SC2i) is a USU research program established in October 2013 to develop, translate, and validate biology-driven critical care....

  20. Ambulatory Surgical Measures - National (United States)

    U.S. Department of Health & Human Services — The Ambulatory Surgical Center Quality Reporting (ASCQR) Program seeks to make care safer and more efficient through quality reporting. ASCs eligible for this...

  1. Ambulatory Surgical Measures - Facility (United States)

    U.S. Department of Health & Human Services — The Ambulatory Surgical Center Quality Reporting (ASCQR) Program seeks to make care safer and more efficient through quality reporting. ASCs eligible for this...

  2. Surgical site infections

    African Journals Online (AJOL)

    and mortality as well as significant financial implications. Worldwide it has ... common nosocomial infection amongst surgical patients with up to 38% .... antibiotics as soon as the sensitivity results are available. ... Breast surgery. Staph Aureus/ ...

  3. Atom probe crystallography

    National Research Council Canada - National Science Library

    Gault, Baptiste; Moody, Michael P; Cairney, Julie M; Ringer, Simon P


    This review addresses new developments in the emerging area of "atom probe crystallography", a materials characterization tool with the unique capacity to reveal both composition and crystallographic...

  4. 3D Surgical Simulation (United States)

    Cevidanes, Lucia; Tucker, Scott; Styner, Martin; Kim, Hyungmin; Chapuis, Jonas; Reyes, Mauricio; Proffit, William; Turvey, Timothy; Jaskolka, Michael


    This paper discusses the development of methods for computer-aided jaw surgery. Computer-aided jaw surgery allows us to incorporate the high level of precision necessary for transferring virtual plans into the operating room. We also present a complete computer-aided surgery (CAS) system developed in close collaboration with surgeons. Surgery planning and simulation include construction of 3D surface models from Cone-beam CT (CBCT), dynamic cephalometry, semi-automatic mirroring, interactive cutting of bone and bony segment repositioning. A virtual setup can be used to manufacture positioning splints for intra-operative guidance. The system provides further intra-operative assistance with the help of a computer display showing jaw positions and 3D positioning guides updated in real-time during the surgical procedure. The CAS system aids in dealing with complex cases with benefits for the patient, with surgical practice, and for orthodontic finishing. Advanced software tools for diagnosis and treatment planning allow preparation of detailed operative plans, osteotomy repositioning, bone reconstructions, surgical resident training and assessing the difficulties of the surgical procedures prior to the surgery. CAS has the potential to make the elaboration of the surgical plan a more flexible process, increase the level of detail and accuracy of the plan, yield higher operative precision and control, and enhance documentation of cases. Supported by NIDCR DE017727, and DE018962 PMID:20816308

  5. Anxiety in veterinary surgical students

    DEFF Research Database (Denmark)

    Langebæk, Rikke; Eika, Berit; Jensen, Asger Lundorff


    The surgical educational environment is potentially stressful and this can negatively affect students' learning. The aim of this study was to investigate whether veterinary students' level of anxiety is higher in a surgical course than in a non-surgical course and if pre-surgical training...... in a Surgical Skills Lab (SSL) has an anxiety reducing effect. Investigations were carried out as a comparative study and a parallel group study. Potential participants were fourth-year veterinary students who attended a surgical course (Basic Surgical Skills) and a non-surgical course (Clinical Examination...... and 28 students from 2010). Our results show that anxiety levels in veterinary students are significantly higher in a surgical course than in a non-surgical course (p...

  6. Surgical bleeding in microgravity (United States)

    Campbell, M. R.; Billica, R. D.; Johnston, S. L. 3rd


    A surgical procedure performed during space flight would occur in a unique microgravity environment. Several experiments performed during weightlessness in parabolic flight were reviewed to ascertain the behavior of surgical bleeding in microgravity. Simulations of bleeding using dyed fluid and citrated bovine blood, as well as actual arterial and venous bleeding in rabbits, were examined. The high surface tension property of blood promotes the formation of large fluid domes, which have a tendency to adhere to the wound. The use of sponges and suction will be adequate to prevent cabin atmosphere contamination with all bleeding, with the exception of temporary arterial droplet streams. The control of the bleeding with standard surgical techniques should not be difficult.

  7. Surgical management of presbyopia

    Directory of Open Access Journals (Sweden)

    Torricelli AA


    Full Text Available André AM Torricelli, Jackson B Junior, Marcony R Santhiago, Samir J BecharaDivision of Ophthalmology, University of São Paulo Medical School, São Paulo, BrazilAbstract: Presbyopia, the gradual loss of accommodation that becomes clinically significant during the fifth decade of life, is a physiologic inevitability. Different technologies are being pursued to achieve surgical correction of this disability; however, a number of limitations have prevented widespread acceptance of surgical presbyopia correction, such as optical and visual distortion, induced corneal ectasia, haze, anisometropy with monovision, regression of effect, decline in uncorrected distance vision, and the inherent risks with invasive techniques, limiting the development of an ideal solution. The correction of the presbyopia and the restoration of accommodation are considered the final frontier of refractive surgery. The purpose of this paper is to provide an update about current procedures available for presbyopia correction, their advantages, and disadvantages.Keywords: presbyopia, surgical correction, treatment

  8. Flexible, Penetrating Brain Probes Enabled by Advances in Polymer Microfabrication

    Directory of Open Access Journals (Sweden)

    Ahuva Weltman


    Full Text Available The acquisition of high-fidelity, long-term neural recordings in vivo is critically important to advance neuroscience and brain–machine interfaces. For decades, rigid materials such as metal microwires and micromachined silicon shanks were used as invasive electrophysiological interfaces to neurons, providing either single or multiple electrode recording sites. Extensive research has revealed that such rigid interfaces suffer from gradual recording quality degradation, in part stemming from tissue damage and the ensuing immune response arising from mechanical mismatch between the probe and brain. The development of “soft” neural probes constructed from polymer shanks has been enabled by advancements in microfabrication; this alternative has the potential to mitigate mismatch-related side effects and thus improve the quality of recordings. This review examines soft neural probe materials and their associated microfabrication techniques, the resulting soft neural probes, and their implementation including custom implantation and electrical packaging strategies. The use of soft materials necessitates careful consideration of surgical placement, often requiring the use of additional surgical shuttles or biodegradable coatings that impart temporary stiffness. Investigation of surgical implantation mechanics and histological evidence to support the use of soft probes will be presented. The review concludes with a critical discussion of the remaining technical challenges and future outlook.

  9. Pioneer Jupiter orbiter probe mission 1980, probe description (United States)

    Defrees, R. E.


    The adaptation of the Saturn-Uranus Atmospheric Entry Probe (SUAEP) to a Jupiter entry probe is summarized. This report is extracted from a comprehensive study of Jovian missions, atmospheric model definitions and probe subsystem alternatives.

  10. [Optimizing surgical hand disinfection]. (United States)

    Kampf, G; Kramer, A; Rotter, M; Widmer, A


    For more than 110 years hands of surgeons have been treated before a surgical procedure in order to reduce the bacterial density. The kind and duration of treatment, however, has changed significantly over time. Recent scientific evidence suggests a few changes with the aim to optimize both the efficacy and the dermal tolerance. Aim of this article is the presentation and discussion of new insights in surgical hand disinfection. A hand wash should be performed before the first disinfection of a day, ideally at least 10 min before the beginning of the disinfection as it has been shown that a 1 min hand wash significantly increases skin hydration for up to 10 min. The application time may be as short as 1.5 min depending on the type of hand rub. Hands and forearms should be kept wet with the hand rub for the recommended application time in any case. A specific rub-in procedure according to EN 12791 has been found to be suitable in order to avoid untreated skin areas. The alcohol-based hand rub should have a proven excellent dermal tolerance in order to ensure appropriate compliance. Considering these elements in clinical practice can have a significant impact to optimize the high quality of surgical hand disinfection for prevention of surgical site infections.

  11. Surgical experience of the ruptured distal anterior cerebral artery aneurysms. (United States)

    Lee, Jong-Young; Kim, Moon-Kyu; Cho, Byung-Moon; Park, Se-Hyuck; Oh, Sae-Moon


    Distal anterior cerebral artery (DACA) aneurysms are fragile and known to have high risks for intraoperative premature rupture and a relatively high associated morbidity. To improve surgical outcomes of DACA aneurysms, we reviewed our surgical strategy and its results postoperatively. A total of 845 patients with ruptured cerebral aneurysms were operated in our hospital from January 1991 to December 2005. Twenty-three of 845 patients had ruptured DACA aneurysms which were operated on according to our surgical strategy. Our surgical strategy was as follows; early surgery, appropriate releasing of CSF, appropriate surgical approach, using neuronavigating system, securing the bridging veins, using temporary clipping and/or tentative clipping, meticulous manipulation of aneurysm, and using micro-Doppler flow probe. Twenty of 23 patients who had complete medical records were studied retrospectively. We observed the postoperative radiographic findings and checked Glasgow Outcome Scale score sixth months after the operation. Nineteen DACA aneurysms were clipped through a unilateral interhemispheric approach and one DACA aneurysm was clipped through a pterional approach. Postoperative radiographic findings revealed complete clipping of aneurysmal neck without stenosis or occlusion of parent arteries. In two patients, a residual neck of aneurysm was visualized. Seventeen patients showed good recovery, one patient resulted in moderate disability, while 2 patients died. With our surgical strategy it was possible to achieve acceptable surgical morbidity and mortality rates in patients with DACA aneurysms. Appropriate use of tentative clipping, temporary clipping and neuro-navigating systems can give great help for safe approach and clipping of DACA aneurysm.

  12. [da Vinci surgical system]. (United States)

    Watanabe, Gou; Ishikawa, Norihiro


    The da Vinci surgical system was developed by Intuitive Surgical Inc. in the United States as an endoscopic surgical device to assist remote control surgeries. In 1998, the Da Vinci system was first used for cardiothoracic procedures. Currently a combination of robot-assisted internal thoracic artery harvest together with coronary artery bypass grafting (CABG) through a mini-incision (ThoraCAB) or totally endoscopic procedures including anastomoses under robotic assistance (TECAB) are being conducted for the treatment of coronary artery diseases. With the recent advances in catheter interventions, hybrid procedures combining catheter intervention with ThoraCAB or TECAB are anticipated in the future.On the other hand, with the decrease in number of coronary artery bypass surgeries, the share of valvular surgeries is expected to increase in the future. Among them, mitral valvuloplasty for mitral regurgitation is anticipated to be conducted mainly by low-invasive procedures, represented by minimally invasive cardiac surgery( MICS) and robot-assisted surgery. Apart from the intrinsic good surgical view, robotic-assisted systems offer additional advantages of the availability of an amplified view and the easy to observe the mitral valve in the physiological position. Thus, robotic surgical surgeries that make complicated procedures easier are expected to accomplish further developments in the future. Furthermore, while the number of surgeries for atrial septal defects has decreased dramatically following the widespread use of Amplatzer septal occluder, robotic surgery may become a good indication for cases in which the Amplatzer device is not indicated. In Japan, clinical trial of the da Vinci robotic system for heart surgeries has been completed. Statutory approval of the da Vinci system for mitral regurgitation and atrial septal defects is anticipated in the next few years.

  13. Optimizing Surgical Margins in Breast Conservation

    Directory of Open Access Journals (Sweden)

    Preya Ananthakrishnan


    Full Text Available Adequate surgical margins in breast-conserving surgery for breast cancer have traditionally been viewed as a predictor of local recurrence rates. There is still no consensus on what constitutes an adequate surgical margin, however it is clear that there is a trade-off between widely clear margins and acceptable cosmesis. Preoperative approaches to plan extent of resection with appropriate margins (in the setting of surgery first as well as after neoadjuvant chemotherapy, include mammography, US, and MRI. Improvements have been made in preoperative lesion localization strategies for surgery, as well as intraoperative specimen assessment, in order to ensure complete removal of imaging findings and facilitate margin clearance. Intraoperative strategies to accurately assess tumor and cavity margins include cavity shave techniques, as well as novel technologies for margin probes. Ablative techniques, including radiofrequency ablation as well as intraoperative radiation, may be used to extend tumor-free margins without resecting additional tissue. Oncoplastic techniques allow for wider resections while maintaining cosmesis and have acceptable local recurrence rates, however often involve surgery on the contralateral breast. As systemic therapy for breast cancer continues to improve, it is unclear what the importance of surgical margins on local control rates will be in the future.

  14. An Ultrasonographic Periodontal Probe (United States)

    Bertoncini, C. A.; Hinders, M. K.


    Periodontal disease, commonly known as gum disease, affects millions of people. The current method of detecting periodontal pocket depth is painful, invasive, and inaccurate. As an alternative to manual probing, an ultrasonographic periodontal probe is being developed to use ultrasound echo waveforms to measure periodontal pocket depth, which is the main measure of periodontal disease. Wavelet transforms and pattern classification techniques are implemented in artificial intelligence routines that can automatically detect pocket depth. The main pattern classification technique used here, called a binary classification algorithm, compares test objects with only two possible pocket depth measurements at a time and relies on dimensionality reduction for the final determination. This method correctly identifies up to 90% of the ultrasonographic probe measurements within the manual probe's tolerance.

  15. Hard probes 2006 Asilomar

    CERN Multimedia


    "The second international conference on hard and electromagnetic probes of high-energy nuclear collisions was held June 9 to 16, 2006 at the Asilomar Conference grounds in Pacific Grove, California" (photo and 1/2 page)

  16. Vitiligo- A surgical approach

    Directory of Open Access Journals (Sweden)

    Deepti Ghia


    Full Text Available Aims and objective- To describe the spectrum of surgical modalities for stable vitiligo patients Methods- Patients having stable vitiligo since past 2 years with no improvement with medical line of treatment were enrolled for surgery after informed consent. Depending upon the size and location of vitiligo patch different modalities were performed. Suction blister, mini-punch grafting, split thickness skin grafting, trypsinised melanocyte-keratinocyte transfer and non-trypsinised melanocyte- keratinocyte transfer (Jodhpur technique and follicular grafting technique have been described photographically which have been performed at a tertiary care hospital. Conclusion- Vitiligo is often difficult to treat, stable patches resistant to medical line of management do respond to surgical treatment; however it is very important to choose the modality of surgery according location of the patch, size of the lesion and available resources.

  17. Spacecraft surgical scrub system (United States)

    Abbate, M.


    Ease of handling and control in zero gravity and minimizing the quantity of water required were prime considerations. The program tasks include the selection of biocidal agent from among the variety used for surgical scrub, formulation of a dispensing system, test, and delivery of flight dispensers. The choice of an iodophore was based on effectiveness on single applications, general familiarity among surgeons, and previous qualification for space use. The delivery system was a choice between the squeeze foamer system and impregnated polyurethane foam pads. The impregnated foam pad was recommended because it is a simpler system since the squeeze foamer requires some applicator to effectively clean the skin surfaces, whereas the form pad is the applicator and agent combined. Testing demonstrated that both systems are effective for use as surgical scrubs.

  18. Gossypiboma—Retained Surgical Sponge

    Directory of Open Access Journals (Sweden)

    Hung-Shun Sun


    Full Text Available Intra-abdominal retained surgical sponge is an uncommon surgical error. Herein, we report a 92-year-old woman who was brought to the emergency room for acute urinary retention. She had a history of vaginal hysterectomy for uterine prolapse 18 years previously, performed at our hospital. Retained surgical sponge in the pelvic cavity was suspected by abdominal computed tomography. The surgical gauze was removed by laparotomy excision and the final diagnosis was gossypiboma.

  19. Hepatic surgical anatomy. (United States)

    Skandalakis, John E; Skandalakis, Lee J; Skandalakis, Panajiotis N; Mirilas, Petros


    The liver, the largest organ in the body, has been misunderstood at nearly all levels of organization, and there is a tendency to ignore details that do not fit the preconception. A complete presentation of the surgical anatomy of the liver includes the study of hepatic surfaces, margins, and fissures; the various classifications of lobes and segments; and the vasculature and lymphatics. A brief overview of the intrahepatic biliary tract is also presented.

  20. Louis Pasteur surgical revolution. (United States)

    Toledo-Pereyra, Luis H


    Louis Pasteur (1822-1895) is considered the most notable medical scientist of his time and perhaps one of the most distinguished of all times in the history of medicine. From Dole in France to Paris, from a student of crystals to "living ferments," and from chemistry to biology and medicine, Pasteur changed the world for the benefit of humanity. The genius of Pasteur dealt with the most pressing issues of his time, basing the germ theory on the effects that microorganisms had on fermentation and putrefaction of organic matter, which gave birth to the science of bacteriology. Many other difficult problems in medicine and biology were tackled by Pasteur, culminating in the spectacular results seen with the treatment of rabies. Surgery was no exception to the scientific conquests of Pasteur. The transformation of the surgical world arose from the antiseptic concepts of Lister that were based on the germ theory of the disease, which had been derived from the germ theory of fermentation and putrefaction discovered by Pasteur. The acceptance of these principles represented the surgical revolution brought on by the science of Pasteur, a revolution that is now accepted in our daily care of surgical patients.

  1. Guideline implementation: Surgical attire. (United States)

    Cowperthwaite, Liz; Holm, Rebecca L


    Surgical attire helps protect patients from microorganisms that may be shed from the hair and skin of perioperative personnel. The updated AORN "Guideline for surgical attire" provides guidance on scrub attire, shoes, head coverings, and masks worn in the semirestricted and restricted areas of the perioperative setting, as well as how to handle personal items (eg, jewelry, backpacks, cell phones) that may be taken into the perioperative suite. This article focuses on key points of the guideline to help perioperative personnel adhere to facility policies and regulatory requirements for attire. The key points address the potential benefits of wearing scrub attire made of antimicrobial fabric, covering the arms when in the restricted area of the surgical suite, removing or confining jewelry when wearing scrub attire, disinfecting personal items that will be taken into the perioperative suite, and sending reusable attire to a health care-accredited laundry facility after use. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures.

  2. Surgical navigation with QR codes

    Directory of Open Access Journals (Sweden)

    Katanacho Manuel


    Full Text Available The presented work is an alternative to established measurement systems in surgical navigation. The system is based on camera based tracking of QR code markers. The application uses a single video camera, integrated in a surgical lamp, that captures the QR markers attached to surgical instruments and to the patient.

  3. Dr. Harry Whelan With the Light Emitting Diode Probe (United States)


    The red light from the Light Emitting Diode (LED) probe shines through the fingers of Dr. Harry Whelan, a pediatric neurologist at the Children's Hospital of Wisconsin in Milwaukee. Dr. Whelan uses the long waves of light from the LED surgical probe to activate special drugs that kill brain tumors. Laser light previously has been used for this type of surgery, but the LED light illuminates through all nearby tissues, reaching parts of tumors that shorter wavelengths of laser light carnot. The new probe is safer because the longer wavelengths of light are cooler than the shorter wavelengths of laser light, making the LED less likely to injure normal brain tissue near the tumor. Also, it can be used for hours at a time while still remaining cool to the touch. The probe was developed for photodynamic cancer therapy under a NASA Small Business Innovative Research Program grant. The program is part of NASA's Technology Transfer Department at the Marshall Space Flight Center.

  4. Debridement for surgical wounds. (United States)

    Dryburgh, Nancy; Smith, Fiona; Donaldson, Jayne; Mitchell, Melloney


    Surgical wounds that become infected are often debrided because clinicians believe that removal of this necrotic or infected tissue will expedite wound healing. There are numerous methods available but no consensus on which one is most effective for surgical wounds. The aim of this review is to determine the effect of different methods of debridement on the rate of debridement and healing of surgical wounds. We developed a search strategy to search the following electronic databases: Wounds Group Specialised Trials Register (searched 3/3/08) , Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2008, issue 1), MEDLINE (1950 to February Week 3 2008 ), EMBASE (1980 to 2008 Week 09) and CINHAL (1982 to February Week 4 2008). We checked the citations within obtained studies to identify additional papers and also relevant conference proceedings. We contacted manufactures of wound debridement agents to ascertain the existence of published, unpublished and ongoing trials. Our search was not limited by language or publication status. We included relevant randomised controlled trials (RCT) with outcomes including at least one of the following: time to complete debridement, or time to complete healing. Two authors independently reviewed the abstracts and titles obtained from the search, two extracted data independently using a standardised extraction sheet, and two independently assessed methodological quality. One author was involved in all stages of the data collection and extraction process, thus ensuring continuity. Five RCTs were eligible for inclusion; all compared treatments for infected surgical wounds and reported time required to achieve a clean wound bed (complete debridement). One trial compared an enzymatic agent (Streptokinase/streptodornase) with saline-soaked dressings and reported the time to complete debridement. Four of the trials compared the effectiveness of dextranomer beads or paste with other products (different comparator

  5. Microball lens integrated fiber probe for optical frequency domain imaging

    Institute of Scientific and Technical Information of China (English)

    Jae-Ho Han; J.U.Kang


    An integrated microball lens fiber catheter probe is demonstrated, which has better lateral resolution and longer working distance than a corresponding bare fiber probe with diverging beam for Fourier domain optical coherence tomography (FDOCT). Simulation results are shown to gain the effect of the distance between the microball lens and the bare fiber to the focusing plane and beam width. The freedom of modifying the working distance and lateral resolution is shown. This is achieved by changing the gap distance between the single-mode fiber and the microball lens within the packaged surgical needle catheter without using an additional beam expander having a fixed length. The probe successfully acquired cross-sectional images of ocular tissues from an animal sample with the proposed miniaturized imaging probe.%@@ An integrated microball lens fiber catheter probe is demonstrated,which has better lateral resolution and longer working distance than a corresponding bare fiber probe with diverging beam for Fourier domain optical coherence tomography(FDOCT).Simulation results are shown to gain the effect of the distance between the microball lens and the bare fiber to the focusing plane and beam width.The freedom of modifying the working distance and lateral resolution is shown.This is achieved by changing the gap distance between the single-mode fiber and the microball lens within the packaged surgical needle catheter without using an additional beam expander having a fixed length.The probe successfully acquired crosssectional images of ocular tissues from an animal sample with the proposed miniaturized imaging probe.

  6. New Frontiers in Surgical Innovation. (United States)

    Jackson, Ryan S; Schmalbach, Cecelia E


    It is an exciting time for head and neck surgical innovation with numerous advances in the perioperative planning and intraoperative management of patients with cancer, trauma patients, and individuals with congenital defects. The broad and rapidly changing realm of head and neck surgical innovation precludes a comprehensive summary. This article highlights some of the most important innovations from surgical planning with sentinel node biopsy and three-dimensional, stereolithic modeling to intraoperative innovations, such as transoral robotic surgery and intraoperative navigation. Future surgical innovations, such as intraoperative optical imaging of surgical margins, are also highlighted. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Analysis of surgical intervention populations using generic surgical process models. (United States)

    Neumuth, Thomas; Jannin, Pierre; Schlomberg, Juliane; Meixensberger, Jürgen; Wiedemann, Peter; Burgert, Oliver


    According to differences in patient characteristics, surgical performance, or used surgical technological resources, surgical interventions have high variability. No methods for the generation and comparison of statistical 'mean' surgical procedures are available. The convenience of these models is to provide increased evidence for clinical, technical, and administrative decision-making. Based on several measurements of patient individual surgical treatments, we present a method of how to calculate a statistical 'mean' intervention model, called generic Surgical Process Model (gSPM), from a number of interventions. In a proof-of-concept study, we show how statistical 'mean' procedure courses can be computed and how differences between several of these models can be quantified. Patient individual surgical treatments of 102 cataract interventions from eye surgery were allocated to an ambulatory or inpatient sample, and the gSPMs for each of the samples were computed. Both treatment strategies are exemplary compared for the interventional phase Capsulorhexis. Statistical differences between the gSPMs of ambulatory and inpatient procedures of performance times for surgical activities and activity sequences were identified. Furthermore, the work flow that corresponds to the general recommended clinical treatment was recovered out of the individual Surgical Process Models. The computation of gSPMs is a new approach in medical engineering and medical informatics. It supports increased evidence, e.g. for the application of alternative surgical strategies, investments for surgical technology, optimization protocols, or surgical education. Furthermore, this may be applicable in more technical research fields, as well, such as the development of surgical workflow management systems for the operating room of the future.

  8. [Duane vertical surgical treatment]. (United States)

    Merino, M L; Gómez de Liaño, P; Merino, P; Franco, G


    We report 3 cases with a vertical incomitance in upgaze, narrowing of palpebral fissure, and pseudo-overaction of both inferior oblique muscles. Surgery consisted of an elevation of both lateral rectus muscles with an asymmetrical weakening. A satisfactory result was achieved in 2 cases, whereas a Lambda syndrome appeared in the other case. The surgical technique of upper-insertion with a recession of both lateral rectus muscles improved vertical incomitance in 2 of the 3 patients; however, a residual deviation remains in the majority of cases. Copyright © 2011 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  9. Diverticulitis: selective surgical management. (United States)

    Rugtiv, G M


    The surgical treatment of complications of diverticulitis remains most challenging. A review of twenty years' experience with one hundred fifteen cases is presented with one proved anastomotic leak and no deaths. Interval primary resection with anastomosis for chronic recurrent disease including colovesical fistula and mesocolic abscess was proved sate with low morbidity. The three-stage procedure for perforated diverticulitis with spreading peritonitis or pericolic abscess was associated with a high rate of complications and morbidity. An aggressive approach with resection without anastomosis in two stages is indicated.

  10. The efficacy of transgingival probing in class II buccal furcation defects treated by guided tissue regeneration

    Directory of Open Access Journals (Sweden)

    Monika Bansal


    Full Text Available Background: The objectives of the present study were to establish transgingival probing as an evaluating method in the clinical studies of periodontal regenerative techniques and to compare the effectiveness of transgingival probing to the surgical entry. Materials and Methods: Ten systemically healthy persons (20–50 years with moderate to severe chronic periodontitis participated in this study. These cases were recruited into the study only when they fulfilled the eligibility criteria. Vertical probing depth (VPD and horizontal probing depth (HPD of furcation defects were measured with and without opening the flap, following local anesthesia during initial surgery and at 6 months after collagen membrane placement. The defect fill (DF was also noted. The mean measurements of clinical parameters were compared by two-tailed paired t-test at 5% level of significance. Results: The difference between the measurements of VPD and HPD taken during transgingival probing and after opening the flap was lie in the range of 0.10–0.30 mm at the time of initial surgery and 6 months after surgery that was not statistically significant. Persons experienced slight discomfort or pain during opening the flap as compared to transgingival probing, and this method was also appreciated by the patients as it is easy, simple and does not involve the surgical procedure. Conclusion: The results of the study suggest that measurements recorded during transgingival probing and after opening the flap do not influence the required outcome of regenerative therapies, i.e., DF that was not statistically significant difference from surgical reentry. Therefore, it was concluded that transgingival probing could be used as evaluating parameters to see the outcome of regenerative surgeries and the surgical reentry procedure may be avoided because it is a second surgical procedure, time-consuming and interrupts the healing process.

  11. Minimally invasive surgical technique for tethered surgical drains

    Directory of Open Access Journals (Sweden)

    Shane R Hess


    Full Text Available A feared complication of temporary surgical drain placement is from the technical error of accidentally suturing the surgical drain into the wound. Postoperative discovery of a tethered drain can frequently necessitate return to the operating room if it cannot be successfully removed with nonoperative techniques. Formal wound exploration increases anesthesia and infection risk as well as cost and is best avoided if possible. We present a minimally invasive surgical technique that can avoid the morbidity associated with a full surgical wound exploration to remove a tethered drain when other nonoperative techniques fail.

  12. Hard Probes at ATLAS

    CERN Document Server

    Citron, Z; The ATLAS collaboration


    The ATLAS collaboration has measured several hard probe observables in Pb+Pb and p+Pb collisions at the LHC. These measurements include jets which show modification in the hot dense medium of heavy ion collisions as well as color neutral electro-weak bosons. Together, they elucidate the nature of heavy ion collisions.

  13. One-Probe Search

    DEFF Research Database (Denmark)

    Östlin, Anna; Pagh, Rasmus


    We consider dictionaries that perform lookups by probing a single word of memory, knowing only the size of the data structure. We describe a randomized dictionary where a lookup returns the correct answer with probability 1 - e, and otherwise returns don't know. The lookup procedure uses an expan...

  14. Probing the Solar System (United States)

    Wilkinson, John


    Humans have always had the vision to one day live on other planets. This vision existed even before the first person was put into orbit. Since the early space missions of putting humans into orbit around Earth, many advances have been made in space technology. We have now sent many space probes deep into the Solar system to explore the planets and…

  15. One-Probe Search

    DEFF Research Database (Denmark)

    Östlin, Anna; Pagh, Rasmus


    We consider dictionaries that perform lookups by probing a single word of memory, knowing only the size of the data structure. We describe a randomized dictionary where a lookup returns the correct answer with probability 1 - e, and otherwise returns don't know. The lookup procedure uses an expan...

  16. Probing the Solar System (United States)

    Wilkinson, John


    Humans have always had the vision to one day live on other planets. This vision existed even before the first person was put into orbit. Since the early space missions of putting humans into orbit around Earth, many advances have been made in space technology. We have now sent many space probes deep into the Solar system to explore the planets and…

  17. Surgical scar revision: An overview

    Directory of Open Access Journals (Sweden)

    Shilpa Garg


    Full Text Available Scar formation is an inevitable consequence of wound healing from either a traumatic or a surgical intervention. The aesthetic appearance of a scar is the most important criteria to judge the surgical outcome. An understanding of the anatomy and wound healing along with experience, meticulous planning and technique can reduce complications and improve the surgical outcome. Scar revision does not erase a scar but helps to make it less noticeable and more acceptable. Both surgical and non-surgical techniques, used either alone or in combination can be used for revising a scar. In planning a scar revision surgeon should decide on when to act and the type of technique to use for scar revision to get an aesthetically pleasing outcome. This review article provides overview of methods applied for facial scar revision. This predominantly covers surgical methods.

  18. Tophi - surgical treatment. (United States)

    Słowińska, Iwona; Słowiński, Radosław; Rutkowska-Sak, Lidia


    Gout is an inflammatory joint disease associated with deposition of monosodium urate crystals in the bones forming the joints, in periarticular tissues and in other organs. The disease is one of the most frequent causes of disability. This paper presents the case of a 57-year-old male patient treated for generalised gout. A "clinical mask" suggesting another disease was the cause of making the correct diagnosis only six years after the occurrence of the first manifestations. The patient, with high values of inflammatory markers, severe pain and advanced joint destruction, was given an aggressive anti-inflammatory treatment. The unsatisfactory effect of the conservative treatment forced the authors to perform surgical resection of the gouty nodules in the hands. After several operations the function of the hand joints operated on, appearance of the hands and the quality of the patient's life improved significantly.

  19. Tophi – surgical treatment (United States)

    Słowińska, Iwona; Słowiński, Radosław


    Gout is an inflammatory joint disease associated with deposition of monosodium urate crystals in the bones forming the joints, in periarticular tissues and in other organs. The disease is one of the most frequent causes of disability. This paper presents the case of a 57-year-old male patient treated for generalised gout. A “clinical mask” suggesting another disease was the cause of making the correct diagnosis only six years after the occurrence of the first manifestations. The patient, with high values of inflammatory markers, severe pain and advanced joint destruction, was given an aggressive anti-inflammatory treatment. The unsatisfactory effect of the conservative treatment forced the authors to perform surgical resection of the gouty nodules in the hands. After several operations the function of the hand joints operated on, appearance of the hands and the quality of the patient’s life improved significantly. PMID:27994273

  20. Neuronavigation. Principles. Surgical technique. (United States)

    Ivanov, Marcel; Ciurea, Alexandru Vlad


    Neuronavigation and stereotaxy are techniques designed to help neurosurgeons precisely localize different intracerebral pathological processes by using a set of preoperative images (CT, MRI, fMRI, PET, SPECT etc.). The development of computer assisted surgery was possible only after a significant technological progress, especially in the area of informatics and imagistics. The main indications of neuronavigation are represented by the targeting of small and deep intracerebral lesions and choosing the best way to treat them, in order to preserve the neurological function. Stereotaxis also allows lesioning or stimulation of basal ganglia for the treatment of movement disorders. These techniques can bring an important amount of confort both to the patient and to the neurosurgeon. Neuronavigation was introduced in Romania around 2003, in four neurosurgical centers. We present our five-years experience in neuronavigation and describe the main principles and surgical techniques.

  1. Surgical education in Mexico. (United States)

    Cervantes, Jorge


    Surgical education in Mexico basically follows the same model as in the United States, with a selection process resembling the matching program. There is a 4-year training period during which residents in their third year spend 4 months as the sole surgeon in a rural community. During the senior year they are entitled to an elective period in a place of their choosing. After completion of the 4 years, residents have to present a thesis and undergo an oral examination before getting a university diploma. They are then encouraged to pass the written and oral examination of the Mexican Board of Surgery before they are fully certified to enter practice in a public or private hospital.

  2. EDITORIAL: Probing the nanoworld Probing the nanoworld (United States)

    Miles, Mervyn


    In nanotechnology, it is the unique properties arising from nanometre-scale structures that lead not only to their technological importance but also to a better understanding of the underlying science. Over the last twenty years, material properties at the nanoscale have been dominated by the properties of carbon in the form of the C60 molecule, single- and multi-wall carbon nanotubes, nanodiamonds, and recently graphene. During this period, research published in the journal Nanotechnology has revealed the amazing mechanical properties of such materials as well as their remarkable electronic properties with the promise of new devices. Furthermore, nanoparticles, nanotubes, nanorods, and nanowires from metals and dielectrics have been characterized for their electronic, mechanical, optical, chemical and catalytic properties. Scanning probe microscopy (SPM) has become the main characterization technique and atomic force microscopy (AFM) the most frequently used SPM. Over the past twenty years, SPM techniques that were previously experimental in nature have become routine. At the same time, investigations using AFM continue to yield impressive results that demonstrate the great potential of this powerful imaging tool, particularly in close to physiological conditions. In this special issue a collaboration of researchers in Europe report the use of AFM to provide high-resolution topographical images of individual carbon nanotubes immobilized on various biological membranes, including a nuclear membrane for the first time (Lamprecht C et al 2009 Nanotechnology 20 434001). Other SPM developments such as high-speed AFM appear to be making a transition from specialist laboratories to the mainstream, and perhaps the same may be said for non-contact AFM. Looking to the future, characterisation techniques involving SPM and spectroscopy, such as tip-enhanced Raman spectroscopy, could emerge as everyday methods. In all these advanced techniques, routinely available probes will

  3. Calibration Fixture For Anemometer Probes (United States)

    Lewis, Charles R.; Nagel, Robert T.


    Fixture facilitates calibration of three-dimensional sideflow thermal anemometer probes. With fixture, probe oriented at number of angles throughout its design range. Readings calibrated as function of orientation in airflow. Calibration repeatable and verifiable.

  4. Acquiring minimally invasive surgical skills

    NARCIS (Netherlands)

    Hiemstra, Ellen


    Many topics in surgical skills education have been implemented without a solid scientific basis. For that reason we have tried to find this scientific basis. We have focused on training and evaluation of minimally invasive surgical skills in a training setting and in practice in the operating room.

  5. Surgical innovations in canine gonadectomy

    NARCIS (Netherlands)

    Van Goethem, Bart


    In this thesis some recent technological developments in human surgery are evaluated for their potential use in veterinary medicine by introducing them as surgical innovations for canine gonadectomy. Barbed sutures achieve wound apposition without surgical knot tying and thus avoid knot-associated n

  6. Surgical treatment of acquired tracheocele. (United States)

    Porubsky, Edward A; Gourin, Christine G


    Acquired tracheoceles are rare clinical entities that can cause a variety of chronic and recurrent aerodigestive tract symptoms. The management of acquired tracheoceles is primarily conservative, but surgical intervention may be indicated for patients with refractory symptoms. We present a case of acquired tracheocele and describe a method of successful surgical management.

  7. Surgical innovations in canine gonadectomy

    NARCIS (Netherlands)

    Van Goethem, Bart


    In this thesis some recent technological developments in human surgery are evaluated for their potential use in veterinary medicine by introducing them as surgical innovations for canine gonadectomy. Barbed sutures achieve wound apposition without surgical knot tying and thus avoid knot-associated n

  8. Probing properties of cold radiofrequency plasma with polymer probe (United States)

    Bormashenko, E.; Chaniel, G.; Multanen, V.


    The probe intended for the characterization of cold plasma is introduced. The probe allows the estimation of Debye length of cold plasma. The probe is based on the pronounced modification of surface properties (wettability) of polymer films by cold plasmas. The probe was tested with the cold radiofrequency inductive air plasma discharge. The Debye length and the concentration of charge carriers were estimated for various gas pressures. The reported results coincide reasonably with the corresponding values established by other methods. The probe makes possible measurement of characteristics of cold plasmas in closed chambers.

  9. Probing Properties of Cold Radiofrequency Plasma with Polymer Probe

    CERN Document Server

    Bormashenko, Edward; Multanen, Victor


    The probe intended for the characterization of cold plasma is introduced. The probe allows estimation of the Debye length of the cold plasma. The probe is based on the pronounced modification of surface properties (wettability) of polymer films by cold plasmas. The probe was tested with the cold radiofrequency inductive air plasma discharge. The Debye length and the concentration of charge carriers were estimated for various gas pressures. The reported results coincide reasonably with the corresponding values established by other methods. The probe makes possible measurement of characteristics of cold plasmas in closed chambers.

  10. Phoenix Conductivity Probe (United States)


    This image taken by the Surface Stereo Imager on Sol 49, or the 49th Martian day of the mission (July 14, 2008), shows thermal and electrical conductivity probe on NASA's Phoenix Mars Lander's Robotic Arm. The Phoenix Mission is led by the University of Arizona, Tucson, on behalf of NASA. Project management of the mission is led by NASA's Jet Propulsion Laboratory, Pasadena, Calif. Spacecraft development is by Lockheed Martin Space Systems, Denver.

  11. Atom probe tomography today


    Alfred Cerezo; Peter H. Clifton; Mark J. Galtrey; Humphreys, Colin J.; Kelly, Thomas. F.; David J. Larson; Sergio Lozano-Perez; Marquis, Emmanuelle A.; Oliver, Rachel A.; Gang Sha; Keith Thompson; Mathijs Zandbergen; Roger L. Alvis


    This review aims to describe and illustrate the advances in the application of atom probe tomography that have been made possible by recent developments, particularly in specimen preparation techniques (using dual-beam focused-ion beam instruments) but also of the more routine use of laser pulsing. The combination of these two developments now permits atomic-scale investigation of site-specific regions within engineering alloys (e.g. at grain boundaries and in the vicinity of cracks) and also...

  12. Modeling of ballistic and trapping effects on the collection efficiency of holes and electrons separately for a planar mercuric iodide detector (HgI2

    Directory of Open Access Journals (Sweden)

    Cedric E. Beogo


    Full Text Available For the room temperature nuclear detector application, signal created in the detector depends not only to the energy of the incident photon but also to the position of the interaction. This can bring an incomplete charge collection caused by a deep-trapping or a ballistic deficit of charge carrier. Many scientists used to demonstrate their impact on the global efficiency of the charge collection. Here we show this effect, not globally but separately, according to the position where holes and electrons are created. It permits us to see the contribution of each kind of carrier in the signal formation. An analytical model of charge collection is developed firstly to take into account the deep-trapping only. Secondly, this model is improved adding the ballistic deficit effect. The deep-trapping contributes to reduce the efficiency of hole above all on thicker detector. In the other part, ballistic deficit reduce electron efficiency above all near anode in the negatively polarized detector.

  13. Einstein Inflationary Probe (EIP) (United States)

    Hinshaw, Gary


    I will discuss plans to develop a concept for the Einstein Inflation Probe: a mission to detect gravity waves from inflation via the unique signature they impart to the cosmic microwave background (CMB) polarization. A sensitive CMB polarization satellite may be the only way to probe physics at the grand-unified theory (GUT) scale, exceeding by 12 orders of magnitude the energies studied at the Large Hadron Collider. A detection of gravity waves would represent a remarkable confirmation of the inflationary paradigm and set the energy scale at which inflation occurred when the universe was a fraction of a second old. Even a strong upper limit to the gravity wave amplitude would be significant, ruling out many common models of inflation, and pointing to inflation occurring at much lower energy, if at all. Measuring gravity waves via the CMB polarization will be challenging. We will undertake a comprehensive study to identify the critical scientific requirements for the mission and their derived instrumental performance requirements. At the core of the study will be an assessment of what is scientifically and experimentally optimal within the scope and purpose of the Einstein Inflation Probe.

  14. Nanoscale thermal probing

    Directory of Open Access Journals (Sweden)

    Yanan Yue


    Full Text Available Nanoscale novel devices have raised the demand for nanoscale thermal characterization that is critical for evaluating the device performance and durability. Achieving nanoscale spatial resolution and high accuracy in temperature measurement is very challenging due to the limitation of measurement pathways. In this review, we discuss four methodologies currently developed in nanoscale surface imaging and temperature measurement. To overcome the restriction of the conventional methods, the scanning thermal microscopy technique is widely used. From the perspective of measuring target, the optical feature size method can be applied by using either Raman or fluorescence thermometry. The near-field optical method that measures nanoscale temperature by focusing the optical field to a nano-sized region provides a non-contact and non-destructive way for nanoscale thermal probing. Although the resistance thermometry based on nano-sized thermal sensors is possible for nanoscale thermal probing, significant effort is still needed to reduce the size of the current sensors by using advanced fabrication techniques. At the same time, the development of nanoscale imaging techniques, such as fluorescence imaging, provides a great potential solution to resolve the nanoscale thermal probing problem.

  15. Post-Surgical Clinical Monitoring of Soft Tissue Wound Healing in Periodontal and Implant Surgery. (United States)

    Pippi, Roberto


    Clinical features of surgical soft tissue wound healing in dentistry have been rarely discussed in the international literature. The aim of the present paper is to highlight both the main clinical findings of surgical wound healing, especially in periodontal and implant dentistry, and the wound healing monitoring procedures which should be followed. Wound inspection after careful food and plaque debridement is the essential part of wound healing monitoring. Periodontal and peri-implant probing should be performed only after tissue healing has been completed and not on a weekly basis in peri-implant tissue monitoring. Telephone follow-up and patient self-assessment scales can also be used the days following surgery to monitor the most common surgical complications such as pain, swelling, bleeding, and bruising. Wound healing monitoring is an important concern in all surgical procedures since it allows to identify signs or/and symptoms possibly related to surgical complications.

  16. Nine New Fluorescent Probes (United States)

    Lin, Tsung-I.; Jovanovic, Misa V.; Dowben, Robert M.


    Absorption and fluorescence spectroscopic studies are reported here for nine new fluorescent probes recently synthesized in our laboratories: four pyrene derivatives with substituents of (i) 1,3-diacetoxy-6,8-dichlorosulfonyl, (ii) 1,3-dihydroxy-6,8-disodiumsulfonate, (iii) 1,3-disodiumsulfonate, and (iv) l-ethoxy-3,6,8-trisodiumsulfonate groups, and five [7-julolidino] coumarin derivatives with substituents of (v) 3-carboxylate-4-methyl, (vi) 3- methylcarboxylate, (vii) 3-acetate-4-methyl, (viii) 3-propionate-4-methyl, and (ix) 3-sulfonate-4-methyl groups. Pyrene compounds i and ii and coumarin compounds v and vi exhibit interesting absorbance and fluorescence properties: their absorption maxima are red shifted compared to the parent compound to the blue-green region, and the band width broadens considerably. All four blue-absorbing dyes fluoresce intensely in the green region, and the two pyrene compounds emit at such long wavelengths without formation of excimers. The fluorescence properties of these compounds are quite environment-sensitive: considerable spectral shifts and fluorescence intensity changes have been observed in the pH range from 3 to 10 and in a wide variety of polar and hydrophobic solvents with vastly different dielectric constants. The high extinction and fluorescence quantum yield of these probes make them ideal fluorescent labeling reagents for proteins, antibodies, nucleic acids, and cellular organelles. The pH and hydrophobicity-dependent fluorescence changes can be utilized as optical pH and/or hydrophobicity indicators for mapping environmental difference in various cellular components in a single cell. Since all nine probes absorb in the UV, but emit at different wavelengths in the visible, these two groups of compounds offer an advantage of utilizing a single monochromatic light source (e.g., a nitrogen laser) to achieve multi-wavelength detection for flow cytometry application. As a first step to explore potential application in

  17. Surgical infection in art. (United States)

    Meakins, J L


    The earliest images of medicine and surgery in Western art are from the late Middle Ages. Although often attractive, at that time they were illustrative and mirrored the text on how to diagnose or treat a specific condition. These drawings in medieval manuscripts represent management of abscesses, perianal infection and fistulas, amputation, and wound dressings. With the Renaissance, art in all its forms flourished, and surgeons were represented at work draining carbuncles, infected bursae, and mastoiditis; managing ulcers, scrofula, and skin infections; and performing amputations. Specific diagnosis can be made, such as streptococcal infection in the discarded leg of the miraculous transplantation performed by Saints Cosmas and Damian and in the works of Rembrandt van Rijn and Frederic Bazille. Evocations of cytokine activity are evident in works by Albrecht Dürer, Edvard Munch, and James Tissot. The iconography of society's view of a surgeon is apparent and often not complimentary. The surgeon's art is a visual art. Astute observation leads to early diagnosis and better results in surgical infection and the septic state. Learning to see what we look at enhances our appreciation of the world around us but, quite specifically, makes us better clinicians.

  18. Laser thermal probe recanalization of occluded arteries. (United States)

    White, R A; White, G H


    Applications of laser energy for treatment of vascular disease have recently received much attention; metal-tipped laser probes are being investigated as a device for recanalization of occluded arteries, especially as an adjunct to balloon dilatation. Developments in instrumentation and techniques have reduced the incidence of complications, notably perforation, to an acceptable level. Initial data show that recanalization of iliac, femoral, and popliteal lesions can be accomplished in a majority of cases, with the chance of success being inversely proportional to the length of occlusion. Results in the tibial vessels are disappointing. Patency of the treated vessels at 12 months appears to be superior to that of percutaneous transluminal angioplasty for similar lesions but inferior to that of surgical bypass for all occlusions greater than 3 cm in length.

  19. Surgical Robotics Research in Cardiovascular Disease

    Energy Technology Data Exchange (ETDEWEB)

    Pohost, Gerald M; Guthrie, Barton L; Steiner, Charles


    This grant is to support a research in robotics at three major medical centers: the University of Southern California-USC- (Project 1); the University of Alabama at Birmingham-UAB-(Project 2); and the Cleveland Clinic Foundation-CCF-(Project 3). Project 1 is oriented toward cardiovascular applications, while projects 2 and 3 are oriented toward neurosurgical applications. The main objective of Project 1 is to develop an approach to assist patients in maintaining a constant level of stress while undergoing magnetic resonance imaging or spectroscopy. The specific project is to use handgrip to detect the changes in high energy phosphate metabolism between rest and stress. The high energy phosphates, ATP and phosphocreatine (PCr) are responsible for the energy of the heart muscle (myocardium) responsible for its contractile function. If the blood supply to the myocardium in insufficient to support metabolism and contractility during stress, the high energy phosphates, particularly PCr, will decrease in concentration. The high energy phosphates can be tracked using phosphorus-31 magnetic resonance spectroscopy ({sup 31}P MRS). In Project 2 the UAB Surgical Robotics project focuses on the use of virtual presence to assist with remote surgery and surgical training. The goal of this proposal was to assemble a pilot system for proof of concept. The pilot project was completed successfully and was judged to demonstrate that the concept of remote surgical assistance as applied to surgery and surgical training was feasible and warranted further development. The main objective of Project 3 is to develop a system to allow for the tele-robotic delivery of instrumentation during a functional neurosurgical procedure (Figure 3). Instrumentation such as micro-electrical recording probes or deep brain stimulation leads. Current methods for the delivery of these instruments involve the integration of linear actuators to stereotactic navigation systems. The control of these delivery

  20. Development of Mackintosh Probe Extractor (United States)

    Rahman, Noor Khazanah A.; Kaamin, Masiri; Suwandi, Amir Khan; Sahat, Suhaila; Jahaya Kesot, Mohd


    Dynamic probing is a continuous soil investigation technique, which is one of the simplest soil penetration test. It basically consist of repeatedly driving a metal tipped probe into the ground using a drop weight of fixed mass and travel. Testing was carried out continuously from ground level to the final penetration depth. Once the soil investigation work done, it is difficult to pull out the probe rod from the ground, due to strong soil structure grip against probe cone and prevent the probe rod out from the ground. Thus, in this case, a tool named Extracting Probe was created to assist in the process of retracting the probe rod from the ground. In addition, Extracting Probe also can reduce the time to extract the probe rod from the ground compare with the conventional method. At the same time, it also can reduce manpower cost because only one worker involve to handle this tool compare with conventional method used two or more workers. From experiment that have been done we found that the time difference between conventional tools and extracting probe is significant, average time difference is 155 minutes. In addition the extracting probe can reduce manpower usage, and also labour cost for operating the tool. With all these advantages makes this tool has the potential to be marketed.

  1. Probe-based data storage

    CERN Document Server

    Koelmans, Wabe W; Abelmann, L


    Probe-based data storage attracted many researchers from academia and industry, resulting in unprecendeted high data-density demonstrations. This topical review gives a comprehensive overview of the main contributions that led to the major accomplishments in probe-based data storage. The most investigated technologies are reviewed: topographic, phase-change, magnetic, ferroelectric and atomic and molecular storage. Also, the positioning of probes and recording media, the cantilever arrays and parallel readout of the arrays of cantilevers are discussed. This overview serves two purposes. First, it provides an overview for new researchers entering the field of probe storage, as probe storage seems to be the only way to achieve data storage at atomic densities. Secondly, there is an enormous wealth of invaluable findings that can also be applied to many other fields of nanoscale research such as probe-based nanolithography, 3D nanopatterning, solid-state memory technologies and ultrafast probe microscopy.

  2. The Surgical Treatment of Mycetoma. (United States)

    Suleiman, Suleiman Hussein; Wadaella, El Sammani; Fahal, Ahmed Hassan


    Surgical intervention is an integral component in the diagnosis and management of mycetoma. Surgical treatment is indicated for small, localised lesions and massive lesions to reduce the mycetoma load and to enable better response to medical therapy. It is also a life-saving procedure in patients with massive disease and sepsis. Surgical options for mycetoma treatment range from a wide local surgical excision to repetitive debridement excisions to amputation of the affected part. Adequate anaesthesia, a bloodless field, wide local excision with adequate safety margins in a suitable surgical facility, and expert surgeons are mandatory to achieve the best surgical outcome. Surgical intervention in mycetoma is associated with considerable morbidity, deformities, and disabilities, particularly in advanced disease. These complications can be reduced by educating patients to seek medical advice earlier when the lesion is small, localised, and amenable to surgery. There is no evidence for mycetoma hospital cross infection. This communication is based on the authors' experience in managing over 7,200 mycetoma patients treated at the Mycetoma Research Centre, University of Khartoum, Sudan.

  3. The Surgical Treatment of Mycetoma.

    Directory of Open Access Journals (Sweden)

    Suleiman Hussein Suleiman


    Full Text Available Surgical intervention is an integral component in the diagnosis and management of mycetoma. Surgical treatment is indicated for small, localised lesions and massive lesions to reduce the mycetoma load and to enable better response to medical therapy. It is also a life-saving procedure in patients with massive disease and sepsis. Surgical options for mycetoma treatment range from a wide local surgical excision to repetitive debridement excisions to amputation of the affected part. Adequate anaesthesia, a bloodless field, wide local excision with adequate safety margins in a suitable surgical facility, and expert surgeons are mandatory to achieve the best surgical outcome. Surgical intervention in mycetoma is associated with considerable morbidity, deformities, and disabilities, particularly in advanced disease. These complications can be reduced by educating patients to seek medical advice earlier when the lesion is small, localised, and amenable to surgery. There is no evidence for mycetoma hospital cross infection. This communication is based on the authors' experience in managing over 7,200 mycetoma patients treated at the Mycetoma Research Centre, University of Khartoum, Sudan.

  4. Surgical treatment of pediatric rhinosinusitis. (United States)

    Isaacson, G


    Pediatric rhinosinusitis is a common sequela of upper respiratory infections in children. It is usually a self-limited disease, sometimes requiring antibiotic therapy. Surgery may be indicated in children who suffer complication of acute rhinosinusitis, severe recurrent acute rhinosinusitis, rhinosinusitis in cystic fibrosis with or without polyposis, chronic rhinosinusitis refractory to maximal medical management, allergic fungal sinusitis, and paranasal sinus mucoceles. Surgical options include, adenoidectomy, sinus puncture and lavage, open surgical approaches, endoscopic sinus surgery, balloon sinuplasty, and turbinectomy or turbinate reduction. This paper reviews the anatomy and physiology of rhinosinusitis in children and current knowledge of the indications and best methods of surgical treatment.

  5. Towards Safe Robotic Surgical Systems

    DEFF Research Database (Denmark)

    Sloth, Christoffer; Wisniewski, Rafael


    A proof of safety is paramount for an autonomous robotic surgical system to ensure that it does not cause trauma to patients. However, a proof of safety is rarely constructed, as surgical systems are too complex to be dealt with by most formal verification methods. In this paper, we design...... a controller for motion compensation in beating-heart surgery, and prove that it is safe, i.e., the surgical tool is kept within an allowable distance and orientation of the heart. We solve the problem by simultaneously finding a control law and a barrier function. The motion compensation system is simulated...

  6. Surgical Skills Beyond Scientific Management (United States)

    Whitfield, Nicholas


    During the Great War, the French surgeon Alexis Carrel, in collaboration with the English chemist Henry Dakin, devised an antiseptic treatment for infected wounds. This paper focuses on Carrel’s attempt to standardise knowledge of infected wounds and their treatment, and looks closely at the vision of surgical skill he espoused and its difference from those associated with the doctrines of scientific management. Examining contemporary claims that the Carrel–Dakin method increased rather than diminished demands on surgical work, this paper further shows how debates about antiseptic wound treatment opened up a critical space for considering the nature of skill as a vital dynamic in surgical innovation and practice. PMID:26090737

  7. Retained surgical sponge: An enigma

    Directory of Open Access Journals (Sweden)

    Gurjit Singh


    Full Text Available Retained surgical sponge in the body following a surgery is called "gossypiboma". A 27-year-old female who had undergone lower segment cesarean section 4 months earlier was admitted with complaints of pain abdomen with a palpable mass in left iliac fossa. X-ray, ultrasonography, and CT scan findings were suggestive of retained surgical sponge. Surgical sponge was removed following laparotomy. Surgeons must be aware of the risk factors that lead to gossypiboma, and measures should be taken to prevent it. Besides increasing morbidity and possible mortality, it may result in libel suit for compensation.

  8. Surgical research using national databases. (United States)

    Alluri, Ram K; Leland, Hyuma; Heckmann, Nathanael


    Recent changes in healthcare and advances in technology have increased the use of large-volume national databases in surgical research. These databases have been used to develop perioperative risk stratification tools, assess postoperative complications, calculate costs, and investigate numerous other topics across multiple surgical specialties. The results of these studies contain variable information but are subject to unique limitations. The use of large-volume national databases is increasing in popularity, and thorough understanding of these databases will allow for a more sophisticated and better educated interpretation of studies that utilize such databases. This review will highlight the composition, strengths, and weaknesses of commonly used national databases in surgical research.

  9. Surgical education through video broadcasting. (United States)

    Nagengast, Eric S; Ramos, Margarita S; Sarma, Hiteswar; Deshpande, Gaurav; Hatcher, Kristin; Magee, William P; Campbell, Alex


    Surgical training is facing new obstacles. As advancements in medicine are made, surgeons are expected to know more and to be able to perform more procedures. In the western world, increasing restrictions on residency work hours are adding a new hurdle to surgical training. In low-resource settings, a low attending-to-resident ratio results in limited operative experience for residents. Advances in telemedicine may offer new methods for surgical training. In this article, the authors share their unique experience using live video broadcasting of surgery for educational purposes at a comprehensive cleft care center in Guwahati, India.

  10. PROcess Based Diagnostics PROBE (United States)

    Clune, T.; Schmidt, G.; Kuo, K.; Bauer, M.; Oloso, H.


    Many of the aspects of the climate system that are of the greatest interest (e.g., the sensitivity of the system to external forcings) are emergent properties that arise via the complex interplay between disparate processes. This is also true for climate models most diagnostics are not a function of an isolated portion of source code, but rather are affected by multiple components and procedures. Thus any model-observation mismatch is hard to attribute to any specific piece of code or imperfection in a specific model assumption. An alternative approach is to identify diagnostics that are more closely tied to specific processes -- implying that if a mismatch is found, it should be much easier to identify and address specific algorithmic choices that will improve the simulation. However, this approach requires looking at model output and observational data in a more sophisticated way than the more traditional production of monthly or annual mean quantities. The data must instead be filtered in time and space for examples of the specific process being targeted.We are developing a data analysis environment called PROcess-Based Explorer (PROBE) that seeks to enable efficient and systematic computation of process-based diagnostics on very large sets of data. In this environment, investigators can define arbitrarily complex filters and then seamlessly perform computations in parallel on the filtered output from their model. The same analysis can be performed on additional related data sets (e.g., reanalyses) thereby enabling routine comparisons between model and observational data. PROBE also incorporates workflow technology to automatically update computed diagnostics for subsequent executions of a model. In this presentation, we will discuss the design and current status of PROBE as well as share results from some preliminary use cases.

  11. Surgical Templates for Dental Implant Positioning; Current ...

    African Journals Online (AJOL)

    applied scientifically based research techniques to develop an endosseous implant that forms ... KEYWORDS: Dental implants, surgical templates, surgical procedure, stent .... during the surgical stage for single implant therapy.[24] Afterward,.

  12. Atom probe tomography today

    Directory of Open Access Journals (Sweden)

    Alfred Cerezo


    Full Text Available This review aims to describe and illustrate the advances in the application of atom probe tomography that have been made possible by recent developments, particularly in specimen preparation techniques (using dual-beam focused-ion beam instruments but also of the more routine use of laser pulsing. The combination of these two developments now permits atomic-scale investigation of site-specific regions within engineering alloys (e.g. at grain boundaries and in the vicinity of cracks and also the atomic-level characterization of interfaces in multilayers, oxide films, and semiconductor materials and devices.

  13. Experimental probes of axions

    Energy Technology Data Exchange (ETDEWEB)

    Chou, Aaron S.; /Fermilab


    Experimental searches for axions or axion-like particles rely on semiclassical phenomena resulting from the postulated coupling of the axion to two photons. Sensitive probes of the extremely small coupling constant can be made by exploiting familiar, coherent electromagnetic laboratory techniques, including resonant enhancement of transitions using microwave and optical cavities, Bragg scattering, and coherent photon-axion oscillations. The axion beam may either be astrophysical in origin as in the case of dark matter axion searches and solar axion searches, or created in the laboratory from laser interactions with magnetic fields. This note is meant to be a sampling of recent experimental results.

  14. Atom Probe Tomography 2012 (United States)

    Kelly, Thomas F.; Larson, David J.


    In the world of tomographic imaging, atom probe tomography (APT) occupies the high-spatial-resolution end of the spectrum. It is highly complementary to electron tomography and is applicable to a wide range of materials. The current state of APT is reviewed. Emphasis is placed on applications and data analysis as they apply to many fields of research and development including metals, semiconductors, ceramics, and organic materials. We also provide a brief review of the history and the instrumentation associated with APT and an assessment of the existing challenges in the field.

  15. Mobile Probing Kit

    DEFF Research Database (Denmark)

    Larsen, Jakob Eg; Sørensen, Lene Tolstrup; Sørensen, J.K.


    characterized as being highly nomadic and thus potential users of mobile and ubiquitous technologies. The methodology has been applied in the 1ST MAGNET Beyond project in order to obtain user needs and requirements in the process of developing pilot services. We report on the initial findings from applying......Mobile Probing Kit is a low tech and low cost methodology for obtaining inspiration and insights into user needs, requirements and ideas in the early phases of a system's development process. The methodology is developed to identify user needs, requirements and ideas among knowledge workers...

  16. Evidence-based surgical wound care on surgical wound infection. (United States)

    Reilly, Jaqueline


    Surgical wound infection is an important outcome indicator in the postoperative period. A 3-year prospective cohort epidemiological study of 2202 surgical patients from seven surgical wards across two hospitals was carried out using gold standard surveillance methodology. This involved following patients up as inpatients and postdischarge surveillance to 30 days by an independent observer. The results led to the development of a mathematical model for risk of clean, elective surgical wound infection. Risk of surgical wound infection was increased by smoking, higher body mass index, presence of malignancy, haematoma formation, increasing numbers of people in theatre, adherent dressing usage, and higher times to suture removal (P<0.05). The results show that this type of surveillance is an effective way of collecting accurate data on wound infection rates. It was noted that patient care practices affected the surgical wound infection rate and the surveillance was used to facilitate the adoption of evidence-based practice, through recommendations for clean surgery, to reduce the risk from extrinsic risk factors for wound infection. As a result of the implementation of this evidence-based practice there was a significant reduction (P<0.05) in the clean wound infection rate.

  17. Development of a fiber based Raman probe compatible with interventional magnetic resonance imaging (United States)

    Ashok, Praveen C.; Praveen, Bavishna B.; Rube, Martin; Cox, Benjamin; Melzer, Andreas; Dholakia, Kishan


    Raman spectroscopy has proven to be a powerful tool for discriminating between normal and abnormal tissue types. Fiber based Raman probes have demonstrated its potential for in vivo disease diagnostics. Combining Raman spectroscopy with Magnetic Resonance Imaging (MRI) opens up new avenues for MR guided minimally invasive optical biopsy. Although Raman probes are commercially available, they are not compatible with a MRI environment due to the metallic components which are used to align the micro-optic components such as filters and lenses at the probe head. Additionally they are not mechanically compatible with a typical surgical environment as factors such as sterility and length of the probe are not addressed in those designs. We have developed an MRI compatible fiber Raman probe with a disposable probe head hence maintaining sterility. The probe head was specially designed to avoid any material that would cause MR imaging artefacts. The probe head that goes into patient's body had a diameter biopsy needles and catheters. The probe has been tested in MR environment and has been proven to be capable of obtaining Raman signal while the probe is under real-time MR guidance.

  18. Surgical Treatment of Winged Scapula

    National Research Council Canada - National Science Library

    Galano, Gregory J; Bigliani, Louis U; Ahmad, Christopher S; Levine, William N


    .... Although nonoperative treatment is successful in some patients, failures have led to the evolution of surgical techniques involving various combinations of fascial graft and/or transfer of adjacent muscles...

  19. Essential Tremor (ET): Surgical Options (United States)

    ... t respond to propranolol, primidone, or other common ET medications and whose tremor has become debilitating, there ... treatments were first introduced. Current surgical options for ET include Deep Brain Stimulation (DBS) , Focused Ultrasound Thalamotomy , ...

  20. Surgical treatment of cranial neuralgias. (United States)

    Franzini, Angelo; Ferroli, Paolo; Messina, Giuseppe; Broggi, Giovanni


    The most common types of cranial neuralgias amenable to surgical therapeutic options are trigeminal neuralgia and glossopharyngeal neuralgia, the former having an approximate incidence of 5/100000 cases per year and the latter of 0.05/100000 cases per year. Surgical therapy of these pathological conditions encompasses several strategies, going from ablative procedures to neurovascular decompression, to radiosurgery. The choice of the most appropriate surgical option (which must be taken into account when all conservative treatments have proven to be unsuccessful) has to take into account many factors, the most important ones being neuroradiological evidence of a neurovascular conflict, severity of symptoms, the age and clinical history of the patient, and the patient's overall medical condition. In this chapter we report our experience with the treatment of trigeminal and glossopharyngeal neuralgia, describing the surgical procedures performed and reviewing the most recent aspects on this subject in the past literature.

  1. Surgical trainees and trauma emergencies. (United States)

    Wybaillie, E; Broos, P L O


    An accident and emergency (A&E) training has been suggested as an essential part of the basic surgical training. The A&E curriculum should be divided into three sections: a critical curriculum, a core curriculum and a comprehensive curriculum. For instance, the critical curriculum contains topics that provide the opportunity to translate the ABCDE principles of trauma management into practice. Furthermore, a post in the A&E department provides the surgical trainee with significant exposure to the management of the polytrauma patient and to the management of other acute general surgical, urological and orthopaedic conditions. By presenting better educational programs and by reducing the non-medical tasks a trainee has to deal with, the education of surgical trainees during A&E attachment can be improved.

  2. Access to Specialized Surgical Care

    African Journals Online (AJOL)

    to reduce the global burden of disease (GBD), it is ... global players have supported efforts to improve access and safety of surgery ... (i) strengthening surgical services at district hospitals ... of the surrounding community and a model for other.

  3. Intermittent exotropia: Surgical treatment strategies

    Directory of Open Access Journals (Sweden)

    Jai Aditya Kelkar


    Full Text Available Surgical management of intermittent exotropias (IXTs is ambiguous, with techniques of management varying widely between institutions. This review aims to examine available literature on the surgical management of IXT. A literature search was performed using PubMed, Web of Knowledge, LILACS, and the University of Liverpool Orthoptic Journals and Conference Transactions Database. All English-language papers published between 1958 and the present day were considered.

  4. Aesthetic Surgical Crown Lengthening Procedure. (United States)

    de Oliveira, Pablo Santos; Chiarelli, Fabio; Rodrigues, José A; Shibli, Jamil A; Zizzari, Vincenzo Luca; Piattelli, Adriano; Iezzi, Giovanna; Perrotti, Vittoria


    The aim of this case report was to describe the surgical sequence of crown lengthening to apically reposition the dentogingival complex, in addition to an esthetic restorative procedure. Many different causes can be responsible for short clinical crown. In these cases, the correct execution of a restorative or prosthetic rehabilitation requires an increasing of the crown length. According to the 2003 American Academy of Periodontology (Practice Profile Survey), crown lengthening is the most habitual surgical periodontal treatment.

  5. Aesthetic Surgical Crown Lengthening Procedure (United States)

    de Oliveira, Pablo Santos; Chiarelli, Fabio; Rodrigues, José A.; Shibli, Jamil A.; Zizzari, Vincenzo Luca; Piattelli, Adriano; Iezzi, Giovanna; Perrotti, Vittoria


    The aim of this case report was to describe the surgical sequence of crown lengthening to apically reposition the dentogingival complex, in addition to an esthetic restorative procedure. Many different causes can be responsible for short clinical crown. In these cases, the correct execution of a restorative or prosthetic rehabilitation requires an increasing of the crown length. According to the 2003 American Academy of Periodontology (Practice Profile Survey), crown lengthening is the most habitual surgical periodontal treatment. PMID:26609452

  6. Aesthetic Surgical Crown Lengthening Procedure

    Directory of Open Access Journals (Sweden)

    Pablo Santos de Oliveira


    Full Text Available The aim of this case report was to describe the surgical sequence of crown lengthening to apically reposition the dentogingival complex, in addition to an esthetic restorative procedure. Many different causes can be responsible for short clinical crown. In these cases, the correct execution of a restorative or prosthetic rehabilitation requires an increasing of the crown length. According to the 2003 American Academy of Periodontology (Practice Profile Survey, crown lengthening is the most habitual surgical periodontal treatment.

  7. Surgical Treatment of Facial Paralysis


    Mehta, Ritvik P.


    The management of facial paralysis is one of the most complex areas of reconstructive surgery. Given the wide variety of functional and cosmetic deficits in the facial paralysis patient, the reconstructive surgeon requires a thorough understanding of the surgical techniques available to treat this condition. This review article will focus on surgical management of facial paralysis and the treatment options available for acute facial paralysis (2 yr). For acute facial paralysis, the main surgi...

  8. Innovation in pediatric surgical education. (United States)

    Clifton, Matthew S; Wulkan, Mark L


    Pediatric surgical training in the United States remained basically unchanged from the model developed by Ladd and Gross in the 1930s until recently. Standardized curriculum and novel evaluation methods are now being implemented. Pediatric Surgical education is currently undergoing a transition to competency-based evaluation and promotion. Unfortunately, there is little data on the efficacy of these changes. This presents an opportunity for further study of how we conduct training, and how we evaluate and promote our trainees.

  9. Development of nanowire arrays for neural probe (United States)

    Abraham, Jose K.; Xie, Jining; Varadan, Vijay K.


    It is already established that functional electrical stimulation is an effective way to restore many functions of the brain in disabled individuals. The electrical stimulation can be done by using an array of electrodes. Neural probes stimulate or sense the biopotentials mainly through the exposed metal sites. These sites should be smaller relative to the spatial potential distribution so that any potential averaging in the sensing area can be avoided. At the same time, the decrease in size of these sensing sites is limited due to the increase in impedance levels and the thermal noise while decreasing its size. It is known that current density in a planar electrode is not uniform and a higher current density can be observer around the perimeter of the electrodes. Electrical measurements conducted on many nanotubes and nanowires have already proved that it could be possible to use for current density applications and the drawbacks of the present design in neural probes can be overcome by incorporating many nanotechnology solutions. In this paper we present the design and development of nanowire arrays for the neural probe for the multisite contact which has the ability to collect and analyze isolated single unit activity. An array of vertically grown nanowires is used as contact site and many of such arrays can be used for stimulating as well as recording sites. The nanolevel interaction and wireless communication solution can extend to applications involving the treatment of many neurological disorders including Parkinson"s disease, Alzheimer"s disease, spinal injuries and the treatment of blindness and paralyzed patients with minimal or no invasive surgical procedures.

  10. Evolution of surgical skills training

    Institute of Scientific and Technical Information of China (English)

    Kurt E Roberts; Robert L Bell; Andrew J Duffy


    Surgical training is changing: one hundred years of tradition is being challenged by legal and ethical concerns for patient safety, work hours restrictions, the cost of operating room time, and complications. Surgical simulation and skills training offers an opportunity to teach and practice advanced skills outside of the operating room environment before attempting them on living patients.Simulation training can be as straight forward as using real instruments and video equipment to manipulate simulated "tissue" in a box trainer. More advanced,virtual reality simulators are now available and ready for widespread use. Early systems have demonstrated their effectiveness and discriminative ability. Newer systems enable the development of comprehensive curricula and full procedural simulations.The Accreditation Council of Graduate Medical Education's (ACGME) has mandated the development of novel methods of training and evaluation. Surgical organizations are calling for methods to ensure the maintenance of skills, advance surgical training, and to credential surgeons as technically competent.Simulators in their current form have been demonstrated to improve the operating room performance of surgical residents. Development of standardized training curricula remains an urgent and important agenda, particularly for minimal invasive surgery.An innovative and progressive approach, borrowing experiences from the field of aviation, can provide the foundation for the next century of surgical training,ensuring the quality of the product. As the technology develops, the way we practice will continue to evolve, to the benefit of physicians and patients.

  11. Bacterial migration through punctured surgical gloves under real surgical conditions

    Directory of Open Access Journals (Sweden)

    Heidecke Claus-Dieter


    Full Text Available Abstract Background The aim of this study was to confirm recent results from a previous study focussing on the development of a method to measure the bacterial translocation through puncture holes in surgical gloves under real surgical conditions. Methods An established method was applied to detect bacterial migration from the operating site through the punctured glove. Biogel™ double-gloving surgical gloves were used during visceral surgeries over a 6-month period. A modified Gaschen-bag method was used to retrieve organisms from the inner glove, and thus-obtained bacteria were compared with micro-organisms detected by an intra-operative swab. Results In 20 consecutive procedures, 194 gloves (98 outer gloves, 96 inner gloves were examined. The rate of micro-perforations of the outer surgical glove was 10% with a median wearing time of 100 minutes (range: 20-175 minutes. Perforations occurred in 81% on the non-dominant hand, with the index finger most frequently (25% punctured. In six cases, bacterial migration could be demonstrated microbiologically. In 5% (5/98 of outer gloves and in 1% (1/96 of the inner gloves, bacterial migration through micro-perforations was observed. For gloves with detected micro-perforations (n = 10 outer layers, the calculated migration was 50% (n = 5. The minimum wearing time was 62 minutes, with a calculated median wearing time of 71 minutes. Conclusions This study confirms previous results that bacterial migration through unnoticed micro-perforations in surgical gloves does occur under real practical surgical conditions. Undetected perforation of surgical gloves occurs frequently. Bacterial migration from the patient through micro-perforations on the hand of surgeons was confirmed, limiting the protective barrier function of gloves if worn over longer periods.

  12. Minimally invasive surgical techniques in periodontal regeneration. (United States)

    Cortellini, Pierpaolo


    A review of the current scientific literature was undertaken to evaluate the efficacy of minimally invasive periodontal regenerative surgery in the treatment of periodontal defects. The impact on clinical outcomes, surgical chair-time, side effects and patient morbidity were evaluated. An electronic search of PUBMED database from January 1987 to December 2011 was undertaken on dental journals using the key-word "minimally invasive surgery". Cohort studies, retrospective studies and randomized controlled clinical trials referring to treatment of periodontal defects with at least 6 months of follow-up were selected. Quality assessment of the selected studies was done through the Strength of Recommendation Taxonomy Grading (SORT) System. Ten studies (1 retrospective, 5 cohorts and 4 RCTs) were included. All the studies consistently support the efficacy of minimally invasive surgery in the treatment of periodontal defects in terms of clinical attachment level gain, probing pocket depth reduction and minimal gingival recession. Six studies reporting on side effects and patient morbidity consistently indicate very low levels of pain and discomfort during and after surgery resulting in a reduced intake of pain-killers and very limited interference with daily activities in the post-operative period. Minimally invasive surgery might be considered a true reality in the field of periodontal regeneration. The observed clinical improvements are consistently associated with very limited morbidity to the patient during the surgical procedure as well as in the post-operative period. Minimally invasive surgery, however, cannot be applied at all cases. A stepwise decisional algorithm should support clinicians in choosing the treatment approach.

  13. The Antartic Ice Borehole Probe (United States)

    Behar, A.; Carsey, F.; Lane, A.; Engelhardt, H.


    The Antartic Ice Borehole Probe mission is a glaciological investigation, scheduled for November 2000-2001, that will place a probe in a hot-water drilled hole in the West Antartic ice sheet. The objectives of the probe are to observe ice-bed interactions with a downward looking camera, and ice inclusions and structure, including hypothesized ice accretion, with a side-looking camera.

  14. FY1995 development of a endoscopic surgical system utilizing multi-modal functional images; 1995 nendo tashu kino gazo wo mochiiru teishinshu naishikyo shujutsu system no kaihatsu

    Energy Technology Data Exchange (ETDEWEB)



    The purpose of this study is to develop an endoscope system for neurosurgery that can provide not only conventional endoscopic images but also ultraviolet-visible spectra, fluorescence spectra, near infrared spectra, and ultra-soundimages of tissue aiming for real-time identification of pathological tissue. The system also incorporates surgical manipulator and devices such as micro forceps and laser surgical instruments for endoscopic image guided surgery. Surgical Manipulator should be a high performance and easy to operate surgical instrument as well as conventional surgical tools such as scissors and knife. Since living tissue deforms during surgical operation, pre-operative three dimensional information for registration of pathological tissue should be modified based on information obtained during surgery. Thus surgical manipulator should be operated under guidance of surgeon's observation. Consequently, surgical manipulator should have various types of imaging and measurement devices such as an endoscope and an ultrasound imaging probe at its end effectors. Based on this concept, a prototype of a new multi channel surgical manipulator system CM cube (CM3, Computer aided Micro Multichannel Manipulator) that has various types of imaging and measurement devices such as ultra-violet-visible camera for spectroscopic measurement, ultra-sound imaging probe, three dimensional endoscope, together with micro surgical instruments and laser surgical systems has been developed. Its performance was evaluated through in vitro/in vivo experiments and clinical application. (NEDO)

  15. Surgical versus non-surgical treatment of congenital hyperinsulinism. (United States)

    Mazor-Aronovitch, Kineret; Landau, Heddy; Gillis, David


    Congenital hyperinsulinism is a functional disorder of insulin secretion. In its diffuse severe form, it is traditionally treated with over 95% pancreatectomy. However, even after this procedure normoglycemia is not always achieved. Non-surgical therapy with frequent or continuous feeding, medication and close monitoring is another alternative. In this review we compare the two approaches to this condition focusing on early complications, diabetes, neurological outcome and home management issues. Early complications of pancreatectomy include mechanical, metabolic and infectious complications. Non-surgical interventions can be complicated by unwarranted effects of medications and of invasive procedures. Diabetes occurs with both approaches but much less frequently and years later with non-surgical treatment. Regarding neurodevelopmental outcome, most data come from heterogeneous groups. Nevertheless, it appears that outcome is not adversely affected by avoiding surgery. Home management is far more difficult for the non-surgical form. When the non-surgical approach is successful in achieving normoglycemia and parents are highly motivated, this mode of therapy should be considered.

  16. Micro scanning probes

    CERN Document Server

    Niblock, T


    This thesis covers the design methodology, theory, modelling, fabrication and evaluation of a Micro-Scanning-Probe. The device is a thermally actuated bimorph quadrapod fabricated using Micro Electro Mechanical Systems technology. A quadrapod is a structure with four arms, in this case a planar structure with the four arms forming a cross which is dry etched out of a silicon diaphragm. Each arm has a layer of aluminium deposited on it forming a bimorph. Through heating each arm actuation is achieved in the plane of the quadrapod and the direction normal to it. Fabrication of the device has required the development of bulk micromachining techniques to handle post CMOS fabricated wafers and the patterning of thickly sputtered aluminium in bulk micro machined cavities. CMOS fabrication techniques were used to incorporate diodes onto the quadrapod arms for temperature measurement of the arms. Fine tungsten and silicon tips have also been fabricated to allow tunnelling between the tip and the platform at the centr...

  17. Cosmological Probes for Supersymmetry

    Directory of Open Access Journals (Sweden)

    Maxim Khlopov


    Full Text Available The multi-parameter character of supersymmetric dark-matter models implies the combination of their experimental studies with astrophysical and cosmological probes. The physics of the early Universe provides nontrivial effects of non-equilibrium particles and primordial cosmological structures. Primordial black holes (PBHs are a profound signature of such structures that may arise as a cosmological consequence of supersymmetric (SUSY models. SUSY-based mechanisms of baryosynthesis can lead to the possibility of antimatter domains in a baryon asymmetric Universe. In the context of cosmoparticle physics, which studies the fundamental relationship of the micro- and macro-worlds, the development of SUSY illustrates the main principles of this approach, as the physical basis of the modern cosmology provides cross-disciplinary tests in physical and astronomical studies.

  18. Cosmological Probes for Supersymmetry

    CERN Document Server

    Khlopov, Maxim


    The multi-parameter character of supersymmetric dark-matter models implies the combination of their experimental studies with astrophysical and cosmological probes. The physics of the early Universe provides nontrivial effects of non-equilibrium particles and primordial cosmological structures. Primordial black holes (PBHs) are a profound signature of such structures that may arise as a cosmological consequence of supersymmetric (SUSY) models. SUSY-based mechanisms of baryosynthesis can lead to the possibility of antimatter domains in a baryon asymmetric Universe. In the context of cosmoparticle physics, which studies the fundamental relationship of the micro- and macro-worlds, the development of SUSY illustrates the main principles of this approach, as the physical basis of the modern cosmology provides cross-disciplinary tests in physical and astronomical studies.

  19. Spontaneous Symmetry Probing

    CERN Document Server

    Nicolis, Alberto


    For relativistic quantum field theories, we consider Lorentz breaking, spatially homogeneous field configurations or states that evolve in time along a symmetry direction. We dub this situation "spontaneous symmetry probing" (SSP). We mainly focus on internal symmetries, i.e. on symmetries that commute with the Poincare group. We prove that the fluctuations around SSP states have a Lagrangian that is explicitly time independent, and we provide the field space parameterization that makes this manifest. We show that there is always a gapless Goldstone excitation that perturbs the system in the direction of motion in field space. Perhaps more interestingly, we show that if such a direction is part of a non-Abelian group of symmetries, the Goldstone bosons associated with spontaneously broken generators that do not commute with the SSP one acquire a gap, proportional to the SSP state's "speed". We outline possible applications of this formalism to inflationary cosmology.

  20. New probe of naturalness. (United States)

    Craig, Nathaniel; Englert, Christoph; McCullough, Matthew


    Any new scalar fields that perturbatively solve the hierarchy problem by stabilizing the Higgs boson mass also generate new contributions to the Higgs boson field-strength renormalization, irrespective of their gauge representation. These new contributions are physical, and in explicit models their magnitude can be inferred from the requirement of quadratic divergence cancellation; hence, they are directly related to the resolution of the hierarchy problem. Upon canonically normalizing the Higgs field, these new contributions lead to modifications of Higgs couplings that are typically great enough that the hierarchy problem and the concept of electroweak naturalness can be probed thoroughly within a precision Higgs boson program. Specifically, at a lepton collider this can be achieved through precision measurements of the Higgs boson associated production cross section. This would lead to indirect constraints on perturbative solutions to the hierarchy problem in the broadest sense, even if the relevant new fields are gauge singlets.

  1. Advanced Langmuir Probe (LP) (United States)

    Voronka, N. R.; Block, B. P.; Carignan, G. R.


    The dynamic response of the MK-2 version of the Langmuir probe amplifier was studied. The settling time of the step response is increased by: (1) stray node-to-ground capacitance at series connections between high value feedback resistors; and (2) input capacitance due to the input cable, FET switches, and input source follower. The stray node-to-ground capacitances can be reduced to tolerable levels by elevating the string of feedback resistors above the printing board. A new feedback network was considered, with promising results. The design uses resistances having much lower nominal values, thereby minimizing the effect of stray capacitances. Faster settling times can be achieved by using an operational amplifier having a higher gain-bandwidth product.

  2. Using dummies for surgical skills training

    DEFF Research Database (Denmark)

    Langebæk, Rikke


    teaching methods for veterinary surgical training. At the Department of Small Animal Clinical Sciences, Faculty of Life Sciences, a number of low fidelity, stuffed toy animal dummies was developed for the Surgical Skills Lab in order to teach 4th year students the basic surgical skills. In the Surgical...... this a relatively low budget solution with a big ethical benefit....

  3. 21 CFR 878.4040 - Surgical apparel. (United States)


    ... known as scrub suits, are excluded. (b) Classification. (1) Class II (special controls) for surgical... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Surgical apparel. 878.4040 Section 878.4040 Food... DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4040 Surgical apparel....

  4. Design optimization and performances of an intraoperative positron imaging probe for radioguided cancer surgery (United States)

    Spadola, S.; Verdier, M.-A.; Pinot, L.; Esnault, C.; Dinu, N.; Charon, Y.; Duval, M.-A.; Ménard, L.


    Extent and accuracy of surgical resection is a crucial step in operable tumor therapy. Emergence of promising specific tumor-seeking agents labeled with positron emitters is giving rise to a renewed interest for radioguided surgery using beta probes. Beta detection, due to the particle short range, allows a more sensitive and accurate tumor localization compared to gamma radiotracers. In that context, we are currently developing an intraoperative positron imaging probe using SiPM photosensors to perform tumor localization and post-operative control of the surgical cavity. Because compactness is a key feature when trying to detect positron emitters with high sensitivity in small surgical cavities, we chose to study the simplest detector design based on the use of a very thin organic scintillator coupled to the photosensor. Different designs of the positron imaging probe, including scintillator material and thickness, light spreading window and optical reflector, were investigated with Monte-Carlo simulations and measurements. Their impact on the probe performances were optimized in terms of positron sensitivity, gamma rays background noise contamination, spatial resolution and bias and uniformity. The ability of the probes to detect small radiolabeled tumors was also investigated by simulating different phantom uptake configurations.

  5. Surgical treatment for male prolactinoma (United States)

    Song, Yi-Jun; Chen, Mei-Ting; Lian, Wei; Xing, Bing; Yao, Yong; Feng, Ming; Wang, Ren-Zhi


    Abstract A total of 184 cases of surgically treated male prolactinoma were analyzed retrospectively to summarize the outcome of this surgical intervention. We analyzed the general characteristics, clinical manifestations, hormone levels, imaging features, preoperative treatments, surgical outcomes, pathology results, and follow-up records for all included patients. The most common clinical manifestations included sexual dysfunction (47.4%), headache (55.9%), and visual disturbance (46.7%). Serum prolactin levels ranged from 150 to 204,952 ng/mL. Tumor size varied from 6 to 70 mm. Pituitary adenomas grew in a parasellar pattern with visual deficits occurring 40.7% of the time. After surgical therapy, 88.6% of patients achieved symptom relief, and 98.4% experienced an immediate postoperative decline in prolactin level. Fifty-seven patients (31.0%) achieved initial remission, and 26 patients (45.6%) experienced recurrence. Hence, our results suggest that in male prolactinoma characterized by a large pituitary diameter and high serum prolactin level, tumor size predicts the degree of gross resection. The prognostic predictors included preoperative tumor growth pattern and Ki-67 index. Citation: Yi-jun S, Mei-ting C, Wei L, Bing X, Yong Y, Ming F, Ren-zhi W. (2016) Surgical treatment for male prolactinoma: a retrospective study of 184 cases PMID:28079813

  6. Can we measure surgical resilience? (United States)

    Graham, David; Becerril-Martinez, Guillermo; Quinto, Lena; Zhao, Dong Fang


    Surgical resilience describes psychological resilience within a surgical setting. Within a surgical setting, psychologically resilient patients have improved recovery and wound-healing. The search for biological correlates in resilient patients has led to the hypothesis that certain endogenous biomarkers (namely neuropeptide Y (NPY), testosterone, and dehydroepiandrosterone (DHEA)) are altered in resilient patients. The concept of surgical resilience raises the question of whether enhanced recovery following surgery can be demonstrated in patients with high titres of resilience biomarkers as compared to patients with low titres of resilience biomarkers. To determine the prognostic value of resilience biomarkers in surgical recovery, a cohort of patients undergoing major surgery should initially be psychometrically tested for their resilience levels before and after surgery so that biomarker levels of NPY, testosterone and DHEA can be compared to a validated psychometric test of resilience. The primary outcome would be length of hospital stay with and without an enhanced recovery program. Secondary outcome measures such as complications, time in rehabilitation and readmission could also be included. If the hypothesis is upheld, resilience biomarkers could be used to support more individualised perioperative management and lead to more efficient and effective allocation of healthcare resources.

  7. Long-term clinical observation of treatment of infrabony defects with enamel matrix derivative (Emdogain): surgical reentry. (United States)

    Rasperini, Giulio; Silvestri, Maurizio; Ricci, Giano


    A surgical protocol for the placement of Emdogain during new attachment procedures was published in this journal in 1999. Three cases with infrabony defects were treated, and significant periodontal attachment level gain, probing depth reduction, and bone fill were evident upon clinical probing and reentry procedures after 1 year. The patients were enrolled in a maintenance protocol with 3-month recall visits. After 7 years, the clinical parameters were stable, as was the radiographic evaluation. Surgical reentry after 7 years in two cases and 5 years in one case demonstrated the stability of the previous findings. These data show the long-term efficacy of enamel matrix derivative in new attachment procedures.

  8. Synthesis of Photoactivatable Phospholipidic Probes

    Institute of Scientific and Technical Information of China (English)

    Qing PENG; Fan Qi QU; Yi XIA; Jie Hua ZHOU; Qiong You WU; Ling PENG


    We synthesized and characterized photoactivatable phospholipidic probes 1-3. These probes have the perfluorinated aryl azide function at the polar head of phospholipid. They are stable in dark and become highly reactive upon photoirradiation. The preliminary results suggest that they are promising tools to study the topology of membrane proteins and protein-lipid interactions using photolabeling approach.

  9. Non-inductive current probe

    DEFF Research Database (Denmark)

    Bak, Christen Kjeldahl


    The current probe described is a low-cost, shunt resistor for monitoring current pulses in e.g., pulsed lasers. Rise time is......The current probe described is a low-cost, shunt resistor for monitoring current pulses in e.g., pulsed lasers. Rise time is...

  10. Surgical treatment of facial paralysis. (United States)

    Mehta, Ritvik P


    The management of facial paralysis is one of the most complex areas of reconstructive surgery. Given the wide variety of functional and cosmetic deficits in the facial paralysis patient, the reconstructive surgeon requires a thorough understanding of the surgical techniques available to treat this condition. This review article will focus on surgical management of facial paralysis and the treatment options available for acute facial paralysis (facial paralysis (3 weeks to 2 yr) and chronic facial paralysis (>2 yr). For acute facial paralysis, the main surgical therapies are facial nerve decompression and facial nerve repair. For facial paralysis of intermediate duration, nerve transfer procedures are appropriate. For chronic facial paralysis, treatment typically requires regional or free muscle transfer. Static techniques of facial reanimation can be used for acute, intermediate, or chronic facial paralysis as these techniques are often important adjuncts to the overall management strategy.


    Directory of Open Access Journals (Sweden)

    Andonovska Biljana J.


    Full Text Available The term 'malnutrition' is a broad term used to describe any imbalance in the diet. In 2009 it was confirmed that malnutrition is an urgent health problem. The reasons for which malnutrition may develop are different. Loss on cellular, physical and physiological level happens as a consequence of malnutrition. Studies show that in surgical practice there is malnutrition in 50% of patients and that there is an association between inadequate nutritional status and surgical result. It leads to prolonged treatment, increasing of the level of morbidity and mortality, increased hospital costs, etc. Sometimes malnutrition is unrecognised, untreated and worsened in hospitals. For this reason this paper will elaborate: nutrition and a surgical patient, assessment of a nutritional status, assessment of energy requirements, and enteral and parenteral nutrition in order to determine the conditions and procedures that affect the appearance, recognition and treatment of malnutrition.

  12. Surgical Complications of Cochlear Implantation

    Directory of Open Access Journals (Sweden)

    Basir Hashemi


    Full Text Available Cochlear implantation is a method used for the treatment ofpatients with profound hearing loss. This procedure may theaccompanied by some major or minor complications. Weevaluated the surgical complications of cochlear implantationin Fars province (south of Iran. A total of 150 patients withcochlear implantation were enrolled in the present study. Mostof the patients were pre-lingual children and most of our deviceswere nucleus prosthesis. We had three device failuresand four major complications, including one misplaced electrode,one case of meningitis, one case of foreign body reactionto suture and one case with extensive hematoma. Thesecomplications were managed successfully by surgical interventionor re-implantation. Facial nerve damage or woundbreakdown was not seen. Minor complications including smallhematoma, edema, stitch infection and dizziness were found in15 cases, which were managed medically. In our center, therate of minor complications was comparable to other centersin the world. But the rate of major surgical complications waslower than other centers.

  13. Nutrition support in surgical oncology. (United States)

    Huhmann, Maureen B; August, David A


    This review article, the second in a series of articles to examine the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) Guidelines for the Use of Parenteral and Enteral Nutrition in Adult and Pediatric Patients, evaluates the evidence related to the use of nutrition support in surgical oncology patients. Cancer patients develop complex nutrition issues. Nutrition support may be indicated in malnourished cancer patients undergoing surgery, depending on individual patient characteristics. As with the first article in this series, this article provides background concerning nutrition issues in cancer patients, as well as discusses the role of nutrition support in the care of surgical cancer patients. The goal of this review is to enrich the discussion contained in the clinical guidelines as they relate to recommendations made for surgical patients, cite the primary literature more completely, and suggest updates to the guideline statements in light of subsequently published studies.

  14. [Surgical adrenal approaches: learned experiences]. (United States)

    Bravo-Lázaro, Santos; Hernandis-Villalba, Juan; Meroño-Carbajosa, Emilio; Navío-Perales, Juan; Marzal-Felici, Vicente


    Laparoscopic surgery is the standard approach for surgical adrenal gland pathology. However, the open procedure still has its role. Our intention is to report our results and experience using different techniques. A retrospective study of 40 patients was carried out. Demographic and surgical data were analyzed. Thirty two patients had benign pathology and eight had malignant tumors. Laparotomy was performed in 18 patients: seven patients with malignant tumors and 11 with benign pathology. Young's approach was indicated in four patients. Laparoscopic aproach was indicated in 25 patients with seven patients requiring conversion to laparotomy. The conversion rate was 28% In most cases, the laparoscopic approach is the standard technique. Appropriate case selection is of primary importance. Other surgical techniques should be considered if necessary.

  15. Cobra Probes Containing Replaceable Thermocouples (United States)

    Jones, John; Redding, Adam


    A modification of the basic design of cobra probes provides for relatively easy replacement of broken thermocouples. Cobra probes are standard tube-type pressure probes that may also contain thermocouples and that are routinely used in wind tunnels and aeronautical hardware. They are so named because in side views, they resemble a cobra poised to attack. Heretofore, there has been no easy way to replace a broken thermocouple in a cobra probe: instead, it has been necessary to break the probe apart and then rebuild it, typically at a cost between $2,000 and $4,000 (2004 prices). The modified design makes it possible to replace the thermocouple, in minimal time and at relatively low cost, by inserting new thermocouple wire in a tube.

  16. Nanobits: customizable scanning probe tips

    DEFF Research Database (Denmark)

    Kumar, Rajendra; Shaik, Hassan Uddin; Sardan Sukas, Özlem


    silicon processing. Using a microgripper they were detached from an array and fixed to a standard pyramidal AFM probe or alternatively inserted into a tipless cantilever equipped with a narrow slit. The nanobit-enhanced probes were used for imaging of deep trenches, without visible deformation, wear......We present here a proof-of-principle study of scanning probe tips defined by planar nanolithography and integrated with AFM probes using nanomanipulation. The so-called 'nanobits' are 2-4 mu m long and 120-150 nm thin flakes of Si3N4 or SiO2, fabricated by electron beam lithography and standard...... or dislocation of the tips of the nanobit after several scans. This approach allows an unprecedented freedom in adapting the shape and size of scanning probe tips to the surface topology or to the specific application....

  17. Wearable probes for service design

    DEFF Research Database (Denmark)

    Mullane, Aaron; Laaksolahti, Jarmo Matti; Svanæs, Dag


    by service employees in reflecting on the delivery of a service. In this paper, we present the ‘wearable probe’, a probe concept that captures sensor data without distracting service employees. Data captured by the probe can be used by the service employees to reflect and co-reflect on the service journey......Probes are used as a design method in user-centred design to allow end-users to inform design by collecting data from their lives. Probes are potentially useful in service innovation, but current probing methods require users to interrupt their activity and are consequently not ideal for use......, helping to identify opportunities for service evolution and innovation....

  18. Electrophoresis-mass spectrometry probe (United States)

    Andresen, Brian D.; Fought, Eric R.


    The invention involves a new technique for the separation of complex mixtures of chemicals, which utilizes a unique interface probe for conventional mass spectrometers which allows the electrophoretically separated compounds to be analyzed in real-time by a mass spectrometer. This new chemical analysis interface, which couples electrophoresis with mass spectrometry, allows complex mixtures to be analyzed very rapidly, with much greater specificity, and with greater sensitivity. The interface or probe provides a means whereby large and/or polar molecules in complex mixtures to be completely characterized. The preferred embodiment of the probe utilizes a double capillary tip which allows the probe tip to be continually wetted by the buffer, which provides for increased heat dissipation, and results in a continually operating interface which is more durable and electronically stable than the illustrated single capillary tip probe interface.

  19. Mobile Probes in Mobile Learning

    DEFF Research Database (Denmark)

    Ørngreen, Rikke; Blomhøj, Ulla; Duvaa, Uffe

    as an agent for acquiring empirical data (as the situation in hitherto mobile probe settings) but was also the technological medium for which data should say something about (mobile learning). Consequently, not only the content of the data but also the ways in which data was delivered and handled, provided......In this paper experiences from using mobile probes in educational design of a mobile learning application is presented. The probing process stems from the cultural probe method, and was influenced by qualitative interview and inquiry approaches. In the project, the mobile phone was not only acting...... a valuable dimension for investigating mobile use. The data was collected at the same time as design activities took place and the collective data was analysed based on user experience goals and cognitive processes from interaction design and mobile learning. The mobile probe increased the knowledge base...

  20. Emotions in veterinary surgical students

    DEFF Research Database (Denmark)

    Langebæk, Rikke; Eika, Berit; Pedersen, Lene Tanggaard


    A surgical educational environment is potentially stressful and can negatively affect students' learning. The aim of the present study was to investigate the emotions experienced by veterinary students in relation to their first encounter with live-animal surgery and to identify possible sources...... of positive and negative emotions, respectively. During a Basic Surgical Skills course, 155 veterinary fourth-year students completed a survey. Of these, 26 students additionally participated in individual semi-structured interviews. The results of the study show that students often experienced a combination...

  1. Exact probes of orientifolds

    CERN Document Server

    Fiol, Bartomeu; Torrents, Genis


    We compute the exact vacuum expectation value of circular Wilson loops for Euclidean ${\\cal N}=4$ super Yang-Mills with $G=SO(N),Sp(N)$, in the fundamental and spinor representations. These field theories are dual to type IIB string theory compactified on $AdS_5\\times {\\mathbb R} {\\mathbb P}^5$ plus certain choices of discrete torsion, and we use our results to probe this holographic duality. We first revisit the LLM-type geometries having $AdS_5\\times {\\mathbb R} {\\mathbb P}^5$ as ground state. Our results clarify and refine the identification of these LLM-type geometries as bubbling geometries arising from fermions on a half harmonic oscillator. We furthermore identify the presence of discrete torsion with the one-fermion Wigner distribution becoming negative at the origin of phase space. We then turn to the string world-sheet interpretation of our results and argue that for the quantities considered they imply two features: first, the contribution coming from world-sheets with a single crosscap is closely ...

  2. Steerable Doppler transducer probes

    Energy Technology Data Exchange (ETDEWEB)

    Fidel, H.F.; Greenwood, D.L.


    An ultrasonic diagnostic probe is described which is capable of performing ultrasonic imaging and Doppler measurement consisting of: a hollow case having an acoustic window which passes ultrasonic energy and including chamber means for containing fluid located within the hollow case and adjacent to a portion of the acoustic window; imaging transducer means, located in the hollow case and outside the fluid chamber means, and oriented to direct ultrasonic energy through the acoustic window toward an area which is to be imaged; Doppler transducer means, located in the hollow case within the fluid chamber means, and movably oriented to direct Doppler signals through the acoustic window toward the imaged area; means located within the fluid chamber means and externally controlled for controllably moving the Doppler transducer means to select one of a plurality of axes in the imaged area along which the Doppler signals are to be directed; and means, located external to the fluid chamber means and responsive to the means for moving, for providing an indication signal for identifying the selected axis.

  3. Transient Astrophysics Probe (United States)

    Camp, Jordan


    Transient Astrophysics Probe (TAP), selected by NASA for a funded Concept Study, is a wide-field high-energy transient mission proposed for flight starting in the late 2020s. TAP’s main science goals, called out as Frontier Discovery areas in the 2010 Decadal Survey, are time-domain astrophysics and counterparts of gravitational wave (GW) detections. The mission instruments include unique imaging soft X-ray optics that allow ~500 deg2 FoV in each of four separate modules; a high sensitivity, 1 deg2 FoV soft X-ray telescope based on single crystal silicon optics; a passively cooled, 1 deg2 FoV Infrared telescope with bandpass 0.6-3 micron; and a set of ~8 small NaI gamma-ray detectors. TAP will observe many events per year of X-ray transients related to compact objects, including tidal disruptions of stars, supernova shock breakouts, neutron star bursts and superbursts, and high redshift Gamma-Ray Bursts. Perhaps most exciting is TAP’s capability to observe X-ray and IR counterparts of GWs involving stellar mass black holes detected by LIGO/Virgo, and possibly X-ray counterparts of GWs from supermassive black holes, detected by LISA and Pulsar Timing Arrays.

  4. Multifrequency scanning probe microscopy study of nanodiamond agglomerates (United States)

    Aravind, Vasudeva; Lippold, Stephen; Li, Qian; Strelcov, Evgheny; Okatan, Baris; Legum, Benjamin; Kalinin, Sergei; Clarion University Team; Oak Ridge National Laboratory Team

    Due to their rich surface chemistry and excellent mechanical properties and non-toxic nature, nanodiamond particles have found applications such as biomedicine, tribology and lubrication, targeted drug delivery systems, tissue scaffolds and surgical implants. Although single nanodiamond particles have diameters about 4-5nm, they tend to form agglomerates. While these agglomerates can be useful for some purposes, many applications of nanodiamonds require single particle, disaggregated nanodiamonds. This work is oriented towards studying forces and interactions that contribute to agglomeration in nanodiamonds. In this work, using multifrequency scanning probe microscopy techniques, we show that agglomerate sizes can vary between 50-100nm in raw nanodiamonds. Extremeties of particles and Interfaces between agglomerates show dissipative forces with scanning probe microscope tip, indicating agglomerates could act as points of increased adhesion, thus reducing lubricating efficiency when nanodiamonds are used as lubricant additives. This research was conducted at the Center for Nanophase Materials Sciences, which is a DOE Office of Science User Facility.

  5. Prototype of a single probe Compton camera for laparoscopic surgery (United States)

    Koyama, A.; Nakamura, Y.; Shimazoe, K.; Takahashi, H.; Sakuma, I.


    Image-guided surgery (IGS) is performed using a real-time surgery navigation system with three-dimensional (3D) position tracking of surgical tools. IGS is fast becoming an important technology for high-precision laparoscopic surgeries, in which the field of view is limited. In particular, recent developments in intraoperative imaging using radioactive biomarkers may enable advanced IGS for supporting malignant tumor removal surgery. In this light, we develop a novel intraoperative probe with a Compton camera and a position tracking system for performing real-time radiation-guided surgery. A prototype probe consisting of Ce :Gd3 Al2 Ga3 O12 (GAGG) crystals and silicon photomultipliers was fabricated, and its reconstruction algorithm was optimized to enable real-time position tracking. The results demonstrated the visualization capability of the radiation source with ARM = ∼ 22.1 ° and the effectiveness of the proposed system.

  6. The surgical treatment of cloaca. (United States)

    Bischoff, Andrea


    Similar to other anorectal malformations, cloaca also represents a spectrum of defects that goes from "benign" cloaca with a good functional prognosis that can be repaired with a relatively simple surgical technique, to very complex malformations with many anatomic variations that require different surgical maneuvers to be able to successfully reconstruct those patients. The group of patients born with a "benign" type of cloaca will have bowel and urinary control, will become sexually active and may get pregnant and deliver by cesarean section. All this is possible, provided the malformation is repaired with a meticulous and delicate technique. Fortunately this represents more than 50% of all cloacas. Our belief is that the surgical technique to repair this group of defects is reproducible and can be taught to pediatric surgical trainees. On the other hand, complex cloaca with a common channel longer than 3 cm should be repaired by surgeons fully dedicated to repair these malformations. The experience reported in this paper is based on 570 patients with cloaca operated by Dr. Alberto Peña and the author in the last 8 years. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Surgical treatment of primary hyperparathyroidism

    DEFF Research Database (Denmark)

    Brasso, K; Karstrup, S; Lundby, C M


    One hundred and two patients with primary hyperparathyroidism underwent a total of 108 bilateral neck explorations with attempted identification and biopsy of all four glands. Hypercalcaemia was surgically eliminated in 97 of 102 patients (95%). Of the remaining hypercalcaemic patients one was cu......--including bilateral neck exploration and attempted biopsies of all parathyroid glands--is safe with a high cure rate....

  8. Surgical Training in the Netherlands

    NARCIS (Netherlands)

    Borel Rinkes, I.H.M.; Gouma, D.J.; Hamming, J.F.


    Surgical training in the Netherlands has traditionally been characterized by learning on the job under the classic master-trainee doctrine. Over the past decades, it has become regionally organized with intensive structural training courses, and a peer-based quality control system. Recently, the nat

  9. Surgical smoke and infection control.

    NARCIS (Netherlands)

    Alp, E.; Bijl, D.; Bleichrodt, R.P.; Hansson, B.M.; Voss, A.


    Gaseous byproducts produced during electrocautery, laser surgery or the use of ultrasonic scalpels are usually referred to as 'surgical smoke'. This smoke, produced with or without a heating process, contains bio-aerosols with viable and non-viable cellular material that subsequently poses a risk of

  10. Posterior fossa meningioma (surgical experiences)

    African Journals Online (AJOL)

    Wael M. Moussa


    Aug 27, 2012 ... Morbidity included decreased level of consciousness, cranial nerve palsy and wound infection. ..... (10 cases), trigeminal nerve compression (6 cases), facial nerve .... and magnetic resonance imaging for surgical planning for menin- ... anatomy scanning in the operation of intracranial parasagittal.

  11. Surgical pearl: the temporary assistant. (United States)

    Jacobs, Aleda A; Orengo, Ida F


    A simple maneuver is presented which simultaneously facilitates both adequate surgical site exposure and sufficient traction. A single suture with high tensile strength can be utilized to this end. This technique is especially helpful when the cutaneous surgeon is operating alone.

  12. Surgical options after Fontan failure

    DEFF Research Database (Denmark)

    van Melle, Joost P; Wolff, Djoeke; Hörer, Jürgen;


    OBJECTIVE: The objective of this European multicenter study was to report surgical outcomes of Fontan takedown, Fontan conversion and heart transplantation (HTX) for failing Fontan patients in terms of all-cause mortality and (re-)HTX. METHODS: A retrospective international study was conducted by...

  13. Surgical Lasers In Veterinary Medicine (United States)

    Newman, H. C.


    Veterinary medicine is a latecomer in benefiting from the advent of surgical lasers. It is ironic that although most of the basic work in lasers is carried out in animal species with which we are most conversant, veterinary medicine as a profession has not been very extensively involved.

  14. Surgical management of tubal pregnancy

    NARCIS (Netherlands)

    Mol, F.


    The work presented in this thesis first addresses the magnitude of the clinical problem of surgically treated tubal pregnancy in The Netherlands. Next, we studied the adherence to recommendations from the Dutch guideline on diagnosis and management of ectopic pregnancy. A systematic review and meta-

  15. Surgical Treatment of Mirizzi Syndrome

    Directory of Open Access Journals (Sweden)

    Е.М. Goch


    Full Text Available The results of treatment of 53 patients with Mirizzi syndrome are presented in the work. The article focuses on the modern classification of syndrome, diagnostics and surgical approach according to the severity of duct damage. Mirizzi syndrome proves to be the complication of cholelithiasis. It is one of the most complicated problems of biliary surgery

  16. [Surgical education has its price]. (United States)

    Schröder, W; Krones, C J


    The radical economisation of the German health-care system has caused an increasing cost awareness. Following this trend, medical education has been identified as a possible expense factor. The theoretical and practical training of young doctors needs time and costs money. However, a detailed cost analysis is still not available, since the complex daily work schedule of young professionals only allows the calculation of single cost factors. Investigations in the USA estimate the costs of surgical training at US$ 80 000 per year and per resident. At present in Germany, surgical training is indirectly financed by the DRG flat rates of the health insurance companies. Possible alternatives include the implementation of a "training fond" which is financed by a percentage fee of the DRG's as well as an on-top funding by the federal government. This "training fond" would support only those surgical units that offer a structured and certified training to surgical residents. However, a systematic cost analysis of such a structured curriculum is necessary for any further discussion.

  17. Pseudothrombocytopenia in cardiac surgical practice. (United States)

    Nair, Sukumaran K; Shah, Roma; Petko, Matus; Keogh, Bruce E


    Pseudothrombocytopenia is observed occasionally in post-cardiac surgical patients. It is commonly due to EDTA-mediated immunological mechanisms, which lead to agglutination of functionally intact platelets. This condition is harmless and does not warrant platelet transfusion. We describe an instance of pseudothrombocytopenia in our practice and discuss its clinical relevance.

  18. Surgical smoke and infection control.

    NARCIS (Netherlands)

    Alp, E.; Bijl, D.; Bleichrodt, R.P.; Hansson, B.M.; Voss, A.


    Gaseous byproducts produced during electrocautery, laser surgery or the use of ultrasonic scalpels are usually referred to as 'surgical smoke'. This smoke, produced with or without a heating process, contains bio-aerosols with viable and non-viable cellular material that subsequently poses a risk of

  19. Surgical treatment of post-infarction left ventricular pseudoaneurysm: Case series highlighting various surgical strategies

    Directory of Open Access Journals (Sweden)

    Edvin Prifti, MD, PhD


    Conclusion: In conclusion, this study revealed that surgical repair of post infarct left ventricular pseudoaneurysm was associated with an acceptable surgical mortality rate, that cardiac rupture did not occur in surgically treated patients.

  20. A subcutaneous Raman needle probe. (United States)

    Day, John C C; Stone, Nicholas


    Raman spectroscopy is a powerful tool for studying the biochemical composition of tissues and cells in the human body. We describe the initial results of a feasibility study to design and build a miniature, fiber optic probe incorporated into a standard hypodermic needle. This probe is intended for use in optical biopsies of solid tissues to provide valuable information of disease type, such as in the lymphatic system, breast, or prostate, or of such tissue types as muscle, fat, or spinal, when identifying a critical injection site. The optical design and fabrication of this probe is described, and example spectra of various ex vivo samples are shown.

  1. Subminiature Hot-Wire Probes (United States)

    Westphal, R. V.; Lemos, F. R.; Ligrani, P. M.


    Class of improved subminiature hot-wire flow-measuring probes developed. Smaller sizes yield improved resolution in measurements of practical aerodynamic flows. Probe made in one-wire, two-perpendicular-wire, and three-perpendicular-wire version for measurement of one, two, or all three components of flow. Oriented and positioned on micromanipulator stage and viewed under microscope during fabrication. Tested by taking measurements in constant-pressure turbulent boundary layer. New probes give improved measurements of turbulence quantities near surfaces and anisotropies of flows strongly influence relative errors caused by phenomena related to spatial resolution.

  2. Optic probe for semiconductor characterization (United States)

    Sopori, Bhushan L.; Hambarian, Artak


    Described herein is an optical probe (120) for use in characterizing surface defects in wafers, such as semiconductor wafers. The optical probe (120) detects laser light reflected from the surface (124) of the wafer (106) within various ranges of angles. Characteristics of defects in the surface (124) of the wafer (106) are determined based on the amount of reflected laser light detected in each of the ranges of angles. Additionally, a wafer characterization system (100) is described that includes the described optical probe (120).

  3. Surgical travellers: tapestry to Bayeux. (United States)

    Hedley-Whyte, John; Milamed, Debra R


    The planning for surgery in war was revisited in 1937 when Ian Fraser was elected a member of the Surgical Travellers. At their 1938 Surgical Travellers meeting in Vienna, Ian and Eleanor Fraser were evicted from their hotel room by the Nazis. The 1939 meeting in Belfast discussed the organization of surgery and the conduct of Emergency Medical Service Hospitals in the United Kingdom; the vast majority were to be under civilian government and military control. From 1943 lengthy and informative organizational meetings were held at least monthly under the chairmanship of Sir Alexander Hood, KBE, Head of the RAMC. Surgical Consultants, now Major Generals, Brigadiers or Full Colonels in the British and U.S. Armies stationed in the UK, prepared for the invasion of Europe. The allocation of medical, surgical, nursing and auxiliary responsibilities was delineated. Liaison with the RAF and US Army Air Force was close as it was with the proposed leaders, Ulstermen Brooke and Montgomery. Montgomery chose Arthur Porritt as Surgeon in Chief to Supreme Headquarters Allied Expeditionary Force (SHAEF), and Eisenhower, General Albert W. Kenner. Just after D-Day, Porritt met Ian Fraser, who had waded in on Arromanches Beach. The triage and evacuation plans for Allied casualties had been controversial, particularly as regards Landing Ship Tanks (LSTs). The dispute with the Hood-selected surgeons on one side, against medical and surgical deployment of LSTs, and Admiral Ernest King and Winston Churchill on the other, favouring LST use for surgery and evacuation. King and Churchill were correct but total Allied air superiority allowed wide use of many of the Allies' Dakotas; 10,000 DC-3s were eventually in service. Supported by forty Allied combat planes to each Luftwaffe, the dispute about Landing Ship Tank use in about a fortnight became moot. The multifaceted role of the Princess Royal in the Emergency Medical Services of the United Kingdom and her close liaison with the Consultant

  4. Surgical management of chronic pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Stavros Gourgiotis; Stylianos Germanos; Marco Pericoli Ridolifni


    BACKGROUND:Treatment of chronic pancreatitis (CP) is a challenging condition for surgeons. During the last decades, increasing knowledge about pathophysiology of CP, improved results of major pancreatic resections, and integration of sophisticated diagnostic methods in clinical practice have resulted in signiifcant changes in surgery for CP. DATA SOURCES:To detail the indications for CP surgery, the surgical procedures, and outcome, a Pubmed database search was performed. The abstracts of searched articles about surgical management of CP were reviewed. The articles could be identiifed and further scrutinized. Further references were extracted by cross-referencing. RESULTS: Main indications of CP for surgery are intractable pain, suspicion of malignancy, and involvement of adjacent organs. The goal of surgical treatment is to improve the quality of life of patients. The surgical approach to CP should be individualized according to pancreatic anatomy, pain characteristics, baseline exocrine and endocrine function, and medical co-morbidity. The approach usually involves pancreatic duct drainage and resection including longitudinal pancreatojejunostomy, pancreatoduodenectomy (Whipple's procedure), pylorus-preserving pancreatoduodenectomy, distal pancreatectomy, total pancreatectomy, duodenum-preserving pancreatic head resection (Beger's procedure), and local resection of the pancreatic head with longitudinal pancreatojejunostomy (Frey's procedure). Non-pancreatic and endoscopic management of pain has also been advocated. CONCLUSIONS:Surgical procedures provide long-term pain relief, a good postoperative quality of life with preservation of endocrine and exocrine pancreatic function, and are associated with low early and late mortality and morbidity. In addition to available results from randomized controlled trials, new studies are needed to determine which procedure is the most effective for the management of patients with CP.

  5. Assessment of Periodontal Status of Surgically Exposed and Orthodontically Aligned Impacted Maxillary Canines

    Directory of Open Access Journals (Sweden)

    Adina Coșarcă


    Full Text Available Aim: The aim of this study was to compare the periodontal status of impacted canines after 5 years following completion of the combined surgical and orthodontic treatment. Materials and methods: We examined 20 labially impacted canines and 20 palatally impacted canines at 5 years after the end of treatment. We assessed the periodontal status of these teeth. Results: Different outcomes were found regarding the probing depth and the amount of keratinized gingiva in the two mentioned groups of teeth. Conclusions: The assessed periodontal indices may signal the appearance of a periodontal disease around the teeth that were surgically and orthodontically treated

  6. Development of AR Surgical Navigation Systems for Multiple Surgical Regions. (United States)

    Suzuki, Naoki; Hattori, Asaki; Iimura, Jiro; Otori, Nobuyoshi; Onda, Shinji; Okamoto, Tomoyoshi; Yanaga, Katsuhiko


    The purpose of our research is to develop surgical navigation systems to enhance surgical safety. Our systems make use of augmented reality technology to superimpose, on the surgery screen on a real time basis, patients' organ models reconstructed in 3D from their X-ray CT data taken before surgery. By doing so, the systems display anatomical risk materials, tumors and blood vessels which surgeons cannot see with their naked eyes. This will in turn lead to surgeons intuitively grasping the inner structures of the operational fields. We so far have been developing navigation systems that can conduct surgeries in various fields. The basic structure of the navigation systems are the same. The navigation systems uses different peripheral equipment and different methods to display navigation images which best meet the demands of each type of surgery. In this thesis, we report on our navigation systems for 2 types of surgery - endoscopic sinus surgery and hepatobilialy-pancreatic surgery.

  7. Small Probe Reentry System Project (United States)

    National Aeronautics and Space Administration — Global Aerospace Corporation (GAC), and its research partner, Cal Poly San Luis Obispo (CPSLO), will develop an integrated Small Probe Reentry System (SPRS) for low...

  8. Lunar Probe Reaches Deep Space

    Institute of Scientific and Technical Information of China (English)


    @@ China's second lunar probe, Chang'e-2, has reached an orbit 1.5 million kilometers from Earth for an additional mission of deep space exploration, the State Administration for Science, Technology and Industry for National Defense announced.

  9. DNA probe for lactobacillus delbrueckii

    Energy Technology Data Exchange (ETDEWEB)

    Delley, M.; Mollet, B.; Hottinger, H. (Nestle Research Centre, Lausanne (Switzerland))


    From a genomic DNA library of Lactobacillus delbrueckii subsp. bulgaricus, a clone was isolated which complements a leucine auxotrophy of an Escherichia coli strain (GE891). Subsequent analysis of the clone indicated that it could serve as a specific DNA probe. Dot-blot hybridizations with over 40 different Lactobacillus strains showed that this clone specifically recognized L. delbrueckii subsp. delbrueckii, bulgaricus, and lactis. The sensitivity of the method was tested by using an {alpha}-{sup 32}P-labeled probe.

  10. Transformer-coupled NMR probe (United States)

    Utsuzawa, Shin; Mandal, Soumyajit; Song, Yi-Qiao


    In this study, we propose an NMR probe circuit that uses a transformer with a ferromagnetic core for impedance matching. The ferromagnetic core provides a strong but confined coupling that result in efficient energy transfer between the sample coil and NMR spectrometer, while not disturbing the B1 field generated by the sample coil. We built a transformer-coupled NMR probe and found that it offers comparable performance (loss NQR.

  11. Surgical and Nonsurgical Management of Bilateral Periapical ...

    African Journals Online (AJOL)

    Journal of Surgical Technique and Case Report | Jan-Jun 2011 | Vol-3 | Issue-1. 44. Surgical .... incisor and canine. Same was ... The operative field was isolated, and access preparation .... environment in which periapical healing can occur.

  12. Surgical intervention in patients with necrotizing pancreatitis

    NARCIS (Netherlands)

    Besselink, MG; de Bruijn, MT; Rutten, JP; Boermeester, MA; Hofker, HS; Gooszen, HG


    Background: This study evaluated the various surgical strategies for treatment of (suspected) infected necrotizing pancreatitis (INP) and patient referrals for this condition in the Netherlands. Methods: This retrospective study included all 106 consecutive patients who had surgical treatment for IN

  13. Surgical skin-marking techniques. (United States)

    Granick, M S; Heckler, F R; Jones, E W


    Surgical skin-marking inks and dyes are in everyday use for designing and planning incisions in plastic and reconstructive surgery. We have traced the historical development of surgical skin-marking techniques from ancient times to the present. The biochemical characteristics of the commonly used marking agents are discussed. A three-part experiment utilizing a pig model was carried out to test the tissue inflammatory response to the various dyes and inks when used intradermally as tattoos, the persistence of such tattoos, and the ease of skin erasure for each of eight stains. Methylene blue and gentian violet are recommended as the best all-purpose marking agents. The use of proprietary inks is discouraged.

  14. Surgical considerations about amyloid goiter. (United States)

    García Villanueva, Augusto; García Villanueva, María Jesús; García Villanueva, Mercedes; Rojo Blanco, Roberto; Collado Guirao, María Vicenta; Cabañas Montero, Jacobo; Beni Pérez, Rafael; Moreno Montes, Irene


    Amyloidosis is an uncommon syndrome consisting of a number of disorders having in common an extracellular deposit of fibrillary proteins. This results in functional and structural changes in the affected organs, depending on deposit location and severity. Amyloid infiltration of the thyroid gland may occur in 50% and up to 80% of patients with primary and secondary amyloidosis respectively. Amyloid goiter (AG) is a true rarity, usually found associated to secondary amyloidosis. AG may require surgical excision, usually because of compressive symptoms. We report the case of a patient with a big AG occurring in the course of a secondary amyloidosis associated to polyarticular onset juvenile idiopathic arthritis who underwent total thyroidectomy. Current literature is reviewed, an attempt is made to provide action guidelines, and some surgical considerations on this rare condition are given.

  15. Sushruta: Foundation for Surgical Practice

    Directory of Open Access Journals (Sweden)

    Siddharth P. Dubhashi


    Full Text Available Sushruta was an ancient Indian surgeon (600 B.C. who resided in Varanasi.The teachings and work of Sushruta is compiled in a treatise called Sushruta Samhita (Sushruta's compendium, which is believed to be a part of Atharvaveda. It contains 184 chapters, descriptions of 1,120 illnesses, 300 surgical procedures, classification of human surgery in 8 categories, over 120 surgical instruments and around 700 drugs of animal, plant and mineral origin. Sushruta was one of the earliest exponents of surgery as an art and science. Sushruta's principles and teachings took surgery in ancient India to a noteworthy pedestal, making it the Golden Age of Surgery. He is truly the “Father of Surgery” and “Father of Plastic Surgery”. It is extremely essential that we put his principles into practice, and preserve the dignity of our noble profession. That would be the ideal tribute to this legendary figure.

  16. Surgical training in the Netherlands. (United States)

    Borel-Rinkes, Inne H M; Gouma, Dirk J; Hamming, Jaap F


    Surgical training in the Netherlands has traditionally been characterized by learning on the job under the classic master-trainee doctrine. Over the past decades, it has become regionally organized with intensive structural training courses, and a peer-based quality control system. Recently, the nationwide programme has been modernized further and now involves a systematic, competency-based education with structural training courses, formalized assessment and room for reflection by residents under the supervision of surgical teaching groups. To this end, a uniform web-based digital portfolio is being introduced to facilitate monitoring of the individual resident's progress. Though requiring inspirational leadership, commitment, and determination, this modernization has sparked enthusiasm among trainees and teachers.

  17. Surgical tools and medical devices

    CERN Document Server

    Jackson, Mark


    This new edition presents information and knowledge on the field of biomedical devices and surgical tools. The authors look at the interactions between nanotechnology, nanomaterials, design, modeling, and tools for surgical and dental applications, as well as how nanostructured surfaces can be created for the purposes of improving cell adhesion between medical devices and the human body. Each original chapter is revised in this second edition and describes developments in coatings for heart valves, stents, hip and knee joints, cardiovascular devices, orthodontic applications, and regenerative materials such as bone substitutes. There are also 8 new chapters that address: Microvascular anastomoses Inhaler devices used for pulmonary delivery of medical aerosols Surface modification of interference screws Biomechanics of the mandible (a detailed case study) Safety and medical devices The synthesis of nanostructured material Delivery of anticancer molecules using carbon nanotubes Nano and micro coatings for medic...

  18. [Surgical treatment of paralytic lagophthalmos]. (United States)

    Schrom, T; Bast, F


    Impairment of the peripheral or central part of the facial nerve causes an ipsilateral peripheral facial nerve paresis. It is quite a common syndrome and affects 20-35 persons per 100,000 per year in Western Europe and the United States. A possible complication of facial palsy is paralytic lagophthalmos with aesthetic and functional impairment for the patient. Beside primary nerve reconstructive procedures plastic-reconstructive procedures play a major role in correcting paralytic lagophthalmos. The eyebrow, upper and lower lids, medial and lateral lid angle as well as the lacrimal system need to be seen as functional units and can be corrected with local surgical procedures. Restoration of eye closure is the most important goal in treating the affected eye. Due to the significant aesthetic limitations and resultant psychological stress for the patient cosmetic aspects must be included in the surgical concept.

  19. A New Surgical Technique for Ingrown Toenail


    Seyed Reza Mousavi; Jaledin Khoshnevice


    Background. Ingrowing toenails are a common condition which, when recurrent and painful, are often treated surgically. The aim of this study is to present a new simple surgical technique for ingrown toenails with good results. Method and Patients. The selected 250 patients with affected toes were surgically treated by our technique and observed from 1998 to 2004. Marginal nail elevation combined with surgical excision of the granulation tissue was more successful. For fixing the nail margin o...

  20. 68 INVITED Personalized surgical treatment for sarcoma

    National Research Council Canada - National Science Library

    Hohenberger, P


    ... belongtothemodernsurgicalapproachinthebattleagainstlocalisedand locallyadvancedprostatecancer. 67 INVITED Personalized surgical treatment for early breast cancer E.Rutgers. The Netherlands Cancer Institute, Department...

  1. Aesthetic Surgical Crown Lengthening Procedure



    The aim of this case report was to describe the surgical sequence of crown lengthening to apically reposition the dentogingival complex, in addition to an esthetic restorative procedure. Many different causes can be responsible for short clinical crown. In these cases, the correct execution of a restorative or prosthetic rehabilitation requires an increasing of the crown length. According to the 2003 American Academy of Periodontology (Practice Profile Survey), crown lengthening is the most h...

  2. Surgical checklists: the human factor.

    LENUS (Irish Health Repository)

    O Connor, Paul


    BACKGROUND: Surgical checklists has been shown to improve patient safety and teamwork in the operating theatre. However, despite the known benefits of the use of checklists in surgery, in some cases the practical implementation has been found to be less than universal. A questionnaire methodology was used to quantitatively evaluate the attitudes of theatre staff towards a modified version of the World Health Organisation (WHO) surgical checklist with relation to: beliefs about levels of compliance and support, impact on patient safety and teamwork, and barriers to the use of the checklist. METHODS: Using the theory of planned behaviour as a framework, 14 semi-structured interviews were conducted with theatre personnel regarding their attitudes towards, and levels of compliance with, a checklist. Based upon the interviews, a 27-item questionnaire was developed and distribute to all theatre personnel in an Irish hospital. RESULTS: Responses were obtained from 107 theatre staff (42.6% response rate). Particularly for nurses, the overall attitudes towards the effect of the checklist on safety and teamworking were positive. However, there was a lack of rigour with which the checklist was being applied. Nurses were significantly more sensitive to the barriers to the use of the checklist than anaesthetists or surgeons. Moreover, anaesthetists were not as positively disposed to the surgical checklist as surgeons and nurse. This finding was attributed to the tendency for the checklist to be completed during a period of high workload for the anaesthetists, resulting in a lack of engagement with the process. CONCLUSION: In order to improve the rigour with which the surgical checklist is applied, there is a need for: the involvement of all members of the theatre team in the checklist process, demonstrated support for the checklist from senior personnel, on-going education and training, and barriers to the implementation of the checklist to be addressed.

  3. [Surgical anatomy of the nose]. (United States)

    Nguyen, P S; Bardot, J; Duron, J B; Jallut, Y; Aiach, G


    Thorough knowledge of the anatomy of the nose is an essential prerequisite for preoperative analysis and the understanding of surgical techniques. Like a tent supported by its frame, the nose is an osteo-chondral structure covered by a peri-chondroperiosteal envelope, muscle and cutaneous covering tissues. For didactic reasons, we have chosen to treat this chapter in the form of comments from eight key configurations that the surgeon should acquire before performing rhinoplasty.

  4. [Surgical options in ulcerative colitis]. (United States)

    Hultén, L; Ecker, K W


    Surgery is needed in every second patient with pancolitis. Historically four surgical options have been developed: conventional ileostomy, ileorectostomy, continent ileostomy (Kock's pouch) and ileo-anal pouch. However, in emergent or unclear situations subtotal colectomy, ileostomy and preservation of the rectum is the most suitable operation. After recovery and in elective indications proctectomy and proctocolectomy establish the general surgical standard. Today, in most cases ileo-pouch-anal anastomosis is performed instead of creation of an ileostomy. Both lowered frequency of defecation and acceptable continence contribute to a better quality of life. However, functional disturbances are not uncommon and result in most cases from complications of the demanding technique. Definitive cure of the colitis is in interference with the risk of pouchitis in about 30%. The cumulative probability to loose the pouch may rise to 15-20% in the long-term course. Thus, ileorectostomy may be considered as a first step of surgical treatment, since pelvic nerve damage is excluded, function is much better and persistent proctitis can be treated topically. The attractively is that ileo-anal pouch can be performed later on, when decreasing function and increasing risk of malignant change will eventually require proctectomy. A Kock-pouch is seldom considered, especially in patients with ileostomy wishing sure fecal control. But the continent reservoir becomes more and more interesting again since it can be reconstructed from a failed ileo-anal pouch without loss of bowel. Conventional ileostomy should be reserved for patients not suitable for reconstructive methods or those who consider pough operations risk. However, it is the safest procedure with absolute cure of disease. The optimal choice of method considers medical and surgical aspects as well as patients conception and desire.

  5. Towards MRI guided surgical manipulator. (United States)

    Chinzei, K; Miller, K


    The advantages of surgical robots and manipulators are well recognized in the clinical and technical community. Precision, accuracy and the potential for telesurgery are the prime motivations in applying advanced robot technology in surgery. In this paper critical interactions between Magnetic Resonance Imaging equipment and mechatronic devices are discussed and a novel Magnetic Resonance compatible surgical robot is described. Experimental results of the effects from several passive (metallic materials) and active (ultrasound motors) mechanical elements are demonstrated. The design principles for Magnetic Resonance compatible robots are established and the compatibility of the proposed robot is assessed by comparing images taken with and without the robot's presence within Signa SP/I GE Medical Systems scanner. The results showed that, in principle, it is possible to construct precision mechatronic devices intended to operate inside MR scanner. Use of such a device will not cause image shift or significant degradation of signal-to-noise-ratio. An MR compatible surgical assist robot was designed and constructed. The robot is not affected by the presence of strong magnetic fields and is able to manoeuvre during imaging without compromising the quality of images. A novel image-guided robot control scheme was proposed. As a part of the control scheme, biomechanics-based organ deformation model was constructed and validated by in-vivo experiment. It has been recognised that for robust control of an image guided surgical robot the precise knowledge of the mechanical properties of soft organs operated on must be known. As an illustration, results in mathematical modelling and computer simulation of brain deformation are given. The novel MR compatible robot was designed to position and direct an axisymmetric tool, such as a laser pointer or a biopsy catheter. New Robot control system based on the prediction of soft organ deformation was proposed.

  6. Surgical smoke and ultrafine particles

    Directory of Open Access Journals (Sweden)

    Nowak Dennis


    Full Text Available Abstract Background Electrocautery, laser tissue ablation, and ultrasonic scalpel tissue dissection all generate a 'surgical smoke' containing ultrafine ( Methods To measure the amount of generated particulates in 'surgical smoke' during different surgical procedures and to quantify the particle number concentration for operation room personnel a condensation particle counter (CPC, model 3007, TSI Inc. was applied. Results Electro-cauterization and argon plasma tissue coagulation induced the production of very high number concentration (> 100000 cm-3 of particles in the diameter range of 10 nm to 1 μm. The peak concentration was confined to the immediate local surrounding of the production side. In the presence of a very efficient air conditioning system the increment and decrement of ultrafine particle occurrence was a matter of seconds, with accumulation of lower particle number concentrations in the operation room for only a few minutes. Conclusion Our investigation showed a short term very high exposure to ultrafine particles for surgeons and close assisting operating personnel – alternating with longer periods of low exposure.

  7. Ethical issues in surgical innovation. (United States)

    Miller, Megan E; Siegler, Mark; Angelos, Peter


    Innovation is responsible for most advances in the field of surgery. Innovative approaches to solving clinical problems have significantly decreased morbidity and mortality for many surgical procedures, and have led to improved patient outcomes. While innovation is motivated by the surgeon's expectation that the new approach will be beneficial to patients, not all innovations are successful or result in improved patient care. The ethical dilemma of surgical innovation lies in the uncertainty of whether a particular innovation will prove to be a "good thing." This uncertainty creates challenges for surgeons, patients, and the healthcare system. By its very nature, innovation introduces a potential risk to patient safety, a risk that may not be fully known, and it simultaneously fosters an optimism bias. These factors increase the complexity of informed consent and shared decision making for the surgeon and the patient. Innovative procedures and their associated technology raise issues of cost and resource distribution in the contemporary, financially conscious, healthcare environment. Surgeons and institutions must identify and address conflicts of interest created by the development and application of an innovation, always preserving the best interest of the patient above the academic or financial rewards of success. Potential strategies to address the challenges inherent in surgical innovation include collecting and reporting objective outcomes data, enhancing the informed consent process, and adhering to the principles of disclosure and professionalism. As surgeons, we must encourage creativity and innovation while maintaining our ethical awareness and responsibility to patients.

  8. Surgical treatment for myelodysplastic clubfoot,

    Directory of Open Access Journals (Sweden)

    Alexandre Zuccon


    Full Text Available Objective:To analyze the results from surgical treatment of 69 cases of clubfoot in 43 patients with myelodysplasia according to clinical and radiographic criteria, at our institution between 1984 and 2004.Methods:This was a retrospective study involving analysis of medical files, radiographs and consultations relating to patients who underwent surgical correction of clubfoot. The surgical technique consisted of radical posteromedial and lateral release with or without associated talectomy.Results:The patients' mean age at the time of the surgery was four years and two months, and the mean length of postoperative follow-up was seven years and two months. Satisfactory results were achieved in 73.9% of the feet and unsatisfactory results in 26.1% (p < 0.0001.Conclusion:Residual deformity in the immediate postoperative period was associated with unsatisfactory results. Opening of the Kite (talocalcaneal angle in feet that only underwent posteromedial and lateral release, along with appropriate positioning of the calcaneus in cases that underwent talectomy, was the radiographic parameter that correlated with satisfactory results.

  9. Simulation-based surgical education. (United States)

    Evgeniou, Evgenios; Loizou, Peter


    The reduction in time for training at the workplace has created a challenge for the traditional apprenticeship model of training. Simulation offers the opportunity for repeated practice in a safe and controlled environment, focusing on trainees and tailored to their needs. Recent technological advances have led to the development of various simulators, which have already been introduced in surgical training. The complexity and fidelity of the available simulators vary, therefore depending on our recourses we should select the appropriate simulator for the task or skill we want to teach. Educational theory informs us about the importance of context in professional learning. Simulation should therefore recreate the clinical environment and its complexity. Contemporary approaches to simulation have introduced novel ideas for teaching teamwork, communication skills and professionalism. In order for simulation-based training to be successful, simulators have to be validated appropriately and integrated in a training curriculum. Within a surgical curriculum, trainees should have protected time for simulation-based training, under appropriate supervision. Simulation-based surgical education should allow the appropriate practice of technical skills without ignoring the clinical context and must strike an adequate balance between the simulation environment and simulators.

  10. Uncommon surgical emergencies in neonatology. (United States)

    Angotti, R; Bulotta, A L; Ferrara, F; Molinaro, F; Cerchia, E; Meucci, D; Messina, M


    Objective. Over the past decade, multiple factors have changed the pattern of neonatal surgical emergencies. An increase in prenatal screenings and the development of neonatal tertiary care centres have changed the clinical approach to these kids. Materials and methods. Between 1995 to 2011 were retrospectively reviewed 34 patients with diagnosis of uncommon rare neonatal surgical emergencies at our institute. We analyzed: sex, gestational age, weight at birth, primary pathology, prenatal diagnosis, associated anomalies, age and weight at surgery, clinical presentation, start of oral feeding and hospitalization. The follow-up was performed at 6,12, 24 and 36 months. Results. There were 21 male and 13 female. The gestational age ranged between 28 and 36 weeks. The weight at birth ranged between 700 and 1400 grams. Oral feeding was started between 4th and 10th postoperative day. The average hospitalization was about 70.47 days. To date, all patients have finished the followup. They are healthy. Conclusion. The outcome of the patients with uncommon surgical emergencies is different based on the etiology. Overall survival is generally good but is influenced by the associated anomalies.

  11. Control tower to surgical theater

    Directory of Open Access Journals (Sweden)

    Buccioli Matteo


    Full Text Available The main social priority is to reduce public debt and to streamline national health service (NHS costs. Consequently, health managers need to acquire operating methods within their managerial structures so that all available resources are better planned in terms of effectiveness and efficiency, without compromising patient safety. In order to identify the information categories needed to know the whole surgical process is necessary to divide these in two main categories, supply and demand. Demand Information Group (DIG contains the information that identify patients and its needs in terms of care. Instead Supply Information Group (SIG contains information about hospital resources in order to cover the supply. The surgical process analyzed in terms such as industrial production process has the goal of produce the “health product for the patient” and its central part is performed in the operating room by a surgical team. This does not mean that the precedent and subsequent phases of the operating room have minor importance, in fact to obtain a high quality “health product” and reduce to a minimum the clinical risks related to the patient it is necessary that each phase of the process is carried out in the right way. The implementation of a Control Tower Approach allows for the management of productive process, able to guide hospital managers to identify the best strategies and to improve the risk management of patient safety in response to the guidelines of the World Health Organization.

  12. Decision making in surgical oncology. (United States)

    Lamb, B; Green, J S A; Vincent, C; Sevdalis, N


    Decisions in surgical oncology are increasingly being made by multi-disciplinary teams (MDTs). Although MDTs have been widely accepted as the preferred model for cancer service delivery, the process of decision making has not been well described and there is little evidence pointing to the ideal structure of an MDT. Performance in surgery has been shown to depend on non-technical skills, such as decision making, as well as patient factors and the technical skills of the healthcare team. Application of this systems approach to MDT working allows the identification of factors that affect the quality of decision making for cancer patients. In this article we review the literature on decision making in surgical oncology and by drawing from the systems approach to surgical performance we provide a framework for understanding the process of decision making in MDTs. Technical factors that affect decision making include the information about patients, robust ICT and video-conferencing equipment, a minimum dataset with expert review of radiological and pathological information, implementation and recording of the MDTs decision. Non-technical factors with an impact on decision making include attendance of team members at meetings, leadership, teamwork, open discussion, consensus on decisions and communication with patients and primary care. Optimising these factors will strengthen the decision making process and raise the quality of care for cancer patients.

  13. Surgical Treatment for Hepatocellular Carcinoma

    Directory of Open Access Journals (Sweden)

    Ahmad A Madkhali


    Full Text Available Hepatocellular carcinoma (HCC is an epithelial tumor derived from hepatocytes; it accounts for 80% of all primary liver cancers and ranks globally as the fourth leading cause of cancer-related deaths. HCC treatment is a multidisciplinary and a multimodal task, with surgery in the form of liver resection and liver transplantation (LT representing the only potentially curative modality. However, there are variable opinions and discussions about applying these surgical options and using other supporting treatments. This article is a narrative review that includes articles published from 1984 to 2013 located by searching scientific databases such as PubMed, SCOPUS, and Elsevier, with the main keyword of hepatocellular carcinoma in addition to other keywords such as liver transplantation, liver resection, transarterial chemoembolization, portal vein embolization, bridging therapy, and downstaging. In this review, we focus mainly on the surgical treatment options offered for HCC, in order to illustrate the current relevant data available in the literature to help in applying these surgical options and to use other supporting treatment modalities when appropriate.

  14. Career satisfaction of surgical specialties. (United States)

    Deshpande, Satish P; Deshpande, Sagar S


    To examine the factors that impact career satisfaction for various surgical specialties. An acute shortage of surgeons is anticipated in the future. Career dissatisfaction can make this already difficult situation worse. It is important to understand and address factors that influence career satisfaction of surgeons to prolong tenure of existing surgeons and understand anticipated needs of future surgeons. The Center for Studying Health System Change 2008 Health Tracking Physician Survey data were used in this study. Regression analysis was done to examine the impact of various practice-related factors, compensation-related factors, practice location, extent of minority patient, and various demographics on career satisfaction of various surgical specialties (n = 762). Among practice related factors, although threat of malpractice had a significant negative impact on career satisfaction, ability to provide quality care to patients and time with patients had a significant positive impact on career satisfaction of surgical specialists. Among compensation related factors, income and financial incentives to expand services had a significant positive impact on career satisfaction. Among practice location factors, those who primarily worked in medical schools were significantly more satisfied with their careers than others. Among minority factors, those treating a large proportion of Hispanic patients were significantly less likely to be satisfied with their careers. Ability to provide quality care, time with patients, income, and financial incentives had a significant positive impact on career satisfaction. Similarly, threat of malpractice and high proportion of Hispanic patients had a negative impact on career satisfaction.

  15. Surgical smoke in dermatologic surgery. (United States)

    Oganesyan, Gagik; Eimpunth, Sasima; Kim, Silvia Soohyun; Jiang, Shang I Brian


    Potential dangers associated with smoke generated during electrosurgery have been described. However, the use of smoke management in dermatology is unknown. There is no objective data showing the amount or the composition of the smoke generated in dermatologic surgeries. To assess the use of smoke management in dermatologic surgery and provide data on the amount and chemical composition of surgical smoke. A total of 997 surveys were sent to dermatologic surgeons across the United States to assess the use of smoke management. Amounts and concentrations of particulates and chemical composition were measured during electrosurgery using a particulate meter and the Environmental Protection Agency-standardized gas chromatography-mass spectrometry analysis. Thirty-two percent of the surgeons responded to the survey, and 77% of the respondents indicated no use of smoke management at all. Only approximately 10% of surgeons reported consistent use of smoke management. Active electrosurgery produced significant amounts of particulates. In addition, surgical smoke contained high concentrations of known carcinogens, such as benzene, butadiene, and acetonitrile. Surgical smoke contains toxic compounds and particulates. Most dermatologic surgeons do not use smoke management within their practices. Raising the awareness of the potential risks can help increase the use of smoke management.

  16. Surgical Treatment of Skin Tumors

    Directory of Open Access Journals (Sweden)



    Full Text Available When we mention about surgical treatment of any tumor residing on the skin independent of its benign or malignant nature, the first method we recall is excision. Elliptical excision is the mainstay of the dermatologic surgery. Each excision ends with a defect for which we are responsible to repair functionally and cosmetically. The diameter of the tumor we excised and the safety margin used for excision determine the diameter of the final defect. After achieving tumor free lateral and deep margins with the appropriate surgical method, we decide between the repair options of second intention healing, primary repair, flaps, full or split thickness grafts, considering the diameter and the anatomic localization of the defect, for the best functional and cosmetic result for that specific defect. This review overviews not only the most common dermatologic surgical methods, but also Mohs surgery which is a method rarely used in our country, although it is the treatment of choice for the treatment of high risk basal cell carcinoma (BCC and squamous cell carcinoma (SCC.

  17. [Surgical managment of retinal detachment]. (United States)

    Haritoglou, C; Wolf, A


    The detachment of the neurosensory retina from the underlying retinal pigment epithelium can be related to breaks of the retina allowing vitreous fluid to gain access to the subretinal space, to exudative changes of the choroid such as tumours or inflammatory diseases or to excessive tractional forces exerted by interactions of the collagenous vitreous and the retina. Tractional retinal detachment is usually treated by vitrectomy and exudative detachment can be addressed by treatment of the underlying condition in many cases. In rhegmatogenous retinal detachment two different surgical procedures, vitrectomy and scleral buckling, can be applied for functional and anatomic rehabilitation of our patients. The choice of the surgical procedure is not really standardised and often depends on the experience of the surgeon and other more ocular factors including lens status, the number of retinal breaks, the extent of the detachment and the amount of preexisting PVR. Using both techniques, anatomic success rates of over 90 % can be achieved. Especially in young phakic patients scleral buckling offers the true advantage to prevent the progression of cataract formation requiring cataract extraction and intraocular lens implantation. Therefore, scleral buckling should be considered in selected cases as an alternative surgical option in spite of the very important technical refinements in modern vitrectomy techniques. Georg Thieme Verlag KG Stuttgart · New York.

  18. Is surgical workforce diversity increasing? (United States)

    Andriole, Dorothy A; Jeffe, Donna B; Schechtman, Kenneth B


    We sought to determine the extent to which recent increases in levels of gender and racial diversity in the overall resident-physician workforce were evident among core-surgical specialty resident workforces. Chi-square tests for trend assessed the importance of changes from 1996 to 2004 in proportions of women and African Americans in the surgery-resident workforce. Surgery-resident trends were compared with overall resident workforce trends using two-tailed t-tests to compare regression slopes that quantified rates of change over time. Chi-square tests assessed differences between proportions of women and African Americans in the current overall board-certified workforce and their proportions in the surgery board-certified workforce. From 1996 to 2004, proportions of women increased in all seven surgical specialties studied. Compared with the overall trend toward increasing proportions of women in the resident workforce, the trend in one surgical specialty was larger (obstetrics/gynecology, p 0.05), and two were smaller (each p 0.05). Proportions of African Americans decreased in three specialties (each p workforce, except obstetrics/gynecology, remained lower than in the overall board-certified workforce (each p workforces have persisted since 1996 and will likely perpetuate ongoing surgery board-certified workforce disparities.


    Directory of Open Access Journals (Sweden)

    N. Safaei


    Full Text Available Cardiac myxoma is generally considered to be a surgical emergency. Surgical excision must be done as soon as possible after diagnosis because of the high risk of valve obstruction or systemic embolization. In this study we report the result of operation in patient with benign cardiac myxoma. From 2001 to 2006, 35 patients (15 men and 20 women between the ages of 26 and 82 years (mean of 52 ± 14 years were operated on for cardiac myxoma. In all of them cardiac myxoma was excised with large cuff of atrial septum. The postoperative mortality was 2.9% (1 patient. No patient was lost in 5 years follow up. Emergency operation was performed in 80% of the patients; in the remaining (20% of the patients, condition was stable and the clinical presentation was less worrying, so elective operation was done. Now as echocardiography can reveal smaller tumors in generally elderly patients, most cases of cardiac myxoma correspond to stable forms. With early diagnosis and surgical excision of atrial myxoma, 97.1% of patients survived post operatively and had an excellent short-term and long-term results leading to eventual cure of nonfamilial myxomas. However, familial myxomas retain a strong tendency to recur after excision.

  20. Fighting surgical site infections in small animals

    DEFF Research Database (Denmark)

    Verwilghen, Denis; Singh, Ameet


    A diverse array of pathogen-related, patient-related, and caretaker-related issues influence risk and prevention of surgical site infections (SSIs). The entire surgical team involved in health care settings in which surgical procedures are performed play a pivotal role in the prevention of SSIs...

  1. Crown lengthening: a surgical flap approach. (United States)

    Lundergan, W; Hughes, W R


    In many instances it is not possible to place a restoration margin without encroaching on the periodontal attachment apparatus. A surgical crown-lengthening procedure can provide a good solution to this common clinical problem. This article discusses indication and contraindication for surgical crown-lengthening procedures and presents an appropriate surgical technique.

  2. Surgical electronic logbook: A step forward. (United States)

    Gómez Díaz, Carlos Javier; Luna Aufroy, Alexis; Rebasa Cladera, Pere; Serra Pla, Sheila; Jurado Ruiz, Cristina; Mora López, Laura; Serra Aracil, Xavier; Navarro Soto, Salvador


    The surgical electronic logbook (surgical e-logbook) aims to: simplify registration of the training activities of surgical residents, and to obtain reliable and detailed reports about these activities for resident evaluation. The surgical e-logbook is a unique and shared database. Residents prospectively record their activities in 3 areas: surgical, scientific and teaching. We can access activity reports that are constantly updated. Study period using the surgical e-logbook: Between June 2011 and May 2013. Number of surgeries reported: 4,255. Number of surgical procedures reported: 11,907. Number of surgeries per resident per year reported: 250. Number of surgical procedures per resident per year reported: 700. Surgical activity as a primary surgeon during the first year of residency is primarily in emergency surgery (68,01%) and by laparotomy (97,73%), while during the fifth year of residency 51,27% is performed in elective surgery and laparoscopy is used in 23,10% of cases. During this period, residents participated in a total of 11 scientific publications, 75 conference presentations and 69 continuing education activities. The surgical e-logbook is a useful tool that simplifies the recording and analysis of data about surgical and scientific activities of the residents. It is a step forward in the evaluation of the training of surgical residents, however, is only an intermediate step towards the development of a larger Spanish registry. Copyright © 2014 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  3. Inadvertent femoral artery "stripping": surgical management. (United States)

    Liddicoat, J E; Bekassy, S M; Daniell, M B; De Bakey, M E


    Following "vein stripping" for varicosities, two patients were referred to our service for evaluation of arterial insufficiency of the lower extremities. Both patients had had surgical interruption of the femoral arterial system which required reconstruction. This paper emphasizes the importance of understanding surgical anatomy and presents the techniques of successful surgical management of both cases.

  4. Surgical versus non-surgical management for pleural empyema. (United States)

    Redden, Mark D; Chin, Tze Yang; van Driel, Mieke L


    Empyema refers to pus in the pleural space, commonly due to adjacent pneumonia, chest wall injury, or a complication of thoracic surgery. A range of therapeutic options are available for its management, ranging from percutaneous aspiration and intercostal drainage to video-assisted thoracoscopic surgery (VATS) or thoracotomy drainage. Intrapleural fibrinolytics may also be administered following intercostal drain insertion to facilitate pleural drainage. There is currently a lack of consensus regarding optimal treatment. To assess the effectiveness and safety of surgical versus non-surgical treatments for complicated parapneumonic effusion or pleural empyema. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (2016, Issue 9), MEDLINE (Ebscohost) (1946 to July week 3 2013, July 2015 to October 2016) and MEDLINE (Ovid) (1 May 2013 to July week 1 2015), Embase (2010 to October 2016), CINAHL (1981 to October 2016) and LILACS (1982 to October 2016) on 20 October 2016. We searched and WHO International Clinical Trials Registry Platform for ongoing studies (December 2016). Randomised controlled trials that compared a surgical with a non-surgical method of management for all age groups with pleural empyema. Two review authors independently assessed trials for inclusion and risk of bias, extracted data, and checked the data for accuracy. We contacted trial authors for additional information. We assessed the quality of the evidence using the GRADE approach. We included eight randomised controlled trials with a total of 391 participants. Six trials focused on children and two on adults. Trials compared tube thoracostomy drainage (non-surgical), with or without intrapleural fibrinolytics, to either VATS or thoracotomy (surgical) for the management of pleural empyema. Assessment of risk of bias for the included studies was generally unclear for selection and blinding but low for attrition and reporting bias. Data analyses compared

  5. IVVS probe mechanical concept design

    Energy Technology Data Exchange (ETDEWEB)

    Rossi, Paolo, E-mail:; Neri, Carlo; De Collibus, Mario Ferri; Mugnaini, Giampiero; Pollastrone, Fabio; Crescenzi, Fabio


    Highlights: • ENEA designed, developed and tested a laser based In Vessel Viewing System (IVVS). • IVVS mechanical design has been revised from 2011 to 2013 to meet ITER requirements. • Main improvements are piezoceramic actuators and a step focus system. • Successful qualification activities validated the concept design for ITER environment. - Abstract: ENEA has been deeply involved in the design, development and testing of a laser based In Vessel Viewing System (IVVS) required for the inspection of ITER plasma-facing components. The IVVS probe shall be deployed into the vacuum vessel, providing high resolution images and metrology measurements to detect damages and possible erosion. ENEA already designed and manufactured an IVVS probe prototype based on a rad-hard concept and driven by commercial micro-step motors, which demonstrated satisfying viewing and metrology performances at room conditions. The probe sends a laser beam through a reflective rotating prism. By rotating the axes of the prism, the probe can scan all the environment points except those present in a shadow cone and the backscattered light signal is then processed to measure the intensity level (viewing) and the distance from the probe (metrology). During the last years, in order to meet all the ITER environmental conditions, such as high vacuum, gamma radiation lifetime dose up to 5 MGy, cumulative neutron fluence of about 2.3 × 10{sup 17} n/cm{sup 2}, temperature of 120 °C and magnetic field of 8 T, the probe mechanical design was significantly revised introducing a new actuating system based on piezo-ceramic actuators and improved with a new step focus system. The optical and mechanical schemes have been then modified and refined to meet also the geometrical constraints. The paper describes the mechanical concept design solutions adopted in order to fulfill IVVS probe functional performance requirements considering ITER working environment and geometrical constraints.

  6. Multiple-probe scanning probe microscopes for nanoarchitectonic materials science (United States)

    Nakayama, Tomonobu; Shingaya, Yoshitaka; Aono, Masakazu


    Nanoarchitectonic systems are of interest for utilizing a vast range of nanoscale materials for future applications requiring a huge number of elemental nanocomponents. To explore the science and technology of nanoarchitectonics, advanced characterization tools that can deal with both nanoscale objects and macroscopically extended nanosystems are demanded. Multiple-probe scanning probe microscopes (MP-SPMs) are powerful tools that meet this demand because they take the advantages of conventional scanning probe microscopes and realize atomically precise electrical measurements, which cannot be done with conventional microprobing systems widely used in characterizing materials and devices. Furthermore, an MP-SPM can be used to operate some nanoarchitectonic systems. In this review, we overview the indispensable features of MP-SPMs together with the past, present and future of MP-SPM technology.

  7. Surgical techniques for quantitative nutrient digestion and absorbtion studies in the pig

    DEFF Research Database (Denmark)

    Jørgensen, Henry; Serena, Anja; Theil, Peter Kappel;


    Surgical techniques allow quantitative measurement of nutrient digestion and absorption in pigs. The present paper presents our updated techniques for anaesthesia and surgery. The surgery technique of catheterization of the portal vein, mesenteric vein and mesenteric artery, as well as the fittin...... of a flow probe for continuous portal blood flow measurements in sows is described. Further, the cannulation of the terminal ileum with a dirigible bi-directional T-cannula for the total collection of ileal digesta is described...

  8. Optical imaging probes in oncology. (United States)

    Martelli, Cristina; Lo Dico, Alessia; Diceglie, Cecilia; Lucignani, Giovanni; Ottobrini, Luisa


    Cancer is a complex disease, characterized by alteration of different physiological molecular processes and cellular features. Keeping this in mind, the possibility of early identification and detection of specific tumor biomarkers by non-invasive approaches could improve early diagnosis and patient management.Different molecular imaging procedures provide powerful tools for detection and non-invasive characterization of oncological lesions. Clinical studies are mainly based on the use of computed tomography, nuclear-based imaging techniques and magnetic resonance imaging. Preclinical imaging in small animal models entails the use of dedicated instruments, and beyond the already cited imaging techniques, it includes also optical imaging studies. Optical imaging strategies are based on the use of luminescent or fluorescent reporter genes or injectable fluorescent or luminescent probes that provide the possibility to study tumor features even by means of fluorescence and luminescence imaging. Currently, most of these probes are used only in animal models, but the possibility of applying some of them also in the clinics is under evaluation.The importance of tumor imaging, the ease of use of optical imaging instruments, the commercial availability of a wide range of probes as well as the continuous description of newly developed probes, demonstrate the significance of these applications. The aim of this review is providing a complete description of the possible optical imaging procedures available for the non-invasive assessment of tumor features in oncological murine models. In particular, the characteristics of both commercially available and newly developed probes will be outlined and discussed.

  9. Surgical correction of cleft lip and palate. (United States)

    Jayaram, Rahul; Huppa, Christoph


    Surgical cleft repair aims to restore function of the oro-nasal sphincter and oro-nasal soft tissues and re-establish the complex relationship between perioral and perinasal muscle rings without compromising subsequent mid-facial growth and development. Here we review the surgical anatomy of this region, optimal timing for surgical repair and current thinking on the use of surgical adjuncts. In addition, an overview of current surgical techniques available for the repair of cleft lip, cleft palate and velopharyngeal insufficiency is presented. Finally, we briefly discuss nasal revision surgery and the use of osteotomy, including distraction osteogenesis in the cleft patient.

  10. Surgical Non-Regenerative Treatments for Peri-Implantitis: a Systematic Review

    Directory of Open Access Journals (Sweden)

    Ausra Ramanauskaite


    Full Text Available Objectives: The purposes of the present study were 1 to systematically review the literature on the surgical non-regenerative treatments of peri-implantitis and 2 to determine a predictable therapeutic option for the clinical management of peri-implantitis lesions. Material and Methods: The study search was performed on primary database MEDLINE and EMBASE from 2005 until 2016. Sequential screenings at the title, abstract, and full-text levels were performed. Clinical human studies in the English language that had reported changes in probing depth (PD and/or bleeding on probing (BOP and/or radiologic marginal bone level changes after peri-implantitis surgical non-regenerative treatment at 6-month follow-up or longer were included accordingly PRISMA guidelines. Results: The first electronic and hand search resulted in 765 citations. From 16 full-text articles reviewed, 6 were included in this systematic review. Surgical non-regenerative methods were found to be efficient in reducing clinical parameters. BOP and PD values were significantly decreased following implantoplasty and systematic administration of antibacterials, but not after local application of chemical compounds or diode laser. Similarly, significant improvement in clinical and radiographic parameters was found only after implantoplasty compared with resective surgery alone. We found significant heterogeneity in study designs and treatments provided among the pooled studies. All of the studies revealed an unclear or high risk of bias. Conclusions: Surgical non-regenerative treatment of peri-implantitis was found to be effective to reduce the soft tissue inflammation and decrease probing depth. More randomized controlled clinical trials are needed to assess the efficacy of surgical non-regenerative therapy of peri-implantitis.

  11. Surgical Non-Regenerative Treatments for Peri-Implantitis: a Systematic Review (United States)

    Ramanauskaite, Ausra; Daugela, Povilas; Faria de Almeida, Ricardo


    ABSTRACT Objectives The purposes of the present study were 1) to systematically review the literature on the surgical non-regenerative treatments of peri-implantitis and 2) to determine a predictable therapeutic option for the clinical management of peri-implantitis lesions. Material and Methods The study search was performed on primary database MEDLINE and EMBASE from 2005 until 2016. Sequential screenings at the title, abstract, and full-text levels were performed. Clinical human studies in the English language that had reported changes in probing depth (PD) and/or bleeding on probing (BOP) and/or radiologic marginal bone level changes after peri-implantitis surgical non-regenerative treatment at 6-month follow-up or longer were included accordingly PRISMA guidelines. Results The first electronic and hand search resulted in 765 citations. From 16 full-text articles reviewed, 6 were included in this systematic review. Surgical non-regenerative methods were found to be efficient in reducing clinical parameters. BOP and PD values were significantly decreased following implantoplasty and systematic administration of antibacterials, but not after local application of chemical compounds or diode laser. Similarly, significant improvement in clinical and radiographic parameters was found only after implantoplasty compared with resective surgery alone. We found significant heterogeneity in study designs and treatments provided among the pooled studies. All of the studies revealed an unclear or high risk of bias. Conclusions Surgical non-regenerative treatment of peri-implantitis was found to be effective to reduce the soft tissue inflammation and decrease probing depth. More randomized controlled clinical trials are needed to assess the efficacy of surgical non-regenerative therapy of peri-implantitis. PMID:27833739

  12. Spaser as a biological probe (United States)

    Galanzha, Ekaterina I.; Weingold, Robert; Nedosekin, Dmitry A.; Sarimollaoglu, Mustafa; Nolan, Jacqueline; Harrington, Walter; Kuchyanov, Alexander S.; Parkhomenko, Roman G.; Watanabe, Fumiya; Nima, Zeid; Biris, Alexandru S.; Plekhanov, Alexander I.; Stockman, Mark I.; Zharov, Vladimir P.


    Understanding cell biology greatly benefits from the development of advanced diagnostic probes. Here we introduce a 22-nm spaser (plasmonic nanolaser) with the ability to serve as a super-bright, water-soluble, biocompatible probe capable of generating stimulated emission directly inside living cells and animal tissues. We have demonstrated a lasing regime associated with the formation of a dynamic vapour nanobubble around the spaser that leads to giant spasing with emission intensity and spectral width >100 times brighter and 30-fold narrower, respectively, than for quantum dots. The absorption losses in the spaser enhance its multifunctionality, allowing for nanobubble-amplified photothermal and photoacoustic imaging and therapy. Furthermore, the silica spaser surface has been covalently functionalized with folic acid for molecular targeting of cancer cells. All these properties make a nanobubble spaser a promising multimodal, super-contrast, ultrafast cellular probe with a single-pulse nanosecond excitation for a variety of in vitro and in vivo biomedical applications.

  13. Sensor probe for rectal manometry

    Energy Technology Data Exchange (ETDEWEB)

    Blechschmidt, R.A.; Hohlfeld, O.; Mueller, R.; Werthschuetzky, R. [Technische Univ. Darmstadt (Germany). Inst. fuer Elektromechanische Konstruktionen


    In this paper a pressure sensor probe is presented that is suitable for assessing dynamic rectal pressure profiles. It consists of ten piezoresistive sensors, mounted on low temperature co-fired ceramics. The sensors are coated with a bio-compatible silicone elastomer. It was possible to reduce the size of the ceramic to 4.5 x 5.5 mm with a height of 1.4 mm. The whole probe has a diameter of 9 mm and a length of 20 cm. One healthy test person underwent rectal manometry. The experimental data and the analysis of linearity, hysteresis, temperature stability, and reproducibility are discussed. The presented sensor probe extends the classical anorectal manometry, particularly in view of quantifying disorders of the rectal motility. (orig.)

  14. Probing of Nascent Riboswitch Transcripts. (United States)

    Chauvier, Adrien; Lafontaine, Daniel A


    The study of biologically significant and native structures is vital to characterize RNA-based regulatory mechanisms. Riboswitches are cis-acting RNA molecules that are involved in the biosynthesis and transport of cellular metabolites. Because riboswitches regulate gene expression by modulating their structure, it is vital to employ native probing assays to determine how native riboswitch structures perform highly efficient and specific ligand recognition. By employing RNase H probing, it is possible to determine the accessibility of specific RNA domains in various structural contexts. Herein, we describe how to employ RNase H probing to characterize nascent mRNA riboswitch molecules as a way to obtain information regarding the riboswitch regulation control mechanism.

  15. Hand-held survey probe (United States)

    Young, Kevin L [Idaho Falls, ID; Hungate, Kevin E [Idaho Falls, ID


    A system for providing operational feedback to a user of a detection probe may include an optical sensor to generate data corresponding to a position of the detection probe with respect to a surface; a microprocessor to receive the data; a software medium having code to process the data with the microprocessor and pre-programmed parameters, and making a comparison of the data to the parameters; and an indicator device to indicate results of the comparison. A method of providing operational feedback to a user of a detection probe may include generating output data with an optical sensor corresponding to the relative position with respect to a surface; processing the output data, including comparing the output data to pre-programmed parameters; and indicating results of the comparison.

  16. All-Fiber Raman Probe

    DEFF Research Database (Denmark)

    Brunetti, Anna Chiara

    The design and development of an all-in-fiber probe for Raman spectroscopy are presented in this Thesis. Raman spectroscopy is an optical technique able to probe a sample based on the inelastic scattering of monochromatic light. Due to its high specificity and reliability and to the possibility...... to perform real-time measurements with little or no sample preparation, Raman spectroscopy is now considered an invaluable analytical tool, finding application in several fields including medicine, defense and process control. When combined with fiber optics technology, Raman spectroscopy allows...... for the realization of flexible and minimally-invasive devices, able to reach remote or hardly accessible samples, and to perform in-situ analyses in hazardous environments. The work behind this Thesis focuses on the proof-of-principle demonstration of a truly in-fiber Raman probe, where all parts are realized...

  17. Giant choledochal calculosis: Surgical treatment

    Directory of Open Access Journals (Sweden)

    Hasan Bektas


    Full Text Available Context: Gallstone disease is one of the most common surgical pathologies. Choledocholithiasis may occur in some of these cases and require surgical intervention. Although there are relatively non-invasive procedures such as endoscopic retrograde cholangiopancreatography (ERCP, this technique is usually unsuccessful in patients with stones larger than 10 mm. In our case, we aimed to report a giant choledochal stone (15 cm × 4.5 cm, which is rare in surgical practice and our treatment with open surgery. Case Report: The patient was a 59-year-old woman. Magnetic resonance cholangiopancreatography (MRCP had showed a hydropic gallbladder with an excessively dilated CBD and a 110 mm × 41 mm stone. In the operation, an excessively dilated CBD was seen and after choledochotomy and a very large calculus that filled CBD completely. Choledochotomy incision was carried forward and a T-tube choledochostomy with choledochoduodenostomy (CD was performed. The patient was discharged without any complications on postoperative 8 th day. Conclusion: Benign gallstone disease is a multifactorial process, with risk factors such as obesity, hemolytic diseases, diabetes mellitus, and pregnancy. Risk factors for choledocholithiasis are similar to those for gallstone disease. MRCP is a non-invasive technique in detecting choledocholithiasis. The gold standard intervention for CBD stones is ERCP. Stones in CBD may reach very considerable dimensions without causing serious symptoms. The most common symptom is jaundice. During preoperative radiological examination, giant stones may be interfered with malignancies. Surgeons should obey conventional algorithms in diagnosis and open surgery must be kept in mind in earlier stages without being too insistent on endoscopic interventions.

  18. Disc degeneration: current surgical options

    Directory of Open Access Journals (Sweden)

    C Schizas


    Full Text Available Chronic low back pain attributed to lumbar disc degeneration poses a serious challenge to physicians. Surgery may be indicated in selected cases following failure of appropriate conservative treatment. For decades, the only surgical option has been spinal fusion, but its results have been inconsistent. Some prospective trials show superiority over usual conservative measures while others fail to demonstrate its advantages. In an effort to improve results of fusion and to decrease the incidence of adjacent segment degeneration, total disc replacement techniques have been introduced and studied extensively. Short-term results have shown superiority over some fusion techniques. Mid-term results however tend to show that this approach yields results equivalent to those of spinal fusion. Nucleus replacement has gained some popularity initially, but evidence on its efficacy is scarce. Dynamic stabilisation, a technique involving less rigid implants than in spinal fusion and performed without the need for bone grafting, represents another surgical option. Evidence again is lacking on its superiority over other surgical strategies and conservative measures. Insertion of interspinous devices posteriorly, aiming at redistributing loads and relieving pain, has been used as an adjunct to disc removal surgery for disc herniation. To date however, there is no clear evidence on their efficacy. Minimally invasive intradiscal thermocoagulation techniques have also been tried, but evidence of their effectiveness is questioned. Surgery using novel biological solutions may be the future of discogenic pain treatment. Collaboration between clinicians and basic scientists in this multidisciplinary field will undoubtedly shape the future of treating symptomatic disc degeneration.

  19. The surgical treatment of acromegaly. (United States)

    Buchfelder, Michael; Schlaffer, Sven-Martin


    Surgical extraction of as much tumour mass as possible is considered the first step of treatment in acromegaly in many centers. In this article the potential benefits, disadvantages and limitations of operative acromegaly treatment are reviewed. Pertinent literature was selected to provide a review covering current indications, techniques and results of operations for acromegaly. The rapid reduction of tumour volume is an asset of surgery. To date, in almost all patients, minimally invasive, transsphenoidal microscopic or endoscopic approaches are employed. Whether a curative approach is feasible or a debulking procedure is planned, can be anticipated on the basis of preoperative magnetic resonance imaging. The radicality of adenoma resection essentially depends on localization, size and invasive character of the tumour. The normalization rates of growth hormone and IGF-1 secretion, respectively, depend on tumour-related factors such as size, extension, the presence or absence of invasion and the magnitude of IGF-1 and growth hormone oversecretion. However, also surgeon-related factors such as experience and patient load of the centers have been shown to strongly affect surgical results and the rate of complications. As compared to most medical treatments, surgery is relatively cheap since the costs occur only once and not repeatedly. There are several new technical gadgets which aid in the surgical procedure: navigation and variants of intraoperative imaging. For the mentioned reasons, current algorithms of acromegaly management suggest an initial operation, unless the patients are unfit for surgery, refuse an operation or only an unsatisfactory resection is anticipated. A few suggestions are made when a re-operation could be considered.

  20. Probe Project Status and Accomplishments

    Energy Technology Data Exchange (ETDEWEB)

    Burris, RD


    The Probe project has completed its first full year of operation. In this document we will describe the status of the project as of December 31, 2000. We will describe the equipment configuration, then give brief descriptions of the various projects undertaken to date. We will mention first those projects performed for outside entities and then those performed for the benefit of one of the Probe sites. We will then describe projects that are under consideration, including some for which initial actions have been taken and others which are somewhat longer-term.

  1. Radioactive Probes on Ferromagnetic Surfaces

    CERN Multimedia


    On the (broad) basis of our studies of nonmagnetic radioactive probe atoms on magnetic surfaces and at interfaces, we propose to investigate the magnetic interaction of magnetic probe atoms with their immediate environment, in particular of rare earth (RE) elements positioned on and in ferromagnetic surfaces. The preparation and analysis of the structural properties of such samples will be performed in the UHV chamber HYDRA at the HMI/Berlin. For the investigations of the magnetic properties of RE atoms on surfaces Perturbed Angular Correlation (PAC) measurements and Mössbauer Spectroscopy (MS) in the UHV chamber ASPIC (Apparatus for Surface Physics and Interfaces at CERN) are proposed.

  2. Surgical Innovation in Sarcoma Surgery. (United States)

    Jeys, L; Morris, G; Evans, S; Stevenson, J; Parry, M; Gregory, J


    The field of orthopaedic oncology relies on innovative techniques to resect and reconstruct a bone or soft tissue tumour. This article reviews some of the most recent and important innovations in the field, including biological and implant reconstructions, together with computer-assisted surgery. It also looks at innovations in other fields of oncology to assess the impact and change that has been required by surgeons; topics including surgical margins, preoperative radiotherapy and future advances are discussed. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  3. Lesson plans in surgical training. (United States)

    Lester, S E; Robson, A K R


    Lesson plans in surgery enable trainers and trainees to agree on goals that balance training needs with service commitments. Lesson plans are individualised to the trainee and encourage ownership of learning. They are based on SMART criteria and therefore have a sound educational footing. Most of the work in creating a lesson plan falls to the trainee. The total time for creation of each plan is approximately 20 min. Our use of lesson plans for surgical training has been met with favourable response from both trainer and trainees.

  4. Surgical packages for laparoscopic surgery

    Directory of Open Access Journals (Sweden)

    Bhattacharya K


    Full Text Available ′Packages′ are in fashion today for most surgical procedures in various corporate hospitals and this has included laparoscopic procedures too. A package system enables the hospitals to get cost settlements done more easily. Also, it is more convenient for the patients who are aware upfront of the charges. The principal disadvantages seems to be for the surgeon, who may face displeasure of the patient, hospital or insurance agencies apart from forfeiting his personal charges if (a he is a novice in laparoscopic surgery and takes extra time to complete a procedure, (b unforeseen problems occur during surgery, or (c new pathologies are discovered on exploration.

  5. Surgical treatment of cleft lip

    Directory of Open Access Journals (Sweden)

    Mateus Domingues Miachon

    Full Text Available We performed a systematic review of the literature on the surgical treatment of cleft lip, emphasizing the prevalence, complications associated with the treatment and the points of disagreement between authors. We conducted a literature cross-sectional search that analyzed publications in books, articles and on the databases SciELO - Scientific Electronic Library Online, PubMed, of the National Center for Biotechnology Information. We conclude that: 1 the severity of the cleft will indicate the technique presenting more advantages; 2 the different approaches indicate that there is no consensus on the optimal technique; and 3 the surgeon experience contributes to choosing the best option.

  6. Surgical Treatment of Peri-Implantitis: A 17-Year Follow-Up Clinical Case Report

    Directory of Open Access Journals (Sweden)

    Fabrizio Bassi


    Full Text Available The purpose of the present case report was to describe the surgical treatment of a peri-implantitis lesion associated with a regenerative approach. A 48-year-old patient came to authors’ attention 36 months after the placement of a dental implant (ITI-Bonefit Straumann, Waldenburg, Switzerland in position 46. A swelling of the peri-implant soft tissues was observed, associated with bleeding on probing and probing depth > 10 mm. A significant peri-implant bone loss was clearly visible on the periapical radiograph. A nonsurgical periodontal supportive therapy was firstly conducted to reduce the inflammation, followed by the surgical treatment of the defect. After mechanical and chemical decontamination with tetracycline solution, a regenerative approach consisting in the application of deproteinized bovine bone mineral (Bio-Oss, Geistlich Pharma AG, Wolhusen, Switzerland and a collagen membrane (Bio-Gide, Geistlich Pharma AG, Wolhusen, Switzerland was performed. An antibiotic therapy was associated with the treatment. The 17-year follow-up showed a physiological probing depth with no clinical signs of peri-implant inflammation and bleeding on probing. No further radiographic bone loss was observed. The treatment described in the present case report seemed to show improved clinical results up to a relevant follow-up period.

  7. Electroless nickel plating on optical fiber probe

    Institute of Scientific and Technical Information of China (English)

    Li Huang; Zhoufeng Wang; Zhuomin Li; Wenli Deng


    As a component of near-field scanning optical microscope (NSOM),optical fiber probe is an important factor influncing the equipment resolution.Electroless nickel plating is introduced to metallize the optical fiber probe.The optical fibers are etched by 40% HF with Turner etching method.Through pretreatment,the optical fiber probe is coated with Ni-P film by clectrolcss plating in a constant temperature water tank.Atomic absorption spectrometry (AAS),scanning electron microscopy (SEM),and energy dispersive X-ray spectrometry (EDXS) are carried out to charaeterizc the deposition on fiber probe.We have rcproducibly fabricated two kinds of fiber probes with a Ni-P fihn:aperture probe and apertureless probe.In addition,reductive particle transportation on the surface of fiber probe is proposed to explain the cause of these probes.

  8. Characterization of near-field optical probes

    DEFF Research Database (Denmark)

    Vohnsen, Brian; Bozhevolnyi, Sergey I.


    Radiation and collection characteristics of four different near-field optical-fiber probes, namely, three uncoated probes and an aluminium-coated small-aperture probe, are investigated and compared. Their radiation properties are characterized by observation of light-induced topography changes...... in a photo-sensitive film illuminated with the probes, and it is confirmed that the radiated optical field is unambigiously confined only for the coated probe. Near-field optical imaging of a standing evanescent-wave pattern is used to compare the detection characteristics of the probes, and it is concluded...... that, for the imaging of optical-field intensity distributions containing predominantly evanescent-wave components, a sharp uncoated tip is the probe of choice. Complementary results obtained with optical phase-conjugation experiments with he uncoated probes are discussed in relation to the probe...

  9. Surgical management of hepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)

    Tony CY Pang; Vincent WT Lam


    Hepatocellular carcinoma (HCC) is the second mostcommon cause of death from cancer worldwide.Standard potentially curative treatments are eitherresection or transplantation. The aim of this paper isto provide an overview of the surgical managementof HCC, as well as highlight current issues in hepaticresection and transplantation. In summary, due to therelationship between HCC and chronic liver disease,the management of HCC depends both on tumourrelatedand hepatic function-related considerations. Assuch, HCC is currently managed largely through nonsurgicalmeans as the criteria, in relation to the aboveconsiderations, for surgical management is still largelyrestrictive. For early stage tumours, both resectionand transplantation offer fairly good survival outcomes(5 years overall survival of around 50%). Selectiontherefore would depend on the level of hepatic functionderangement, organ availability and local expertise.Patients with intermediate stage cancers have limitedoptions, with resection being the only potential forcure. Otherwise, locoregional therapy with transarterialchemoembolization or radiofrequency ablation are viableoptions. Current issues in resection and transplantationare also briefly discussed such as laparoscopic resection,ablation vs resection, anatomical vs non-anatomicalresection, transplantation vs resection, living donor livertransplantation and salvage liver transplantation.


    Directory of Open Access Journals (Sweden)

    V. I. Zavarukhin


    Full Text Available The purpose - to study the morphofunctional changes of upper extremities in patients with brachymetacarpia. Material and methods. The results of the examination and surgical treatment by distraction osteosynthesis of six patients (10 hands, shortening of the 18-metacarpal bones with brachymetacarpia are presented. Results. All patients noted dissatisfaction with the cosmetic state of hands and tiredness during physical activities with the hand. IV ray was shortened in 50%, V ray - in 33% of cases and III ray - in 17%. Limitation of active flexion was noted in all patients, an average flexion was 58.9 ± 7,1°. After treatment flexion increased an average on 20.5 ° (22.7%. Complications were obtained in two patients on three hands. Conclusions. Brachymetacarpia is a rare disease, the etiology of which is still unknown and requires further study. In all cases of brachymetacarpia there is a restriction of active flexion of the MCP joint of the affected ray and the indications for treatment are caused not only by a cosmetic defect, but also functional impairment. Surgical treatment of brachymetacarpia by distraction osteosynthesis gives predictably good results. Complications during the treatment of brachymetacarpia are rare and mostly related to the appearance of contractures, in order to prevent which in the postoperative period should be used preventive conservative therapy.

  11. [Amebiasis. Surgical treatment in 1989]. (United States)

    Sigler Morales, L; Mier y Díaz, J; Melgoza Ortiz, C; Blanco Benavides, R; Medina González, E


    Even when the number of patients with invasive amebiasis has decreased, the internist and surgeon must be alert in case that the patient requires an operation. Amebic liver abscess is treated medically; percutaneous evacuation is rarely used and surgical drainage is made when there is not response to medical treatment or there is high risk of abscess rupture. Operation is mandatory when the abscess has ruptured to the abdominal cavity or through the pericardial sac. In fulminant colitis it is necessary to resect the diseased portion of the colon without primary anastomoses. Amebic apendicitis is difficult to diagnosis before an operation. It may be suspected in cases of apendicitis if the cecal wall is inflammed. Colon ameboma requires medical treatment except if it is associated with necrosis or perforation. In a four year period (1985-1988) 294 patients with diagnosis of invasive amebiasis were admitted to three hospitals of the Instituto Mexicano del Seguro Social in Mexico City. 218 had hepatic abscess, 45 required surgical drainage with four deaths (9%) and four not operated patients died. In this series only four patients had their abscess drained percutaneously. 31 patients with amebic colitis were treated; three required colonic resection with one death. Ameboma was seen in five patients and there were 11 cases of amebic apendicitis. No deaths occurred in these last two groups.


    Directory of Open Access Journals (Sweden)

    Singh R.K


    Full Text Available The Sushruta Samhita is an Ayurvedic text, by the legendary Sushruta, foundational to Ayurvedic medicine (Indian traditional medicine, with innovative chapters mainly on surgery. There is a general impression that Sushruta Samhita is only an ancient Indian Ayurvedic text book of surgery. Sushruta Samhita contains 184 chapters and description of 1120 illnesses, 700 medicinal plants, a detailed study on anatomy, 64 preparations from mineral sources and 57 preparations based on animal sources. It still retains the land mark position in the field of surgical texts. In addition to his worldwide known work of historical significance on plastic surgery, he also made similar unique contributions on numerous aspects of medicine, such as fracture and dislocations, urinary stones, skin diseases including leprosy, Pancha Karma (Purification procedures, toxicology, pediatrics, eye diseases, psychiatry, obstetrics and gynaecology, etc. A very limited conceptual work has been performed on the selected chapters of Sushruta Samhita. Therefore a review conceptual study has been carried out on the various surgical concepts of Sushruta Samhita. Outcome of this study shows, Sushruta Samhita is written in the aphorism form and the techniques described in it are eminently in line with technical abilities of the times. It is need of the hour to explore the hidden truth by decoding the versions of the texts.

  13. The surgical management of spasticity. (United States)

    Lazorthes, Y; Sol, J-C; Sallerin, B; Verdié, J-C


    Neurosurgery is only considered for severe spasticity following the failure of noninvasive management (adequate medical and physical therapy). The patients are carefully selected, based on rigorous multidisciplinary clinical assessment. In this we evaluate the contribution of the spasticity to the disability and any residual voluntary motor function. The goals for each patient are: (a) improvement of function and autonomy; (b) control of pain; and (c) prevention of orthopaedic disorders. To achieve these objectives, the surgical procedure must be selective and reduce the excessive hypertonia without suppressing useful muscle tone and limb functions. The surgical procedures are: (1) Classical neuro-ablative techniques (peripheral neurotomies, dorsal rhizotomies) and their modern modifications using microsurgery and intra-operative neural stimulation (dorsal root entry zone: DREZotomy). These techniques are destructive and irreversible, with the reduced muscle tone reflecting the nerve topography. It is mainly indicated when patients have localized spasticity without useful mobility. (2) Conservative techniques based on a neurophysiological control mechanism. These procedures are totally reversible. The methods involve chronic neurostimulation of the spinal cord or the cerebellum. There are only a few patients for whom this is indicated. Conversely, chronic intrathecal administration of baclofen, using an implantable pump, is well established in the treatment of diffuse spasticity of spinal origin. From reports in the literature, we critically review the respective indications in terms of function, clinical progression and the topographic extent of the spasticity.

  14. Surgical infections: a microbiological study

    Directory of Open Access Journals (Sweden)

    Santosh Saini

    Full Text Available Surgical infections are mostly polymicrobial, involving both aerobes and anaerobes. One hundred seventeen cases comprised of abscesses (n=51, secondary peritonitis (n=25, necrotizing fascitis (n=22 and wounds with devitalized tissues (n=19 were studied. The number of microorganisms isolated per lesion was highest in secondary peritonitis (2.32. The aerobe/ anaerobe ratio was 0.81 in secondary peritonitis and 1.8 in necrotizing fascitis. Most secondary peritonitis (80%, necrotizing fascitis (75% and wounds with devitalized tissues (66.7% were polymicrobial. Common microorganisms isolated in our study were E. coli, Staphylococcus aureus, Klebsiella spp., Pseudomonas aeruginosa, Bacteroides fragilis and Peptostreptococcus spp. The most effective antibiotics for S. aureus were clindamycin (79.1% and cefuroxime (70.8%. For Gram-negatives (Klebsiella spp., E. coli and Proteus spp., the most effective antibiotics were cefotaxime, ceftizoxime, amikacin and ciprofloxacin. Pseudomonas aeruginosa was maximally sensitive to amikacin (35.2% and ciprofloxacin (35.2%. The greatest degree of multidrug resistance to all the drugs was found in P. aeruginosa (52.9%, followed by Klebsiella spp. (33.3%, Proteus spp. (33.3%, E. coli (22.2%, and S. aureus (12.5%. All the anaerobes that we isolated were 100% sensitive to metronidazole and chloramphenicol, followed by clindamycin (95% to 100%. Apart from antibiotic therapy, non-antimicrobial methods, such as hyperbaric oxygen therapy and debridement also play an important role in the treatment of surgical infections.

  15. Surgical infections: a microbiological study

    Directory of Open Access Journals (Sweden)

    Santosh Saini


    Full Text Available Surgical infections are mostly polymicrobial, involving both aerobes and anaerobes. One hundred seventeen cases comprised of abscesses (n=51, secondary peritonitis (n=25, necrotizing fascitis (n=22 and wounds with devitalized tissues (n=19 were studied. The number of microorganisms isolated per lesion was highest in secondary peritonitis (2.32. The aerobe/ anaerobe ratio was 0.81 in secondary peritonitis and 1.8 in necrotizing fascitis. Most secondary peritonitis (80%, necrotizing fascitis (75% and wounds with devitalized tissues (66.7% were polymicrobial. Common microorganisms isolated in our study were E. coli, Staphylococcus aureus, Klebsiella spp., Pseudomonas aeruginosa, Bacteroides fragilis and Peptostreptococcus spp. The most effective antibiotics for S. aureus were clindamycin (79.1% and cefuroxime (70.8%. For Gram-negatives (Klebsiella spp., E. coli and Proteus spp., the most effective antibiotics were cefotaxime, ceftizoxime, amikacin and ciprofloxacin. Pseudomonas aeruginosa was maximally sensitive to amikacin (35.2% and ciprofloxacin (35.2%. The greatest degree of multidrug resistance to all the drugs was found in P. aeruginosa (52.9%, followed by Klebsiella spp. (33.3%, Proteus spp. (33.3%, E. coli (22.2%, and S. aureus (12.5%. All the anaerobes that we isolated were 100% sensitive to metronidazole and chloramphenicol, followed by clindamycin (95% to 100%. Apart from antibiotic therapy, non-antimicrobial methods, such as hyperbaric oxygen therapy and debridement also play an important role in the treatment of surgical infections.

  16. Surgical Treatment of Calcaneal Spur.

    Directory of Open Access Journals (Sweden)

    Eduardo Sarmiento Sánchez


    Full Text Available Background: Pain in the plantar region of the heel is technically known as talalgia, and it is a very frequent complaint in the orthopaedic service in Guyana. Due to its frequent mortality, the current investigation was carried out. Objectives: To characterize the application of the surgical treatment to a group of patients in Guyana. Method: 70 patients surgically treated were studied presenting rebel talalgia with no responses to the conservative treatment. Age, sex, race, educational level, antibiotic prophylaxis, final outcomes, and patient's satisfaction with the treatment were the set of variables selected. Results: High morbidity of the heel pain syndrome was evidenced in this studied. The most frequent cause was the calcaneal spur. There is predominance in female Indian race. The high influenced of the socio-cultural factor in the genesis of this disease is proved as well as the impossibility of carrying out the conservative treatment due to high cost of medications. Conclusions: The efficacy achieved with combined treatment technique allowed the results obtained. All this contributed to achieve high satisfaction levels.

  17. Automatic localization of the da Vinci surgical instrument tips in 3-D transrectal ultrasound. (United States)

    Mohareri, Omid; Ramezani, Mahdi; Adebar, Troy K; Abolmaesumi, Purang; Salcudean, Septimiu E


    Robot-assisted laparoscopic radical prostatectomy (RALRP) using the da Vinci surgical system is the current state-of-the-art treatment option for clinically confined prostate cancer. Given the limited field of view of the surgical site in RALRP, several groups have proposed the integration of transrectal ultrasound (TRUS) imaging in the surgical workflow to assist with accurate resection of the prostate and the sparing of the neurovascular bundles (NVBs). We previously introduced a robotic TRUS manipulator and a method for automatically tracking da Vinci surgical instruments with the TRUS imaging plane, in order to facilitate the integration of intraoperative TRUS in RALRP. Rapid and automatic registration of the kinematic frames of the da Vinci surgical system and the robotic TRUS probe manipulator is a critical component of the instrument tracking system. In this paper, we propose a fully automatic registration technique based on automatic 3-D TRUS localization of robot instrument tips pressed against the air-tissue boundary anterior to the prostate. The detection approach uses a multiscale filtering technique to identify and localize surgical instrument tips in the TRUS volume, and could also be used to detect other surface fiducials in 3-D ultrasound. Experiments have been performed using a tissue phantom and two ex vivo tissue samples to show the feasibility of the proposed methods. Also, an initial in vivo evaluation of the system has been carried out on a live anaesthetized dog with a da Vinci Si surgical system and a target registration error (defined as the root mean square distance of corresponding points after registration) of 2.68 mm has been achieved. Results show this method's accuracy and consistency for automatic registration of TRUS images to the da Vinci surgical system.

  18. A fluorescent probe for ecstasy. (United States)

    Masseroni, D; Biavardi, E; Genovese, D; Rampazzo, E; Prodi, L; Dalcanale, E


    A nanostructure formed by the insertion in silica nanoparticles of a pyrene-derivatized cavitand, which is able to specifically recognize ecstasy in water, is presented. The absence of effects from interferents and an efficient electron transfer process occurring after complexation of ecstasy, makes this system an efficient fluorescent probe for this popular drug.

  19. Health. CEM Probe, January 1977. (United States)

    Billington, Roy

    The importance of health and its relationship to personal and community life are explored in this issue of PROBE. Designed to acquaint British secondary school youth with topical problems, the series contains discussion and case studies of national and world issues, followed by questions for student discussion and research. Nine chapters comprise…

  20. High pressure optical combustion probe

    Energy Technology Data Exchange (ETDEWEB)

    Woodruff, S.D.; Richards, G.A.


    The Department of Energy`s Morgantown Energy Technology Center has developed a combustion probe for monitoring flame presence and heat release. The technology involved is a compact optical detector of the OH radical`s UV fluorescence. The OH Monitor/Probe is designed to determine the flame presence and provide a qualitative signal proportional to the flame intensity. The probe can be adjusted to monitor a specific volume in the combustion zone to track spatial fluctuations in the flame. The probe is capable of nanosecond time response and is usually slowed electronically to fit the flame characteristics. The probe is a sapphire rod in a stainless steel tube which may be inserted into the combustion chamber and pointed at the flame zone. The end of the sapphire rod is retracted into the SS tube to define a narrow optical collection cone. The collection cone may be adjusted to fit the experiment. The fluorescence signal is collected by the sapphire rod and transmitted through a UV transmitting, fused silica, fiber optic to the detector assembly. The detector is a side window photomultiplier (PMT) with a 310 run line filter. A Hamamatsu photomultiplier base combined with a integral high voltage power supply permits this to be a low voltage device. Electronic connections include: a power lead from a modular DC power supply for 15 VDC; a control lead for 0-1 volts to control the high voltage level (and therefore gain); and a lead out for the actual signal. All low voltage connections make this a safe and easy to use device while still delivering the sensitivity required.

  1. Surgical safety checklists in developing countries. (United States)

    Vivekanantham, Sayinthen; Ravindran, Rahul Prashanth; Shanmugarajah, Kumaran; Maruthappu, Mahiben; Shalhoub, Joseph


    The World Health Organization Surgical Safety Checklist (WHO SSC) has demonstrated efficacy in developed and developing countries alike. Recent increases in awareness of surgical morbidity in developing countries has placed greater emphasis on strategies to improve surgical safety in resource-limited settings. The implementation of surgical safety checklists in low-income countries has specific barriers related to resources and culture. Adapting and amending existing surgical safety checklists, as well as considering factors unique to developing countries, may allow the potential of this simple intervention to be fully harnessed in a wider setting. This review will address the benefits and challenges of implementation of surgical safety checklists in developing countries. Moreover, inspiration for the original checklist is revisited to identify areas that will be of particular benefit in a resource-poor setting. Potential future strategies to encourage the implementation of checklists in these countries are also discussed.

  2. Surgical Management of Fractures and Tendons. (United States)

    Pentecost, Rebecca; Niehaus, Andrew J; Anderson, David E


    Long bone fractures and disorders of tendons and ligaments represent a significant proportion of surgical orthopedic cases presented to ruminant veterinarians. The presentation of these patients, their diagnostic work-up, surgical treatment, and expected outcome will be discussed. The outcome of these cases depends largely on the presenting problem; however, accurate diagnosis and prompt surgical intervention can greatly improve the outcome of many of these cases.

  3. Effects of art on surgical patients


    Vetter, Diana; Barth, Jürgen; Uyulmaz, Sema; Uyulmaz, Semra; Vonlanthen, René; Belli, Giulio; Montorsi, Marco; Bismuth, Henri; Claudia M. Witt; Clavien, Pierre-Alain


    Objectives: The aim of the study was to assess the effect of art including ambient features such as music, interior design including visual art, and architectural features on health outcomes in surgical patients. Background: Healing environments can have a positive influence on many patients, but data focusing on art in surgical patients remain scarce. Methods: We conducted a systematic search following the PRISMA guidelines from January 2000 to October 2014 on art in surgical patients....

  4. [Financing and control of surgical training]. (United States)

    Schröder, W; Welcker, K


    The present analyses of different surgical training systems show that training of surgical residents significantly contributes to hospital costs. These are predominantly caused by prolonged operation times of residents with increased work load for other staff members in the operating room. In addition, the productivity of surgical residents is less compared to experienced surgeons. On the other hand, hospital managements save money by the lower standard wages paid to the residents. The amount of educational costs is difficult to determine because surgical training takes place as on the job training. Therefore, from an economic point of view, the two products patient care and surgical training are difficult to separate. There are no reliable cost analyses available for the German training system. At present surgical training is indirectly financed by the DRG (diagnosis-related groups) flat rates of the health insurance. Possible options of financing the surgical training are additional funding from the health department or redistribution with supplemental payment for those surgical departments which contribute significantly more to the residents' training. Statements of medical associations, health departments and health insurances demonstrate the difficulty to come to an agreement concerning the finances of the training system. Despite this controversial discussion it should be taken into consideration that there is no alternative to a high quality surgical training as this is the basis for an effective health system.

  5. Intraoperative OCT in Surgical Oncology (United States)

    South, Fredrick A.; Marjanovic, Marina; Boppart, Stephen A.

    The global incidence of cancer is rising, putting an increasingly heavy burden upon health care. The need to effectively detect and treat cancer is one of the most significant problems faced in health care today. Effective cancer treatment typically depends upon early detection and, for most solid tumors, successful removal of the cancerous tumor tissue via surgical procedures. Difficulties arise when attempting to differentiate between normal and tumor tissue during surgery. Unaided visual examination of the tissue provides only superficial, low-resolution information and often with little visual contrast. Many imaging modalities widely used for cancer screening and diagnostics are of limited use in the operating room due to low spatial resolution. OCT provides cellular resolution allowing for more precise localization of the tumor tissue. It is also relatively inexpensive and highly portable, making it well suited for intraoperative applications.

  6. [Surgical therapy for entrapment neuropathy]. (United States)

    Tachibana, Shigekuni


    Entrapment neuropathy is not uncommon, and surgical treatment is followed by favorite result. Therefore, to obtain an accurate diagnosis based on precise knowledge of the peripheral nervous system is very important. The most popular and useful symptoms and signs of the entrapment neuropathy is paresthesia, dysesthesia and Tinel's like sign at the lesion site. Nerve conduction study is also valuable for the accurate diagnosis. For the last 30 years, the author operated on 1,399 lesions of entrapment neuropathy. They consist of 877 carpal tunnel syndrome (63%), 284 tarsal tunnel syndrome (20%), 135 ulnar neuropathy at the elbow (10%), 53 piriformis syndrome (4%), 15 thoracic outlet syndrome (1%), and others. From the pathophysiological point to view, except for the carpal tunnel syndrome, several locations and factors come into play producing the entrapment of the nerve. The author would like to stress that the entrapment neuropathy is not severe disease, though, it strongly insult the patient's quality of life.

  7. Surgical castration, coercion and ethics

    DEFF Research Database (Denmark)

    Ryberg, Jesper; Petersen, Thomas Søbirk


    that the matter is more complicated than his approach to it suggests. The first thing that adds to the complexity of the discussion concerns the alternative for sex offenders who do not accept the offer of castration. As mentioned, it is likely that these offenders will be kept in prison. McMillan even underlines......John McMillan's detailed ethical analysis concerning the use of surgical castration of sex offenders in the Czech Republic and Germany is mainly devoted to considerations of coercion.1 This is not surprising. When castration is offered as an option to offenders and, at the same time, constitutes...... the only means by which these offenders are likely to be released from prison, it is reasonable—and close to the heart of modern medical ethics—to consider whether the offer involves some kind of coercion. However, despite McMillan's seemingly careful consideration of this question, it appears to us...

  8. [Living donor transplantation. Surgical complications]. (United States)

    Karam, Georges


    Although nephrectomy by open surgery is the most used technique for the extraction of kidney transplants in the living donor, nephrectomy under laparaoscopy is increasingly practiced. Laparoscopic nephrectomy is less invasive and performed under videoscopy control, after insufflation of the peritoneal cavity. Three to four incisions are done in order to enter the surgical instruments. The kidney is extracted through a horizontal sus-pubic incision. The exposition is either exclusively transperitoneal, retroperitoneal or hand assisted. The advantages of laparoscopy are esthetical, financial due to a shorter hospitalisation and a quicker recovery, as well a confort for the donor. The disadvantages are a longer warm ischemia time and possibly a higher risk of delayed graft function. Randomised studies having compared laparoscopy and open surgery in the living donor have not find any significant difference regarding the per- and perioperative in the complications.

  9. [Surgical dilemmas. Sinus floor elevation]. (United States)

    ten Bruggenkate, C M; Schulten, E A J M; Zijderveld, S A


    Limited alveolar bone height prevents the placement of dental implants. Sinus floor elevation is an internal augmentation of the maxillary sinus that allows implants to be placed. The principle of this surgical procedure is the preparation of a 'top hinge door', that is raised together with the Schneiderian membrane in the cranial direction. The space which created under this lid is filled with a bone transplant. Autogenous bone is the standard transplant material, despite the fact that a second surgery site is necessary. Under certain circumstances bone substitutes can be used, with a longer healing phase. If sufficient alveolar bone height is available to secure implant stability, simultaneous implantation and sinus floor elevation are possible. Considering the significant anatomical variation in the region of the maxillary sinus, a sound knowledge of the anatomy is of great importance.

  10. Coccidioidomycosis: Surgical Issues and Implications. (United States)

    Forrester, Joseph D; Guo, Haiwei Henry; Weiser, Thomas G


    Coccidioidomycosis, commonly called "valley fever," "San Joaquin fever," "desert fever," or "desert rheumatism," is a multi-system illness caused by infection with Coccidioides fungi (C. immitis or C. posadasii). This organism is endemic to the desert Southwest regions of the United States and Mexico and to parts of South America. The manifestations of infection occur along a spectrum from asymptomatic to mild self-limited fever to severe disseminated disease. Review of the English-language literature. There are five broad indications for surgical intervention in patients with coccidioidomycosis: Tissue diagnosis in patients at risk for co-existing pathology, perforation, bleeding, impingement on critical organs, and failure to resolve with medical management. As part of a multidisciplinary team, surgeons may be responsible for the care of infected patients, particularly those with severe disease. This review discusses the history, microbiology, epidemiology, pathology, diagnosis, and treatment of coccidioidomycosis, focusing on situations that may be encountered by surgeons.

  11. Surgical Craniotomy for Intracerebral Haemorrhage. (United States)

    Mendelow, A David


    may improve the completeness of surgical evacuation and outcomes, regardless of which surgical technique is employed.

  12. Acromioclavicular motion after surgical reconstruction. (United States)

    Motta, Pierorazio; Bruno, Laura; Maderni, Alberto; Tosco, Piermario; Mariotti, Umberto


    A retrospective long-term study was carried out to determine whether there was any correlation between the clinical motion of the acromioclavicular joint evaluated by a test we set up using 90° of abduction and 0° of external rotation against resistance [90°/0°RTest] and the cross arm test (compared to the healthy side) and full return to everyday activities after surgical repair. A clinical and radiographic evaluation was carried out on 51/80 subjects at a 5.4-year mean follow-up, treated for acromioclavicular joint dislocation with an extra-articular artificial loop, between 2000 and 2006. The 25 subjects with ossifications obtained a normal acromioclavicular joint motion, on both the horizontal and vertical planes. There was a correlation between the normal motion of the reconstructed acromioclavicular joint (compared to the healthy side) in these 25 patients and full clinical recovery, whilst there was no correlation between the Constant score, the simple shoulder test, the radiographic evaluation on one hand and the clinical motion of the joint on the other. Two patients had recurrent dislocation. Three had mobilization of the screws without reduction loss, or negative clinical outcome. A postoperative radiographic evaluation should be correlated with a clinical evaluation of the acromioclavicular joint motion (normal, hypermobile, unstable). Normal acromioclavicular joint motion was observed in subjects who developed significant ossifications. The study shows that the clinical evaluation of acromioclavicular joint motion is a simple and trustworthy method to assess the clinical result of a surgical repair. Diagnostic study investigating a diagnostic test, Level III.

  13. The Dutch surgical colorectal audit. (United States)

    Van Leersum, N J; Snijders, H S; Henneman, D; Kolfschoten, N E; Gooiker, G A; ten Berge, M G; Eddes, E H; Wouters, M W J M; Tollenaar, R A E M; Bemelman, W A; van Dam, R M; Elferink, M A; Karsten, Th M; van Krieken, J H J M; Lemmens, V E P P; Rutten, H J T; Manusama, E R; van de Velde, C J H; Meijerink, W J H J; Wiggers, Th; van der Harst, E; Dekker, J W T; Boerma, D


    In 2009, the nationwide Dutch Surgical Colorectal Audit (DSCA) was initiated by the Association of Surgeons of the Netherlands (ASN) to monitor, evaluate and improve colorectal cancer care. The DSCA is currently widely used as a blueprint for the initiation of other audits, coordinated by the Dutch Institute for Clinical Auditing (DICA). This article illustrates key elements of the DSCA and results of three years of auditing. Key elements include: a leading role of the professional association with integration of the audit in the national quality assurance policy; web-based registration by medical specialists; weekly updated online feedback to participants; annual external data verification with other data sources; improvement projects. In two years, all Dutch hospitals participated in the audit. Case-ascertainment was 92% in 2010 and 95% in 2011. External data verification by comparison with the Netherlands Cancer Registry (NCR) showed high concordance of data items. Within three years, guideline compliance for diagnostics, preoperative multidisciplinary meetings and standardised reporting increased; complication-, re-intervention and postoperative mortality rates decreased significantly. The success of the DSCA is the result of effective surgical collaboration. The leading role of the ASN in conducting the audit resulted in full participation of all colorectal surgeons in the Netherlands. By integrating the audit into the ASNs' quality assurance policy, it could be used to set national quality standards. Future challenges include reduction of administrative burden; expansion to a multidisciplinary registration; and addition of financial information and patient reported outcomes to the audit data. Copyright © 2013 Elsevier Ltd. All rights reserved.

  14. Cantilevered probe detector with piezoelectric element (United States)

    Adams, Jesse D; Sulchek, Todd A; Feigin, Stuart C


    A disclosed chemical detection system for detecting a target material, such as an explosive material, can include a cantilevered probe, a probe heater coupled to the cantilevered probe, and a piezoelectric element disposed on the cantilevered probe. The piezoelectric element can be configured as a detector and/or an actuator. Detection can include, for example, detecting a movement of the cantilevered probe or a property of the cantilevered probe. The movement or a change in the property of the cantilevered probe can occur, for example, by adsorption of the target material, desorption of the target material, reaction of the target material and/or phase change of the target material. Examples of detectable movements and properties include temperature shifts, impedance shifts, and resonant frequency shifts of the cantilevered probe. The overall chemical detection system can be incorporated, for example, into a handheld explosive material detection system.

  15. Overview of Probe-based Storage Technologies (United States)

    Wang, Lei; Yang, Ci Hui; Wen, Jing; Gong, Si Di; Peng, Yuan Xiu


    The current world is in the age of big data where the total amount of global digital data is growing up at an incredible rate. This indeed necessitates a drastic enhancement on the capacity of conventional data storage devices that are, however, suffering from their respective physical drawbacks. Under this circumstance, it is essential to aggressively explore and develop alternative promising mass storage devices, leading to the presence of probe-based storage devices. In this paper, the physical principles and the current status of several different probe storage devices, including thermo-mechanical probe memory, magnetic probe memory, ferroelectric probe memory, and phase-change probe memory, are reviewed in details, as well as their respective merits and weakness. This paper provides an overview of the emerging probe memories potentially for next generation storage device so as to motivate the exploration of more innovative technologies to push forward the development of the probe storage devices.

  16. Where do pulse oximeter probes break? (United States)

    Crede, S; Van der Merwe, G; Hutchinson, J; Woods, D; Karlen, W; Lawn, J


    Pulse oximetry, a non-invasive method for accurate assessment of blood oxygen saturation (SPO2), is an important monitoring tool in health care facilities. However, it is often not available in many low-resource settings, due to expense, overly sophisticated design, a lack of organised procurement systems and inadequate medical device management and maintenance structures. Furthermore medical devices are often fragile and not designed to withstand the conditions of low-resource settings. In order to design a probe, better suited to the needs of health care facilities in low-resource settings this study aimed to document the site and nature of pulse oximeter probe breakages in a range of different probe designs in a low to middle income country. A retrospective review of job cards relating to the assessment and repair of damaged or faulty pulse oximeter probes was conducted at a medical device repair company based in Cape Town, South Africa, specializing in pulse oximeter probe repairs. 1,840 job cards relating to the assessment and repair of pulse oximeter probes were reviewed. 60.2 % of probes sent for assessment were finger-clip probes. For all probes, excluding the neonatal wrap probes, the most common point of failure was the probe wiring (>50 %). The neonatal wrap most commonly failed at the strap (51.5 %). The total cost for quoting on the broken pulse oximeter probes and for the subsequent repair of devices, excluding replacement components, amounted to an estimated ZAR 738,810 (USD $98,508). Improving the probe wiring would increase the life span of pulse oximeter probes. Increasing the life span of probes will make pulse oximetry more affordable and accessible. This is of high priority in low-resource settings where frequent repair or replacement of probes is unaffordable or impossible.

  17. Radioactive probe-guided parathyroidectomy for secondary hyperparathyroidism

    Institute of Scientific and Technical Information of China (English)

    Yuan Fei; Yu Weijia; Waqas Ahmad; Yang Zhixue; Cao Hua; Li Juncheng; Jiang Guoqin


    Background The value of gamma probes in the surgical treatment of secondary hyperparathyroidism (sHPT) was determined.The aim of this study was to enhance the rate of successful total parathyroidectomy in patients with sHPT using intraoperative gamma probe investigations.Methods We retrospectively analyzed the clinical data of 48 sHPT patients between May 2007 and September 2011.Preoperative 99Tcm-methoxyisobutyl isonitrile (MIBI) scintigraphy and high-frequency ultrasonography were used for parathyroid localization.Thirty-five patients (group Ⅰ) underwent conventional neck exploration and open parathyroidectomy.Thirteen patients (group Ⅱ) underwent gamma probe-guided total parathyroidectomy and parathyroid transplantation.The two groups were compared in terms of the number of parathyroid resections,operative time,and postoperative changes in the blood levels of parathyroid hormone (PTH),calcium,and phosphate.Results The clinical manifestations,PTH and calcium levels,age distribution,and clinical characteristics did not differ between the two groups.The accuracy of preoperative 99Tcm-MIBI scintigraphy (89.74%) for the diagnosis of hyperparathyroidism did not differ from that of ultrasonography (81.25%).However,the accuracy of 99TcmMIBI scintigraphy (66.67%) for localizing hyperfunctioning parathyroids was significantly lower than that of ultrasonography (76.86%).The operation time was significantly longer in group Ⅰ ((120±25) minutes) than in group Ⅱ ((90±30) minutes).The accuracy of parathyroid identification was significantly higher in group Ⅱ (92.59%) than in group Ⅰ (80.39%).On average,significantly fewer parathyroid specimens were obtained in group Ⅰ (2.5±0.5) than in group Ⅱ (3.5±0.5).Compared with group Ⅰ,group Ⅱ showed a significant increase (15.4%) in the number of parathyroid resections.The PTH,calcium,and phosphate levels significantly decreased postoperatively in all patients.Conclusions Intraoperative gamma probe

  18. Probing zeolites by vibrational spectroscopies. (United States)

    Bordiga, Silvia; Lamberti, Carlo; Bonino, Francesca; Travert, Arnaud; Thibault-Starzyk, Frédéric


    This review addresses the most relevant aspects of vibrational spectroscopies (IR, Raman and INS) applied to zeolites and zeotype materials. Surface Brønsted and Lewis acidity and surface basicity are treated in detail. The role of probe molecules and the relevance of tuning both the proton affinity and the steric hindrance of the probe to fully understand and map the complex site population present inside microporous materials are critically discussed. A detailed description of the methods needed to precisely determine the IR absorption coefficients is given, making IR a quantitative technique. The thermodynamic parameters of the adsorption process that can be extracted from a variable-temperature IR study are described. Finally, cutting-edge space- and time-resolved experiments are reviewed. All aspects are discussed by reporting relevant examples. When available, the theoretical literature related to the reviewed experimental results is reported to support the interpretation of the vibrational spectra on an atomic level.

  19. Metalloprotein-based MRI probes. (United States)

    Matsumoto, Yuri; Jasanoff, Alan


    Metalloproteins have long been recognized as key determinants of endogenous contrast in magnetic resonance imaging (MRI) of biological subjects. More recently, both natural and engineered metalloproteins have been harnessed as biotechnological tools to probe gene expression, enzyme activity, and analyte concentrations by MRI. Metalloprotein MRI probes are paramagnetic and function by analogous mechanisms to conventional gadolinium or iron oxide-based MRI contrast agents. Compared with synthetic agents, metalloproteins typically offer worse sensitivity, but the possibilities of using protein engineering and targeted gene expression approaches in conjunction with metalloprotein contrast agents are powerful and sometimes definitive strengths. This review summarizes theoretical and practical aspects of metalloprotein-based contrast agents, and discusses progress in the exploitation of these proteins for molecular imaging applications.

  20. Distance probes of dark energy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, A. G.; Padmanabhan, N.; Aldering, G.; Allen, S. W.; Baltay, C.; Cahn, R. N.; D’Andrea, C. B.; Dalal, N.; Dawson, K. S.; Denney, K. D.; Eisenstein, D. J.; Finley, D. A.; Freedman, W. L.; Ho, S.; Holz, D. E.; Kasen, D.; Kent, S. M.; Kessler, R.; Kuhlmann, S.; Linder, E. V.; Martini, P.; Nugent, P. E.; Perlmutter, S.; Peterson, B. M.; Riess, A. G.; Rubin, D.; Sako, M.; Suntzeff, N. V.; Suzuki, N.; Thomas, R. C.; Wood-Vasey, W. M.; Woosley, S. E.


    This document presents the results from the Distances subgroup of the Cosmic Frontier Community Planning Study (Snowmass 2013). We summarize the current state of the field as well as future prospects and challenges. In addition to the established probes using Type Ia supernovae and baryon acoustic oscillations, we also consider prospective methods based on clusters, active galactic nuclei, gravitational wave sirens and strong lensing time delays.

  1. Probing the Tautomerism of Histidine (United States)

    Bermudez, C.; Cabezas, C.; Mata, S.; Alonso, J. L.


    The rotational spectrum of histidine, showing a complex nuclear quadrupole interactions arising from three ^{14}N nuclei in non-equivalent positions have been resolved and completely analyzed. Solid samples (m.p. 290°C) were vaporized by laser ablation and probed by Fourier transform microwave spectroscopy in a supersonic expansion. The experimental constants clearly lead to the unambiguous identification of the \\varepsilon tautomer in the gas phase.

  2. Distance Probes of Dark Energy

    CERN Document Server

    Kim, A; Aldering, G; Allen, S; Baltay, C; Cahn, R; D'Andrea, C; Dalal, N; Dawson, K; Denney, K; Eisenstein, D; Finley, D; Freedman, W; Ho, S; Holz, D; Kent, A; Kasen, D; Kessler, R; Kuhlmann, S; Linder, E; Martini, P; Nugent, P; Perlmutter, S; Peterson, B; Riess, A; Rubin, D; Sako, M; Suntzeff, N; Suzuki, N; Thomas, R; Wood-Vasey, W M; Woosley, S


    This document presents the results from the Distances subgroup of the Cosmic Frontier Community Planning Study (Snowmass 2013). We summarize the current state of the field as well as future prospects and challenges. In addition to the established probes using Type IA supernovae and baryon acoustic oscillations, we also consider prospective methods based on clusters, active galactic nuclei, gravitational wave sirens and strong lensing time delays.

  3. Chemomechanics with Molecular Force Probes (United States)


    probe should have [25,26]: (1) a size that is small enough to allow high-level quantum -chemical calcu- lations of geometries and energies of...macrocycles makes them amenable to high-level quantum -chemical calculations, which yield restoring forces without the ambi- guities intrinsic to...reactions to be measured and in- terpreted structurally and mechanistically by integrating molecular design, synthesis, kinetic/ mechanis - tic studies and

  4. Flying Probe Tester: Architecture, Principle and Implementation

    Institute of Scientific and Technical Information of China (English)

    Fu,Xu; Fang,Kangling; Chen,Guoqing


    This paper introduces the flying probe tester, which is a testing device for PCB. The architecture and principle of flying probe tester are firstly introduced. Then the implementation of hardware and software is illuminated briefly. Finally, the optimizing method for the probe's moving path is researched based on the traveling salesman problem.

  5. The Van Allen Probes mission

    CERN Document Server

    Burch, James


    This collection of articles provides broad and detailed information about NASA’s Van Allen Probes (formerly known as the Radiation Belt Storm Probes) twin-spacecraft Earth-orbiting mission. The mission has the objective of achieving predictive understanding of the dynamic, intense, energetic, dangerous, and presently unpredictable belts of energetic particles that are magnetically trapped in Earth’s space environment above the atmosphere. It documents the science of the radiation belts and the societal benefits of achieving predictive understanding. Detailed information is provided about the Van Allen Probes mission design, the spacecraft, the science investigations, and the onboard instrumentation that must all work together to make unprecedented measurements within a most unforgiving environment, the core of Earth’s most intense radiation regions.
 This volume is aimed at graduate students and researchers active in space science, solar-terrestrial interactions and studies of the up...

  6. [Acute appendicitis. Surgical and non-surgical treatment]. (United States)

    Souza-Gallardo, Luis Manuel; Martínez-Ordaz, José Luis


    Appendicitis represents a common disease for the surgeon with a relative risk between 7-8%. It was thought that if more time passed between diagnosis and treatment, the risk for complications, such as perforation or abscess formation, was higher; nevertheless; the evolution is variable, making necessary the development of different strategies such as antibiotic use only, interval surgery or endoscopic treatment. The purpose of this study is to make a revision in the management of appendicitis comparing conservative and surgical treatment. It is known that traditional management of appendicitis is appendectomy with a complication rate of 2.5% to 48%. Nowadays, laparoscopy is the approach of choice by many surgeons and there have proposed new invasive techniques such as endoscopic treatment with the use of prosthesis and ambulatory surgery. Antibiotic use is essential in the management of appendicitis. Its use as the only strategy to treat this disease has the purpose of lowering costs and diminishing complications related to surgery or the resection of the organ. We conclude that the ideal management of appendicitis remains controversial and it will depend of the clinical characteristics of each patient and the resources available.

  7. Surgical learning activities for house officers: do they improve the surgical experience? (United States)

    Maweni, R M; Foley, R W; Lupi, M; Shier, D; Ronan O'Connell, P; Vig, S


    To ascertain whether house officers (HOs) attain a more satisfactory surgical rotation experience when they perform basic surgical learning activities. We also sought to establish how many and which learning activities HOs achieve and the effect on their surgical experience. A questionnaire listing 20 learning activities and questions regarding satisfaction with an overall experience was disseminated to HOs in the UK and Ireland who had completed ≥3 months of surgical rotations. Satisfaction with surgical experience was dichotomised in order to perform logistic regression using R Studio software v0.98. The survey was completed by 150 respondents, with 26 % completing at least 10 basic surgical learning activities during their surgical rotation. On multivariate analysis, the completion of these learning activities was significantly associated with a satisfactory rotation experience (p learning activities (p = 0.003). Surgical HOs who were informed about potential basic surgical learning activities that can be performed during their rotations performed significantly more of these activities. And these activities were associated with a significantly greater satisfaction with surgical rotations. Therefore, we recommend facilitating HOs completion of these activities as this will ensure that basic surgical competencies are achieved and that HOs will be more satisfied with their surgical experience.

  8. Influence of probe geometry on the response of an electrostatic probe

    DEFF Research Database (Denmark)

    Johansson, Torben; Crichton, George C; McAllister, Iain Wilson


    The response of an electrostatic probe is examined with reference to the probe geometry. The study involves the evaluation of the probe lambda function, from which response-related characteristic parameters can be derived. These parameters enable the probe detection sensitivity Se and spatial...

  9. Surgical management of primary and recurrent melanoma. (United States)

    Farma, Jeffrey M; Kulkarni, Nandini; Hsu, Cary


    Melanoma accounts for less than 2% of skin cancer cases but causes most skin cancer-related deaths. Surgery continues to be the cornerstone of treatment of melanoma and surgical principles are guided by data derived from clinical research. This article examines the evolution of surgical techniques for the diagnosis and treatment of primary and locally recurrent melanoma.

  10. Traumatic foot injuries in horses: surgical management. (United States)

    Burba, Daniel J


    Managing traumatic foot wounds in horses may require surgical intervention. These wounds include coronary-band and heel-bulb lacerations, septic pedal osteitis, septic navicular bursitis, sepsis of the collateral cartilages, and hoof-wall injuries. This article provides a practical overview of the surgical management of these types of wounds.

  11. Surgical site infection in posterior spine surgery

    African Journals Online (AJOL)


    Mar 20, 2016 ... Background: Surgical site infections (SSIs) in spine surgery remain a significant cause of ... before postoperative day 5 were associated with an increase in the rate of SSI. .... Table 1: Patient characteristics and associated wound .... patients with superficial or deep surgical site infection after spinal surgery.

  12. Multimodal strategies to improve surgical outcome

    DEFF Research Database (Denmark)

    Kehlet, Henrik; Wilmore, Douglas W


    surgical procedures or require only 1 to 2 days of postoperative hospitalization. Reorganization of the perioperative team (anesthesiologists, surgeons, nurses, and physical therapists) will be essential to achieve successful fast track surgical programs. CONCLUSIONS: Understanding perioperative...... track" surgery programs represents the major challenge for the medical professionals working to achieve a "pain and risk free" perioperative course....

  13. Non-surgical embryo transfer in pigs

    NARCIS (Netherlands)

    Hazeleger, W.


    Embryo transfer in pigs has been performed surgically for a long time. However, a less invasive, non-surgical, procedure of embryo transfer could be a valuable tool for research (to study embryo survival and embryo-uterus interactions) and practical applications (export, prevention of




    Orthognathic surgery is a surgical procedure largely practiced throughout the world for the correction of various maxillofacial deformities. The procedure for correcting a particular deformity will be done after proper evaluation, which includes cephalometric, dental model analysis and photographs. The patient undergoes pre-surgical orthodontic correction for dental compensation, after which surgery is planned. During the last few decades, the profession has witnessed ...

  15. Surgical management of pancreatic neuroendocrine tumors

    NARCIS (Netherlands)

    Jilesen, A.P.J.


    This thesis gives an overview of the surgical management and prognosis of patients with pancreatic neuroendocrine tumors (pNET). A systematic review including 2600 studies, was performed on complications and survival after different surgical procedures for pNETs. The overall pancreatic fistula rate

  16. A Comparative Evaluation for Biologic Width following Surgical Crown Lengthening Using Gingivectomy and Ostectomy Procedure. (United States)

    Ganji, Kiran Kumar; Patil, Veena Ashok; John, Jiji


    Surgical crown lengthening has been proposed as a means of facilitating restorative procedures and preventing injuries in teeth with structurally inadequate clinical crown or exposing tooth structure in the presence of deep, subgingival pathologies which may hamper the access for proper restorative measures. Histological studies utilizing animal models have shown that postoperative crestal resorption allowed reestablishment of the biologic width. However, very little has been done in humans. Aims. The purpose of the study was to evaluate the potential changes in the periodontal tissues, particularly the biologic width, following surgical crown lengthening by two surgical procedures before and after crown placement. Methods and Material. Twenty (20) patients who needed surgical crown lengthening to gain retention necessary for prosthetic treatment and/or to access caries, tooth fracture, or previous prosthetic margins entered the study. The following parameters were obtained from line angles of treated teeth (teeth requiring surgical crown lengthening) and adjacent sites: Plaque and Gingival Indices (PI) & (GI), Position of Gingival Margin from reference Stent (PGMRS), Probing depth (PD), and Biologic Width (BW). Statistical Analysis Used. Student "t" Test. Results. Initial baseline values of biologic width were 2.55 mm (Gingivectomy procedure B1 Group) and 1.95 mm (Ostectomy procedure B2 Group) and after surgical procedure the values were 1.15 mm and 1.25 mm. Conclusions. Within the limitations of the study the biologic width, at treated sites, was re-established to its original vertical dimension by 3 months. Ostectomy with apically positioned flap can be considered as a more effective procedure than Gingivectomy for Surgical Crown Lengthening.

  17. A Comparative Evaluation for Biologic Width following Surgical Crown Lengthening Using Gingivectomy and Ostectomy Procedure

    Directory of Open Access Journals (Sweden)

    Kiran Kumar Ganji


    Full Text Available Surgical crown lengthening has been proposed as a means of facilitating restorative procedures and preventing injuries in teeth with structurally inadequate clinical crown or exposing tooth structure in the presence of deep, subgingival pathologies which may hamper the access for proper restorative measures. Histological studies utilizing animal models have shown that postoperative crestal resorption allowed reestablishment of the biologic width. However, very little has been done in humans. Aims. The purpose of the study was to evaluate the potential changes in the periodontal tissues, particularly the biologic width, following surgical crown lengthening by two surgical procedures before and after crown placement. Methods and Material. Twenty (20 patients who needed surgical crown lengthening to gain retention necessary for prosthetic treatment and/or to access caries, tooth fracture, or previous prosthetic margins entered the study. The following parameters were obtained from line angles of treated teeth (teeth requiring surgical crown lengthening and adjacent sites: Plaque and Gingival Indices (PI & (GI, Position of Gingival Margin from reference Stent (PGMRS, Probing depth (PD, and Biologic Width (BW. Statistical Analysis Used. Student “t” Test. Results. Initial baseline values of biologic width were 2.55 mm (Gingivectomy procedure B1 Group and 1.95 mm (Ostectomy procedure B2 Group and after surgical procedure the values were 1.15 mm and 1.25 mm. Conclusions. Within the limitations of the study the biologic width, at treated sites, was re-established to its original vertical dimension by 3 months. Ostectomy with apically positioned flap can be considered as a more effective procedure than Gingivectomy for Surgical Crown Lengthening.

  18. Surgical Strategies for Cervical Spinal Neurinomas. (United States)

    Ito, Kiyoshi; Aoyama, Tatsuro; Miyaoka, Yoshinari; Horiuchi, Tetsuyoshi; Hongo, Kazuhiro


    Cervical spinal neurinomas are benign tumors that arise from nerve roots. Based on their location, these tumors can also take the form of a dumbbell-shaped mass. Treatment strategies for these tumors have raised several controversial issues such as appropriate surgical indications and selection of surgical approaches for cervical dumbbell-shaped spinal neurinomas. In this report, we review previous literature and retrospectively analyze cervical spinal neurinoma cases that have been treated at our hospital. Surgical indications and approaches based on tumor location and severity are discussed in detail. Thus, with advances in neuroimaging and neurophysiological monitoring, we conclude that appropriate surgical approaches and intraoperative surgical manipulations should be chosen on a case-by-case basis.

  19. Disparities between industrial and surgical ergonomics. (United States)

    Seagull, F Jacob


    A surgeon's work environment and working conditions are often harsher than those of an industrial worker. Accepted principles and regulations of ergonomics in manufacturing are largely ignored or absent in the medical/surgical domain. Examples include poor surgical tool handle design, awkward and stressful surgical postures, and prolonged standing without breaks and without a foot mat. In these and other areas, there are documented "best practices" for industrial hygiene and ergonomics that are not yet widely accepted for surgery. There is support in the literature for innovations in surgical ergonomics, yet adoption is not widespread. In the absence of these ergonomic principles, surgical repetitive strain injuries in minimally invasive surgery are reaching epidemic levels. As ergonomists, it falls upon us to understand why current solutions have not been widely adopted within this domain, and to derive solutions to the unique challenges of surgery.

  20. The effect of fasting on surgical performance

    DEFF Research Database (Denmark)

    Schefte, David Fenger; Rosenstock, Steffen Jais


    BACKGROUND: It is unknown whether fasting has any impact on surgical performance. This simulator-based study investigates whether fasting affects surgical performance. METHODS: Twelve healthy medical students [seven women, mean age 26.5 years (range 23-34)] with no prior experience with surgical...... simulators underwent a short course introduction to the LapSim(®) simulator. After having reached a predefined level, the participants performed five simulated salpingectomies on the LapSim(®) simulator 5-30 days after the initial introduction. The procedures took place at 9 a.m. and 2 p.m. after fasting...... in the longitudinal axis with the left hand. CONCLUSION: The simulator-based study suggests that 17 h of fasting does not deteriorate surgical performance. Further studies on the effect of fasting on surgical performance are needed....

  1. Zero voltage mass spectrometry probes and systems

    Energy Technology Data Exchange (ETDEWEB)

    Cooks, Robert Graham; Wleklinski, Michael Stanley; Bag, Soumabha; Li, Yafeng


    The invention generally relates to zero volt mass spectrometry probes and systems. In certain embodiments, the invention provides a system including a mass spectrometry probe including a porous material, and a mass spectrometer (bench-top or miniature mass spectrometer). The system operates without an application of voltage to the probe. In certain embodiments, the probe is oriented such that a distal end faces an inlet of the mass spectrometer. In other embodiments, the distal end of the probe is 5 mm or less from an inlet of the mass spectrometer.

  2. Project Prometheus and Future Entry Probe Missions (United States)

    Spilker, Thomas R.


    A viewgraph presentation on project Prometheus and future entry probe missions is shown. The topics include: 1) What Is Project Prometheus?; 2) What Capabilities Can Project Prometheus Offer? What Mission Types Are Being Considered?; 3) Jupiter Icy Moons Orbiter (JIMO); 4) How Are Mission Opportunities Changing?; 5) Missions Of Interest a Year Ago; 6) Missions Now Being Considered For Further Study; 7) Galileo-Style (Conventional) Probe Delivery; 8) Galileo-Style Probe Support; 9) Conventional Delivery and Support of Multiple Probes; 10) How Entry Probe Delivery From an NEP Vehicle Is Different; and 11) Concluding Remarks.

  3. [Surgical treatment of chiasmal gliomas in children]. (United States)

    Helcl, F


    Chiasmal gliomas are rare brain tumors occurring especially in children. Their proper treatment is still controversial and consists of surgery, radiotherapy and chemotherapy. Surgical removal of these tumors can usually be only partial or subtotal and radiotherapy frequently follows. There are supporters of surgical approach, as well as its enemies. The author has been engaged in problems of optimal treatment of this entity for more than 10 years. He is offering a review of knowledge from the literature concerning surgical treatment of this disease in children. The great majority of articles in the literature are dealing with retrospective analysis of relatively small series of patients usually treated in single neurosurgical department and the surgical treatment is enclosed like a part of combined therapy. Articles dealing only with surgical treatment of chiasmal gliomas are few and reviews determining the contemporary role of surgery of this entity are also lacking. This was the main impulse for writing this compilation. The short history of surgical therapy is reviewed. Some new trends of this therapy are also mentioned (microsurgery, Cavitron Ultrasonic Surgical Aspirator and peroperative use of visual evoked potentials). Up to date criteria for surgical treatment of chiasmal gliomas in children are given-exploration of chiasmal region and performing a biopsy in all cases, radical surgery only in extrinsic gliomas of the chiasmal region and conservative surgical approach to intrinsic chiasmal gliomas. It is emphasized that the significance of obstructive hydrocephalus in this entity has not been fully estimated till now, as well as the role of shunting procedures. Surgical treatment remains, nevertheless, an important armamentarium in the management of chiasmal gliomas in children. (Ref. 20.)

  4. Quality of pharmaceutical care in surgical patients.

    Directory of Open Access Journals (Sweden)

    Monica de Boer

    Full Text Available BACKGROUND: Surgical patients are at risk for preventable adverse drug events (ADEs during hospitalization. Usually, preventable ADEs are measured as an outcome parameter of quality of pharmaceutical care. However, process measures such as QIs are more efficient to assess the quality of care and provide more information about potential quality improvements. OBJECTIVE: To assess the quality of pharmaceutical care of medication-related processes in surgical wards with quality indicators, in order to detect targets for quality improvements. METHODS: For this observational cohort study, quality indicators were composed, validated, tested, and applied on a surgical cohort. Three surgical wards of an academic hospital in the Netherlands (Academic Medical Centre, Amsterdam participated. Consecutive elective surgical patients with a hospital stay longer than 48 hours were included from April until June 2009. To assess the quality of pharmaceutical care, the set of quality indicators was applied to 252 medical records of surgical patients. RESULTS: Thirty-four quality indicators were composed and tested on acceptability and content- and face-validity. The selected 28 candidate quality indicators were tested for feasibility and 'sensitivity to change'. This resulted in a final set of 27 quality indicators, of which inter-rater agreements were calculated (kappa 0.92 for eligibility, 0.74 for pass-rate. The quality of pharmaceutical care was assessed in 252 surgical patients. Nearly half of the surgical patients passed the quality indicators for pharmaceutical care (overall pass rate 49.8%. Improvements should be predominantly targeted to medication care related processes in surgical patients with gastro-intestinal problems (domain pass rate 29.4%. CONCLUSIONS: This quality indicator set can be used to measure quality of pharmaceutical care and detect targets for quality improvements. With these results medication safety in surgical patients can be enhanced.

  5. Surgical Treatment for Pulmonary Hamartomas

    Directory of Open Access Journals (Sweden)

    Funda Ižncekara


    Full Text Available Aim: In this study, we evaluated the patients operated for hamartoma and treated endobronchially and the diagnostic value of this approach has been examined. Material and Method: 59 patients (24 females, 35 males; mean age 53 years, range 28-78 years which were operated and endobronchial treated for hamartoma in our clinic between January 2003 - January 2013 were analyzed retrospectively. Patient age, sex, symptoms, histopathological, surgical procedures and treatment outcomes were evaluated. Results: The most common complaint was shortness of breath, while 25 patients were asymptomatic. Thoracotomy and mass enucleation in 29 patients (%49,15, thoracotomy and wedge resection in 18 patients (%30.5, VATS and wedge resection in 4 patients (%6.77, thoracotomy and upper lobectomy in 4 patients (%6.77, thoracotomy and lower lobectomy in 2 patients (%3.38 and left upper lobe segmentectomy in 1 patient (%1.69 and right upper bronchial sleeve resection in 1 patient were performed. The postoperative pathology of lesions examined and diagnosis were chondroid hamartoma in 28 , pulmonary hamartoma in 20 , hamartoma chondrolypomatous in 11 and the bronchial hamartoma in 2 . No mortality was observed intraoperatively. Discussion: Although hamartomas are benign , diagnosis should be made because it can be confused with lung cancer. Definitive diagnosis and treatment can be performed successfully through VATS in primarily appropriate cases with minimal morbidity or thoracotomy or endobronchial treatment.

  6. Augmented reality in surgical procedures (United States)

    Samset, E.; Schmalstieg, D.; Vander Sloten, J.; Freudenthal, A.; Declerck, J.; Casciaro, S.; Rideng, Ø.; Gersak, B.


    Minimally invasive therapy (MIT) is one of the most important trends in modern medicine. It includes a wide range of therapies in videoscopic surgery and interventional radiology and is performed through small incisions. It reduces hospital stay-time by allowing faster recovery and offers substantially improved cost-effectiveness for the hospital and the society. However, the introduction of MIT has also led to new problems. The manipulation of structures within the body through small incisions reduces dexterity and tactile feedback. It requires a different approach than conventional surgical procedures, since eye-hand co-ordination is not based on direct vision, but more predominantly on image guidance via endoscopes or radiological imaging modalities. ARIS*ER is a multidisciplinary consortium developing a new generation of decision support tools for MIT by augmenting visual and sensorial feedback. We will present tools based on novel concepts in visualization, robotics and haptics providing tailored solutions for a range of clinical applications. Examples from radio-frequency ablation of liver-tumors, laparoscopic liver surgery and minimally invasive cardiac surgery will be presented. Demonstrators were developed with the aim to provide a seamless workflow for the clinical user conducting image-guided therapy.

  7. Audit of Orthopaedic Surgical Documentation

    Directory of Open Access Journals (Sweden)

    Fionn Coughlan


    Full Text Available Introduction. The Royal College of Surgeons in England published guidelines in 2008 outlining the information that should be documented at each surgery. St. James’s Hospital uses a standard operation sheet for all surgical procedures and these were examined to assess documentation standards. Objectives. To retrospectively audit the hand written orthopaedic operative notes according to established guidelines. Methods. A total of 63 operation notes over seven months were audited in terms of date and time of surgery, surgeon, procedure, elective or emergency indication, operative diagnosis, incision details, signature, closure details, tourniquet time, postop instructions, complications, prosthesis, and serial numbers. Results. A consultant performed 71.4% of procedures; however, 85.7% of the operative notes were written by the registrar. The date and time of surgery, name of surgeon, procedure name, and signature were documented in all cases. The operative diagnosis and postoperative instructions were frequently not documented in the designated location. Incision details were included in 81.7% and prosthesis details in only 30% while the tourniquet time was not documented in any. Conclusion. Completion and documentation of operative procedures were excellent in some areas; improvement is needed in documenting tourniquet time, prosthesis and incision details, and the location of operative diagnosis and postoperative instructions.

  8. Surgical Treatment in Uveal Tumors

    Directory of Open Access Journals (Sweden)

    Kaan Gündüz


    Full Text Available Surgical treatment in uveal tumors can be done via iridectomy, partial lamellar sclerouvectomy (PLSU and endoresection. Iridectomy is done in iris tumors without angle and ciliary body involvement. PLSU is performed in tumors with ciliary body and choroidal involvement. For this operation, a partial thickness scleral flap is dissected, the intraocular tumor is excised, and the flap is sutured back in position. PLSU surgery is done in iridociliary and ciliary body tumors with less than 3 clock hours of iris and ciliary body involvement and in choroidal tumors with a base diameter less than 15 mm. However, it can be employed in any size tumor for biopsy purposes. Potential complications of PLSU surgery include vitreous hemorrhage, cataract, retinal detachment, and endophthalmitis. Endoresection is a technique whereby the intraocular tumor is excised using vitrectomy techniques. The rationale for performing endoresection is based on the fact that irradiated uveal melanomas may be associated with exudation and neovascular glaucoma and removing the dead tumor tissue may contribute to better visual outcome. There are some centers where endoresection is done without prior radiotherapy. Allegedly, avoidance of radiation retinopathy and papillopathy are the main advantages of using endoresection without prior radiotherapy. (Turk J Ophthalmol 2014; 44: Supplement 29-34

  9. [Surgical treatment of anal fistula]. (United States)

    Zeng, Xiandong; Zhang, Yong


    Anal fistula is a common disease. It is also quite difficult to be solved without recurrence or damage to the anal sphincter. Several techniques have been described for the management of anal fistula, but there is no final conclusion of their application in the treatment. This article summarizes the history of anal fistula management, the current techniques available, and describes new technologies. Internet online searches were performed from the CNKI and Wanfang databases to identify articles about anal fistula management including seton, fistulotomy, fistulectomy, LIFT operation, biomaterial treatment and new technology application. Every fistula surgery technique has its own place, so it is reasonable to give comprehensive individualized treatment to different patients, which may lead to reduced recurrence and avoidance of damage to the anal sphincter. New technologies provide promising alternatives to traditional methods of management. Surgeons still need to focus on the invention and improvement of the minimally invasive techniques. Besides, a new therapeutic idea is worth to explore that the focus of surgical treatment should be transferred to prevention of the formation of anal fistula after perianal abscess.

  10. Flexible Ultrasonic Phased-Array Probe

    Institute of Scientific and Technical Information of China (English)

    施克仁; 阙开良; 郭大勇


    In ultrasonic phased-array testing, most probes are rigid with fixed elements. However, when testing a cambered piece, a rigid probe cannot be used directly, but an ultrasonic chock or coupling media must be used, which adds cost and reduces the accuracy. The objective of this research was to improve the tests of cambered pieces. A flexible ultrasonic phased-array probe was developed to do the flexible phased-array testing. The key technologies in the flexible phased-array probe include the probe design and the phased-array control. A new method was developed to design the flexible probe according to the curvature of the piece and the test depth. The method includes the calculation of the element's height (he), the relative rotation angle ((e), the distance between the adjoining elements (de), and the element's effective testing range. A flexible ultrasonic phased-array probe has been developed using this method.

  11. Retrospective study of teeth with a poor prognosis following non-surgical periodontal treatment. (United States)

    Ekuni, Daisuke; Yamamoto, Tatsuo; Takeuchi, Noriko


    The aim of this retrospective study was to assess teeth with a poor prognosis and the proximal periodontium of adjacent teeth, and to identify the risk factors associated with the loss of teeth with a poor prognosis following non-surgical periodontal treatment. Teeth with a poor prognosis (n=113), teeth adjacent to those of poor prognosis (n=105) and non-adjacent teeth (n=51) were evaluated in 25 non-smoking patients who had received supportive periodontal treatment for 5-16 years following non-surgical periodontal treatment at a university hospital. Probing pocket depth (PPD), percentage of alveolar bone loss, presence of tooth mobility and bleeding on probing in all teeth improved significantly after treatment. Logistic regression analysis showed that loss of teeth with a poor prognosis depended on the initial deepest PPD, tooth mobility and multi-rooted tooth. Teeth with a poor prognosis did not affect the proximal periodontium of the adjacent teeth, and progression of periodontal disease in these teeth and adjacent teeth can be prevented by non-surgical periodontal treatment in non-smokers. The risk factors for loss of teeth with a poor prognosis were the initial deepest PPD, tooth mobility and multi-rooted tooth.

  12. New real-time MR image-guided surgical robotic system for minimally invasive precision surgery

    Energy Technology Data Exchange (ETDEWEB)

    Hashizume, M.; Yasunaga, T.; Konishi, K. [Kyushu University, Department of Advanced Medical Initiatives, Faculty of Medical Sciences, Fukuoka (Japan); Tanoue, K.; Ieiri, S. [Kyushu University Hospital, Department of Advanced Medicine and Innovative Technology, Fukuoka (Japan); Kishi, K. [Hitachi Ltd, Mechanical Engineering Research Laboratory, Hitachinaka-Shi, Ibaraki (Japan); Nakamoto, H. [Hitachi Medical Corporation, Application Development Office, Kashiwa-Shi, Chiba (Japan); Ikeda, D. [Mizuho Ikakogyo Co. Ltd, Tokyo (Japan); Sakuma, I. [The University of Tokyo, Graduate School of Engineering, Bunkyo-Ku, Tokyo (Japan); Fujie, M. [Waseda University, Graduate School of Science and Engineering, Shinjuku-Ku, Tokyo (Japan); Dohi, T. [The University of Tokyo, Graduate School of Information Science and Technology, Bunkyo-Ku, Tokyo (Japan)


    To investigate the usefulness of a newly developed magnetic resonance (MR) image-guided surgical robotic system for minimally invasive laparoscopic surgery. The system consists of MR image guidance [interactive scan control (ISC) imaging, three-dimensional (3-D) navigation, and preoperative planning], an MR-compatible operating table, and an MR-compatible master-slave surgical manipulator that can enter the MR gantry. Using this system, we performed in vivo experiments with MR image-guided laparoscopic puncture on three pigs. We used a mimic tumor made of agarose gel and with a diameter of approximately 2 cm. All procedures were successfully performed. The operator only advanced the probe along the guidance device of the manipulator, which was adjusted on the basis of the preoperative plan, and punctured the target while maintaining the operative field using robotic forceps. The position of the probe was monitored continuously with 3-D navigation and 2-D ISC images, as well as the MR-compatible laparoscope. The ISC image was updated every 4 s; no artifact was detected. A newly developed MR image-guided surgical robotic system is feasible for an operator to perform safe and precise minimally invasive procedures. (orig.)


    Institute of Scientific and Technical Information of China (English)

    YANG Yun-zhu(杨芸珠); SUN Zhe(孙喆); HU Chun-zhen(胡纯贞); YANG Yu-guo(杨裕国); JIN Li-jian(金力坚); LEUNG Hui-qiang(梁惠强); Esmond F Corbet


    Objective To observe the therapeutic effect of non-surgical treatment on diabetic Chinese with chronic periodontitis. Methods Moderate to advanced chronic periodontitis (CP) was studied in 36 diabetes mellitus (DM) patients classified as 20 with high and fiuctuating blood glucose level (DM-H) and 16 with relatively low and stable blood glucose level (DM-L). 28 non-DM CP patients acted as controls (Non-DM). Plaque index (PH), gingival index (Gl), bleeding on probing (BOP), probing depth (PD) and clinical attachment loss (AL)of all patients were recorded at 6 sites on each tooth at the baseline and 1,3 and 6 months after oral hygiene instruction ( OHI) , scaling and root planing. Results It was found that the short-term effect of non-surgical periodontal procedure had resulted in significant resolution of gingival inflammation and pronounced reduction in pocket depth and gain of attachment loss in both DM and Non-DM CP patients. Conclusion The pilot study suggested that non-surgical periodontal treatment allowed for favorable treatment responses in a group of Chinese diabetic subjects with chronic periodontitis and that their various profiles of blood glucose did not influence the short-term healing response to OHI, scaling and root planning.

  14. Surgical periodontal therapy at Tokyo Dental College Suidobashi Hospital: a statistical profile in 2010-2011. (United States)

    Hayakawa, Hiroki; Ota, Kei; Ida, Atsushi; Fujinami, Koushu; Furusawa, Masahiro; Makiishi, Takemi; Nikaido, Masahiko; Ichinohe, Tatsuya; Saito, Atsushi


    The aim of the present study was to investigate the profile of surgical periodontal therapy performed at the Suidobashi Hospital of Tokyo Dental College, during the period of April 2010 through March 2011. A total of 112 periodontal surgeries in 69 patients (mean age: 51.4 years; 28 men and 41 women) were registered for the data analysis. The surgical interventions performed by 17 dentists comprised 79 cases of open flap debridement, 27 cases of periodontal regenerative therapy with enamel matrix derivative and 6 cases of periodontal plastic surgery. Eighty percent of the surgical sites were in the molar region and 41 cases had furcation involvement. In these patients, an improvement in oral hygiene status was observed prior to surgery: the mean plaque score of 45% at initial visit was significantly reduced to 31% after initial periodontal therapy (p<0.01). At sites that subsequently received open flap debridement or periodontal regenerative therapy, the mean probing depth and clinical attachment level after initial therapy was 6.4 mm and 7.6 mm, respectively. These values were significantly lower than those at initial visit (p<0.01). Lower prevalence of sites with positive bleeding on probing was observed after initial therapy. The initial periodontal therapy performed was considered to be effective in improving the periodontal condition of the sites prior to surgery. More effort, however, is indicated in improvement of patient oral hygiene status.

  15. Videolaparoscopic surgical interventions in emergency surgery

    Directory of Open Access Journals (Sweden)

    Сергей Николаевич Завгородний


    Full Text Available Aim: To improve the results of treatment of patients with emergency surgical pathology by the analysis of the use of videolaparoscopic surgical interventions.Methods: in the period 2012–2014 year in MI “Zaporozhye municipal clinical hospital of emergency” in the first surgical department on the base of subdepartment “General surgery with care for patients” of Zaporozhye state medical university were carried out 791 videolaparoscopic surgical interventions.508 (64,2 % women, 283 (35,8 % men. The mean age of patients was 48±2,1.The most videolaparoscopic operations were carried out at the acute appendicitis– 359 (45,5 %. Laparoscopic cholecystectomy at the acute cholecystitis was carried out in 157 patients (19,9 %. At the acute commissural intestinal obstruction were carried out 8 videolaparoscopic operations – (1 %. Videolaparoscopic drainage of abdominal cavity at the acute pancreatitis was carried out in 79 patients (10 %. At gynecological pathology were carried out 162 videolaparoscopic surgical interventions (20,6 % and in 26 patients (3,1 % was done diagnostic videolaparoscopy.Result: At the acute appendicitis were carried out 359 (45,5 % videolaparoscopic surgical interventions. There were no complications in postsurgical period. The mean bed-day was 6,8±0,7.Videolaparoscopy at the acute cholecistitis was carried out in 157 patients (19,9 %. In 17 (10,8 % was carried out conversion and surgical intervention was continued from laparotory access.At the commissure intestinal obstruction were carried out 8 surgical interventions (1,0 %. All patients underwent surgery after the short-term pre-surgical preparation. Conversion was carried out in 2 patients (25 %. In 1 (12,5 % was injured the loop of small intestine and in 1 (12,5 % took place the total commissure disease in abdominal cavity.Diagnostic laparoscopy was carried out in 26 patients (3,1 %, in two of them – at the close blunt trauma of the stomach

  16. Probing the nano-bio interface with nanoplasmonic optical probes (United States)

    Yu, X.; Wu, Linxi; Khanehzar, Ali; Feizpour, Amin; Xu, Fangda; Reinhard, Björn M.


    Noble metal nanoparticles have large cross-sections in both optical and electron microscopy and plasmon coupling between noble metal nanoparticles facilitate the characterization of subdiffraction limit separations through spectral analysis of the scattered light in Plasmon Coupling Microscopy (PCM). The size compatibility of noble metal nanoparticles together with the ability to encode specific functionality in a rational fashion by control of the nanoparticle surface makes noble metal nanoparticles unique probes for a broad range of biological processes. Recent applications of the technology include i.) characterization of cellular heterogeneity in nanomaterial uptake and processing through macrophages, ii.) testing the role of viral membrane lipids in mediating viral binding and trafficking, and iii.) characterizing the spatial organization of cancer biomarkers in plasma membranes. This paper reviews some of these applications and introduces the physical and material science principles underlying them. We will also introduce the use of membrane wrapped noble metal nanoparticles, which combine the superb photophysical properties of a nanoparticle core with the biological functionality of a membrane, as probes in PCM.

  17. Astrophysical probes of fundamental physics

    Energy Technology Data Exchange (ETDEWEB)

    Martins, C.J.A.P. [Centro de Astrofisica, Universidade do Porto, Rua das Estrelas, 4150-762 Porto (Portugal); DAMTP, University of Cambridge, Wilberforce Road, Cambridge CB3 0WA (United Kingdom)


    I review the motivation for varying fundamental couplings and discuss how these measurements can be used to constrain fundamental physics scenarios that would otherwise be inaccessible to experiment. I highlight the current controversial evidence for varying couplings and present some new results. Finally I focus on the relation between varying couplings and dark energy, and explain how varying coupling measurements might be used to probe the nature of dark energy, with some advantages over standard methods. In particular I discuss what can be achieved with future spectrographs such as ESPRESSO and CODEX.

  18. Soft QGP probes with ALICE

    CERN Document Server

    Graczykowski, Łukasz Kamil


    In heavy-ion collisions at the LHC a hot and dense medium of deconfided partons, the Quark-Gluon Plasma (QGP), is created. Its global properties can be characterized by the measurements of particles in the low transverse momentum (or "soft") regime, which represent the majority of created particles. In this report we outline a selection of measurements of the soft probes by the ALICE experiment in pp, p--Pb, and Pb--Pb collisions. The paper focuses on recent flow measurements via angular correlations and femtoscopic studies. The first ever preliminary analysis of $\\mathrm{K}^0_{\\rm S}\\mathrm{K}^{\\pm}$ femtoscopy is also presented.

  19. Surgical treatment of perforated gastric ulcer

    Directory of Open Access Journals (Sweden)

    Korica Milan


    Full Text Available Introduction Peptic ulcer perforation is a complication of ulcer disease which requires urgent surgical treatment. The aim of this paper was to point out our experience in surgical treatment of perforated peptic ulcer. Material and methods This retrospective study analyzes results of surgical treatment in 365 patients with perforated peptic ulcer during the period January 1996 to December 2000. Results During the last 5-year period 365 patients were treated following peptic ulcer perforation. The average age was 43.53±8.26, with the span from 18 to 86. The most frequent surgical procedures in treatment of peptic ulcer perforation were: simple closure with biopsy (55.88%, excision of the ulcer with a pyloroplasty and vagotomy (35.29% as nonresection surgical procedures and stomach resection after Billroth II (8.83%. The postoperative mortality was 4.41%. Conclusions The methods of choice in surgical treatment of gastric ulcer perforation are nonresection surgical procedures with drug therapy and eradication of Helicobacter pylori, if present.

  20. Surgical treatment of traumatic lower limb pseudoaneurysm

    Institute of Scientific and Technical Information of China (English)

    Pan Zhongjie; Zhang Hua; Li Li; Jia Yutao; Tian Rong


    Objective:To summarize our experience in surgical treatment of traumatic lower limb pseudoaneurysm.Methods:Twenty patients with traumatic lower limb pseudoaneurysm were surgically treated in our department from January 2007 to January 2012.The treatment protocols included interventional covered-stent placement (10 cases),spring coil embolization (2 cases),and surgical operation (8 cases).Surgical operations included pseudoaneurysm repair (2 cases),autologousvein transplantation (1 case),and artificial-vessel bypass graft (5 cases).Results:All the patients were successfully treated without aggravating lower limb ischemia.Pseudoaneurysm disappeared after treatment.A surgical operation is suitable to most pseudoaneurysms,but its damage is relatively obvious and usually leads to more bleeding.It also requires a longer operating time.Compared to a surgical operation,interventional therapy is less traumatic and patients usually have a quicker recovery (P<0.05).All patients were followed up once per month for 12-36 months by color Doppler ultrasound examination.There were no cases of pseudoaneurysm recurrence.Conclusion:Both surgical operation and interventional therapy are safe and effective in the treatment of pseudoaneurysm.

  1. Mastoidectomy: anatomical parameters x surgical difficulty

    Directory of Open Access Journals (Sweden)

    Pereira Júnior, Anastácio Rodrigues


    Full Text Available Introduction: The lowered temporal meninges and/ or anterior sigmoid sinus are contiditions that can determine surgical difficulties in performing mastoidectomy. Objective: To correlate in the tomography the extent of the prolapse of the sigmoid sinus and of temporal meninges with the surgical difficulty in the mastoidectomy. Method: The tomographic measurements of prolapse sigmoid and of temporal meninges were correlated with the presence or non-presence of the surgical difficulty observed during the mastoidectomy procedure in patients with ostomatoiditis chronic (n=30. Form of study: Contemporary cohort transverse. Results: In 10 patients were observed surgical difficulty distributed as: due to prolapse of the sigmoid sinus (n = 2 or temporal meninges prolapse (n = 7 or both (n = 1. In patients in which the surgical difficulty was due to sigmoid sinus prolapse, the tomography distance of the anterior border of the sigmoid sinus to posterior wall of external auditory canal was lower than 9 mm. In patients in which surgical difficulty was due to temporal meninges prolapse, the tomographic distance to the upper plane of the petrous bone was 7 mm. Conclusion: The computerized tomography distance between the temporal meninges and the upper plane of the petrous bone 7 mm and the distance of the anterior border of the sigmoid sinus to posterior wall of external auditory canal was lower than 9 mm are predictive to the surgical difficulties to perform mastoidectomy.

  2. Do psychological variables affect early surgical recovery?

    Directory of Open Access Journals (Sweden)

    Michael N Mavros

    Full Text Available BACKGROUND: Numerous studies have examined the effect of psychological variables on surgical recovery, but no definite conclusion has been reached yet. We sought to examine whether psychological factors influence early surgical recovery. METHODS: We performed a systematic search in PubMed, Scopus and PsycINFO databases to identify studies examining the association of preoperative psychological variables or interventions with objectively measured, early surgical outcomes. RESULTS: We identified 16 eligible studies, 15 of which reported a significant association between at least one psychological variable or intervention and an early postoperative outcome. However, most studies also reported psychological factors not influencing surgical recovery and there was significant heterogeneity across the studies. Overall, trait and state anxiety, state anger, active coping, subclinical depression, and intramarital hostility appeared to complicate recovery, while dispositional optimism, religiousness, anger control, low pain expectations, and external locus of control seemed to promote healing. Psychological interventions (guided relaxation, couple support visit, and psychiatric interview also appeared to favor recovery. Psychological factors unrelated to surgical outcomes included loneliness, perceived social support, anger expression, and trait anger. CONCLUSION: Although the heterogeneity of the available evidence precludes any safe conclusions, psychological variables appear to be associated with early surgical recovery; this association could bear important implications for clinical practice. Large clinical trials and further analyses are needed to precisely evaluate the contribution of psychology in surgical recovery.

  3. Relationship between patient complaints and surgical complications (United States)

    Murff, H J; France, D J; Blackford, J; Grogan, E L; Yu, C; Speroff, T; Pichert, J W; Hickson, G B


    Background Patient complaints are associated with increased malpractice risk but it is unclear if complaints might be associated with medical complications. The purpose of this study was to determine whether an association exists between patient complaints and surgical complications. Methods A retrospective analysis of 16 713 surgical admissions was conducted over a 54 month period at a single academic medical center. Surgical complications were identified using administrative data. The primary outcome measure was unsolicited patient complaints. Results During the study period 0.9% of surgical admissions were associated with a patient complaint. 19% of admissions associated with a patient complaint included a postoperative complication compared with 12.5% of admissions without a patient complaint (p = 0.01). After adjusting for surgical specialty, co‐morbid illnesses and length of stay, admissions with complications had an odds ratio of 1.74 (95% confidence interval 1.01 to 2.98) of being associated with a complaint compared with admissions without complications. Conclusions Admissions with surgical complications are more likely to be associated with a complaint than surgical admissions without complications. Further research is necessary to determine if patient complaints might serve as markers for poor clinical outcomes. PMID:16456204

  4. Keratometry device for surgical support

    Directory of Open Access Journals (Sweden)

    Saia Paula


    Full Text Available Abstract Background High astigmatisms are usually induced during corneal suturing subsequent to tissue transplantation or any other surgery which involves corneal suturing. One of the reasons is that the procedure is intimately dependent on the surgeon's skill for suturing identical stitches. In order to evaluate the influence of the irregularity on suturing for the residual astigmatism, a prototype for ophthalmic surgical support has been developed. The final intention of this prototype is to be an evaluation tool for guided suture and as an outcome diminish the postoperative astigmatism. Methods The system consists of hand held ring with 36 infrared LEDs, that is to be projected onto the lachrymal film of the cornea. The image is reflected back through the optics of the ocular microscope and its distortion from the original circular shape is evaluated by developed software. It provides keratometric and circularity measurements during surgery in order to guide the surgeon for uniformity in suturing. Results The system is able to provide up to 23D of astigmatism (32D - 55D range and is ± 0.25D accurate. It has been tested in 14 volunteer patients intraoperative and has been compared to a commercial keratometer Nidek Oculus Hand-held corneal topographer. The correlation factors are 0.92 for the astigmatism and 0.97 for the associated axis. Conclusion The system is potentially efficient for guiding the surgeon on uniformity of suturing, presenting preliminary data indicating an important decrease on the residual astigmatism, from an average of 8D - for patients not submitted to the prototype guidance - to 1.4D - for patients who have actually been submitted to the prototype guidance - after the first 24 hours post-surgery and in the subsequent weeks. It also indicates that the surgeon should achieve circularity greater or equal to 98% in order to avoid postoperative astigmatisms over 1D. Trial Registration Trial registration number: CAAE - 0212.0.004.000-09.

  5. Recurrent periductal mastitis: Surgical treatment. (United States)

    Taffurelli, Mario; Pellegrini, Alice; Santini, Donatella; Zanotti, Simone; Di Simone, Domenico; Serra, Margherita


    Recurrent periductal mastitis is a benign breast disorder that often features a mammary fistula that runs between periareolar skin and the ductal mammary system. Due to the high recurrence rate of this disease, its management is controversial. This study was designed to assess the efficacy of fistulectomy (Hadfield operation), particularly with regard to its long-term outcome. We reviewed all women with recurrent periductal mastitis who underwent the Hadfield operation in the Breast Center in S.Orsola-Malpighi Hospital (Bologna University) from 2005 to 2015. All but one of the patients were heavy smokers and presented with a recurrent periareolar abscess and a periareolar mammary fistula. Eighteen women underwent the Hadfield surgical treatment. Mean age at the time of presentation was 42 years; 17 of 18 women smoked >10 cigarettes/d. All patients had a breast ultrasonography or mammography. Half of the patients had undergone antibiotic therapy with one or more prior abscess drainages or another form of operative treatment. All patients who underwent operative treatment had no postoperative events and were satisfied with the cosmetic results. Squamous metaplasia was always present in the specimens. After a median follow-up of 36 months, 2 patients developed a recurrence after a few months; neither had stopped smoking. Based on our review of the literature and taking into account the results of this study, it seems clear that the best treatment involves a combined total excision of the affected duct and the fistulous tract. Due to the important role of smoking in this disease, it is important to encourage patients to stop smoking. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Arthroscopic Posterior Subtalar Arthrodesis: Surgical Technique (United States)

    Vilá y Rico, Jesús; Ojeda Thies, Cristina; Parra Sanchez, Guillermo


    Surgical fusion of the subtalar joint is a procedure indicated to alleviate pain of subtalar origin, such as in post-traumatic osteoarthritis, adult-acquired flatfoot deformity, and other disorders. Open subtalar arthrodesis has been performed with predictable results, but concerns exist regarding injury to proprioception and local vascularity due to wide surgical dissection. Minimally invasive techniques try to improve results by avoiding these issues but have a reputation for being technically demanding. We describe the surgical technique for arthroscopic subtalar arthrodesis, which has proved to be a safe and reliable technique in our experience, with consistent improvements in American Orthopaedic Foot & Ankle Society scores. PMID:27073783

  7. Retained Surgical Foreign Bodies after Surgery

    Directory of Open Access Journals (Sweden)

    Valon A. Zejnullahu


    Full Text Available The problem of retained surgical bodies (RSB after surgery is an issue for surgeons, hospitals and the entire medical team. They have potentially harmful consequences for the patient as they can be life threatening and usually, a further operation is necessary. The incidence of RSB is between 0.3 to 1.0 per 1,000 abdominal operations, and they occur due to a lack of organisation and communication between surgical staff during the process. Typically, the RSB are surgical sponges and instruments located in the abdomen, retroperitoneum and pelvis.

  8. Arthroscopic Posterior Subtalar Arthrodesis: Surgical Technique. (United States)

    Vilá Y Rico, Jesús; Ojeda Thies, Cristina; Parra Sanchez, Guillermo


    Surgical fusion of the subtalar joint is a procedure indicated to alleviate pain of subtalar origin, such as in post-traumatic osteoarthritis, adult-acquired flatfoot deformity, and other disorders. Open subtalar arthrodesis has been performed with predictable results, but concerns exist regarding injury to proprioception and local vascularity due to wide surgical dissection. Minimally invasive techniques try to improve results by avoiding these issues but have a reputation for being technically demanding. We describe the surgical technique for arthroscopic subtalar arthrodesis, which has proved to be a safe and reliable technique in our experience, with consistent improvements in American Orthopaedic Foot & Ankle Society scores.

  9. [Orthognathic surgery: surgical failures and complications]. (United States)

    Guyot, Laurent


    Orthognathic surgery procedures mark the endpoint of lengthy orthodontic-surgical preparations and herald the completion of treatment for patients and their families. The main types of procedure are full maxillary Le Fort I osteotomies, mandibular osteotomies and chin surgery. To ensure a successful outcome, all require a favorable environment and extreme technical skill. But, like all surgical operations, they are also subject to peri- and post-operative complications resulting from treatment hazards or errors. Whatever the cause, surgical complications can entail failures in the management of the malformation. By seeking to understand and analyzing these complications, we can already help to prevent and reduce the contingent risks of failure.

  10. [Surgical tactics by various ameloblastic tumors]. (United States)

    Semkin, V A; Grigor'ian, A S; Babichenko, I I; Usachev, E S; Zaretskaia, A S


    Ameloblastoma and ameloblastic fibroma are benign odontogenous tumors of the jaws with local destructive growth, prone to recurrence. They have various typical radiological and histological features. Surgical tactic generally includes partial resection of the affected jaw. Immunohistochemical study of the tumor tissues allows assessing the expression of tumor progression markers and forecasting tumor growth thus providing individual choice of surgical tactics. Our experience in treatment of ameloblastic tumors showed total biopsy with osseous surgical margins resection to be sufficient for normal bone structure remodeling in some patients.

  11. Misuse of statistics in surgical literature. (United States)

    Thiese, Matthew S; Ronna, Brenden; Robbins, Riann B


    Statistical analyses are a key part of biomedical research. Traditionally surgical research has relied upon a few statistical methods for evaluation and interpretation of data to improve clinical practice. As research methods have increased in both rigor and complexity, statistical analyses and interpretation have fallen behind. Some evidence suggests that surgical research studies are being designed and analyzed improperly given the specific study question. The goal of this article is to discuss the complexities of surgical research analyses and interpretation, and provide some resources to aid in these processes.

  12. Dexterity testing and residents' surgical performance. (United States)

    Kirby, T J


    1. With some exceptions, those who choose ophthalmology as a career may approximate the general population in innate manual dexterity. 2. Many factors other than manual dexterity influence the development of surgical skills by residents. 3. If dexterity testing is to be used, the addition or inclusion of tests for spatial aptitudes may be more helpful than simple dexterity tests alone. The predictive value of such tests for surgical performance would need vertification. 4. The development of a special test directly related to handling surgical instruments, to cutting, and to sewing (the criteria) may be more practical than the ones used in this study.

  13. Dermato-Surgical Approach In Vitiliogo

    Directory of Open Access Journals (Sweden)

    Malakar Subrata


    Full Text Available Vitiligo is a hypomelanotic disorder often difficult to treat. Different medicinal treatments such as PUNA, steroids and adjunct theraples give partial or complete repigmentation in about 60-90% cases. Moreover, vitiligo patches which are refractory to most medical therapies are acrofacial, mucosal and segmental. At the backdrop of these medicinal shortcomings, various surgical procedures and their modifications have gradually evolved. To decide why, where and when surgical interference is required, is of utmost importance. In this review different surgical modes, including some of the latest, and their future prospects are discussed.

  14. Radiation damping in microcoil NMR probes. (United States)

    Krishnan, V V


    Radiation damping arises from the field induced in the receiver coil by large bulk magnetization and tends to selectively drive this magnetization back to equilibrium much faster than relaxation processes. The demand for increased sensitivity in mass-limited samples has led to the development of microcoil NMR probes that are capable of obtaining high quality NMR spectra with small sample volumes (nL-microL). Microcoil probes are optimized to increase sensitivity by increasing either the sample-to-coil ratio (filling factor) of the probe or quality factor of the detection coil. Though radiation damping effects have been studied in standard NMR probes, these effects have not been measured in the microcoil probes. Here a systematic evaluation of radiation damping effects in a microcoil NMR probe is presented and the results are compared with similar measurements in conventional large volume samples. These results show that radiation-damping effects in microcoil probe is much more pronounced than in 5 mm probes, and that it is critically important to optimize NMR experiments to minimize these effects. As microcoil probes provide better control of the bulk magnetization, with good RF and B0 inhomogeneity, in addition to negligible dipolar field effects due to nearly spherical sample volumes, these probes can be used exclusively to study the complex behavior of radiation damping.

  15. ProbeMaker: an extensible framework for design of sets of oligonucleotide probes (United States)

    Stenberg, Johan; Nilsson, Mats; Landegren, Ulf


    Background Procedures for genetic analyses based on oligonucleotide probes are powerful tools that can allow highly parallel investigations of genetic material. Such procedures require the design of large sets of probes using application-specific design constraints. Results ProbeMaker is a software framework for computer-assisted design and analysis of sets of oligonucleotide probe sequences. The tool assists in the design of probes for sets of target sequences, incorporating sequence motifs for purposes such as amplification, visualization, or identification. An extension system allows the framework to be equipped with application-specific components for evaluation of probe sequences, and provides the possibility to include support for importing sequence data from a variety of file formats. Conclusion ProbeMaker is a suitable tool for many different oligonucleotide design and analysis tasks, including the design of probe sets for various types of parallel genetic analyses, experimental validation of design parameters, and in silico testing of probe sequence evaluation algorithms. PMID:16171527

  16. Advanced oxidation scanning probe lithography (United States)

    Ryu, Yu K.; Garcia, Ricardo


    Force microscopy enables a variety of approaches to manipulate and/or modify surfaces. Few of those methods have evolved into advanced probe-based lithographies. Oxidation scanning probe lithography (o-SPL) is the only lithography that enables the direct and resist-less nanoscale patterning of a large variety of materials, from metals to semiconductors; from self-assembled monolayers to biomolecules. Oxidation SPL has also been applied to develop sophisticated electronic and nanomechanical devices such as quantum dots, quantum point contacts, nanowire transistors or mechanical resonators. Here, we review the principles, instrumentation aspects and some device applications of o-SPL. Our focus is to provide a balanced view of the method that introduces the key steps in its evolution, provides some detailed explanations on its fundamentals and presents current trends and applications. To illustrate the capabilities and potential of o-SPL as an alternative lithography we have favored the most recent and updated contributions in nanopatterning and device fabrication.

  17. Compact Nanowire Sensors Probe Microdroplets. (United States)

    Schütt, Julian; Ibarlucea, Bergoi; Illing, Rico; Zörgiebel, Felix; Pregl, Sebastian; Nozaki, Daijiro; Weber, Walter M; Mikolajick, Thomas; Baraban, Larysa; Cuniberti, Gianaurelio


    The conjunction of miniature nanosensors and droplet-based microfluidic systems conceptually opens a new route toward sensitive, optics-less analysis of biochemical processes with high throughput, where a single device can be employed for probing of thousands of independent reactors. Here we combine droplet microfluidics with the compact silicon nanowire based field effect transistor (SiNW FET) for in-flow electrical detection of aqueous droplets one by one. We chemically probe the content of numerous (∼10(4)) droplets as independent events and resolve the pH values and ionic strengths of the encapsulated solution, resulting in a change of the source-drain current ISD through the nanowires. Further, we discuss the specificities of emulsion sensing using ion sensitive FETs and study the effect of droplet sizes with respect to the sensor area, as well as its role on the ability to sense the interior of the aqueous reservoir. Finally, we demonstrate the capability of the novel droplets based nanowire platform for bioassay applications and carry out a glucose oxidase (GOx) enzymatic test for glucose detection, providing also the reference readout with an integrated parallel optical detector.

  18. Tunable nanowire nonlinear optical probe

    Energy Technology Data Exchange (ETDEWEB)

    Nakayama, Yuri; Pauzauskie, Peter J.; Radenovic, Aleksandra; Onorato, Robert M.; Saykally, Richard J.; Liphardt, Jan; Yang, Peidong


    One crucial challenge for subwavelength optics has been thedevelopment of a tunable source of coherent laser radiation for use inthe physical, information, and biological sciences that is stable at roomtemperature and physiological conditions. Current advanced near-fieldimaging techniques using fiber-optic scattering probes1,2 have alreadyachieved spatial resolution down to the 20-nm range. Recently reportedfar-field approaches for optical microscopy, including stimulatedemission depletion (STED)3, structured illumination4, and photoactivatedlocalization microscopy (PALM)5, have also enabled impressive,theoretically-unlimited spatial resolution of fluorescent biomolecularcomplexes. Previous work with laser tweezers6-8 has suggested the promiseof using optical traps to create novel spatial probes and sensors.Inorganic nanowires have diameters substantially below the wavelength ofvisible light and have unique electronic and optical properties9,10 thatmake them prime candidates for subwavelength laser and imagingtechnology. Here we report the development of an electrode-free,continuously-tunable coherent visible light source compatible withphysiological environments, from individual potassium niobate (KNbO3)nanowires. These wires exhibit efficient second harmonic generation(SHG), and act as frequency converters, allowing the local synthesis of awide range of colors via sum and difference frequency generation (SFG,DFG). We use this tunable nanometric light source to implement a novelform of subwavelength microscopy, in which an infrared (IR) laser is usedto optically trap and scan a nanowire over a sample, suggesting a widerange of potential applications in physics, chemistry, materials science,and biology.

  19. Sensitive Probe for Symmetry Potential

    Institute of Scientific and Technical Information of China (English)

    LIU Jian-Ye; XIAO Guo-Qing; GUO Wen-Jun; REN ZhongZhou; ZUO Wei; LEE Xi-Guo


    Based on both very obvious isospin effect of the neutron-proton number ratio of nucleon emissions (n/p)nucl on symmetry potential and (n/p)nucl's sensitive dependence on symmetry potential in the nuclear reactions induced by halo-neutron projectiles, compared to the same mass stable projectile, probing symmetry potential is investigated within the isospin-dependent quantum molecular dynamics with isospin and momentum-dependent interactions for different symmetry potentials U1sym and U2sym. It is found that the neutron-halo projectile induces very obvious increase of (n/p)nucl and strengthens the dependence of (n/p)nucl on the symmetry potential for all the beam energies and impact parameters, compared to the same mass stable projectile under the same incident channel condition. Therefore (n/p)nucl induced by the neutron-halo projectile is a more favourable probe than the normal neutron-rich and neutron-poor projectiles for extracting the symmetry potential.

  20. Information Gains from Cosmological Probes

    CERN Document Server

    Grandis, S; Refregier, A; Amara, A; Nicola, A


    In light of the growing number of cosmological observations, it is important to develop versatile tools to quantify the constraining power and consistency of cosmological probes. Originally motivated from information theory, we use the relative entropy to compute the information gained by Bayesian updates in units of bits. This measure quantifies both the improvement in precision and the 'surprise', i.e. the tension arising from shifts in central values. Our starting point is a WMAP9 prior which we update with observations of the distance ladder, supernovae (SNe), baryon acoustic oscillations (BAO), and weak lensing as well as the 2015 Planck release. We consider the parameters of the flat $\\Lambda$CDM concordance model and some of its extensions which include curvature and Dark Energy equation of state parameter $w$. We find that, relative to WMAP9 and within these model spaces, the probes that have provided the greatest gains are Planck (10 bits), followed by BAO surveys (5.1 bits) and SNe experiments (3.1 ...

  1. Advanced oxidation scanning probe lithography. (United States)

    Ryu, Yu K; Garcia, Ricardo


    Force microscopy enables a variety of approaches to manipulate and/or modify surfaces. Few of those methods have evolved into advanced probe-based lithographies. Oxidation scanning probe lithography (o-SPL) is the only lithography that enables the direct and resist-less nanoscale patterning of a large variety of materials, from metals to semiconductors; from self-assembled monolayers to biomolecules. Oxidation SPL has also been applied to develop sophisticated electronic and nanomechanical devices such as quantum dots, quantum point contacts, nanowire transistors or mechanical resonators. Here, we review the principles, instrumentation aspects and some device applications of o-SPL. Our focus is to provide a balanced view of the method that introduces the key steps in its evolution, provides some detailed explanations on its fundamentals and presents current trends and applications. To illustrate the capabilities and potential of o-SPL as an alternative lithography we have favored the most recent and updated contributions in nanopatterning and device fabrication.

  2. Intraoperative detection of ¹⁸F-FDG-avid tissue sites using the increased probe counting efficiency of the K-alpha probe design and variance-based statistical analysis with the three-sigma criteria. (United States)

    Povoski, Stephen P; Chapman, Gregg J; Murrey, Douglas A; Lee, Robert; Martin, Edward W; Hall, Nathan C


    Intraoperative detection of (18)F-FDG-avid tissue sites during 18F-FDG-directed surgery can be very challenging when utilizing gamma detection probes that rely on a fixed target-to-background (T/B) ratio (ratiometric threshold) for determination of probe positivity. The purpose of our study was to evaluate the counting efficiency and the success rate of in situ intraoperative detection of (18)F-FDG-avid tissue sites (using the three-sigma statistical threshold criteria method and the ratiometric threshold criteria method) for three different gamma detection probe systems. Of 58 patients undergoing (18)F-FDG-directed surgery for known or suspected malignancy using gamma detection probes, we identified nine (18)F-FDG-avid tissue sites (from amongst seven patients) that were seen on same-day preoperative diagnostic PET/CT imaging, and for which each (18)F-FDG-avid tissue site underwent attempted in situ intraoperative detection concurrently using three gamma detection probe systems (K-alpha probe, and two commercially-available PET-probe systems), and then were subsequently surgical excised. The mean relative probe counting efficiency ratio was 6.9 (± 4.4, range 2.2-15.4) for the K-alpha probe, as compared to 1.5 (± 0.3, range 1.0-2.1) and 1.0 (± 0, range 1.0-1.0), respectively, for two commercially-available PET-probe systems (P < 0.001). Successful in situ intraoperative detection of 18F-FDG-avid tissue sites was more frequently accomplished with each of the three gamma detection probes tested by using the three-sigma statistical threshold criteria method than by using the ratiometric threshold criteria method, specifically with the three-sigma statistical threshold criteria method being significantly better than the ratiometric threshold criteria method for determining probe positivity for the K-alpha probe (P = 0.05). Our results suggest that the improved probe counting efficiency of the K-alpha probe design used in conjunction with the three-sigma statistical

  3. A combined tactile and Raman probe for tissue characterization—design considerations (United States)

    Nyberg, Morgan; Candefjord, Stefan; Jalkanen, Ville; Ramser, Kerstin; Lindahl, Olof A.


    Histopathology is the golden standard for cancer diagnosis and involves the characterization of tissue components. It is labour intensive and time consuming. We have earlier proposed a combined fibre-optic near-infrared Raman spectroscopy (NIR-RS) and tactile resonance method (TRM) probe for detecting positive surgical margins as a complement to interoperative histopathology. The aims of this study were to investigate the effects of attaching an RS probe inside a cylindrical TRM sensor and to investigate how laser-induced heating of the fibre-optic NIR-RS affected the temperature of the RS probe tip and an encasing TRM sensor. In addition, the possibility to perform fibre-optic NIR-RS in a well-lit environment was investigated. A small amount of rubber latex was preferable for attaching the thin RS probe inside the TRM sensor. The temperature rise of the TRM sensor due to a fibre-optic NIR-RS at 270 mW during 20 s was less than 2 °C. Fibre-optic NIR-RS was feasible in a dimmed bright environment using a small light shield and automatic subtraction of a pre-recorded contaminant spectrum. The results are promising for a combined probe for tissue characterization.

  4. Creating and Probing Graphene Electron Optics with Local Scanning Probes (United States)

    Stroscio, Joseph

    Ballistic propagation and the light-like dispersion of graphene charge carriers make graphene an attractive platform for optics-inspired graphene electronics where gate tunable potentials can control electron refraction and transmission. In analogy to optical wave propagation in lenses, mirrors and metamaterials, gate potentials can be used to create a negative index of refraction for Veselago lensing and Fabry-Pérot interferometers. In circular geometries, gate potentials can induce whispering gallery modes (WGM), similar to optical and acoustic whispering galleries albeit on a much smaller length scale. Klein scattering of Dirac carriers plays a central role in determining the coherent propagation of electron waves in these resonators. In this talk, I examine the probing of electron resonators in graphene confined by linear and circular gate potentials with the scanning tunneling microscope (STM). The tip in the STM tunnel junction serves both as a tunable local gate potential, and as a probe of the graphene states through tunneling spectroscopy. A combination of a back gate potential, Vg, and tip potential, Vb, creates and controls a circular pn junction that confines the WGM graphene states. The resonances are observed in two separate channels in the tunneling spectroscopy experiment: first, by directly tunneling into the state at the bias energy eVb, and, second, by tunneling from the resonance at the Fermi level as the state is gated by the tip potential. The second channel produces a fan-like set of WGM peaks, reminiscent of the fringes seen in planar geometries by transport measurements. The WGM resonances split in a small applied magnetic field, with a large energy splitting approaching the WGM spacing at 0.5 T. These results agree well with recent theory on Klein scattering in graphene electron resonators. This work is done in collaboration with Y. Zhao, J. Wyrick, F.D. Natterer, J. F. Rodriquez-Nieva, C. Lewandoswski, K. Watanabe, T. Taniguchi, N. B

  5. Aspects of probe correction for odd-order probes in spherical near-field antenna measurements

    DEFF Research Database (Denmark)

    Laitinen, Tommi; Pivnenko, Sergey N.; Breinbjerg, Olav


    Probe correction aspects for the spherical near-field antenna measurements are investigated. First, the spherical mode analyses of the radiated fields of several antennas are performed. It is shown that many common antennas are essentially so-called odd-order antennas. Second, the errors caused...... by the use of the first-order probe correction [1] for a rectangular waveguide probe, that is an odd-order antenna, are demonstrated. Third, a recently developed probe correction technique for odd-order probes is applied for the rectangular waveguide probe and shown to provide accurate results....

  6. Surgical management of common canine prostatic conditions

    National Research Council Canada - National Science Library

    Freitag, Thurid; Jerram, Richard M; Walker, Alex M; Warman, Chris G A


    ... (prostatic abscesses or cysts). In intact dogs that present with these disorders, castration should always be part of the specific surgical treatment because it enhances treatment success and may prevent recurrence...

  7. Liability exposure for surgical robotics instructors. (United States)

    Lee, Yu L; Kilic, Gokhan; Phelps, John Y


    Surgical robotics instructors provide an essential service in improving the competency of novice gynecologic surgeons learning robotic surgery and advancing surgical skills on behalf of patients. However, despite best intentions, robotics instructors and the gynecologists who use their services expose themselves to liability. The fear of litigation in the event of a surgical complication may reduce the availability and utility of robotics instructors. A better understanding of the principles of duty of care and the physician-patient relationship, and their potential applicability in a court of law likely will help to dismantle some concerns and uncertainties about liability. This commentary is not meant to discourage current and future surgical instructors but to raise awareness of liability issues among robotics instructors and their students and to recommend certain preventive measures to curb potential liability risks.

  8. Surgical management of large scalp infantile hemangiomas

    Directory of Open Access Journals (Sweden)

    Imad S Khan


    Full Text Available Background: Infantile Hemangiomas (IH are the most common benign tumor of infancy, occurring in over 10% of newborns. While most IHs involute and never require intervention, some scalp IHs may cause severe cosmetic deformity and threaten tissue integrity that requires surgical excision. Case Description: We present our experience with two infants who presented with large scalp IH. After vascular imaging, the patients underwent surgical resection of the IH and primary wound closure with excellent cosmetic outcome. We detail the surgical management of these cases and review the relevant literature. Conclusion: In some cases the IHs leave behind fibro-fatty residuum causing contour deformity. Surgery is often required for very large lesions causing extensive anatomical and/or functional disruption. The goal of surgical intervention is to restore normal anatomic contour and shape while minimizing the size of the permanent scar.

  9. Surgically Correctable Morbidity from Male Circumcision: Indications ...

    African Journals Online (AJOL)

    INTRODUCTION. Circumcision, the surgical removal of the prepuce, is probably the .... circumcision bleeding had haemostatic sutures applied while three patients with .... bridge after clamping with artery forcep for about 3-5 minutes following ...

  10. [Surgical site infections: antibiotic prophylaxis in surgery]. (United States)

    Asensio, Angel


    Surgical site infections (SSI) are very common, and represent more than 20% of all hospital-acquired infections. SSIs are associated with a higher mortality, as well as to an extended hospital stay and costs, depending on the surgical procedure and type of SSI. Advances in control practices for these infections include improvement in operating room ventilation, sterilization methods, barriers, and surgical techniques, as well as in surgical antimicrobial prophylaxis. For the latter, the antimicrobial agent should: be active against the most common pathogens, be administered in an appropriate dosage and in a time frame to ensure serum and tissue concentrations over the period of potential contamination, be safe, and be administered over the shortest effective time period to minimize adverse events, development of resistances, and cost. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  11. Communication Skills among Surgical Trainees: Perceptions of ...

    African Journals Online (AJOL)

    Communication Skills among Surgical Trainees: Perceptions of Residents in a ... ability to communicate with patients and their family members is very important in the ... for training in communication skills as a basis for developing an effective ...

  12. Outcomes of surgical management of intestinal atresias

    African Journals Online (AJOL)


    Nov 22, 2013 ... shock (1), anesthesia‑related (1), undetermined (1). Two of the mortalities (40%) had ... Key words: Intestinal atresia, outcomes, surgical management ... with information on prenatal ultrasonography (18/23), only 50% (9/18) ...

  13. The Surgical Management of Primary Hyperparathyroidism: The ...

    African Journals Online (AJOL)

    The Surgical Management of Primary Hyperparathyroidism: The Experience in ... the gastrointestinal system in the form of dyspepsia from Peptic ulcer disease and ... years from 2007-2014 and only three had complete medical documents.


    Institute of Scientific and Technical Information of China (English)

    徐宏光; 王以朋; 等


    Objective:To evaluate the effect of surgical treatment on metastatic spinal tumor.Methods:The results of surgical intervention for metastatic spinal tumor of 31 consecutive patients since October 1985 were reviewed.Results:The average survival time was 17.6 months (range from 3 months to 9 years),and 4 patients are still alive with an average survival time of 24.6 months(range,14-84 months).No postoperative complication was noted.The preoperative symptoms were partially relieved and neurological functions were improved after surgery.Conclusions:Surgical treatment for metastatic spinal tumor could improve the life quality,but should be adopted cautiously.The surgical procedures such as decompression and internal fixation should be involved only when neurological deficits occurred.The surgery with postoperative complementary therapy may not only improve the life quality,but also extend the patients' life span.

  15. Right Diaphragm Spontaneous Rupture: A Surgical Approach

    Directory of Open Access Journals (Sweden)

    Duilio Divisi


    Full Text Available We present a case of spontaneous rupture of the diaphragm, characterized by nonspecific symptoms. The rapid diagnosis and appropriate surgical approach led to a positive resolution of the pathology.

  16. A porcine model for teaching surgical cricothyridootomy

    Directory of Open Access Journals (Sweden)

    Fernando Antonio Campelo Spencer Netto


    Full Text Available OBJECTIVE: To evaluate the acceptability of an educational project using A porcine model of airway for teaching surgical cricothyroidotomy to medical students and medical residents at a university hospital in southern Brazil.METHODS: we developed a teaching project using a porcine model for training in surgical cricothyroidotomy. Medical students and residents received lectures about this surgical technique and then held practical training with the model. After the procedure, all participants filled out a form about the importance of training in airway handling and the model used.RESULTS: There were 63 participants. The overall quality of the porcine model was estimated at 8.8, while the anatomical correlation between the model and the human anatomy received a mean score of 8.5. The model was unanimously approved and considered useful in teaching the procedure.CONCLUSION: the training of surgical cricothyroidotomy with a porcine model showed good acceptance among medical students and residents of this institution.

  17. An overview of pre-surgical evaluation

    Directory of Open Access Journals (Sweden)

    Kurupath Radhakrishnan


    Full Text Available The success of an epilepsy surgery program depends upon the early identification of potential surgical candidates and selecting from them, ideal candidates for surgery, who are destined to have a post-operative seizure-free outcome without any unacceptable neurological deficits. Since epilepsy surgery centers in resource-poor countries will lack the full range of state-of-the-art technologies usually available in resource-rich countries to perform pre-surgical evaluation, cost-effectively utilization of the locally available investigative facilities to select the surgical candidates becomes challenging. In the present era of rapid electronic communications and telemedicine, it has become possible for epilepsy surgery centers to pool their technological and human resources and to partner with centers nationally and internationally in implementing pre-surgical evaluation strategies.

  18. Complications associated with malnutrition in elective surgical ...

    African Journals Online (AJOL)

    Complications associated with malnutrition in elective surgical patients in a Malaysian setting. ... Tropical Journal of Pharmaceutical Research ... Purpose: To identify the level of malnutrition and complications observed in Malaysia. Methods: A ...

  19. Untreatable Surgical Site Infection: Consider Pyoderma Gangrenosum

    National Research Council Canada - National Science Library

    Berlinrut, Ilan; Bhatia, Nitasha; Josse, Jonathan M; de Vinck, David; Kaul, Sanjeev


    .... Her initial presentation was thought to be consistent with a surgical site infection. Antibiotic therapy was initiated, and the patient was taken for multiple irrigation/lavage of her abdomen and debridement of necrotic tissue...

  20. Non-surgical therapy of Peyronie's disease

    Institute of Scientific and Technical Information of China (English)

    Frederick L. Taylor; Laurence A. Levine


    The present paper provides a review of the available non-surgical treatments for Peyronie's disease (PD). A review of published literature on oral, intralesional, external energy and iontophoresis therapies for PD was performed,and the published results of available treatment options reviewed. The authors' recommendations for appropriate non-surgical management of PD are provided. Although there are many published reports that show the efficacy of non-surgical therapies for PD, there is a lack of large scale, multicenter controlled clinical trials, which makes treatment recommendations difficult. Careful review of the literature does suggest that there are treatment options that make scientific sense and appear to stabilize the disease process, reduce deformity, and improve function. Offering no treatment at all will encourage our patients to pursue alternative treatments, which might do harm, and misses the opportunity to do some good. Clearly further work is necessary to develop safe and effective non-surgical treatments for PD.

  1. Anaesthesia for Ophthalmic Surgical Procedures | Onakpoya | East ...

    African Journals Online (AJOL)

    PROMOTING ACCESS TO AFRICAN RESEARCH ... Background: Ophthalmic surgical procedures are performed under anaesthesia to enhance ... Local anaesthesia was the more commonly (92.1%) employed while general anaesthesia was ...

  2. 'Medical Tattoos' Help Hide Surgical Scars (United States)

    ... 'Medical Tattoos' Help Hide Surgical Scars Pigments can restore more ... scars from cancer surgeries may benefit from "medical tattoos" that can help restore some of the skin's ...

  3. [Some principles in surgical treatment of strabismus]. (United States)

    Dinu, Doina; Grigorescu, Adina; David, Roxana; Urda, S


    Taking into consideration the age of the patient, the strabismus surgery targets different things. Thus, for infants, the goal of the surgical intervention for congenital esotropia, is to prevent the occurrence of amblyopia and binocular vision dysfunctions (ARC, suppression). In preschool children, we operate aiming the recovery of the binocular vision, while in children over ten years old, the surgery is done only for esthetic reasons. On the other hand, in adults, the strabismus surgery has two aspects: for esthetic reasons in monocular strabismus with amblyopia, or for diplopia treatment in strabismus of traumatic or neurological cause. To get the best results, the surgical intervention has to respect several rules, which differ with patient's age. This presentation will discuss several surgical procedures: for congenital esotropia (including its advantages and drawbacks), for preschool children strabismus and also for strabismus in adults. We will also review the surgical treatment for Duane syndrome, Ciancia syndrome and superior oblique muscle palsy.

  4. Evolution of surgical treatment for breast cancer

    Directory of Open Access Journals (Sweden)

    V. P. Letyagin


    Full Text Available The paper considers main surgical interventions used to treat breast cancer. It defines the role and place of conservative surgery and describes current procedures for the organ-saving treatment of cancer at this site.

  5. Surgical repair of pulmonary artery branches. (United States)

    Ghez, Olivier; Saeed, Imran; Serrato, Maria; Quintero, Diana Bernal; Kreitmann, Bernard; Fraisse, Alain; Uemura, Hideki; Seale, Anna; Daubeney, Piers; McCarthy, Karen; Ho, S Yen


    Surgical repair of pulmonary artery (PA) branches encompasses many different clinical scenarios and technical challenges. The most common, such as bifurcation and central PA reconstruction, are described, as well as the challenges of complex and peripheral reconstruction.

  6. Pattern and Management Outcomes of Neonatal Acute Surgical ...

    African Journals Online (AJOL)

    Hp 630 Dual Core

    Key words: Neonates, Acute surgical conditions, Management, Outcomes. Introduction ... undergoing surgery should live and therefore effective and close interdisciplinary collaboration ..... anaesthesia and surgical stress leading to death 13.

  7. Non-surgical treatment of esophageal achalasia

    Institute of Scientific and Technical Information of China (English)

    Vito Annese; Gabrio Bassotti


    Esophageal achalasia is an infrequent motility disorder characterized by a progressive stasis and dilation of the oesophagus; with subsequent risk of aspiration,weight loss, and malnutrition. Although the treatment of achalasia has been traditionally based on a surgical approach, especially with the introduction of laparoscopic techniques, there is still some space for a medical approach. The present article reviews the non-surgical therapeutic options for achalasia.

  8. Spinal intramedullary ependymoma: surgical approaches and outcome. (United States)

    Borges, Lawrence F


    Intramedullary Ependymomas are uncommon tumors that can occur within the medullary substance of the spinal cord. Despite this difficult location, they are typically benign tumors that can most often be removed completely with an acceptable surgical risk. Therefore, the recommended management approach is usually surgical excision. This review will consider the historical context in which surgeons began treating these tumors and then review the more recent literature that guides their current management.

  9. Does gingival recession require surgical treatment?


    Chan, Hsun-Liang; Chun, Yong-Hee Patricia; MacEachern, Mark


    Gingival recession represents a clinical condition in adults frequently encountered in the general dental practice. It is estimated that 23% of adults in the US have one or more tooth surfaces with ≥ 3 mm gingival recession. Clinicians often time face dilemmas of whether or not to treat such a condition surgically. Therefore, we were charged by the editorial board to answer this critical question: “Does gingival recession require surgical treatment?” An initial condensed literature search was...

  10. Surgical Treatment of Laser Induced Eye Injuries (United States)


    AD-A234 849 CONTRACT NO.: DAMD17-89-C-9026 TITLE: SURGICAL TREATMENT OF LASER INDUCED EYE INJURIES AUTHORS: Leonard M. Hjelmeland, Maurice B. Landers...62787A 62787A878 BA JDA318205 11. TITLE (Include Secirity Classification) (U) Surgical Treatment of Laser Induced Eye Injuries 12. PERSONAL AUTHOR(S...TERMS (Continue on reverse if necessary and identify by block number) FIELD GROUP SUB-GROUP RA 3; Lasers; Eye injury ; Surgery 09 03 06 04 19. ABSTRACT

  11. Surgical complications of typhoid fever: enteric perforation. (United States)

    Santillana, M


    Typhoid fever remains a prevalent disease in developing nations as the result of adverse socioeconomic factors. The most frequent complication, and principal cause of mortality, is perforation of the terminal ileum. This report presents our experience with 96 patients surgically treated at Cayetano Heredia University Hospital in Lima, Peru from 1972 to 1986. The clinical characteristics and the diverse surgical procedures utilized in the management of these patients are reviewed.

  12. Improved patient selection by stratified surgical intervention

    DEFF Research Database (Denmark)

    Wang, Miao; Bünger, Cody E; Li, Haisheng


    BACKGROUND CONTEXT: Choosing the best surgical treatment for patients with spinal metastases remains a significant challenge for spine surgeons. There is currently no gold standard for surgical treatments. The Aarhus Spinal Metastases Algorithm (ASMA) was established to help surgeons choose...... of the spinal metastases. This algorithm could help spine surgeons to discriminate the risks of surgeries. The ASMA provides a tool to guild surgeons to evaluate the spinal metastases patients, select potential optimal surgery, and avoid life-threatening risks....

  13. Modifiable risk factors for surgical site infection. (United States)

    Moucha, Calin S; Clyburn, Terry A; Evans, Richard P; Prokuski, Laura


    Multiple risk factors for orthopaedic surgical site infection have been identified. Some of these factors directly affect the wound-healing process, whereas others can lead to blood-borne sepsis or relative immunosuppression. Modifying a patient's medications; screening for comorbidities, such as HIV or diabetes mellitus; and advising the patient on options to diminish or eliminate adverse behaviors, such as smoking, should lower the risk for surgical site infections.

  14. Mast cells in pathological and surgical scars


    Beer, T; Baldwin, H; West, L; Gallagher, P.; Wright, D.


    AIM—To investigate the role of mast cells in surgical and pathological scar reactions by their identification and quantification using immunohistochemistry.
METHODS—Surgical scars and pathological scar reactions were stained immunohistochemically for tryptase to identify mast cells. These were quantified in the scar tissue and surrounding dermis. Statistical analyses were performed to test the hypothesis that mast cell numbers were different in the varying types of scar reaction.

  15. Surgical techniques: past, present and future

    Directory of Open Access Journals (Sweden)

    Karim Qayumi


    Full Text Available The aim of this paper is to provide an analytical survey of the information available on the development of past and present surgical techniques, and to make projections for the future. For the purposes of this paper, the Past starts in the Neolithic period and ends in the 1800s. In this context, I have divided the Past into Prehistoric, Ancient and Middle Ages, and this period ends in the second half of the 19th century when the major obstacles to the further development of surgery, such as overcoming pain and infection, were removed. We will discuss the development of surgical techniques, and the obstacles and opportunities prevalent in these periods. In the context of this paper, the Present begins in 1867, when Louis Pasteur discovered microorganisms, and ends in the present day. There have been many important changes in the development of surgical techniques during this period, such as the transfer of surgery from the unsterile operating room to the modern hospital operating theater, the development of advanced and specialized surgical practices, such as transplants and laparoscopy, and minimally invasive surgical methods, robotic and Natural Orifice Transluminal Endoscopic Surgery. It is very difficult to foresee how surgical techniques will develop in the Future because of the unpredictable nature of technological progress. Therefore, in this paper, the forecast for the Future is limited to the next 50- 100 years and is a realistic calculation based on already existing technologies. In this context, the Future is divided into the development of surgical techniques that will develop in the near and distant future. It is anticipated that this overview will shed light on the historical perspective of surgical techniques and stimulate interest in their further development.

  16. The surgical treatment of Balanitis Xerotica Obliterans



    Background: Balanitis Xerotica Obliterans (BXO) is a chronic, often progressive disease, which can lead to phimosis and urethral stenosis, affecting both urinary and sexual function. Steroid creams are usually the first-line treatment but have a limited role and surgical intervention is frequently necessary. Conservative surgical procedures (circumcision) are often preferred in the first instance with the premise that recurrence of disease will require a more definitive reconstruction. This s...

  17. Visual-Inspection Probe For Cryogenic Chamber (United States)

    Friend, Steve; Valenzuela, James; Yoshinaga, Jay


    Visual-inspection probe that resembles borescope enables observer at ambient temperature to view objects immersed in turbulent flow of liquid oxygen, liquid nitrogen, or other cryogenic fluid. Design of probe fairly conventional, except special consideration given to selection of materials and to thermal expansion to provide for expected range of operating temperatures. Penetrates wall of cryogenic chamber to provide view of interior. Similar probe illuminates scene. View displayed on video monitor.

  18. Antioxidative status of saliva before and after non-surgical periodontal treatment

    Directory of Open Access Journals (Sweden)

    Novaković Nada


    Full Text Available Introduction. Oxidative stress and antioxidants play an important role in the pathogenesis of inflammatory disease, including chronic periodontitis (CP. Saliva contains enzymatic (glutathione peroxidase - GPx, superoxide dismutase - SOD, etc. and non-enzymatic (albumin - ALB, uric acid - UA, glutathione, etc. antioxidants. Objective. The aims of this study were to investigate: a level of SOD, GPx, UA, ALB and total antioxidative status (TAS of saliva in CP patients before and after non-surgical treatment, and b correlations between clinical periodontal parameters and levels of salivary antioxidants. Methods. Saliva was collected from 21 CP patients before and after non-surgical treatment. The condition of periodontium was assessed by plaque index, gingival index, bleeding on probing, probing depth and clinical attachment loss. Level of investigated antioxidants (except GPx and TAS was determined using colorimetric method and commercial kits. GPx activity was determined using UV method and commercial kits. Results. After the treatment significant increase of UA, ALB, Gpx, TAS was detected (p0.05. A significant correlation was observed between GPx and PI (r=0.575, p=0.008, SOD and GI (r=0.525, p=0.017 before therapy, and SOD and bleeding on probing (BP (r=0.59, p=0.006, TAS and BP (r=0.453, p=0.045 after therapy. Conclusion. These data suggest that levels of salivary antioxidants generally increase after non-surgical periodontal treatment. Correlation between some clinical periodontal parameters and level of salivary antioxidants was found. [Projekat Ministarstva nauke Republike Srbije, br. 41008

  19. Surgical extrusion technique for clinical crown lengthening: report of three cases. (United States)

    Kim, Chang-Sung; Choi, Seong-Ho; Chai, Jung-Kiu; Kim, Chong-Kwan; Cho, Kyoo-Sung


    Although a number of techniques have been proposed for clinical crown lengthening procedures, all have some limitation in terms of function and esthetics. This report presents the clinical and radiographic results of a surgical extrusion technique for clinical crown lengthening. Atraumatic surgical extrusion using a specially designed instrument (Periotome) was performed in three cases in which it was expected that extensive resective osseous surgery would have to be used for crown lengthening. Full-thickness mucoperiosteal flaps were raised both labially and palatally. The tooth was carefully luxated and extruded to the desired position without damaging the marginal bone area or root apex. No rigid splint was applied. Clinical examinations performed for more than 1 year after surgery revealed probing depths crown lengthening; it does not induce functional or esthetic deformities, especially in the anterior region.

  20. Towards optical fibre based Raman spectroscopy for the detection of surgical site infection (United States)

    Thompson, Alex J.; Koziej, Lukasz; Williams, Huw D.; Elson, Daniel S.; Yang, Guang-Zhong


    Surgical site infections (SSIs) are common post-surgical complications that remain significant clinical problems, as they are associated with substantial mortality and morbidity. As such, there is significant interest in the development of minimally invasive techniques that permit early detection of SSIs. To this end, we are applying a compact, clinically deployable Raman spectrometer coupled to an optical fibre probe to the study of bacteria, with the long term goal of using Raman spectroscopy to detect infection in vivo. Our system comprises a 785 nm laser diode for excitation and a commercial (Ocean Optics, Inc.) Raman spectrometer for detection. Here we discuss the design, optimisation and validation of this system, and describe our first experiences interrogating bacterial cells (Escherichia coli) in vitro.

  1. Characterization of Akiyama probe applied to dual-probes atomic force microscope (United States)

    Wang, Hequn; Gao, Sitian; Li, Wei; Shi, Yushu; Li, Qi; Li, Shi; Zhu, Zhendong


    The measurement of nano-scale line-width has always been important and difficult in the field of nanometer measurements, while the rapid development of integrated circuit greatly raises the demand again. As one kind of scanning probe microscope (SPM), atomic force microscope (AFM) can realize quasi three-dimensional measurement, which is widely used in nanometer scale line-width measurement. Our team researched a dual-probes atomic force microscope, which can eliminate the prevalent effect of probe width on measurement results. In dual-probes AFM system, a novel head are newly designed. A kind of self-sensing and self-exciting probes which is Nanosensors cooperation's patented probe—Akiyama probe, is used in this novel head. The Akiyama probe applied to dual-probe atomic force microscope is one of the most important issues. The characterization of Akiyama probe would affect performance and accuracy of the whole system. The fundamental features of the Akiyama probe are electrically and optically characterized in "approach-withdraw" experiments. Further investigations include the frequency response of an Akiyama probe to small mechanical vibrations externally applied to the tip and the effective loading force yielding between the tip and the sample during the periodic contact. We hope that the characterization of the Akiyama probe described in this paper will guide application for dual-probe atomic force microscope.

  2. Vertical orbital dystopia--surgical correction. (United States)

    Edgerton, M T; Jane, J A


    The surgical correction of vertical malpositions of the human eye has been made relatively safe and reliable by recent surgical techniques. The authors define this condition as vertical orbital dystopia and review the etiology of this deformity in 38 recent consecutive cases that were surgically treated at the Craniofacial Anomalies Center of The University of Virginia. Some new and useful tests are described that are of value to the plastic surgeon in analysis of the facial deformity and in planning the appropriate surgical procedure to correct the vertical dystopia of one or both eyes. Several cases are illustrated that describe the principal surgical methods of moving the eye up or down without loss of vision. The vertical eye shifts in this series have been in the range of 2 to 3 mm to over 22 mm. No loss of vision was produced by these corrections. The most common difficulties and complications of orbital dystopia corrections are described. The implications of this type of surgery in terms of visual physiology are suggested. The authors conclude that surgical correction of vertical orbital dystopias is possible, safe, and rewarding to the patients. However, they advise that the correction is best performed in young children and by a specially trained team of plastic surgeons, neurosurgeons, and ophthalmologists.

  3. Surgical options in ICH including decompressive craniectomy. (United States)

    Mitchell, Patrick; Gregson, Barbara A; Vindlacheruvu, Raghu R; Mendelow, A David


    Intracerebral haemorrhage (ICH) accounts for 15 to 20% of strokes. The condition carries a higher morbidity and mortality than occlusive stroke. Despite considerable research effort, no therapeutic modality either medical or surgical has emerged with clear evidence of benefit other than in rare aneurysmal cases. Intracerebral haemorrhages can be divided into those that arise from pre-existing macroscopic vascular lesions - so called "ictohaemorrhagic lesions", and those that do not; the latter being the commoner. Most of the research that has been done on the benefits of surgery has been in this latter group. Trial data available to date precludes a major benefit from surgical evacuation in a large proportion of cases however there are hypotheses of benefit still under investigation, specifically superficial lobar ICH treated by open surgical evacuation, deeper ICH treated with minimally invasive surgical techniques, and decompressive craniectomy. When an ICH arises from an ictohaemorrhagic lesion, therapy has two goals: to treat the effects of the acute haemorrhage and to prevent a recurrence. Three modalities are available for treating lesions to prevent recurrence: stereotactic radiosurgery, endovascular embolisation, and open surgical resection. As with ICH without an underlying lesion there is no evidence to support surgical removal of the haemorrhage in most cases. An important exception is ICHs arising from intracranial aneurysms where there is good evidence to support evacuation of the haematoma as well as repair of the aneurysm.

  4. Primary cutaneous mucormycosis: guide to surgical management. (United States)

    Losee, Joseph E; Selber, Jesse; Vega, Stephen; Hall, Caroline; Scott, Glynis; Serletti, Joseph M


    Mucormycosis is the most acute, fulminate, and fatal of all fungal infections in humans. It presents most frequently in immunocompromised patients, but can occur in healthy patients in the presence of often-insignificant trauma. Surgical management of primary cutaneous mucormycosis is almost always required. Case reports of surgical treatment for primary cutaneous mucormycosis are reported in the literature; however, the extent of debridement required for cure is unclear and no uniform plan of treatment has been suggested. To date, no clinical guidelines exist to assist the clinician in the surgical management of this disease. This article reviews the literature, reports on two clinical cases, and submits clinical guidelines designed to assist the clinician in the surgical management of primary cutaneous mucormycosis. Because of the infrequent and potentially fatal nature of the diagnosis, a high index of suspicion and a low threshold for wound biopsy must be maintained. Wound cultures are grossly inadequate and should not be relied on for a false sense of security. It is recommended that, for the early diagnosis of cutaneous mucormycosis, chemotherapy and surgical debridement of grossly necrotic tissue be performed at the earliest possible time. The debrided wound is monitored for the resolution of surrounding erythema and induration before definitive reconstruction. In the case of delayed diagnosis and/or advanced or rapidly progressive disease, surgical debridement of all involved tissue, in addition to chemotherapy, is warranted.

  5. Scanning microscopic four-point conductivity probes

    DEFF Research Database (Denmark)

    Petersen, Christian Leth; Hansen, Torben Mikael; Bøggild, Peter


    A method for fabricating microscopic four-point probes is presented. The method uses silicon-based microfabrication technology involving only two patterning steps. The last step in the fabrication process is an unmasked deposition of the conducting probe material, and it is thus possible to select...... the conducting material either for a silicon wafer or a single probe unit. Using shadow masking photolithography an electrode spacing (pitch) down to 1.1 mum was obtained, with cantilever separation down to 200 run. Characterisation measurements have shown the microscopic probes to be mechanically very flexible...

  6. Optimizing esthetics for implant restorations in the anterior maxilla: anatomic and surgical considerations. (United States)

    Buser, Daniel; Martin, William; Belser, Urs C


    The placement of dental implants in the anterior maxilla is a challenge for clinicians because of patients' exacting esthetic demands and difficult pre-existing anatomy. This article presents anatomic and surgical considerations for these demanding indications for implant therapy. First, potential causes of esthetic implant failures are reviewed, discussing anatomic factors such as horizontal or vertical bone deficiencies and iatrogenic factors such as improper implant selection or the malpositioning of dental implants for an esthetic implant restoration. Furthermore, aspects of preoperative analysis are described in various clinical situations, followed by recommendations for the surgical procedures in single-tooth gaps and in extended edentulous spaces with multiple missing teeth. An ideal implant position in all 3 dimensions is required. These mesiodistal, apicocoronal, and orofacial dimensions are well described, defining "comfort" and "danger" zones for proper implant position in the anterior maxilla. During surgery, the emphasis is on proper implant selection to avoid oversized implants, careful and low-trauma soft tissue handling, and implant placement in a proper position using either a periodontal probe or a prefabricated surgical guide. If missing, the facial bone wall is augmented using a proper surgical technique, such as guided bone regeneration with barrier membranes and appropriate bone grafts and/or bone substitutes. Finally, precise wound closure using a submerged or a semi-submerged healing modality is recommended. Following a healing period of between 6 and 12 weeks, a reopening procedure is recommended with a punch technique to initiate the restorative phase of therapy.

  7. Evaluation of adherence to measures for the prevention of surgical site infections by the surgical team


    Adriana Cristina de Oliveira; Camila Sarmento Gama


    AbstractOBJECTIVEEvaluate pre- and intraoperative practices adopted by medical and nursing teams for the prevention of surgical infections.METHODA prospective study carried out in the period of April to May 2013, in a surgical center of a university hospital in Belo Horizonte, Minas Gerais.RESULTS18 surgeries were followed and 214 surgical gloves were analyzed, of which 23 (10.7%) had postoperative glove perforation detected, with 52.2% being perceived by users. Hair removal was performed on ...

  8. Probing the String Winding Sector

    CERN Document Server

    Aldazabal, Gerardo; Nuñez, Carmen


    We probe a slice of the massive winding sector of bosonic string theory from toroidal compactifications of Double Field Theory (DFT). This string subsector corresponds to states containing one left and one right moving oscillators. We perform a generalized Kaluza Klein compactification of DFT on generic $2n$-dimensional toroidal constant backgrounds and show that, up to third order in fluctuations, the theory coincides with the corresponding effective theory of the bosonic string compactified on $n$-dimensional toroidal constant backgrounds, obtained from three-point amplitudes. The comparison between both theories is facilitated by noticing that generalized diffeomorphisms in DFT allow to fix generalized harmonic gauge conditions that help in identifying the physical degrees of freedom. These conditions manifest as conformal anomaly cancellation requirements on the string theory side. The explicit expression for the gauge invariant effective action containing the physical massless sector (gravity+antisymmetr...

  9. Scanning probe microscopy competency development

    Energy Technology Data Exchange (ETDEWEB)

    Hawley, M.E.; Reagor, D.W.; Jia, Quan Xi [and others


    This is the final report of a three-year, Laboratory Directed Research and Development (LDRD) project at Los Alamos National Laboratory (LANL). The project collaborators developed an ultra-high vacuum scanning tunneling microscope (UHV-STM) capability, integrated it with existing scanning probe microscopes, and developed new, advanced air-based scanning force techniques (SPMs). Programmatic, basic, and industrially related laboratory research requires the existence of SPMs, as well as expertise capable of providing local nano-scale information. The UHV-STM capability, equipped with load-lock system and several surface science techniques, will allow introduction, examination, and reaction of surfaces prepared under well-controlled vacuum conditions, including the examination of morphology and local bonding associated with the initial stages of film growth under controlled growth conditions. The resulting capabilities will enable the authors to respond to a variety of problems requiring local characterization of conducting and nonconducting surfaces in liquids, air, and UHV.

  10. Astrophysical Probes of Fundamental Physics

    CERN Document Server

    Martins, C J A P


    I review the theoretical motivation for varying fundamental couplings and discuss how these measurements can be used to constrain a number of fundamental physics scenarios that would otherwise be inacessible to experiment. As a case study I will focus on the relation between varying couplings and dark energy, and explain how varying coupling measurements can be used to probe the nature of dark energy, with important advantages over the standard methods. Assuming that the current observational evidence for varying $\\alpha$ and $\\mu$ is correct, a several-sigma detection of dynamical dark energy is feasible within a few years, using currently operational ground-based facilities. With forthcoming instruments like CODEX, a high-accuracy reconstruction of the equation of state may be possible all the way up to redshift $z\\sim4$.

  11. New Fluorescence Probes for Biomolecules

    Directory of Open Access Journals (Sweden)

    Katarzyna Jurek


    Full Text Available Steady state fluorescence measurements have been used for the investigation of interaction between the bovine serum albumin (BSA and fluorescence probes: 3-hydroxy-2,4- bis[(3-methyl-1,3-benzoxazol-2(3H-ylidenemethyl]cyclobut-2-en-1-one (SQ6, 3-hydroxy- 2,4-bis[(3-methyl-1,3-benzothiazol-2(3H-ylidenemethyl]cyclobut-2-en-1-one (SQ7 and 3-hydroxy-2,4-bis[(1,3,3-trimethyl-1,3-dihydro-2H-indol-2-ylidenemethyl]cyclobut-2-en-1-one (SQ8. The binding constant between bovine serum albumin and squarine dyes has been determined by using both the Benesi-Hildebrand and Stern-Volmer equations. The negative value of free energy change indicates the existence of a spontaneous complexation process of BSA with squarine dyes.

  12. Angular distributions as lifetime probes

    Energy Technology Data Exchange (ETDEWEB)

    Dror, Jeff Asaf; Grossman, Yuval [Department of Physics, LEPP, Cornell University,Ithaca, NY 14853 (United States)


    If new TeV scale particles are discovered, it will be important to determine their width. There is, however, a problematic region, where the width is too small to be determined directly, and too large to generate a secondary vertex. For a collection of colored, spin polarized particles, hadronization depolarizes the particles prior to their decay. The amount of depolarization can be used to probe the lifetime in the problematic region. In this paper we apply this method to a realistic scenario of a top-like particle that can be produced at the LHC. We study how depolarization affects the angular distributions of the decay products and derive an equation for the distributions that is sensitive to the lifetime.

  13. Angular Distributions as Lifetime Probes

    CERN Document Server

    Dror, Jeff Asaf


    If new TeV scale particles are discovered, it will be important to determine their width. There is, however, a problematic region, where the width is too small to be determined directly, and too large to generate a secondary vertex. For a collection of colored, spin polarized particles, hadronization depolarizes the particles prior to their decay. The amount of depolarization can be used to probe the lifetime in the problematic region. In this paper we apply this method to a realistic scenario of a top-like particle that can be produced at the LHC. We study how depolarization affects the angular distributions of the decay products and derive an equation for the distributions that is sensitive to the lifetime.

  14. Surgical Management of Malignant Tumors of the Trachea: Report of Two Cases and Review of Literature

    Directory of Open Access Journals (Sweden)

    Ryuji Yasumatsu


    Full Text Available Malignant neoplasms occurring from the trachea are extremely rare. Therefore, their clinical characteristics and surgical results have not been thoroughly discussed. These tumors are often misdiagnosed and treated as bronchial asthma or chronic obstructive pulmonary disease. It is critically important to probe the cause-effect relationship between the medical presentations and the clinical diagnosis. In this report, two cases of tracheal malignancy suffering from dyspnea due to obstruction of the proximal trachea are described, and a review of the literature is presented.

  15. Optimization of the extent of surgical treatment in patients with stage I in cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Chernyshova, A. L.; Lyapunov, A. Yu., E-mail: [Tomsk Cancer Research Institute, Kooperativny Street 5, Tomsk, 634050 (Russian Federation); Kolomiets, L. A. [Tomsk Cancer Research Institute, Kooperativny Street 5, Tomsk, 634050 (Russian Federation); Siberian State Medical University, Moskovsky Trakt 2, Tomsk, 634050 (Russian Federation); Sinilkin, I. G.; Chernov, V. I. [Tomsk Cancer Research Institute, Kooperativny Street 5, Tomsk, 634050 (Russian Federation); Tomsk Polytechnic University, Lenin Avenue 30, Tomsk, 634050 (Russian Federation)


    The study included 26 patients with FIGO stage Ia1–Ib1 cervical cancer who underwent fertility-sparing surgery (transabdominaltrachelectomy). To visualize sentinel lymph nodes, lymphoscintigraphy with injection of 99mTc-labelled nanocolloid was performed the day before surgery. Intraoperative identification of sentinel lymph nodes using hand-held gamma probe was carried out to determine the radioactive counts over the draining lymph node basin. The sentinel lymph node detection in cervical cancer patients contributes to the accurate clinical assessment of the pelvic lymph node status, precise staging of the disease and tailoring of surgical treatment to individual patient.

  16. Optimization of the extent of surgical treatment in patients with stage I in cervical cancer (United States)

    Chernyshova, A. L.; Kolomiets, L. A.; Sinilkin, I. G.; Chernov, V. I.; Lyapunov, A. Yu.


    The study included 26 patients with FIGO stage Ia1-Ib1 cervical cancer who underwent fertility-sparing surgery (transabdominaltrachelectomy). To visualize sentinel lymph nodes, lymphoscintigraphy with injection of 99mTc-labelled nanocolloid was performed the day before surgery. Intraoperative identification of sentinel lymph nodes using hand-held gamma probe was carried out to determine the radioactive counts over the draining lymph node basin. The sentinel lymph node detection in cervical cancer patients contributes to the accurate clinical assessment of the pelvic lymph node status, precise staging of the disease and tailoring of surgical treatment to individual patient.

  17. Surgical tools recognition and pupil segmentation for cataract surgical process modeling. (United States)

    Bouget, David; Lalys, Florent; Jannin, Pierre


    In image-guided surgery, a new generation of Computer-Assisted-Surgical (CAS) systems based on information from the Operating Room (OR) has recently been developed to improve situation awareness in the OR. Our main project is to develop an application-dependant framework able to extract high-level tasks (surgical phases) using microscope videos data only. In this paper, we present two methods: one method to segment the pupil and one to extract and recognize surgical tools. We show how both methods improve the accuracy of the framework for analysis of cataract surgery videos, to detect eight surgical phases.

  18. Assessment of the role of a student-led surgical interest group in surgical education. (United States)

    Li, Ran; Buxey, Kenneth; Ashrafi, Akbar; Drummond, Katharine J


    We describe the development of a medical student surgical interest group, its initial evaluation, and future plans. The Surgical Students Society of Melbourne was formed in August 2008 by a group of senior medical students from the University of Melbourne. The Surgical Students Society of Melbourne seeks to provide additional surgical teaching and professional development for students interested in a career in surgery. It also aims to provide junior doctors with leadership and teaching opportunities to meet the requirements of the Royal Australasian College of Surgeons for application to the Surgical Education and Training program. Its program also addresses contemporary workforce issues, such as women in surgery and rural surgery. The society runs a weekly teaching program during the semester and procedural and careers workshops throughout the year. A survey of students attending the teaching program was conducted by means of written and online questionnaires. The results suggest that the society has been successful in augmenting surgical education and providing opportunities to improve procedural skills, but also highlighted areas of the program that may be improved, including aspects of surgical professional development and role modeling. The Surgical Students Society initiative was generally very well received by students and shows great potential as a means for augmenting surgical education at the medical student level. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  19. The Oxford Probe: an open access five-hole probe for aerodynamic measurements (United States)

    Hall, B. F.; Povey, T.


    The Oxford Probe is an open access five-hole probe designed for experimental aerodynamic measurements. The open access probe can be manufactured by the end user via additive manufacturing (metal or plastic). The probe geometry, drawings, calibration maps, and software are available under a creative commons license. The purpose is to widen access to aerodynamic measurement techniques in education and research environments. There are many situations in which the open access probe will allow results of comparable accuracy to a well-calibrated commercial probe. We discuss the applications and limitations of the probe, and compare the calibration maps for 16 probes manufactured in different materials and at different scales, but with the same geometrical design.

  20. Surgical treatment of pectus excavatum. (United States)

    Robicsek, F


    appropriate results, the chest should be carefully inspected after closure of the skin, and flaws, if they exist, should be corrected right then. Also, surgical repair of all pectus anomalies, especially excavatum deformities, should be supplemented in due time with an appropriate exercise program. Swimming and weight lifting are especially useful. 6) We found that the age limit imposed on small children by some authors is unnecessary, and as a matter of fact it is preferable to operate on children at an early age, around 2 years, because of commonly existing psychologic problems at a later age. The author advises restraint in operating on individuals past the teenage years unless the deformity is physiologically restricting. 7) The jury is still out regarding procedures using limited exposure and that do not use transverse sternotomy to correct the depressed or elevated sternal axis. 8) The usage of cosmetic procedures, or in other words, operations that do not correct the anomaly of the bony chest wall but use various implants as camouflage, should be restricted to cases of moderate excavatum anomalies in late teenage patients and to adults without cardiorespiratory symptoms.

  1. Defining and predicting outcomes of non-surgical periodontal treatment: a 1-yr follow-up study. (United States)

    Baelum, Vibeke; López, Rodrigo


    This study reports on 1-yr outcomes of non-surgical periodontal therapy and compares predictive models resulting from different definitions of treatment success. A total of 149 participants, 30-70 yr of age, provided clinical periodontal data and data on sociodemographic status, health status, symptoms, and oral health-care behaviors at baseline. One week later, clinical attachment level and probing pocket depth were recorded again in 148 patients. Participants underwent non-surgical periodontal therapy, including scaling and root planing, during three to four clinical sessions. Three and 12 months later, clinical attachment level, probing pocket depth, and bleeding on probing (BOP) were recorded in 141 and 137 participants, respectively. Using test-retest data, patients were classified as having 'downhill', 'stable', or 'improved' results on three clinical attachment level and three probing pocket depth outcomes, and their classification was found to vary considerably according to outcome. Although the predictors of treatment outcome varied depending on the variable chosen to represent the treatment outcome, some predictors were more commonly noted as predicting improvement, namely a high baseline percentage of sites with subgingival calculus and the presence of suppuration at baseline. The latter was, however, also predictive for tooth loss during the study. Our findings underline the need for uniformity in defining the outcomes in trials of periodontal therapy.

  2. Surgical procedures in pinniped and cetacean species. (United States)

    Higgins, Jennifer L; Hendrickson, Dean A


    Significant advances in veterinary diagnostic and surgical techniques have been made over the past several decades. Many of these advances, however, have not reached the field of marine mammal medicine. A number of limitations exist: risks of anesthesia, anatomical challenges, difficulties with wound closure, environmental constraints, equipment limitations, and perceived risks. Despite these limitations, surgical treatments have been successfully utilized in marine mammals. While surgery is performed in pinnipeds more frequently than in cetaceans, studies conducted in the 1960s and 1970s on dolphin sleep and hearing demonstrated that general anesthesia can be successfully induced in cetaceans. Since this pioneering work, a small number of successful surgeries have been performed in dolphins under both general anesthesia and heavy sedation. While these surgical procedures in pinnipeds and cetaceans have typically been limited to wound management, dentistry, ophthalmic procedures, fracture repair, and superficial biopsy, a number of abdominal surgeries have also been performed. Recently there have been pioneering successes in the application of minimally invasive surgery in marine mammals. Many of the anatomical challenges that almost prohibit traditional laparotomies in cetacean species and present challenges in pinnipeds can be overcome through the use of laparoscopic techniques. Due to the limited number of pinnipeds and cetaceans in captivity and, thus, the limited case load for veterinarians serving marine mammal species, it is vital for knowledge of surgical procedures to be shared among those in the field. This paper reviews case reports of surgical procedures, both traditional and laparoscopic, in pinnipeds and cetaceans. Limitations to performing surgical procedures in marine mammals are discussed and surgical case reports analyzed in an effort to determine challenges that must be overcome in order to make surgery a more feasible diagnostic and treatment

  3. Characterization of aerosols produced by surgical procedures

    Energy Technology Data Exchange (ETDEWEB)

    Yeh, H.C.; Muggenburg, B.A.; Lundgren, D.L.; Guilmette, R.A.; Snipes, M.B.; Jones, R.K. [Inhalation Toxicology Research Institute, Albuquerque, NM (United States); Turner, R.S. [Lovelace Health Systems, Albuquerque, NM (United States)


    In many surgeries, especially orthopedic procedures, power tools such as saws and drills are used. These tools may produce aerosolized blood and other biological material from bone and soft tissues. Surgical lasers and electrocautery tools can also produce aerosols when tissues are vaporized and condensed. Studies have been reported in the literature concerning production of aerosols during surgery, and some of these aerosols may contain infectious material. Garden et al. (1988) reported the presence of papilloma virus DNA in the fumes produced from laser surgery, but the infectivity of the aerosol was not assessed. Moon and Nininger (1989) measured the size distribution and production rate of emissions from laser surgery and found that particles were generally less than 0.5 {mu}m diameter. More recently there has been concern expressed over the production of aerosolized blood during surgical procedures that require power tools. In an in vitro study, the production of an aerosol containing the human immunodeficiency virus (HIV) was reported when power tools were used to cut tissues with blood infected with HIV. Another study measured the size distribution of blood aerosols produced by surgical power tools and found blood-containing particles in a number of size ranges. Health care workers are anxious and concerned about whether surgically produced aerosols are inspirable and can contain viable pathogens such as HIV. Other pathogens such as hepatitis B virus (HBV) are also of concern. The Occupational Safety and Health funded a project at the National Institute for Inhalation Toxicology Research Institute to assess the extent of aerosolization of blood and other tissues during surgical procedures. This document reports details of the experimental and sampling approach, methods, analyses, and results on potential production of blood-associated aerosols from surgical procedures in the laboratory and in the hospital surgical suite.

  4. Surgical care in the Solomon Islands: a road map for universal surgical care delivery. (United States)

    Natuzzi, Eileen S; Kushner, Adam; Jagilly, Rooney; Pickacha, Douglas; Agiomea, Kaeni; Hou, Levi; Houasia, Patrick; Hendricks, Phillip L; Ba'erodo, Dudley


    Access to surgical care and emergency obstetrical care is limited in low-income countries. The Solomon Islands is one of the poorest countries in the Pacific region. Access to surgical care in Solomon Islands is limited and severely affected by a country made up of islands. Surgical care is centralized to the National Referral Hospital (NRH) on Guadalcanal, leaving a void of care in the provinces where more than 80% of the people live. To assess the ability to provide surgical care to the people living on outer islands in the Solomon Islands, the provincial hospitals were evaluated using the World Health Organization's Global Initiative for Emergency and Essential Surgical Care Needs Assessment Tool questionnaire. Data on infrastructure, workforce, and equipment available for treating surgical disease was collected at each provincial hospital visited. Surgical services are centralized to the NRH on Guadalcanal in Solomon Islands. Two provincial hospitals provide surgical care when a surgeon is available. Six of the hospitals evaluated provide only very basic surgical procedures. Infrastructure problems exist at every hospital including lack of running water, electricity, adequate diagnostic equipment, and surgical supplies. The number of surgeons and obstetricians employed by the Ministry of Health is currently inadequate for delivering care at the outer island hospitals. Shortages in the surgical workforce can be resolved in Solomon Islands with focused training of new graduates. Training surgeons locally, in the Pacific region, can minimize the "brain drain." Redistribution of surgeons and obstetricians to the provincial hospitals can be accomplished by creating supportive connections between these hospitals, the NRH, and international medical institutions.

  5. Development of a transient internal probe diagnostic (United States)

    Spanjers, G. G.; Galambos, J. P.; Bohnet, M. A.; Jarboe, T. R.; Christiansen, W. H.; Wurden, G. A.; Wright, B. L.; Smith, R. J.


    The transient internal probe (TIP) diagnostic is a novel method for probing the interior of hot magnetic fusion plasmas. In the TIP scheme, a probe is fired, using a two-stage light gas gun, through a hot plasma at velocities up to 5 km/s, and makes direct, local measurements of the internal magnetic field structure. The data are relayed to the laboratory optical detection system using an incident laser that is directed through a Faraday rotator payload acting as a magneto-optic sensor. Ablative effects are avoided by minimizing the probe size, limiting the time that the probe is in the hot plasma, and encasing the probe with a diamond cladding. The degree to which the diamond probe cladding is susceptible to ablative effects will determine the plasma density and temperature regime in which the TIP diagnostic can be used. If the TIP suffers significant ablation it is an indication that the diagnostic is not usable on this hot and dense of a plasma (or that greater velocity must be imparted to the probe to further minimize the time that it is in the plasma). A quantitative experimental study of the ablation rates of diamond is planned as part of the TIP development. The integrated TIP system will be functional in 1992 and installed on the Helicity Injected Torus (HIT) [T. R. Jarboe, Fusion Tech. 15, 9 (1989)] at the University of Washington.

  6. Planar microcoil-based microfluidic NMR probes.

    NARCIS (Netherlands)

    Massin, C.; Vincent, F.; Homsy, A.; Ehrmann, K.; Boero, G.; Besse, P-A; Daridon, A.; Verpoorte, E.; de Rooij, N.F.; Popovic, R.S.


    Microfabricated small-volume NMR probes consisting of electroplated planar microcoils integrated on a glass substrate with etched microfluidic channels are fabricated and tested. 1H NMR spectra are acquired at 300 MHz with three different probes having observed sample volumes of respectively 30, 120

  7. Fluorescent hybridization probes for nucleic acid detection. (United States)

    Guo, Jia; Ju, Jingyue; Turro, Nicholas J


    Due to their high sensitivity and selectivity, minimum interference with living biological systems, and ease of design and synthesis, fluorescent hybridization probes have been widely used to detect nucleic acids both in vivo and in vitro. Molecular beacons (MBs) and binary probes (BPs) are two very important hybridization probes that are designed based on well-established photophysical principles. These probes have shown particular applicability in a variety of studies, such as mRNA tracking, single nucleotide polymorphism (SNP) detection, polymerase chain reaction (PCR) monitoring, and microorganism identification. Molecular beacons are hairpin oligonucleotide probes that present distinctive fluorescent signatures in the presence and absence of their target. Binary probes consist of two fluorescently labeled oligonucleotide strands that can hybridize to adjacent regions of their target and generate distinctive fluorescence signals. These probes have been extensively studied and modified for different applications by modulating their structures or using various combinations of fluorophores, excimer-forming molecules, and metal complexes. This review describes the applicability and advantages of various hybridization probes that utilize novel and creative design to enhance their target detection sensitivity and specificity.

  8. Planar microcoil-based microfluidic NMR probes.

    NARCIS (Netherlands)

    Massin, C.; Vincent, F.; Homsy, A.; Ehrmann, K.; Boero, G.; Besse, P-A; Daridon, A.; Verpoorte, E.; de Rooij, N.F.; Popovic, R.S.


    Microfabricated small-volume NMR probes consisting of electroplated planar microcoils integrated on a glass substrate with etched microfluidic channels are fabricated and tested. 1H NMR spectra are acquired at 300 MHz with three different probes having observed sample volumes of respectively 30, 120

  9. Inspecting Friction Stir Welding using Electromagnetic Probes (United States)

    Kinchen, David G.


    A report describes the use of advanced electromagnetic probes to measure the dimensions, the spatial distribution of electrical conductivity, and related other properties of friction stir welds (FSWs) between parts made of the same or different aluminum alloy(s). The probes are of the type described in in another Tech Brief. To recapitulate: A probe of this type is essentially an eddy-current probe that includes a primary (driver) winding that meanders and multiple secondary (sensing) windings that meander along the primary winding. Electrical conductivity is commonly used as a measure of heat treatment and tempering of aluminum alloys, but prior to the development of these probes, the inadequate sensitivity and limited accuracy of electrical-conductivity probes precluded such use on FSWs between different aluminum alloys, and the resolution of those probes was inadequate for measurement of FSW dimensions with positions and metallurgical properties. In contrast, the present probes afford adequate accuracy and spatial resolution for the purposes of measuring the dimensions of FSW welds and correlating spatially varying electrical conductivities with metallurgical properties, including surface defects.

  10. Miniature standoff Raman probe for neurosurgical applications (United States)

    Stevens, Oliver A. C.; Hutchings, Joanne; Gray, William; Vincent, Rosa Louise; Day, John C.


    Removal of intrinsic brain tumors is a delicate process, where a high degree of specificity is required to remove all of the tumor tissue without damaging healthy brain. The accuracy of this process can be greatly enhanced by intraoperative guidance. Optical biopsies using Raman spectroscopy are a minimally invasive and lower-cost alternative to current guidance methods. A miniature Raman probe for performing optical biopsies of human brain tissue is presented. The probe allows sampling inside a conventional stereotactic brain biopsy system: a needle of length 200 mm and inner diameter of 1.8 mm. By employing a miniature stand-off Raman design, the probe removes the need for any additional components to be inserted into the brain. Additionally, the probe achieves a very low internal silica background while maintaining good collection of Raman signal. To illustrate this, the probe is compared with a Raman probe that uses a pair of optical fibers for collection. The miniature stand-off Raman probe is shown to collect a comparable number of Raman scattered photons, but the Raman signal to background ratio is improved by a factor of five at Raman shifts below ˜500 cm-1. The probe's suitability for use on tissue is demonstrated by discriminating between different types of healthy porcine brain tissue.

  11. Surface charge measurement using an electrostatic probe

    DEFF Research Database (Denmark)

    Crichton, George C; McAllister, Iain Wilson


    During the 1960s, the first measurements of charge on dielectric surfaces using simple electrostatic probes were reported. However it is only within the last 10 years that a proper understanding of the probe response has been developed. This situation arose as a consequence of the earlier studies...

  12. Lessons learned from planetary entry probe missions (United States)

    Niemann, Hasso; Atreya, Sushil K.; Kasprzak, Wayne

    Probing the atmospheres and surfaces of the planets and their moons with fast moving entry probes has been a very useful and essential technique to obtain in situ or quasi in situ scientific data (ground truth) which could not otherwise be obtained from fly by or orbiter only missions and where balloon, aircraft or lander missions are too complex and too costly. Planetary entry probe missions have been conducted successfully on Venus, Mars, Jupiter and Titan after having been first demonstrated in the Earth's atmosphere. Future planetary missions should also include more entry probe missions back to Venus and to the outer planets. The success of and science returns from past missions, the need for more and unique data, and a continuously advancing technology generate confidence that future missions will be even more successful with respect to science return and technical performance. There are, however, unique challenges associated with entry probe missions and with building instruments for an entry probe, as compared to orbiters, landers, or rovers. Conditions during atmospheric entry are extreme. There are operating time constraints due to the usually short duration of the probe descent, and the instruments experience rapid environmental changes in temperature and pressure. In addition, there are resource limitations, i.e. mass, power, size and bandwidth. Because of the protective heat shield and the high acceleration the probe experiences during entry, the ratio of payload to total probe mass is usually much smaller than in other missions. Finally, the demands on the instrument design are determined in large part by conditions (pressure, temperature, composition) unique to the particular body under study, and as a result, there is no one-size-fits-all instrument for an atmospheric probe. Many of these requirements are more easily met by miniaturizing the probe instrumentation and consequently reducing the required size of the probe. Improved heat shield

  13. 21 CFR 882.4250 - Cryogenic surgical device. (United States)


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cryogenic surgical device. 882.4250 Section 882...) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4250 Cryogenic surgical device. (a) Identification. A cryogenic surgical device is a device used to destroy nervous tissue or produce...

  14. 21 CFR 888.4540 - Orthopedic manual surgical instrument. (United States)


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Orthopedic manual surgical instrument. 888.4540... (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Surgical Devices § 888.4540 Orthopedic manual surgical instrument. (a) Identification. An orthopedic manual surgical instrument is a nonpowered hand-held...

  15. 21 CFR 886.4350 - Manual ophthalmic surgical instrument. (United States)


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Manual ophthalmic surgical instrument. 886.4350... (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4350 Manual ophthalmic surgical instrument. (a) Identification. A manual ophthalmic surgical instrument is a nonpowered, handheld...

  16. 21 CFR 878.5030 - Natural nonabsorbable silk surgical suture. (United States)


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Natural nonabsorbable silk surgical suture. 878... Natural nonabsorbable silk surgical suture. (a) Identification. Natural nonabsorbable silk surgical suture... Bombycidae. Natural nonabsorbable silk surgical suture is indicated for use in soft tissue...

  17. 21 CFR 880.2740 - Surgical sponge scale. (United States)


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Surgical sponge scale. 880.2740 Section 880.2740... Devices § 880.2740 Surgical sponge scale. (a) Identification. A surgical sponge scale is a nonelectrically powered device used to weigh surgical sponges that have been used to absorb blood during surgery so...

  18. 21 CFR 878.4160 - Surgical camera and accessories. (United States)


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Surgical camera and accessories. 878.4160 Section... (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4160 Surgical camera and accessories. (a) Identification. A surgical camera and accessories is a device intended to be...

  19. Development and validation of a numerical model for cross-section optimization of a multi-part probe for soft tissue intervention. (United States)

    Frasson, L; Neubert, J; Reina, S; Oldfield, M; Davies, B L; Rodriguez Y Baena, F


    The popularity of minimally invasive surgical procedures is driving the development of novel, safer and more accurate surgical tools. In this context a multi-part probe for soft tissue surgery is being developed in the Mechatronics in Medicine Laboratory at Imperial College, London. This study reports an optimization procedure using finite element methods, for the identification of an interlock geometry able to limit the separation of the segments composing the multi-part probe. An optimal geometry was obtained and the corresponding three-dimensional finite element model validated experimentally. Simulation results are shown to be consistent with the physical experiments. The outcome of this study is an important step in the provision of a novel miniature steerable probe for surgery.

  20. Surgical data science: the new knowledge domain

    Directory of Open Access Journals (Sweden)

    Vedula S. Swaroop


    Full Text Available Healthcare in general, and surgery/interventional care in particular, is evolving through rapid advances in technology and increasing complexity of care, with the goal of maximizing the quality and value of care. Whereas innovations in diagnostic and therapeutic technologies have driven past improvements in the quality of surgical care, future transformation in care will be enabled by data. Conventional methodologies, such as registry studies, are limited in their scope for discovery and research, extent and complexity of data, breadth of analytical techniques, and translation or integration of research findings into patient care. We foresee the emergence of surgical/interventional data science (SDS as a key element to addressing these limitations and creating a sustainable path toward evidence-based improvement of interventional healthcare pathways. SDS will create tools to measure, model, and quantify the pathways or processes within the context of patient health states or outcomes and use information gained to inform healthcare decisions, guidelines, best practices, policy, and training, thereby improving the safety and quality of healthcare and its value. Data are pervasive throughout the surgical care pathway; thus, SDS can impact various aspects of care, including prevention, diagnosis, intervention, or postoperative recovery. The existing literature already provides preliminary results, suggesting how a data science approach to surgical decision-making could more accurately predict severe complications using complex data from preoperative, intraoperative, and postoperative contexts, how it could support intraoperative decision-making using both existing knowledge and continuous data streams throughout the surgical care pathway, and how it could enable effective collaboration between human care providers and intelligent technologies. In addition, SDS is poised to play a central role in surgical education, for example, through objective

  1. Surgical data science: The new knowledge domain. (United States)

    Vedula, S Swaroop; Hager, Gregory D


    Healthcare in general, and surgery/interventional care in particular, is evolving through rapid advances in technology and increasing complexity of care with the goal of maximizing quality and value of care. While innovations in diagnostic and therapeutic technologies have driven past improvements in quality of surgical care, future transformation in care will be enabled by data. Conventional methodologies, such as registry studies, are limited in their scope for discovery and research, extent and complexity of data, breadth of analytic techniques, and translation or integration of research findings into patient care. We foresee the emergence of Surgical/Interventional Data Science (SDS) as a key element to addressing these limitations and creating a sustainable path toward evidence-based improvement of interventional healthcare pathways. SDS will create tools to measure, model and quantify the pathways or processes within the context of patient health states or outcomes, and use information gained to inform healthcare decisions, guidelines, best practices, policy, and training, thereby improving the safety and quality of healthcare and its value. Data is pervasive throughout the surgical care pathway; thus, SDS can impact various aspects of care including prevention, diagnosis, intervention, or post-operative recovery. Existing literature already provides preliminary results suggesting how a data science approach to surgical decision-making could more accurately predict severe complications using complex data from pre-, intra-, and post-operative contexts, how it could support intra-operative decision-making using both existing knowledge and continuous data streams throughout the surgical care pathway, and how it could enable effective collaboration between human care providers and intelligent technologies. In addition, SDS is poised to play a central role in surgical education, for example, through objective assessments, automated virtual coaching, and robot

  2. Theory of dual probes on graphene structures

    DEFF Research Database (Denmark)

    Settnes, Mikkel

    around the local probes. This necessitates a reformulation of the conventional calculation methods allowing for the description of non-periodic structures embedded within infinite samples. The two-dimensional material graphene, is a highly interesting system for multi- probe characterization as graphene......This thesis concerns the development of theoretical and computational methods for multiprobe systems and their application to nanostructured graphene. Recent experimental advances emphasize the usefulness of multi-probe techniques when analyzing the electrical properties of nanoscale samples...... is purely surface and exhibits a wide range of highly intriguing electronic properties. Using a dual probe setup, we demonstrate the application of the developed formalism to a number of different graphene-based systems. The conductance between the two probes in either scanning or spectroscopy mode, shows...

  3. Surgical management of intraocular lens dislocations

    Directory of Open Access Journals (Sweden)

    Adem Gul


    Full Text Available ABSTRACTPurpose:To report and compare the surgical, visual, and anatomical outcomes following treatment of dislocated intraocular lenses (IOLs.Methods:The medical records of 28 eyes of 28 patients were evaluated. Age, gender, pre-and postoperative best-corrected visual acuity (BCVA, surgical methods, and complications were recorded.Results:Pre-and postoperative BCVA ranged from counting fingers to 20/32 and from counting fingers to 20/25, respectively. Late-onset dislocations were the most frequently observed complication. The most frequent surgical method was IOL repositioning in 15 of 28 patients, followed by IOL exchange in 11 patients, and IOL removal in 2 patients. Only 1 patient required surgical re-intervention with IOL capture.Conclusions:Visual acuity improved following the use of either IOL repositioning or IOL exchange. No superiority of one method over the other was observed. In the present retrospective case series, management of dislocated IOLs with repositioning or exchange of the primary implant conferred comparable surgical and visual outcomes.

  4. Surgical acute abdomen in elderly patients.

    Directory of Open Access Journals (Sweden)

    Itengré Ouédraogo


    Full Text Available Fundaments : The surgical acute abdomen usually is the most frequent cause of abdominal surgery of urgency in t he old one, with the high mortality in spite of the modern surgical technologies. Objective: To evaluate the surgery of the surgical acute abdomen in the old one. Method: Appears a prospectivo descriptive study that includes 102 patients of 60 years or more who underwent surgery at the ¨Dr Gustavo Aldereguía Lima¨ University Hospital of Cienfuegos with this diagnostic. The primary data were obtained from clinical cards of the patients and the daily clinical observation until the debit. Results: The patients presented an average age of 74 years, being the most frequent causes of the syndrome intestinal obstruction (32,4%, the biliary tract affections (22,5%, and acute appendicitis (21,6%. The most frequent symptom was abdominal pain (96,08%, and we noticed tachycardia in 80,4%. Postoperating complications in 47,06% of the patients appeared and was observed a mortality of 26,5% with statistically significant relation with the age, ASA classification, surgical risk, time of evolution and the surgical time. The peritonitis heads the direct causes of death.

  5. Surgical treatment for complex acetabular fractures

    Institute of Scientific and Technical Information of China (English)

    LIU Qiang; WU Dou; LI Ping; HAN Shu-feng


    Objective: To explore the effect of surgical treatment on complex acetabular fractures.Methods: The data of 46 patients (38 males and 8 females, aged 16-75 years, mean = 38. 5 years ) with complex acetabular fractures, who were admitted to our hospital from January 1998 to December 2005, were analyzed retrospectively in this study. According to Letournel rules, posterior wall and posterior column fractures were found in 11 patients, transverse and posterior wall fractures in 13, T-type fracture in 4, both columns fracture in 10, and anterior column and posterior transverse fracture in 8. The choice of surgical approach was based on the individual fractures, which included ilioinguinal approach in 5 patients, Kocher-Langenbech approach in 7, combined approach in 26, and extended iliofemoral approach in 8.Results: All the patients were followed up for 3.5 years averagely. The clinical outcomes were analyzed with Harris hip score and radiography. In 36 patients (78.3%), the surgical procedure was successful (Harris hip score > 80 points). The rate of excellent and good was about 86 %.Conclusions: The keys to increase the effectiveness of surgical treatment on acetabular fractures are correct preoperative classification of factures and choices of appropriate surgical approach and time.

  6. [Surgical management of animal bites in children]. (United States)

    Touzet-Roumazeille, S; Jayyosi, L; Plenier, Y; Guyot, E; Guillard, T; François, C


    Children represent a population at risk, because of their short size, their naivety and their attraction to animals. The face and hands are the most specific locations in young children. Wounds are often multiple. In more than half the cases, the child knows the animal, which are dogs and cats by frequency argument. The bite episode occurs mostly when the child is alone with the pet without direct supervision, while playing or stroking the animal. As in all bites, pediatric lesions are infectious, functional and aesthetic emergencies, but the goal of this work was primarily to make a point on principles of surgical management of animal bites in children, highlighting pediatric specificities. Animal bites require psychological, anesthetic and surgical treatment, adapted to the child, in a specialized structure. Hospitalization and general anesthesia are more frequent in children. Any suspicion of mistreatment (and/or abuse) should lead to the child's hospitalization, even if wounds do not justify monitoring in a surgical environment. Emergency surgery is essential to limit functional and aesthetic consequences. The healing capacities of the child and the frequent lack of co-morbidity allow a conservative surgical treatment with suture, repositioning skin flaps and controlled healing in the first place. Immobilization, drainage, and antibiotics will complete the surgery. The healing process, however, leads to a specific management during scar remodeling phase and growth. Psychological care of the child and parents should not be forgotten, and has to start at the same time as surgical treatment at in acute phase.

  7. [Current possibilities to influence surgical site infection]. (United States)

    Bělina, F


    Infections associated with surgical procedures, also referred to as surgical site infections (SSIs), are the most common nosocomial infections (HAIs - Health Care-Associated Infections) in surgery departments. Although effectively preventable in most cases, they are still associated with significant morbidity and mortality, prolonged or repeated hospitalizations and increased treatment costs. Therefore, compliance with applicable procedures and guidelines is essential for SSI prevention, which was also shown in numerous EBM studies. Relevant procedures and clinical guidelines involve all phases of perioperative care, covering preoperative patient preparation, the course of the surgical procedure itself, as well as post-operative care. In order to effectively reduce the risk of postoperative infectious complications, these proven principles and procedures need to be implemented into daily practice with every single surgical patient. Continuous monitoring of compliance with these procedures, staff education, recording the incidence of SSI in individual departments with regular evaluation and presentation of results should form an integral part of these measures.Key words: surgical site infection - incidence - risk factors - prevention - guidelines.

  8. [Recent surgical options for vestibular vertigo]. (United States)

    Volkenstein, Stefan; Dazert, Stefan


    Vertigo is not a well defined symptom but a heterogenous entity diagnosed and treated mainly by otolaryngologists, neurologists, internal medicine and primary care physicians. Most vertigo syndroms have a good prognosis and management is predominantly conservative, whereas the need for surgical therapy is rare, but for a subset of patients often the only remaining option. In this paper, we describe the development of surgical therapy for hydropic inner ear diseases, Menière disease, dehiscence syndroms, perilymphatic fistulas, and benign paroxysmal vertigo. At the end, we shortly introduce the most recent development of vestibular implants. Surgical vestibular therapy is still indicated for selected patients nowadays when conservative options did not reduce symptoms and patients are still suffering. Success depends on the correct diagnosis and indication for the different procedures going along with an adequate patient selection. In regard to the invasiveness and the possible risks due to the surgery, in depth individual counselling is necessary. Ablative and destructive surgical procedures usually achieve a successful vertigo control, but go along with a high risk for hearing loss. Therefore, residual hearing has to be included in the decission making process for a surgical therapy. © Georg Thieme Verlag KG Stuttgart · New York.

  9. Surgical stress delays prostate involution in mice.

    Directory of Open Access Journals (Sweden)

    Sazzad Hassan

    Full Text Available Androgens control growth of prostate epithelial cells and androgen deprivation induces apoptosis, leading to prostate involution. We investigated the effects of surgical stress on prostate involution induced by androgen ablation and determined the underlying mechanisms. Androgen ablation in mice was induced by surgical castration and administration of the anti-androgenic drugs bicalutamide and MDV3100. Surgical stress was induced by sham castration under isoflurane anesthesia. Surgical stress delayed apoptosis and prostate involution induced by anti-androgenic drugs. These effects of stress were prevented by administering the selective beta2-adrenoreceptor antagonist ICI118,551 and were also blocked in BAD(3SA/WT mice expressing phosphorylation-deficient mutant BAD3SA. These results indicate that apoptosis and prostate involution in response to androgen ablation therapy could be delayed by surgical stress via the beta2-adrenoreceptor/BAD signaling pathway. Thus, surgery could interfere with androgen ablation therapy, whereas administration of beta2-adrenoreceptor antagonists may enhance its efficacy.

  10. Minimally invasive surgical therapies for benign prostatic hypertrophy: The rise in minimally invasive surgical therapies

    Directory of Open Access Journals (Sweden)

    Daniel Christidis


    The role of minimally invasive surgical therapies in the treatment of BPH is still yet to be strongly defined. Given the experimental nature of many of the modalities, further study is required prior to their recommendation as alternatives to invasive surgical therapy. More mature evidence is required for the analysis of durability of effect of these therapies to make robust conclusions of their effectiveness.

  11. Comparison of surgical hand scrub and alcohol surgical hand rub on reducing hand microbial burden. (United States)

    Ghorbani, Azam; Shahrokhi, Akram; Soltani, Zahra; Molapour, Azam; Shafikhani, Mahin


    This study was performed to compare the effects of two hand decontamination methods on the microbial burden of operating room staff hands. The surgical hand washing methods compared were a traditional surgical hand scrub using a povidone iodine solution, and a social wash using a liquid non-antibacterial soap followed by the application of an alcoholic hand rub.

  12. The role of the surgical care practitioner within the surgical team. (United States)

    Quick, Julie

    Changes to the surgical workforce and the continued development of health policy have perpetuated the requirement for innovative perioperative roles. The surgical care practitioner is a nurse or allied health professional who works within a surgical team and has advanced perioperative skills, including the ability to undertake surgical interventions.With only limited literature evaluating this role, any benefits of their inclusion to a surgical team are largely anecdotal. This article presents the findings of an autoethnographic inquiry that explored the experiences of surgical team members who worked with the nurse researcher in her role as surgical care practitioner. Surgeons identified the provision of a knowledgeable, competent assistant and operator who enhanced patient care, helped maintain surgical services and supported the training of junior doctors. The professional, ethical and legal obligations of advanced perioperative practice were upheld. Interprofessional collaboration was improved, as was service provision. This further enhanced the patient experience. The traditional viewpoint that nurses who undertake tasks previously associated with medicine should be working to the standard of a doctor is challenged but requires further examination.

  13. Teaching surgical exposures to undergraduate medical students: an integration concept for anatomical and surgical education. (United States)

    Hammer, Niels; Hepp, Pierre; Löffler, Sabine; Schleifenbaum, Stefan; Steinke, Hanno; Klima, Stefan


    Decreasing numbers of students are interested in starting a surgical career, posing substantial challenges to patient care in the next years. The anatomy course is one of the key subjects in medical training, especially in surgical disciplines. Innovative teaching concepts that integrate surgically relevant anatomy and manual dexterity might help boost student interest in surgery. A preclinical workshop entitled "Surgical exposures" was developed. A team of anatomists and surgeons introduced the surgical exposures, demonstrating the procedures on Thiel-fixed body donors. Following this introduction, students practiced the exposures in an operating room-like manner. A six-point Likert scale was used to evaluate the workshop and to compare it to the first-year dissection course. The overall evaluation result for the surgical exposures was excellent, proving to be a significantly better result when compared to the first-year dissection course. The students were more satisfied with the teaching time invested by the peers and regarded the workshop as clinically highly relevant. Furthermore, they felt that questions were addressed better and that the overall atmosphere was better than in the gross anatomy course. Subject to criticism was the course size and practicing time in both cases. The surgical exposures workshop provides preclinical students with clinically relevant anatomy and manual dexterity. It may positively influence the decision to follow a surgical career. This course, however, requires extensive teaching resources. The given concept may help implement practical medical skills in the preclinical curriculum, strengthening the professional identity of surgeons and anatomists.

  14. Custom-made Microdialysis Probe Design. (United States)

    Lietsche, Jana; Gorka, Jan; Hardt, Stefanie; Karas, Michael; Klein, Jochen


    Microdialysis is a commonly used technique in neuroscience research. Therefore commercial probes are in great demand to monitor physiological, pharmacological and pathological changes in cerebrospinal fluid. Unfortunately, commercial probes are expensive for research groups in public institutions. In this work, a probe assembly is explained in detail to build a reliable, concentric, custom-made microdialysis probe for less than $10. The microdialysis probe consists of a polysulfone membrane with a molecular cut-off of 30 kDa. Probe in vitro recoveries of substances with different molecular weight (in the range of 100-1,600 Da) and different physicochemical properties are compared. The probe yields an in vitro recovery of approximately 20% for the small compounds glucose, lactate, acetylcholine and ATP. In vitro recoveries for neuropeptides with a molecular weight between 1,000-1,600 Da amount to 2-6%. Thus, while the higher molecular weight of the neuropeptides lowered in vitro recovery values, dialysis of compounds in the lower range (up to 500 Da) of molecular weights has no great impact on the in vitro recovery rate. The present method allows utilization of a dialysis membrane with other cut-off value and membrane material. Therefore, this custom-made probe assembly has the advantage of sufficient flexibility to dialyze substances in a broad molecular weight range. Here, we introduce a microdialysis probe with an exchange length of 2 mm, which is applicable for microdialysis in mouse and rat brain regions. However, dimensions of the probe can easily be adapted for larger exchange lengths to be used in larger animals.

  15. Brown recluse spider bites. A comparison of early surgical excision versus dapsone and delayed surgical excision. (United States)

    Rees, R S; Altenbern, D P; Lynch, J B; King, L E


    In a prospective study, 31 patients with brown recluse spider bites were treated by either immediate surgical excision or with the leukocyte inhibitor, dapsone, followed by delayed surgical excision. Patients were matched for age, gender, and lesion size and were excluded if the typical history and physical findings were not present. In patients treated with immediate surgical excision (N = 14), delayed wound healing (N = 5) and objectional scarring (N = 7) were common complications. However, pretreatment treatment with dapsone reduced the incidence of wound complications (N = 1) and objectional scarring (N = 1) (p less than 0.05), while reducing the need for surgical excision (N = 1). There were no severe drug reactions due to dapsone, although one patient had persistent G.I. upset. Pretreatment with dapsone not only reduced surgical complications but also improved the outcome of patients bitten by the brown recluse spider. PMID:4051613

  16. Surgical attire, practices and their perception in the prevention of surgical site infection. (United States)

    McHugh, S M; Corrigan, M A; Hill, A D K; Humphreys, H


    Clean surgical scrubs, surgical gowns and headgear are worn by operative teams to decrease bacterial contamination and lower surgical site infection (SSI) rates. A detailed review was undertaken of peer-reviewed publications and other sources of material in the English language over the last 50 years included. Surgical scrubs should be clean and made of tightly woven material. Studies investigating single-use gowns and drapes versus reusable gowns report conflicting evidence. Double gloving may reduce SSI rates in procedures where no antibiotic prophylaxis was administered. Bacterial contamination of the operative field has been shown to be decreased by the wearing of surgical headgear by the operating team. Further consideration and better trials are required to determine the impact of different theatre clothing on SSI rates. Copyright © 2013 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  17. Probe for testing electrical properties of a test sample

    DEFF Research Database (Denmark)


    A probe for testing electrical properties of test samples includes a body having a probe arm defining proximal and distal ends, the probe arm extending from the body at the proximal end of the probe arm, whereby a first axis is defined by the proximal and the distal ends. The probe arm defines...

  18. Probing the string winding sector (United States)

    Aldazabal, Gerardo; Mayo, Martín; Nuñez, Carmen


    We probe a slice of the massive winding sector of bosonic string theory from toroidal compactifications of Double Field Theory (DFT). This string subsector corresponds to states containing one left and one right moving oscillators. We perform a generalized Kaluza Klein compactification of DFT on generic 2 n-dimensional toroidal constant backgrounds and show that, up to third order in fluctuations, the theory coincides with the corresponding effective theory of the bosonic string compactified on n-dimensional toroidal constant backgrounds, obtained from three-point amplitudes. The comparison between both theories is facilitated by noticing that generalized diffeomorphisms in DFT allow to fix generalized harmonic gauge conditions that help in identifying the physical degrees of freedom. These conditions manifest as conformal anomaly cancellation requirements on the string theory side. The explicit expression for the gauge invariant effective action containing the physical massless sector (gravity+antisymmetric+gauge+ scalar fields) coupled to towers of generalized Kaluza Klein massive states (corresponding to compact momentum and winding modes) is found. The action acquires a very compact form when written in terms of fields carrying O( n, n) indices, and is explicitly T-duality invariant. The global algebra associated to the generalized Kaluza Klein compactification is discussed.

  19. Probing a Device's Active Atoms. (United States)

    Studniarek, Michał; Halisdemir, Ufuk; Schleicher, Filip; Taudul, Beata; Urbain, Etienne; Boukari, Samy; Hervé, Marie; Lambert, Charles-Henri; Hamadeh, Abbass; Petit-Watelot, Sebastien; Zill, Olivia; Lacour, Daniel; Joly, Loïc; Scheurer, Fabrice; Schmerber, Guy; Da Costa, Victor; Dixit, Anant; Guitard, Pierre André; Acosta, Manuel; Leduc, Florian; Choueikani, Fadi; Otero, Edwige; Wulfhekel, Wulf; Montaigne, François; Monteblanco, Elmer Nahuel; Arabski, Jacek; Ohresser, Philippe; Beaurepaire, Eric; Weber, Wolfgang; Alouani, Mébarek; Hehn, Michel; Bowen, Martin


    Materials science and device studies have, when implemented jointly as "operando" studies, better revealed the causal link between the properties of the device's materials and its operation, with applications ranging from gas sensing to information and energy technologies. Here, as a further step that maximizes this causal link, the paper focuses on the electronic properties of those atoms that drive a device's operation by using it to read out the materials property. It is demonstrated how this method can reveal insight into the operation of a macroscale, industrial-grade microelectronic device on the atomic level. A magnetic tunnel junction's (MTJ's) current, which involves charge transport across different atomic species and interfaces, is measured while these atoms absorb soft X-rays with synchrotron-grade brilliance. X-ray absorption is found to affect magnetotransport when the photon energy and linear polarization are tuned to excite FeO bonds parallel to the MTJ's interfaces. This explicit link between the device's spintronic performance and these FeO bonds, although predicted, challenges conventional wisdom on their detrimental spintronic impact. The technique opens interdisciplinary possibilities to directly probe the role of different atomic species on device operation, and shall considerably simplify the materials science iterations within device research. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  20. Probing QCD at high energy

    CERN Document Server

    Voutilainen, Mikko


    We review recent experimental work on probing QCD at high $p_{T}$ at the Tevatron and at the LHC. The Tevatron has just finished a long and illustrious career at the forefront of high energy physics, while the LHC now has its physics program in full swing and is producing results at a quick rate in a new energy regime. Many of the LHC measurements extend well into the TeV range, with potential sensitivity to new physics. The experimental systematics at the LHC are also becoming competitive with the Tevatron, making precision measurements of QCD possible. Measurements of inclusive jet, dijet and isolated prompt photon production can be used to test perturbative QCD predictions and to constrain parton distribution functions, as well as to measure the strong coupling constant. More exclusive topologies are used to constrain aspects of parton shower modeling, initial and final state radiation. Interest in boosted heavy resonances has resulted in novel studies of jet mass and subjet structure that also test pertu...

  1. Gravity Probe B Gyroscope Rotor (United States)


    The Gravity Probe B (GP-B) is the relativity experiment developed at Stanford University to test two extraordinary predictions of Albert Einstein's general theory of relativity. The experiment will measure, very precisely, the expected tiny changes in the direction of the spin axes of four gyroscopes contained in an Earth-orbiting satellite at a 400-mile altitude. So free are the gyroscopes from disturbance that they will provide an almost perfect space-time reference system. They will measure how space and time are very slightly warped by the presence of the Earth, and, more profoundly, how the Earth's rotation very slightly drags space-time around with it. These effects, though small for the Earth, have far-reaching implications for the nature of matter and the structure of the Universe. This photograph is a close up of a niobium-coated gyroscope motor and its housing halves. GP-B is among the most thoroughly researched programs ever undertaken by NASA. This is the story of a scientific quest in which physicists and engineers have collaborated closely over many years. Inspired by their quest, they have invented a whole range of technologies that are already enlivening other branches of science and engineering. Launched April 20, 2004 , the GP-B program was managed for NASA by the Marshall Space Flight Center. Development of the GP-B is the responsibility of Stanford University along with major subcontractor Lockheed Martin Corporation. (Image credit to Don Harley.)

  2. Probing Light Stops with Stoponium

    CERN Document Server

    Batell, Brian


    We derive new limits on light stops from diboson resonance searches in the $\\gamma\\gamma$, $Z \\gamma$, $ZZ$, $WW$ and $hh$ channels from the first run of the LHC. If the two-body decays of the light stop are mildly suppressed or kinematically forbidden, stoponium bound states will form in $pp$ collisions and subsequently decay via the pair annihilation of the constituent stops to diboson final states, yielding striking resonance signatures. Remarkably, we find that stoponium searches are highly complementary to direct collider searches and indirect probes of light stops such as Higgs coupling measurements. Using an empirical quarkonia potential model and including the first two $S$-wave stoponium states, we find that in the decoupling limit $m_{\\widetilde t_1} \\lesssim 130$ GeV is excluded for any value of the stop mixing angle and heavy stop mass by the combination of the latest resonance searches and the indirect constraints. The $\\gamma \\gamma$ searches are the most complementary to the indirect constraint...

  3. Accuracy of probing attachment levels using a new computerized cemento-enamel junction probe. (United States)

    Deepa, R; Prakash, Shobha


    The assessment of clinical attachment level (CAL) represents the gold standard for diagnosing and monitoring periodontal disease. The aim of the present study was to evaluate the performance of the newly introduced cemento-enamel junction (CEJ) probe in detecting CAL, using CEJ as a fixed reference point, and to compare the CEJ probe with the Florida stent probe (FSP) as well as with a standard manual probe, University of North Carolina-15 (UNC-15). Three examiners recorded the probing attachment level in 384 sites in case group (chronic periodontitis), and in 176 sites, in control group (healthy periodontal status), using the three probes. Subjects included both the sexes and ranged from 35 to 45 years. The experimental design was structured to balance the intra- and inter-examiner consistency at the same site during the two visits. CEJ probe showed higher intra-and inter-examiner consistency over both FSP and UNC-15 in both the case and control groups. Frequency distribution of differences of various magnitudes of repeated measurements ≤1 mm was in the higher range of 86.8% to 87.5% for CEJ probe. The FSP was more reproducible than UNC-15 in detecting relative attachment level (RAL). CEJ automated probe was found to have greatest potential for accuracy and consistency in detecting CAL than FSP and UNC-15. The automated probes appeared to be more reproducible than manual probes.

  4. Disposable surgical face masks for preventing surgical wound infection in clean surgery

    Directory of Open Access Journals (Sweden)

    Allyson Lipp

    Full Text Available BACKGROUND: Surgical face masks were originally developed to contain and filter droplets containing microorganisms expelled from the mouth and nasopharynx of healthcare workers during surgery, thereby providing protection for the patient. However, there are several ways in which surgical face masks could potentially contribute to contamination of the surgical wound, e.g. by incorrect wear or by leaking air from the side of the mask due to poor string tension. OBJECTIVES: To determine whether disposable surgical face masks worn by the surgical team during clean surgery prevent postoperative surgical wound infection. SEARCH METHODS: We searched The Cochrane Wounds Group Specialised Register (searched 14 September 2011; The Cochrane Central Register of Controlled Trials (CENTRAL (The Cochrane Library 2011, Issue 3; Ovid MEDLINE (2008 to August Week 5 2011; Ovid MEDLINE (In-Process &Other Non-Indexed Citations September 13, 2011; Ovid EMBASE (2008 to 2011 Week 35; and EBSCO CINAHL (2008 to 9 September 2011. SELECTION CRITERIA: Randomized controlled trials (RCTs and quasi-randomized controlled trials comparing the use of disposable surgical masks with the use of no mask. DATA COLLECTION AND ANALYSIS: Two review authors extracted data independently. MAIN RESULTS: Three trials were included, involving a total of 2113 participants. There was no statistically significant difference in infection rates between the masked and unmasked group in any of the trials. AUTHORS' CONCLUSIONS: From the limited results it is unclear whether the wearing of surgical face masks by members of the surgical team has any impact on surgical wound infection rates for patients undergoing clean surgery.

  5. Surgical management of OSA in adults. (United States)

    Smith, David F; Cohen, Aliza P; Ishman, Stacey L


    OSA is a common, often chronic, condition requiring long-term therapy. Given the prevalence of OSA, as well as its significant health-related sequelae, a range of medical and surgical treatments have been developed and used with varying success depending on individual anatomy and patient compliance. Although CPAP is the primary treatment, many patients cannot tolerate this treatment and require alternative therapies. In this clinical scenario, surgery is often warranted and useful. Surgical management is aimed at addressing obstruction in the nasal, retropalatal, and retroglossal/hypopharyngeal regions, and many patients have multiple levels of obstruction. This review presents a comprehensive overview of research findings on a wide spectrum of surgical approaches currently used by sleep clinicians when other therapeutic modalities fail to achieve positive outcomes.

  6. Endotoxins in surgical instruments of hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Vania Regina Goveia


    Full Text Available Abstract OBJECTIVE To investigate endotoxins in sterilized surgical instruments used in hip arthroplasties. METHOD A descriptive exploratory study conducted in a public teaching hospital. Six types of surgical instruments were selected, namely: acetabulum rasp, femoral rasp, femoral head remover, chisel box, flexible bone reamer and femoral head test. The selection was based on the analysis of the difficulty in removing bone and blood residues during cleaning. The sample was made up of 60 surgical instruments, which were tested for endotoxins in three different stages. The EndosafeTM Gel-Clot LAL (Limulus Amebocyte Lysate method was used. RESULT There was consistent gel formation with positive analysis in eight instruments, corresponding to 13.3%, being four femoral rasps and four bone reamers. CONCLUSION Endotoxins in quantity ≥0.125 UE/mL were detected in 13.3% of the instruments tested.

  7. Automated kinematic generator for surgical robotic systems. (United States)

    Jung, David L; Dixon, Warren E; Pin, François G


    Unlike traditional assembly line robotic systems that have a fixed kinematic structure associated with a single tool for a structured task, next-generation robotic surgical assist systems will be required to use an array of end-effector tools. Once a robot is connected with a tool, the kinematic equations of motion are altered. Given the need to accommodate evolving surgical challenges and to alleviate the restrictions imposed by the confined minimally invasive environment, new surgical tools may resemble small flexible snakes rather than rigid, cable driven instruments. Connecting to these developing articulated tools will significantly alter the overall kinematic structure of a robotic system. In this paper we present a technique for real-time automated generation and evaluation of manipulator kinematic equations that exhibits the combined advantages of existing methods-speed and flexibility to kinematic change--without their disadvantages.

  8. Acute and chronic pancreatitis: surgical management. (United States)

    Dzakovic, Alexander; Superina, Riccardo


    Pancreatitis is becoming increasingly prevalent in children, posing new challenges to pediatric health care providers. Although some general adult treatment paradigms are applicable in the pediatric population, diagnostic workup and surgical management of acute and chronic pancreatitis have to be tailored to anatomic and pathophysiological entities peculiar to children. Nonbiliary causes of acute pancreatitis in children are generally managed nonoperatively with hydration, close biochemical and clinical observation, and early initiation of enteral feeds. Surgical intervention including cholecystectomy or endoscopic retrograde cholangiopancreatography is often required in acute biliary pancreatitis, whereas infected pancreatic necrosis remains a rare absolute indication for pancreatic debridement and drainage via open, laparoscopic, or interventional radiologic procedure. Chronic pancreatitis is characterized by painful irreversible changes of the parenchyma and ducts, which may result in or be caused by inadequate ductal drainage. A variety of surgical procedures providing drainage, denervation, resection, or a combination thereof are well established to relieve pain and preserve pancreatic function.

  9. Pelvic Surgical Site Infections in Gynecologic Surgery

    Directory of Open Access Journals (Sweden)

    Mark P. Lachiewicz


    Full Text Available The development of surgical site infection (SSI remains the most common complication of gynecologic surgical procedures and results in significant patient morbidity. Gynecologic procedures pose a unique challenge in that potential pathogenic microorganisms from the skin or vagina and endocervix may migrate to operative sites and can result in vaginal cuff cellulitis, pelvic cellulitis, and pelvic abscesses. Multiple host and surgical risk factors have been identified as risks that increase infectious sequelae after pelvic surgery. This paper will review these risk factors as many are modifiable and care should be taken to address such factors in order to decrease the chance of infection. We will also review the definitions, microbiology, pathogenesis, diagnosis, and management of pelvic SSIs after gynecologic surgery.

  10. Surgical Vision: Google Glass and Surgery. (United States)

    Chang, Johnny Yau Cheung; Tsui, Lok Yee; Yeung, Keith Siu Kay; Yip, Stefanie Wai Ying; Leung, Gilberto Ka Kit


    Google Glass is, in essence, a smartphone in the form of a pair of spectacles. It has a display system, a bone conduction "speaker," video camera, and connectivity via WiFi or Bluetooth technologies. It can also be controlled by voice command. Seizing Google Glass' capabilities as windows of opportunity, surgeons have been the first group of doctors trying to incorporate the technology into their daily practices. Experiences from different groups have demonstrated Google Glass' potential in improving perioperative care, intraoperative communication and documentation, surgical outcome as well as surgical training. On the other hand, the device has technical limitations, notably suboptimal image qualities and a short battery life. Its operational functions also bring forth concerns on the protection of patient privacy. Nonetheless, the technological advances that this device embodies hold promises in surgical innovations. Further studies are required, and surgeons should explore, investigate, and embrace similar technologies with keen and informed anticipation.

  11. Surgical and orthodontic management of impacted teeth. (United States)

    Kokich, V G; Mathews, D P


    This article has accomplished four objectives. First of all, the most commonly impacted teeth have been identified. Aside from the third molars, these teeth include the maxillary canines, maxillary central incisors, mandibular second premolars, and mandibular second molars. Second, the cause of impaction has been discussed. In most situations, these unerupted teeth have been diverted or are angulated aberrantly during development. Once the root apex has closed, they lose their potential to erupt. Third, the various surgical procedures to uncover these impacted teeth have been described. Three different techniques (excision, apically positioned flap, and closed eruption technique) may be used to uncover the impacted tooth. The specific criteria used to select the proper surgical technique were stated. Last, the orthodontic mechanics and integration of tooth movement and surgical procedures were delineated and illustrated for each of the various types of impactions and uncovering techniques.

  12. Perfecting patient flow in the surgical setting. (United States)

    Amato-Vealey, Elaine J; Fountain, Patricia; Coppola, Deborah


    Reduced surgical efficiency and productivity, delayed patient discharges, and prolonged use of hospital resources are the results of an OR that is unable to move patients to the postanesthesia care unit or other patient units. A primary reason for perioperative patient flow delay is the lack of hospital beds to accommodate surgical patients, which consequently causes backups of patients currently in the surgical suite. In one facility, implementing Six Sigma methodology helped to improve OR patient flow by identifying ways that frontline staff members could work more intelligently and more efficiently, and with less stress to streamline workflow and eliminate redundancy and waste in ways that did not necessitate reducing the number of employees. The results were improved employee morale, job satisfaction and safety, and an enhanced patient experience.

  13. Approach to Pediatric Patients during Surgical Interventions

    Directory of Open Access Journals (Sweden)

    Seher Ünver


    Full Text Available A child’s surgical period usually contains unpleasant and difficult experiences, for the child and the parents. The child in this period experiences greater anxiety and distress. On the other hand, pediatric patients have complex states that directly effects their perioperative care during. Because their perioperative care includes not only the knowledge of general surgical procedure and care of a patient in the operating room. It also includes the specific understanding of a child’s airway, anatomy and physiology, the understanding of child development and care of the child and family. This review is prepared to present these differences of the pediatric surgical patients and the care during their perioperative period. (Jo­ur­nal of Cur­rent Pe­di­at­rics 2013; 11: 128-33

  14. [Surgical resection of gliomas in 2008]. (United States)

    Carpentier, A C


    Surgical resection of gliomas is a well-established treatment. It allows a histo-genetic diagnosis, a mass effect reduction, an intracranial hypertension treatment, a recovery of an eventual neurological deficit induced by the mass effect, but mostly brings a significant survival. New imaging sequences are optimizing the surgical management of brain tumors by bringing precisions on the tumor morphology, on cortical/subcortical eloquent areas (functional and diffusion MRI), on histology (spectroscopic MR). If the tumor is located in eloquent area, surgery is performed under electrostimulation control to take into account cerebral plasticity and to avoid postoperative functional deficits. Neuronavigation, per-operative echography, and per-operative MRI are recognized tools for optimizing the tumor resection. Ongoing researches concern the adjunction of local treatments within the surgical field (photodynamic therapy, chemotherapy, convection immunotherapy...), but also the development of minimal invasive procedures (radiosurgery, high intensity focalized ultrasounds, laser interstitial thermal therapy).

  15. Surgical risks associated with winter sport tourism. (United States)

    Sanchez, Stéphane; Payet, Cécile; Lifante, Jean-Christophe; Polazzi, Stéphanie; Chollet, François; Carty, Matthew J; Duclos, Antoine


    Mass tourism during winter in mountain areas may cause significant clustering of body injuries leading to increasing emergency admissions at hospital. We aimed at assessing if surgical safety and efficiency was maintained in this particular context. We selected all emergency admissions of open surgery performed in French hospitals between 2010 and 2012. After identifying mountain areas with increasing volume of surgical stays during winter, we considered seasonal variations in surgical outcomes using a difference-in-differences study design. We computed multilevel regressions to evaluate whether significant increase in emergency cases had an effect on surgical mortality, complications and length of stay. Clustering effect of patients within hospitals was integrated in analysis and surgical outcomes were adjusted for both patient and hospital characteristics. A total of 381 hospitals had 559,052 inpatient stays related to emergency open surgery over 3 years. Compared to other geographical areas, a significant peak of activity was noted during winter in mountainous hospitals (Alps, Pyrenees, Vosges), ranging 6-77% volume increase. Peak was mainly explained by tourists' influx (+124.5%, 4,351/3,496) and increased need for orthopaedic procedures (+36.8%, 4,731/12,873). After controlling for potential confounders, patients did not experience increased risk for postoperative death (ratio of OR 1.01, 95%CI 0.89-1.14, p = 0.891), thromboembolism (0.95, 0.77-1.17, p = 0.621) or sepsis (0.98, 0.85-1.12, p = 0.748). Length of stay was unaltered (1.00, 0.99-1.02, p = 0.716). Surgical outcomes are not compromised during winter in French mountain areas despite a substantial influx of major emergencies.

  16. Current management of surgical oncologic emergencies.

    Directory of Open Access Journals (Sweden)

    Marianne R F Bosscher

    Full Text Available For some oncologic emergencies, surgical interventions are necessary for dissolution or temporary relieve. In the absence of guidelines, the most optimal method for decision making would be in a multidisciplinary cancer conference (MCC. In an acute setting, the opportunity for multidisciplinary discussion is often not available. In this study, the management and short term outcome of patients after surgical oncologic emergency consultation was analyzed.A prospective registration and follow up of adult patients with surgical oncologic emergencies between 01-11-2013 and 30-04-2014. The follow up period was 30 days.In total, 207 patients with surgical oncologic emergencies were included. Postoperative wound infections, malignant obstruction, and clinical deterioration due to progressive disease were the most frequent conditions for surgical oncologic emergency consultation. During the follow up period, 40% of patients underwent surgery. The median number of involved medical specialties was two. Only 30% of all patients were discussed in a MCC within 30 days after emergency consultation, and only 41% of the patients who underwent surgery were discussed in a MCC. For 79% of these patients, the surgical procedure was performed before the MCC. Mortality within 30 days was 13%.In most cases, surgery occurred without discussing the patient in a MCC, regardless of the fact that multiple medical specialties were involved in the treatment process. There is a need for prognostic aids and acute oncology pathways with structural multidisciplinary management. These will provide in faster institution of the most appropriate personalized cancer care, and prevent unnecessary investigations or invasive therapy.

  17. Surgical treatment of polymicrogyria-related epilepsy. (United States)

    Cossu, Massimo; Pelliccia, Veronica; Gozzo, Francesca; Casaceli, Giuseppe; Francione, Stefano; Nobili, Lino; Mai, Roberto; Castana, Laura; Sartori, Ivana; Cardinale, Francesco; Lo Russo, Giorgio; Tassi, Laura


    The role of resective surgery in the treatment of polymicrogyria (PMG)-related focal epilepsy is uncertain. Our aim was to retrospectively evaluate the seizure outcome in a consecutive series of patients with PMG-related epilepsy who received, or did not receive, surgical treatment, and to outline the clinical characteristics of patients who underwent surgery. We evaluated 64 patients with epilepsy associated with magnetic resonance imaging (MRI)-documented PMG. After presurgical evaluation, 32 patients were excluded from surgical treatment and 32 were offered surgery, which was declined by 8 patients. Seizure outcome was assessed in the 40 nonsurgical and 24 surgical patients. Of 40 nonsurgical patients, 8 (20%) were seizure-free after a mean follow-up of 91.7 ± (standard deviation) 59.5 months. None of the eight patients who declined surgical treatment was seizure-free (mean follow-up: 74.3 ± 60.6 months). These seizure outcomes differ significantly (p = 0.000005 and p = 0.0003, respectively) from that of the 24 surgical patients, 18 of whom (66.7%) were Engel's class I postoperatively (mean follow-up: 66.5 ± 54.0 months). Of the eight patients excluded from surgery for seizure control at first visit, two had seizure recurrence at last contact. At last contact, antiepileptic drugs (AEDs) had been withdrawn in 6 of 24 surgical and in one of 40 nonsurgical cases (p = 0.0092). The present study indicates that, at least in a subset of adequately selected patients with PMG-related epilepsy, surgery may provide excellent seizure outcomes. Furthermore, it suggests that surgery is superior to AEDs for achieving seizure freedom in these cases. Wiley Periodicals, Inc. © 2016 International League Against Epilepsy.

  18. Feature classification for tracking articulated surgical tools. (United States)

    Reiter, Austin; Allen, Peter K; Zhao, Tao


    Tool tracking is an accepted capability for computer-aided surgical intervention which has numerous applications, both in robotic and manual minimally-invasive procedures. In this paper, we describe a tracking system which learns visual feature descriptors as class-specific landmarks on an articulated tool. The features are localized in 3D using stereo vision and are fused with the robot kinematics to track all of the joints of the dexterous manipulator. Experiments are performed using previously-collected porcine data from a surgical robot.

  19. Surgical options for complex craniofacial pain. (United States)

    Sharma, Mayur; Shaw, Andrew; Deogaonkar, Milind


    Complex craniofacial pain can be a challenging condition to manage both medically and surgically, but there is a resurgence of interest in the role of neurostimulation therapy. Surgical options for complex craniofacial pain syndromes include peripheral nerve/field stimulation, ganglion stimulation, spinal cord stimulation, dorsal nerve root entry zone lesioning, motor cortex stimulation, and deep brain stimulation. Peripheral nerve/field stimulation is rapidly being explored and is preferred by both patients and surgeons. Technological advances and improved understanding of the interactions of pain pathways with its affective component will widen the scope of neurostimulation therapy for craniofacial pain syndromes.

  20. [Surgical treatment of type 2 diabetes mellitus]. (United States)

    Carrillo-Esper, Raúl; Muciño-Bermejo, María Jimena


    Sustained remission of type 2 diabetes mellitus and significantly improved hyperlipidemia and arterial hypertension, control has been achieves in both lean and obese patient after bariatric surgery procedures or other gastrointestinal surgical procedures. It has been demonstrated that the metabolic effects of bariatric surgery in these patients derives not only in reducing weight and caloric intake, but also endocrine changes resulting from surgical manifestation gastrointestinal tract. In this article we review the clinical outcomes of such interventions (collectively called "metabolic surgery") and the perspectives on the role that these surgeries play in the treatment of patients with type 2 diabetes mellitus.

  1. A clarity clinic for surgical writing. (United States)

    Derish, Pamela; Eastwood, Susan


    Although writing and publishing are key to career development and academic success for surgeons, learning the skills needed to write publishable research reports is an often neglected aspect of surgical training. This report distills several lessons from scientific writing courses for surgeons taught at the University of California, San Francisco, to give a wider audience of academic surgeons tools they can use to write scientific prose more clearly. Drawing extensively on real examples of surgical writing, we cover techniques that are indispensable for achieving clarity, including choosing words carefully, designing well-constructed sentences, building structured paragraphs, and displaying your thinking clearly by using topic sentences and transitions.


    Stefan, Cornel; Batras, Mehdi; Iliescu Daniela, Adriana; Timaru Cristina, Mihaela; De Simone, Algerino; Hosseini-Ramhormozi, Jalaladin


    The purpose of this study is to review current surgical treatment and new and better alternatives for patients with glaucoma. Glaucoma refers to a group of related eye disorders that have in common an optic neuropathy associated with visual function loss. It is one of the leading causes of irreversible blindness worldwide. Optic nerve damage and glaucoma-related vision loss can be prevented or limited by early diagnosis and treatment. Surgery offers a better control of the intraocular pressure then medical therapy. Nowadays, research continues for improving current surgical alternatives for treatment.

  3. Achondroplasia in female twins: surgical indications. (United States)

    Albisetti, Walter; Pedretti, Leopoldo; De Bartolomeo, Omar; Verdoni, Fabio; Memeo, Antonio


    Although in literature achondroplasia has been described profusely, reports on achondroplastic twins are limited. We present two cases of monozygotic female twins with achondroplasia, who underwent limb-lengthening surgical procedure with external fixation in the following five steps: tibia, femur, tibia; femur, homer. Both the cases presented a good limb length and an optimal correction of associated deformities after the treatment, fulfilling the indications. Surgical indications were mostly led by the axial deviations of the lower limbs, and the timing of the limb-lengthening procedures has been the same in both couples showing the importance of this aspect.

  4. Practice management education during surgical residency. (United States)

    Jones, Kory; Lebron, Ricardo A; Mangram, Alicia; Dunn, Ernest


    Surgical education has undergone radical changes in the past decade. The introductions of laparoscopic surgery and endovascular techniques have required program directors to alter surgical training. The 6 competencies are now in place. One issue that still needs to be addressed is the business aspect of surgical practice. Often residents complete their training with minimal or no knowledge on coding of charges or basic aspects on how to set up a practice. We present our program, which has been in place over the past 2 years and is designed to teach the residents practice management. The program begins with a series of 10 lectures given monthly beginning in August. Topics include an introduction to types of practices available, negotiating a contract, managed care, and marketing the practice. Both medical and surgical residents attend these conferences. In addition, the surgical residents meet monthly with the business office to discuss billing and coding issues. These are didactic sessions combined with in-house chart reviews of surgical coding. The third phase of the practice management plan has the coding team along with the program director attend the outpatient clinic to review in real time the evaluation and management coding of clinic visits. Resident evaluations were completed for each of the practice management lectures. The responses were recorded on a Likert scale. The scores ranged from 4.1 to 4.8 (average, 4.3). Highest scores were given to lectures concerning negotiating employee agreements, recruiting contracts, malpractice insurance, and risk management. The medical education department has tracked resident coding compliance over the past 2 years. Surgical coding compliance increased from 36% to 88% over a 12-month period. The program director who participated in the educational process increased his accuracy from 50% to 90% over the same time period. When residents finish their surgical training they need to be ready to enter the world of business

  5. Trajectory surgical guide stent for implant placement. (United States)

    Adrian, E D; Ivanhoe, J R; Krantz, W A


    This article describes a new implant placement surgical guide that gives both implant location and trajectory to the surgeon. Radiopaque markers are placed on diagnostic dentures and a lateral cephalometric radiograph is made that shows the osseous anatomy at the symphysis and the anterior tooth location. The ideal implant location and trajectory data are transferred to a surgical stent that programs the angle and location of the fixtures at time of surgery. The stent has the additional benefit of acting as an occlusion rim, a mouth prop, and tongue retractor. Use of this stent has resulted in consistently programming the placement of implant fixtures that are prosthodontically ideal.

  6. [Surgical wound healing in oral surgery]. (United States)

    Bocca, M; Coscia, D; Bottalico, L; Libro, D


    Aim of this study is to improve the in vivo knowledge about the real effects and the physiologic repair by a detached stitches silk suture in the 8th zone. The study has been carried out on 44 patients submitted to surgical extraction of the impacted 8th (19 upper and 25 lower) teeth. Clinical and histological controls have demonstrated the usefulness of this suture procedure, since it gives a good histological reaction and in easy and safe. Histological and clinical results have confirmed the usefulness of silk suture, presenting however the inconvenience of stitches removal and bacterial plaque on the surgical wound.

  7. Immediate Intrauterine Device Insertion Following Surgical Abortion. (United States)

    Patil, Eva; Bednarek, Paula H


    Placement of an intrauterine device (IUD) immediately after a first or second trimester surgical abortion is safe and convenient and decreases the risk of repeat unintended pregnancy. Immediate postabortion IUD placement is not recommended in the setting of postprocedure hemorrhage, uterine perforation, infection, or hematometra. Otherwise, there are few contraindications to IUD placement following surgical abortion. Sexually transmitted infection screening should follow US Centers for Disease Control and Prevention guidelines. No additional antibiotics are needed beyond those used for the abortion. Placing immediate postabortion IUDs makes highly-effective long-acting reversible contraception more accessible to women.

  8. Nutritional supplements in the surgical patient. (United States)

    Stohs, Sidney J; Dudrick, Stanley J


    This article presents an overview of the current knowledge, status, and use of supplements by patients before surgical operations, together with the benefits expected of the supplements by the patients. The indications, potential advantages and disadvantages, and the relationships with various aspects of the preoperative preparation and postoperative management of surgical patients are discussed, with emphasis on the significant percentage of this population that is deficient in fundamental nutrients. Recent revisions and recommendations for some of the macronutrients are presented, together with a summary of federal regulations and an oversight of supplements.

  9. Surgical management of cervical spondylotic myelopathy

    Directory of Open Access Journals (Sweden)

    N Muthukumar


    Full Text Available Cervical spondylotic myelopathy (CSM is emerging as the most common cause of spinal cord dysfunction in the elderly worldwide. In the past decade, our understanding of the biomechanics of the spine has improved along with advances in spinal instrumentation and this has led to significant changes in the surgical management of CSM. This review will discuss the indications, advantages and limitations of different operative approaches as well as the complications and prognosis of surgery for cervical spondylotic myelopathy. Choice of surgical approach for CSM should be based on the clinical and radiological characteristics of the individual patient and not on the preferences of the surgeon.

  10. Surgical management of moyamoya disease: a review. (United States)

    Baaj, Ali A; Agazzi, Siviero; Sayed, Zafar A; Toledo, Maria; Spetzler, Robert F; van Loveren, Harry


    Moyamoya disease (MMD) is a progressive, occlusive disease of the distal internal carotid arteries associated with secondary stenosis of the circle of Willis. Symptoms include ischemic infarcts in children and hemorrhages in adults. Bypass of the stenotic vessel(s) is the primary surgical treatment modality for MMD. Superficial temporal artery-to-middle cerebral artery bypass is the most common direct bypass method. Indirect techniques rely on the approximation of vascularized tissue to the cerebral cortex to promote neoangiogenesis. This tissue may be in the form of muscle, pericranium, dura, or even omentum. This review highlights the surgical options available for the treatment of MMD.

  11. In vivo virtual intraoperative surgical photoacoustic microscopy

    Energy Technology Data Exchange (ETDEWEB)

    Han, Seunghoon, E-mail:; Kim, Sehui, E-mail:; Kim, Jeehyun, E-mail:, E-mail: [School of Electrical Engineering and Computer Science, Kyungpook National University, Daegu 702-701 (Korea, Republic of); Lee, Changho, E-mail:; Jeon, Mansik, E-mail: [Department of Creative IT Engineering, Pohang University of Science and Technology (POSTECH), Pohang 790-784 (Korea, Republic of); Kim, Chulhong, E-mail:, E-mail: [Department of Creative IT Engineering, Pohang University of Science and Technology (POSTECH), Pohang 790-784 (Korea, Republic of); Department of Biomedical Engineering, The State University of New York at Buffalo, Buffalo, New York 14221 (United States)


    We developed a virtual intraoperative surgical photoacoustic microscopy system by combining with a commercial surgical microscope and photoacoustic microscope (PAM). By sharing the common optical path in the microscope and PAM system, we could acquire the PAM and microscope images simultaneously. Moreover, by employing a beam projector to back-project 2D PAM images onto the microscope view plane as augmented reality, the conventional microscopic and 2D cross-sectional PAM images are concurrently mapped on the plane via an ocular lens of the microscope in real-time. Further, we guided needle insertion into phantom ex vivo and mice skins in vivo.

  12. Surgical management of traumatic brain injury

    DEFF Research Database (Denmark)

    Hartings, Jed A; Vidgeon, Steven; Strong, Anthony J;


    OBJECT: Mass lesions from traumatic brain injury (TBI) often require surgical evacuation as a life-saving measure and to improve outcomes, but optimal timing and surgical technique, including decompressive craniectomy, have not been fully defined. The authors compared neurosurgical approaches...... enrolled in the Co-Operative Studies on Brain Injury Depolarizations (COSBID) at King's College Hospital (KCH, n = 27) and Virginia Commonwealth University (VCU, n = 24) from July 2004 to March 2010. Subdural electrode strips were placed at the time of surgery for subsequent electrocorticographic...

  13. Sapphire ball lensed fiber probe for common-path optical coherence tomography in ocular imaging and sensing (United States)

    Zhao, Mingtao; Huang, Yong; Kang, Jin U.


    We describe a novel common-path optical coherence tomography (CP-OCT) fiber probe design using a sapphire ball lens for cross-sectional imaging and sensing in retina vitrectomy surgery. Single mode Gaussian beam (TEM00) simulation was used to optimize lateral resolution and working distance (WD) of the common-path probe. A theoretical sensitivity model for CP-OCT was prosed to assess its optimal performance based an unbalanced photodetector configuration. Two probe designs with working distances (WD) 415μm and 1221μm and lateral resolution 11μm and 18μm, respectively were implemented with sensitivity up to 88dB. The designs are also fully compatible with conventional Michelson interferometer based OCT configurations. The reference plane of the probe, located at the distal beam exit interface of the single mode fiber (SMF), was encased within a 25-gauge hypodermic needle by the sapphire ball lens facilitates its applications in bloody and harsh environments. The performances of the fiber probe with 11μm of lateral resolution and 19μm of axial resolution were demonstrated by cross-sectional imaging of a cow cornea and retina in vitro with a 1310nm swept source OCT system. This probe was also attached to a piezoelectric motor for active compensation of physiological tremor for handheld retinal surgical tools.

  14. Comparative analyses of plasma probe diagnostics techniques

    Energy Technology Data Exchange (ETDEWEB)

    Godyak, V. A. [Electrical Engineering and Computer Science Department, University of Michigan, Ann Arbor, Michigan 48109, USA and RF Plasma Consulting, Brookline, Massachusetts 02446 (United States); Alexandrovich, B. M. [Plasma Sensors, Brookline, Massachusetts 02446 (United States)


    The subject of this paper is a comparative analysis of the plasma parameters inferred from the classical Langmuir probe procedure, from different theories of the ion current to the probe, and from measured electron energy distribution function (EEDF) obtained by double differentiation of the probe characteristic. We concluded that the plasma parameters inferred from the classical Langmuir procedure can be subjected to significant inaccuracy due to the non-Maxwellian EEDF, uncertainty of locating the plasma potential, and the arbitrariness of the ion current approximation. The plasma densities derived from the ion part of the probe characteristics diverge by as much as an order of magnitude from the density calculated according to Langmuir procedure or calculated as corresponding integral of the measured EEDF. The electron temperature extracted from the ion part is always subjected to uncertainty. Such inaccuracy is attributed to modification of the EEDF for fast electrons due to inelastic electron collisions, and to deficiencies in the existing ion current theories; i.e., unrealistic assumptions about Maxwellian EEDFs, underestimation of the ion collisions and the ion ambipolar drift, and discounting deformation of the one-dimensional structure of the region perturbed by the probe. We concluded that EEDF measurement is the single reliable probe diagnostics for the basic research and industrial applications of highly non-equilibrium gas discharge plasmas. Examples of EEDF measurements point up importance of examining the probe current derivatives in real time and reiterate significance of the equipment technical characteristics, such as high energy resolution and wide dynamic range.

  15. Probe Project Status and Accomplishments - Year Two

    Energy Technology Data Exchange (ETDEWEB)

    Burris, R.D.


    The Probe project has established a facility for storage- and network-related research, development and testing. With sites at the Oak Ridge National Laboratory (ORNL) and the National Energy Research Scientific Computing Center (NERSC), Probe is investigating local-area or wide-area distributed storage issues ranging from data mining to optimizing retrieval operations from tape devices. Probe has completed its second full year of operation. In this document we will describe the status of the project as of December 31, 2001. This year we will structure this document by category of work, rather than by project status. We will present sections describing Scientific Discovery through Advanced Computation (SciDAC) projects, network research and research on data mining and distributed cluster analysis. Another section will describe data-transfer application development and testing and other types of hardware- and software-related testing and development activities. We will then describe the work undertaken for presentation at the SC2001 conference. The final section will summarize this year's publications. Individual projects described in this document have used some Probe resource--equipment, software, staff or funding. By describing these projects we do not imply that the work should be entirely credited to Probe, although we do assert that Probe's existence and assistance provided benefit to the work. The Probe project is funded by the Mathematical, Information, and Computer Sciences (MICS) department of the Advanced Scientific Computing Research office, Office of Science, Department of Energy.

  16. Probing Signal Design for Power System Identification

    Energy Technology Data Exchange (ETDEWEB)

    Pierre, John W.; Zhou, Ning; Tuffner, Francis K.; Hauer, John F.; Trudnowski, Daniel J.; Mittelstadt, William


    This paper investigates the design of effective input signals for low-level probing of power systems. In 2005, 2006, and 2008 the Western Electricity Coordinating Council (WECC) conducted four large-scale system wide tests of the western interconnected power system where probing signals were injected by modulating the control signal at the Celilo end of the Pacific DC intertie. A major objective of these tests is the accurate estimation of the inter-area electromechanical modes. A key aspect of any such test is the design of an effective probing signal that leads to measured outputs rich in information about the modes. This paper specifically studies low-level probing signal design for power-system identification. The paper describes the design methodology and the advantages of this new probing signal which was successfully applied during these tests. This probing input is a multi-sine signal with its frequency content focused in the range of the inter-area modes. The period of the signal is over two minutes providing high-frequency resolution. Up to 15 cycles of the signal are injected resulting in a processing gain of 15. The resulting system response is studied in the time and frequency domains. Because of the new probing signal characteristics, these results show significant improvement in the output SNR compared to previous tests.

  17. Hyperpolarized NMR Probes for Biological Assays

    Directory of Open Access Journals (Sweden)

    Sebastian Meier


    Full Text Available During the last decade, the development of nuclear spin polarization enhanced (hyperpolarized molecular probes has opened up new opportunities for studying the inner workings of living cells in real time. The hyperpolarized probes are produced ex situ, introduced into biological systems and detected with high sensitivity and contrast against background signals using high resolution NMR spectroscopy. A variety of natural, derivatized and designed hyperpolarized probes has emerged for diverse biological studies including assays of intracellular reaction progression, pathway kinetics, probe uptake and export, pH, redox state, reactive oxygen species, ion concentrations, drug efficacy or oncogenic signaling. These probes are readily used directly under natural conditions in biofluids and are often directly developed and optimized for cellular assays, thus leaving little doubt about their specificity and utility under biologically relevant conditions. Hyperpolarized molecular probes for biological NMR spectroscopy enable the unbiased detection of complex processes by virtue of the high spectral resolution, structural specificity and quantifiability of NMR signals. Here, we provide a survey of strategies used for the selection, design and use of hyperpolarized NMR probes in biological assays, and describe current limitations and developments.

  18. Development and application of DNA molecular probes

    Directory of Open Access Journals (Sweden)

    Priya Vizzini


    Full Text Available The development of DNA probes started from 1950's for diagnostic purposes and it is still growing. DNA probes are applied in several fields such as food, medical, veterinary, environment and security, with the aim of prevention, diagnosis and treatment. The use of DNA probes permits microorganism identification, including pathogen detection, and their quantification when used in specific systems. Various techniques obtained success by the utilization of specific DNA probes, that allowed the obtainment of rapid and specific results. From PCR, qPCR and blotting techniques that were first used in well equipped laboratories to biosensors such as fiber optic, surface plasmon resonance (SPR, electrochemical, and quartz crystal microbalance (QCM biosensors that use different transduction systems. This review describes i the design and production of primers and probes, and their utilization from the traditional techniques to the new emerging techniques like biosensors used in current applications; ii the possibility to use labelled-free probes and probes labelled with an enzyme/fluorophore, etc.; iii the different sensitivity obtained by using specific systems; and iv the advantage obtained by using biosensors.

  19. Effect of non-surgical periodontal therapy on serum ferritin levels: an interventional study. (United States)

    Chakraborty, Souvik; Tewari, Shikha; Sharma, Rajinder Kumar; Narula, Satish Chander


    Ferritin, an acute-phase reactant, has been found to be elevated in many chronic inflammation-related diseases. The aim of the present study is to investigate differences in concentrations of serum ferritin in patients with and without periodontal disease before and after non-surgical periodontal therapy and correlate these values with clinical variables associated with periodontal disease. Forty-two individuals were included in this study, 20 with chronic periodontitis (CP) and 22 classified as periodontally healthy. Serum ferritin concentrations, hemoglobin levels, and periodontal parameters (probing depth [PD], clinical attachment level, gingival index, bleeding on probing, and plaque index) were recorded at baseline and 3 months after non-surgical periodontal therapy. Patients with CP showed higher concentrations of serum ferritin than periodontally healthy controls (P serum ferritin levels and the number of sites with PD ≥ 6 mm at baseline (P serum ferritin levels at baseline (R(2) = 0.823). Significant reductions in serum ferritin levels were observed at the 3-month assessment after periodontal treatment (P serum ferritin values were comparable to those of controls (P >0.05). Furthermore, the post-treatment degree of change in the serum ferritin level was positively and significantly associated with improvement in PD (R(2) = 0.213, P Serum ferritin levels are raised in patients with CP and decrease to control levels post-treatment.

  20. Intraoperative Assessment of Breast Cancer Margins ex vivo using Aqueous Quantum Dot-Functionalized Molecular Probes (United States)

    Au, Giang Hoang Thuy

    Breast cancer is increasingly diagnosed at an early stage, allowing the diseased breast to be removed only partially or breast conserving surgery (BCS). Current BCS procedures have no rapid methods during surgery to assess if the surgical margin is clear of cancer, often resulting in re-excision. The current breast cancer re-excision rate is estimated to be 15% to as high as 60%. It would be desirable if there is a rapid and reliable breast cancer margin assessment tool in the operating room to help assess if the surgical margin is clean to minimize unnecessary re-excisions. In this research, we seek to develop an intraoperative, molecular probe-based breast cancer surgical margin assessment tool using aqueous quantum dots (AQDs) coupled with cancer specific biomarkers. Quantum dots (QDs) are photoluminescent semiconductor nanoparticles that do not photobleach and are brighter than organic fluorescent dyes. Aqueous quantum dots (AQDs) such as CdSe and near infrared (NIR) CdPbS developed in Shih's lab emit light longer than 600 nm. We have examined conjugating AQDs with antibodies to cancer specific biomarkers such as Tn antigen, a cancer-associated glycan antigen for epithelial cancers. We showed that AQDs could achieve ~80% antibody conjugation efficiency, i.e., 100 times less antibodies than required by commercial, making such AQD molecular probe surgical margin evaluation economically feasible. By conjugating AQDs with anti-Tn-antigen antibody, the AQDs molecular probe exhibited 94% sensitivity and 92% specificity in identifying breast cancer against normal breast tissues as well as benign breast tumors in 480 tissue blocks from 126 patients. Furthermore, mice model and clinical human studies indicated that AQDs imaging did not interfere with the following pathological staining. More interestingly, we showed that it it possible to directly conjugate one antibody to multiple AQDs, further reduces the required amount of antibodies needed, a feat that could not be