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Sample records for include channel incision

  1. Incision of the Jezero Crater Outflow Channel by Fluvial Sediment Transport

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    Holo, S.; Kite, E. S.

    2017-12-01

    Jezero crater, the top candidate landing site for the Mars 2020 rover, once possessed a lake that over-spilled and eroded a large outflow channel into the Eastern rim. The Western deltaic sediments that would be the primary science target of the rover record a history of lake level, which is modulated by the inflow and outflow channels. While formative discharges for the Western delta exist ( 500 m3/s), little work has been done to see if these flows are the same responsible for outflow channel incision. Other models of the Jezero outflow channel incision assume that a single rapid flood (incision timescales of weeks), with unknown initial hydraulic head and no discharge into the lake (e.g. from the inflow channels or the subsurface), incised an open channel with discharge modulated by flow over a weir. We present an alternate model where, due to an instability at the threshold of sediment motion, the incision of the outflow channel occurs in concert with lake filling. In particular, we assume a simplified lake-channel-valley system geometry and that the channel is hydraulically connected to the filling/draining crater lake. Bed load sediment transport and water discharge through the channel are quantified using the Meyer-Peter and Mueller relation and Manning's law respectively. Mass is conserved for both water and sediment as the lake level rises/falls and the channel incises. This model does not resolve backwater effects or concavity in the alluvial system, but it does capture the non-linear feedbacks between lake draining, erosion rate, channel flow rate, and slope relaxation. We identify controls on incision of the outflow channel and estimate the time scale of outflow channel formation through a simple dynamical model. We find that the observed 300m of channel erosion can be reproduced in decades to centuries of progressive bed load as the delta forming flows fill the lake. This corresponds to time scales on the order of or smaller than the time scale

  2. Modelling channel incision and alpine hillslope development using laser altimetry data

    NARCIS (Netherlands)

    Anders, N.S.; Seijmonsbergen, A.C.; Bouten, W.

    2009-01-01

    This paper presents a new approach to simulate drainage basin evolution and demonstrates that high resolution elevation data can be used as useful tool for a dynamic simulation of Alpine landscape development, in which channel incision is incorporated in high spatial detail. A vector channel

  3. Simulation of channel sandstone architecture in an incised valley

    Energy Technology Data Exchange (ETDEWEB)

    Frykman, P.; Johannessen, P.; Andsbjerg, J.

    1998-12-31

    The present report describes a geostatistical modelling study that is aimed at reflecting the architecture of the channel sandstones in an incised valley fill. The example used for this study is a part of the Middle Jurassic sandy succession of the Bryne Formation in the Danish central Graben. The succession consists mainly of fluvial sediments in the lower part, overlain by tidal influenced sediments, which again is overlain by shallow marine sediments. The modelling study has been performed on a sequence of incised valley sediments in the upper part of the Bryne Formation overlying fluvial sediments. (au) EFP-96. 19 refs.

  4. Channel Incision Driven by Suburbanization: Impacts to Riparian Groundwater Flow and Overbank Flow Frequency

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    Bowles, C. J.; Lawrence, R. L.; Noll, C.; Hancock, G. S.

    2005-12-01

    Channel incision is a widely observed response to increased flow in urbanized watersheds, but the effects of channel lowering on riparian water tables is not well documented. In a rapidly incising suburban stream in the Virginia Coastal Plain, we hypothesize that stream incision has lowered floodplain water tables and decreased the overbank flow frequency. The monitored stream is a tributary to the James River draining 1.3 km2 of which 15% is impervious cover. Incision has occurred largely through upstream migration of a one meter high knickpoint at a rate of ~1.5 m/yr, primarily during high flow events. We installed 63 wells in six stream-perpendicular transects as well as a cluster of wells around the knickpoint to assess water table elevations beneath the floodplain adjacent to the incising stream. Two transects are located 30 and 50 m upstream of the knickpoint in the unincised floodplain, and the remainder are 5, 30, 70, and 100 m downstream in the incised floodplain. In one transect above and two below, pressure transducers attached to dataloggers provide a high-resolution record of water table changes. Erosion pins were installed and channel cross-sections surveyed to determine streambed stability. Significant differences are observed in bank morphology and groundwater flow above vs. below the knickpoint. Above the knickpoint, the banks are stable, ~3 m wide, and ~0.3 m deep, and widen and deepen slightly toward the knickpoint. The water table is relatively flat and is 0.2-0.4 m below the floodplain surface, and groundwater contours suggest flow is parallel to the stream direction. The water table responds immediately to precipitation events, and rises to the floodplain surface in significant rainfall events. Immediately downstream of the knickpoint, channel width increases by about a meter, and stream depth increases to ~1.5 meters. The water table immediately below the knickpoint possesses a steep gradient, and is up to one meter below the floodplain

  5. Drainage development and incision rates in an Upper Pleistocene Basalt-Limestone Boundary Channel: The Sa'ar Stream, Golan Heights, Israel

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    Shtober-Zisu, N.; Inbar, M.; Mor, D.; Jicha, B. R.; Singer, B. S.

    2018-02-01

    Long-term fluvial incision processes and corresponding geomorphic evolution are difficult to quantify, especially in complex systems affected by lithological and tectonic factors. Volcanic landscapes offer the most appropriate environment for the study of landscape evolution, as there is a clear starting time of formation and the lithology is homogenous. In the present study we aim to: (1) analyse the interplay of construction and incision processes throughout eruptive activity; (2) study fluvial erosion processes; (3) analyse sedimentary and volcanic lithological responses to channel erosion; and (4) calculate the incision rates in young basaltic bedrock. We have integrated existing and new 40Ar/39Ar ages of lava flows with estimates of channel geometry and tectonic activity, and considered process geomorphology concepts, to fully understand evolution of a bedrock channel incised at the boundary between basalts and sedimentary rocks with coeval active volcanic processes forcing drainage evolution. Our findings indicate that the Sa'ar basin evolution is controlled by: (1) rock strength of the mixed lithology; (2) alternating cycles of volcanic activity followed by erosion and incision; and (3) the Plio-Pleistocene uplift of Mt. Hermon. The carbonate slopes composing the southern flank of Mt. Hermon are moderate (18-26%) while the basalt slopes deriving from the Golan Heights are much steeper (26-51%). The highly erodible sedimentary rocks at Mt. Hermon's piedmont accelerated river incision, shaping a 650 m wide by 100 m deep canyon. Inside the canyon, the steep channel slope (8.6%) enables downstream movement of large boulders, including autochthonous mega-blocks (D90 size > 2.5 m); 24 knickpoints were identified using DS plots, developed within a knick zone over a distance of 6 km. The brittle and porous structure of the rubbly and blocky interflow layers (clinkers), interbedded between two massive basalt flows, enhances erosion and accelerates scouring of the

  6. A Hot Knife Through Ice-Cream: Earthflow Response to Channel Incision (Or Channel Response to Earthflows?), Eel River Canyon, California

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    Mackey, B. H.; Roering, J. J.; McKean, J. A.

    2007-12-01

    Abundant glacier-like earthflow features are recognized as a primary erosional process in the highly erodable Franciscan Melange of the Eel River Basin, CA. Despite their prominence in this "melting ice-cream" topography, many questions regarding their effects on the long term sediment flux from this rapidly eroding basin remain unresolved. For example, does an earthflow's basal shear zone propagate vertically downwards with vertical river incision? What controls the upslope and lateral extent of individual earthflows? How does the erosive power of a river influence the rate of earthflow movement, or conversely do earthflow toe deposits regulate the rate of river incision? Here we present preliminary findings derived from study of 200km2 of lidar data (1m resolution) covering hillslopes adjacent to 30km of the Eel River. Lidar allows detailed analysis of the interaction between earthflows and the drainage network, and we document how inferred changes in local base level are propagated throughout adjacent hillslopes via earthflow movement. The most active earthflows (determined by field surveying and analysis of aerial photos rectified using lidar- generated digital topography) coincide with locally steep sections of channel, while downstream of the most active flows we frequently observe less-active or dormant earthflows. This observation supports the idea that the locations of the most active earthflows coincide with headward propagating knickpoints in the channel. The rate of earthflow movement appears to slow when an earthflow exhausts the upslope area of easily mobilized sediment. Earthflow toes can protrude directly into the channel, causing the channel to narrow and steepen, and even undercut the opposite bank. Large resistant boulders (>2m diameter) transported by the earthflow accumulate in the streambed and appear to both act as a check on further channel incision and earthflow movement. In contrast, areas adjacent to active earthflows exhibit smooth

  7. Rapid channel incision of the lower Pearl River (China since the 1990s as a consequence of sediment depletion

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    X. X. Lu

    2007-12-01

    Full Text Available This paper reported a dramatic channel incision (>10 m in the deepest cut during the past 10 y or so in the lower Pearl River, the second largest river in terms of water discharge in China. The channel incision had caused changes both in the channel geometry as well as in the river hydraulics. Also, the water exchange between the two major tributaries of the Pearl River, the Xijiang and Beijiang, had been significantly changed due to the channel incision. The rapid channel incision was principally the result of extensive sand mining in the lower Pearl River and the delta region due to the booming economy in the Pearl Delta region. Slight increase of water discharge and significant decrease of sediment load since the early 1990s in both the Xijiang and Beijiang also likely contributed to the observed dramatic river bed downcutting to some extent. This has important implications for river management, as the large Chinese rivers have seen a dramatic depletion of sediment fluxes due to the combined effects of declining rainfall, dam constructions, water diversion, reforestation and afforestation, and sediment mining over the recent decades.

  8. Water table and overbank flow frequency changes due to suburbanization-induced channel incision, Virginia Coastal Plain, USA

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    Hancock, G.; Mattell, N.; Christianson, E.; Wacksman, J.

    2004-12-01

    Channel incision is a widely observed response to increased flow in urbanized watersheds, but the effects of channel lowering on riparian water tables is not well documented. In a rapidly incising suburban stream in the Virginia Coastal Plain, we hypothesize that incision has lowered floodplain water tables and decreased the overbank flow frequency, and suggest these changes impact vegetation distribution in a diverse, protected riparian habitat. The monitored stream is a tributary to the James River draining 1.3 km2, of which 15% is impervious cover. Incision has occurred largely through upstream migration of a one m high knickpoint at a rate of 1-2 m/yr, primarily during high flow events. We installed 33 wells in six floodplain transects to assess water table elevations beneath the floodplain adjacent to the incising stream. To document the impacts of incision, two transects are located 30 and 50 m upstream of the knickpoint in unincised floodplain, and the remainder are 5, 30, 70, and 100 m downstream of the knickpoint in incised floodplain. In one transect above and two below, pressure transducers attached to dataloggers provide a high-resolution record of water table response to storm events. Significant differences have been observed in the water table above and below the knickpoint. Above the knickpoint, the water table is relatively flat and is 0.2-0.4 m below the floodplain surface. Water table response to precipitation events is nearly immediate, with the water table rising to the floodplain surface in significant rainfall events. In the transect immediately downstream of the knickpoint, the water table possesses a steep gradient, rising from ~1 m below the floodplain at the stream to 0.3 m below the surface within 20 m. In the most downstream transects, the water table is relatively flat, but is one m below the floodplain surface, equivalent to the depth of incision generated by knickpoint passage. Upstream of the knickpoint, overbank flooding occurs

  9. Strong feedbacks between hillslope sediment production and channel incision by saltation-abrasion

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    Lundbek Egholm, David; Faurschou Knudsen, Mads; Sandiford, Mike

    2013-04-01

    While it is well understood that rivers erode mountain ranges by incising the bedrock and by transporting sediments away from the ranges, the basic physical mechanisms that drive long-term bedrock erosion and control the lifespan of mountain ranges remain uncertain. A particularly challenging paradox is reconciling the dichotomy associated with the high incision rates observed in active mountain belts, and the long-term (108 years) preservation of significant topographic reliefs in inactive orogenic belts (e.g. von Blankenburg, 2005). We have performed three-dimensional computational experiments with a landscape evolution model that couples bedrock landslides and sediment flux-dependent river erosion by saltation-abrasion (Sklar & Dietrich, 2004). The coupled model experiments show strong feedbacks between the channel erosion and the hillslope delivery of sediments. The feedbacks point to hillslope sediment production rate as the main control on channel erosion rates where saltation-abrasion dominates over other fluvial erosion processes. Our models results thus highlight the importance of hillslope sediment production controlled by climate and tectonic activity for scaling erosion rates in fluvial systems. Because of variations in landslide frequency, the feedbacks make tectonic activity a primary driver of fluvial erosion and help clarifying the long-standing paradox associated with the persistence of significant relief in old orogenic belts, up to several hundred-million-years after tectonic activity has effectively ceased. References F. von Blankenburg. The control mechanisms of erosion and weathering at basin scale from cosmogenic nuclides in river sediment. Earth Planet. Sci. Lett. 237, 462-479 (2005). L. S. Sklar, W. E. Dietrich. A mechanistic model for river incision into bedrock by saltating bed load. Water Resour. Res. 40, W06301 (2004).

  10. Holocene Evolution of Incised Coastal Channels on the Isle of Wight, UK: Interpretation via Numerical Simulation.

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    Leyland, J.; Darby, S. E.

    2006-12-01

    Incised coastal channels are found in numerous locations around the world where the shoreline morphology consists of cliffs. The incised coastal channels found on the Isle of Wight, UK, are known locally as `Chines' and debouche (up to 45m) through the soft cliffs of the south west coast, maintaining steep side walls subject to deep-seated mass wasting. These canyons offer sheltered locations and bare substrate, providing habitat for plant (Philonotis marchica, Anthoceros punctatos) and invertebrate (Psen atratinus, Baris analis, Melitaea cinxi) species of international importance. The base level of the Chines is highly dynamic, with episodes of sea cliff erosion causing the rejuvenation of the channel network. Consequently a key factor in Chine evolution is the relative balance between rates of cliff retreat and headwards incision caused by knickpoint migration. Specifically, there is concern that if contemporary coastal retreat rates are higher than the corresponding rates of knickpoint recession, there will be long-term a reduction in the overall extent of the Chines and their associated habitats. In an attempt to provide a long-term context for these issues, in this poster we explore the Holocene erosional history of the Chines using a numerical landscape evolution model. The model includes a stochastic cliff recession function that controls the position of the outlet boundary. Knickpoint recession rates are simulated using a detachment-limited channel erosion law wherein erosion rate is a power function of drainage area and stream gradient with model parameters defined using empirically- derived data. Simulations are undertaken for a range of imposed boundary conditions representing different scenarios of long-term cliff retreat forced by Holocene sea-level rise, plausible scenarios corresponding to cases where simulated and observed Chine and landscape forms match. The study provides an example of how a landscape evolution model could be used to reconstruct

  11. Rate of bedrock channel incision by waterfall retreat and landscape response constrained by cosmogenic 3He, Kauai, Hawaii

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    Mackey, B. H.; Lamb, M. P.; Scheingross, J. S.; Farley, K. A.

    2011-12-01

    Channel incision and knickpoint retreat are the drivers of landscape evolution, yet we are still challenged to quantify the rate and processes by which rivers cut into rock. The Napali Coast on the northwestern side of Kauai, Hawaii, has multiple linear channels incising >200 m into the shield volcano surface. The channels have well-constrained initial conditions, including original topography, and relatively uniform layered basalt of known age (~4.5 Ma), which have attracted previous studies of channel evolution (e.g., Seidl et al., 1994, 1997). Many channels feature prominent waterfalls, although the mechanism of knickpoint initiation (submarine landslide vs cliff erosion) and subsequent retreat remain ambiguous. Motivated by these knowledge gaps and recent advances in cosmogenic helium geochronology, we revisited the Kaulaula Valley, a 9 km long narrow valley, beheaded on its upslope extent by the Waimea Canyon, and ending near the coast at the northern Mana Plain. Four kilometers up the canyon is a prominent 40 m high vertical knickpoint, dividing the valley into strongly contrasting geomorphic domains. The boulder-lined channel below the knickpoint is linear, steep (15%), and confined to a narrow valley with steep rocky cliffs (average slope 31°). Large, >2 m diameter angular boulders in the lower section of channel show evidence of mobility from debris flows. Above the knickpoint, average channel gradient is reduced (9%), bed load is much finer, and convex, soil-mantled hillslopes have a consistently lower mean slope of 18°. We constrained the exposure age of 18 features (in-channel boulders, stable boulders on terraces, and in-channel bedrock) along the length of the channel, by analysis of cosmogenic 3He in olivine phenocrysts. Cosmogenic exposure ages are oldest near the coast (80 ka) and systematically decrease with upstream distance towards the waterfall (model of knickpoint retreat and downstream terrace abandonment advocated by Seidl (1997), and we

  12. Climate-modulated channel incision and rupture history of the San Andreas Fault in the Carrizo Plain.

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    Grant Ludwig, Lisa; Akçiz, Sinan O; Noriega, Gabriela R; Zielke, Olaf; Arrowsmith, J Ramón

    2010-02-26

    The spatial and temporal distribution of fault slip is a critical parameter in earthquake source models. Previous geomorphic and geologic studies of channel offset along the Carrizo section of the south central San Andreas Fault assumed that channels form more frequently than earthquakes occur and suggested that repeated large-slip earthquakes similar to the 1857 Fort Tejon earthquake illustrate typical fault behavior. We found that offset channels in the Carrizo Plain incised less frequently than they were offset by earthquakes. Channels have been offset by successive earthquakes with variable slip since ~1400. This nonuniform slip history reveals a more complex rupture history than previously assumed for the structurally simplest section of the San Andreas Fault.

  13. The fourth incision: a cosmetic autopsy incision technique.

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    Patowary, Amarjyoti

    2010-03-01

    Autopsy procedure includes thorough external examination as well as internal examination including opening of all the body cavities for proper visualization of all the visceral organs. As such, there remains incision marks with stitches which harts the sentiment of the already traumatized relatives of the deceased. Moreover, it looks odd especially in cases of otherwise healthy dead bodies. So, autopsy incisions should be such that, we can get maximum possible visualization of the body cavities, particularly the thorax and abdomen, and at the same time the incision as well as the stitch marks are also hidden. This article is aimed to describe few modifications in the autopsy incisions for opening the thorax and abdomen and also proper visualization of the neck structures during autopsy where the incisions and the stitches are kept hidden.

  14. Lateral Erosion Encourages Vertical Incision in a Bimodal Alluvial River

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    Gran, K. B.

    2015-12-01

    Sand can have a strong impact on gravel transport, increasing gravel transport rates by orders of magnitude as sand content increases. Recent experimental work by others indicates that adding sand to an armored bed can even cause armor to break-up and mobilize. These two elements together help explain observations from a bimodal sand and gravel-bedded river, where lateral migration into sand-rich alluvium breaks up the armor layer, encouraging further incision into the bed. Detailed bedload measurements were coupled with surface and subsurface grain size analyses and cross-sectional surveys in a seasonally-incised channel carved into the upper alluvial fan of the Pasig-Potrero River at Mount Pinatubo, Philippines. Pinatubo erupted in 1991, filling valleys draining the flanks of the volcano with primarily sand-sized pyroclastic flow debris. Twenty years after the eruption, sand-rich sediment inputs are strongly seasonal, with most sediment input to the channel during the rainy season. During the dry season, flow condenses from a wide braided planform to a single-thread channel in most of the upper basin, extending several km onto the alluvial fan. This change in planform creates similar unit discharge ranges in summer and winter. Lower sediment loads in the dry season drive vertical incision until the bed is sufficiently armored. Incision proceeds downstream in a wave, with increasing sediment transport rates and decreasing grain size with distance downstream, eventually reaching a gravel-sand transition and return to a braided planform. Incision depths in the gravel-bedded section exceeded 3 meters in parts of a 4 km-long study reach, a depth too great to be explained by predictions from simple winnowing during incision. Instead, lateral migration into sand-rich alluvium provides sufficient fine sediment to break up the armor surface, allowing incision to start anew and increasing the total depth of the seasonally-incised valley. Lateral migration is recorded in a

  15. Channel incision and suspended sediment delivery at Caspar Creek, Mendocino County, California

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    Nicholas J. Dewey; Thomas E. Lisle; Leslie M. Reid

    2003-01-01

    Tributary and headwater valleys in the Caspar Creek watershed,in coastal Mendocino County, California,show signs of incision along much of their lengths.An episode of incision followed initial-entry logging which took place between 1860 and 1906. Another episode of incision cut into skid-trails created for second-entry logging in the 1970's.

  16. A self-regulating model of bedrock river channel geometry

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    Stark, C. P.

    2006-02-01

    The evolution of many mountain landscapes is controlled by the incision of bedrock river channels. While the rate of incision is set by channel shape through its mediation of flow, the channel shape is itself set by the history of bedrock erosion. This feedback between channel geometry and incision determines the speed of landscape response to tectonic or climatic forcing. Here, a model for the dynamics of bedrock channel shape is derived from geometric arguments, a normal flow approximation for channel flow, and a threshold bed shear stress assumption for bedrock abrasion. The model dynamics describe the competing effects of channel widening, tilting, bending, and variable flow depth. Transient solutions suggest that channels may take ~1-10 ky to adapt to changes in discharge, implying that channel disequilibrium is commonplace. If so, landscape evolution models will need to include bedrock channel dynamics if they are to probe the effects of climate change.

  17. Transconjunctival incision for total maxillectomy--an alternative for subciliary incision.

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    Goyal, Amit; Tyagi, Isha; Jain, Shilpa; Syal, Rajan; Singh, Alok Pratap; Kapila, Rajeev

    2011-09-01

    A subciliary incision may be associated with various complications of the lower eyelid when it is used during a total maxillectomy. The use of the transconjunctival incision instead is an alternative in suitable patients. The records of 17 patients were reviewed in whom a transconjunctival incision was used during total maxillectomy. These included 13 in whom the Weber-Ferguson incision was used, and 4 who had a sublabial incision. There was mild conjunctival oedema in all the cases during the immediate postoperative period but it did not last for more than two days. Four patients had mild to moderate oedema of the lid that resolved within two days. One had mild ectropion with transient epiphora, which was caused by early removal of the medial canthal sutures. We found the approach to be cosmetically acceptable as it avoids a scar in the subciliary region. The transconjunctival incision can be used in place of the subciliary incision for lateral exposure during total maxillectomy. There are few complications associated with the lower lid, and it has good cosmetic results; if it is combined with a sublabial incision in suitable patients, the maxillectomy is virtually scar-free. Copyright © 2010 British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  18. A numerical model for meltwater channel evolution in glaciers

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    A. H. Jarosch

    2012-04-01

    Full Text Available Meltwater channels form an integral part of the hydrological system of a glacier. Better understanding of how meltwater channels develop and evolve is required to fully comprehend supraglacial and englacial meltwater drainage. Incision of supraglacial stream channels and subsequent roof closure by ice deformation has been proposed in recent literature as a possible englacial conduit formation process. Field evidence for supraglacial stream incision has been found in Svalbard and Nepal. In Iceland, where volcanic activity provides meltwater with temperatures above 0 °C, rapid enlargement of supraglacial channels has been observed. Supraglacial channels provide meltwater through englacial passages to the subglacial hydrological systems of big ice sheets, which in turn affects ice sheet motion and their contribution to eustatic sea level change. By coupling, for the first time, a numerical ice dynamic model to a hydraulic model which includes heat transfer, we investigate the evolution of meltwater channels and their incision behaviour. We present results for different, constant meltwater fluxes, different channel slopes, different meltwater temperatures, different melt rate distributions in the channel as well as temporal variations in meltwater flux. The key parameters governing incision rate and depth are channel slope, meltwater temperature loss to the ice and meltwater flux. Channel width and geometry are controlled by melt rate distribution along the channel wall. Calculated Nusselt numbers suggest that turbulent mixing is the main heat transfer mechanism in the meltwater channels studied.

  19. Recent, climate-driven river incision rate fluctuations in the Mercantour crystalline massif, southern French Alps

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    Petit, C.; Goren, L.; Rolland, Y.; Bourlès, D.; Braucher, R.; Saillard, M.; Cassol, D.

    2017-06-01

    We present a new geomorphological analysis of the Tinée River tributaries in the southern French Alps based on numerical inverse and forward modelling of their longitudinal profiles. We model their relative uplift history with respect to the main channel, hence the incision rate history of this channel. Inverse models show that all tributaries have consistent incision rate histories with alternating high and low values. A comparison with global temperature curves shows that these variations correlate with quaternary climate changes. We suggest that during warm periods, a wave of regressive erosion propagates in the Tinée River, while its tributaries deeply incise their substratum to catch up with the falling base-level. We also show that the post 140 ka history of this landscape evolution is dominated by fluvial incision. We then perform forward models of river incision and simulate the incision of the Tinée River system over a time span of 600 ka. This model allows us to extract time and space incision rate variations of the Tinée River. With a background of a few mm.yr-1, incision rate can increase up to more than 1 cm yr-1 during short periods of time due to climatic oscillations. This result is compatible with published cosmogenic nuclide based dating, which evidenced incision rates from 0.2 to 24 mm yr-1. The part of the channel located between 12 and 20 km downstream from the source has undergone several periods of rapid incision rates, which could explain the steep hillslopes and the triggering of a landslide ∼10 ka ago.

  20. Climate-sensitive feedbacks between hillslope processes and fluvial erosion in sediment-driven incision models

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    Skov, Daniel S.; Egholm, David L.

    2016-04-01

    Surface erosion and sediment production seem to have accelerated globally as climate cooled in the Late Cenozoic, [Molnar, P. 2004, Herman et al 2013]. Glaciers emerged in many high mountain ranges during the Quaternary, and glaciation therefore represents a likely explanation for faster erosion in such places. Still, observations and measurements point to increases in erosion rates also in landscapes where erosion is driven mainly by fluvial processes [Lease and Ehlers (2013), Reusser (2004)]. Flume experiments and fieldwork have shown that rates of incision are to a large degree controlled by the sediment load of streams [e.g. Sklar and Dietrich (2001), Beer and Turowski (2015)]. This realization led to the formulation of sediment-flux dependent incision models [Sklar and Dietrich (2004)]. The sediment-flux dependence links incision in the channels to hillslope processes that supply sediment to the channels. The rates of weathering and soil transport on the hillslopes are processes that are likely to respond to changing temperatures, e.g. because of vegetation changes or the occurrence of frost. In this study, we perform computational landscape evolution experiments, where the coupling between fluvial incision and hillslope processes is accounted for by coupling a sediment-flux-dependent model for fluvial incision to a climate-dependent model for weathering and hillslope sediment transport. The computational experiments first of all demonstrate a strong positive feedback between channel and hillslope processes. In general, faster weathering leads to higher rates of channel incision, which further increases the weathering rates, mainly because of hillslope steepening. Slower weathering leads to the opposite result. The experiments also demonstrate, however, that the feedbacks vary significantly between different parts of a drainage network. For example, increasing hillslope sediment production may accelerate incision in the upper parts of the catchment, while at

  1. The inverted Batman incision: a new incision in transcolumellar incision for open rhinoplasty.

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    Nakanishi, Yuji; Nagasao, Tomohisa; Shimizu, Yusuke; Miyamoto, Junpei; Fukuta, Keizo; Kishi, Kazuo

    2013-12-01

    Columellar and nostril shapes often present irregularity after transcolumellar incision for open rhinoplasty, because of the contracture of the incised wound. The present study introduces a new technique to prevent this complication, and verifies its efficacy in improving cosmetic appearance. In our new method, a zig-zag incision with three small triangular flaps is made on the columella and in the pericolumellar regions of the bilateral nostril rims. Since the shape of the incision resembles the contour of an inverted "batman", we term our new method the "Inverted Batman" incision. To verify the effectiveness of the Inverted Batman incision, aesthetic evaluation was conducted for 21 patients operated on using the conventional transcolumellar incision (Conventional Group) and 19 patients operated on using the Inverted Batman incision (Inverted Batman Group). The evaluation was performed by three plastic surgeons, using a four-grade scale to assess three separate items: symmetry of bilateral soft triangles, symmetry of bilateral margins of the columella, and evenness of the columellar surface. The scores of the two groups for these three items were compared using a non-parametric test (Mann-Whitney U-test). With all three items, the Inverted Batman group patients present higher scores than Conventional Group patients. The Inverted Batman incision is effective in preserving the correct anatomical structure of the columella, soft triangle, and nostril rims. Hence, we recommend the Inverted Batman incision as a useful technique for open rhinoplasty.

  2. Single-incision total laparoscopic hysterectomy

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    Sinha Rakesh

    2011-01-01

    Full Text Available Single-incision laparoscopic surgery is an alternative to conventional multiport laparoscopy. Single-access laparoscopy using a transumbilical port affords maximum cosmetic benefits because the surgical incision is hidden in the umbilicus. The advantages of single-access laparoscopic surgery may include less bleeding, infection, and hernia formation and better cosmetic outcome and less pain. The disadvantages and limitations include longer surgery time, difficulty in learning the technique, and the need for specialized instruments. Ongoing refinement of the surgical technique and instrumentation is likely to expand its role in gynecologic surgery in the future. We perform single-incision total laparoscopic hysterectomy using three ports in the single transumbilical incision.

  3. Laboratory Experiments on Meandering Meltwater Channels

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    Fernandez, R.; Berens, J.; Parker, G.; Stark, C. P.

    2017-12-01

    Meandering channels of all scales and flowing over a wide variety of media have common planform patterns. Although the analogy in planform suggests there is a common underlying framework, the constitutive relations driving planform evolution through vertical incision/deposition and lateral migration differ from medium to medium. The driving processes in alluvial and mixed bedrock-alluvial meandering channels have been studied substantially over the last decades. However, this is not the case for meandering channels in other media such as ice or soluble rock. Here we present results from experiments conducted at the Ven Te Chow Hydrosystems Laboratory of the University of Illinois at Urbana-Champaign on meltwater meandering channels. A rivulet is carved into an ice block and water is allowed to flow at a constant discharge. Planform evolution is analyzed with time lapse imaging and complemented with rubber molds of the channel once the experiment is over. These molds give us the full 3D structure of the meandering, including incisional overhang. Vertical incision rates are measured throughout the run by taking elevations along the channel, and these measurements are complemented with analysis from the molds. We show examples of meandering of intense amplitude with deep overhangs. Features resembling scroll bars document cyclically punctuated melting. We report on lateral migration rates, incision rates, sinuosity, channel depths, channel widths, reach averaged velocities, bend wavelengths and amplitudes and compare them to values reported in the literature for alluvial rivers.

  4. Morphodynamic Model of Submarine Canyon Incision by Sandblasting

    Science.gov (United States)

    Zhang, L.; Parker, G.; Izumi, N.; Cartigny, M.; Li, T.; Wang, G.

    2017-12-01

    Submarine canyons are carved by turbidity currents under the deep sea. As opposed to subaerial canyons, the relevant processes are not easy to observe directly. Turbidity currents are bottom-hugging sediment gravity flows of that can incise or deposit on the seafloor to create submarine canyons or fans. The triggers of turbidity currents can be storms, edge waves, internal waves, canyon wall sapping, delta failure, breaching and hyperpycnal flows. The formation and evolution mechanisms of submarine canyons are similar to those of subaerial canyons, but have substantial differences. For example, sandblasting, rather than wear due to colliding gravel clasts is more likely to be the mechanism of bedrock incision. Submarine canyons incise downward, and often develop meander bends and levees within the canyon, so defining "fairways". Here we propose a simple model for canyon incision. The starting point of our model is the Macro Roughness Saltation Abrasion Alluviation model of Zhang et al. [2015], designed for bedrock incision by gravel clasts in mixed bedrock-alluvial rivers. We adapt this formulation to consider sandblasting as a means of wear. We use a layer-averaged model for turbidity current dynamics. The current contains a mixture of mud, which helps drive the flow but which does not cause incision, and sand, which is the agent of incision. We show that the model can successfully model channel downcutting, and indeed illustrate the early formation of net incisional cyclic steps, i.e. upstream-migrating undulations on the bed associated with transcritical (in the Froude sense) flow. These steps can be expected to abet the process of incision.

  5. Incision integrity and postoperative outcomes after microcoaxial phacoemulsification performed using 2 incision-dependent systems.

    Science.gov (United States)

    Vasavada, Vaishali; Vasavada, Abhay R; Vasavada, Viraj A; Srivastava, Samaresh; Gajjar, Devarshi U; Mehta, Siddharth

    2013-04-01

    To compare incision integrity and clinical outcomes of 2 microcoaxial phacoemulsification systems. Iladevi Cataract & IOL Research Centre, Ahmedabad, India. Prospective randomized clinical trial. Eyes were randomized to have phacoemulsification using a 1.8 mm clear corneal incision (CCI) system (Group 1, Stellaris system) or a 2.2 mm CCI system (Group 2, Intrepid Infiniti system). Incision enlargement at end of surgery was measured. At the conclusion of surgery, trypan blue was applied over the conjunctival surface, anterior chamber aspirate withdrawn, and ingress into anterior chamber measured. Postoperative observations included evaluation of the CCI using anterior segment optical coherence tomography (AS-OCT), change in central corneal thickness (CCT), and anterior segment inflammation at 1 day, 1 week, and 1 month and endothelial cell loss and surgically induced astigmatism (SIA) at 3 months. Incision enlargement (P.05). At the end of surgery, it is not the initial incision size alone but also the distortion of the incision during subsequent stages of surgery that determine the integrity of the CCI. Copyright © 2013 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  6. Rapid fluvial incision of a late Holocene lava flow: Insights from LiDAR, alluvial stratigraphy, and numerical modeling

    Science.gov (United States)

    Sweeney, Kristin; Roering, Joshua J.

    2016-01-01

    Volcanic eruptions fundamentally alter landscapes, paving over channels, decimating biota, and emplacing fresh, unweathered material. The fluvial incision of blocky lava flows is a geomorphic puzzle. First, high surface permeability and lack of sediment should preclude geomorphically effective surface runoff and dissection. Furthermore, past work has demonstrated the importance of extreme floods in driving incision via column toppling and plucking in columnar basalt, but it is unclear how incision occurs in systems where surface blocks are readily mobile. We examine rapid fluvial incision of the Collier lava flow, an andesitic Holocene lava flow in the High Cascades of Oregon. Since lava flow emplacement ∼1600 yr ago, White Branch Creek has incised bedrock gorges up to 8 m deep into the coherent core of the lava flow and deposited >0.2 km3 of sediment on the lava flow surface. Field observation points to a bimodal discharge regime in the channel, with evidence for both annual snowmelt runoff and outburst floods from Collier glacier, as well as historical evidence of vigorous glacial meltwater. To determine the range of discharge events capable of incision in White Branch Creek, we used a mechanistic model of fluvial abrasion. We show that the observed incision implies that moderate flows are capable of both initiating channel formation and sustaining incision. Our results have implications for the evolution of volcanic systems worldwide, where glaciation and/or mass wasting may accelerate fluvial processes by providing large amounts of sediment to otherwise porous, sediment-starved landscapes.

  7. Two Late Pleistocene climate-driven incision/aggradation rhythms in the middle Dnieper River basin, west-central Russian Plain

    Science.gov (United States)

    Panin, Andrei; Adamiec, Grzegorz; Buylaert, Jan-Pieter; Matlakhova, Ekaterina; Moska, Piotr; Novenko, Elena

    2017-06-01

    In valleys of the River Seim and its tributaries in the middle Dnieper basin (west-central Russian Plain), two low terraces (T1, 10-16 m, and T0, 5-7 m above the river) and a floodplain (2-4 m) with characteristic large and small palaeochannels exist. A range of field and laboratory techniques was applied and ∼30 new numerical ages (OSL and 14C dates) were obtained to establish a chronology of incision and aggradation events that resulted in the current valley morphology. Two full incision/aggradation rhythms and one additional aggradation phase from the previous rhythm were recognized in the Late Pleistocene - Holocene climate cycle. The following events were detected. (1) Late MIS 5 - early MIS 4: aggradation of Terrace T1 following the deep incision at the end of MIS 6. (2) Late MIS 4 (40-30 ka): incision into Terrace T1 below the present-day river, formation of the main scarp in the bottom of the valley between Terrace T1 and Terrace T0/Floodplain levels. (3) MIS 2: aggradation of Terrace T0, lateral migrations of a shallow braided channel located few meters above the present-day river since ∼25 ka through the LGM. (4) 18-13 ka: incision into Terrace T0 below the modern river. Multiple-thread channels concentrated in a single flow that at some places formed large meanders. In the period 15-13 ka, high floods that rose above the present-day floods left large levees and overbank loams on Terrace T0. (5) Younger Dryas - Holocene transition: aggradation up to the modern channel level, transformation of large Late Glacial to small Holocene meanders. The established incision/aggradation rhythms are believed to be manifested over the Central Russian Plain outside the influence of ice sheets in the north and base level changes in the south. The two-phase deepening of the valley occurred in the last quarter of the last glacial epoch but can not be attributed directly to the glacial-interglacial transition. Both the detected incision events correspond to relatively

  8. The Breakdown: Hillslope Sources of Channel Blocks in Bedrock Landscapes

    Science.gov (United States)

    Selander, B.; Anderson, S. P.; Rossi, M.

    2017-12-01

    Block delivery from hillslopes is a poorly understood process that influences bedrock channel incision rates and shapes steep terrain. Previous studies demonstrate that hillslope sediment delivery rate and grain size increases with channel downcutting rate or fracture density (Attal et al., 2015, ESurf). However, blocks that exceed the competence of the channel can inhibit incision. In Boulder Creek, a bedrock channel in the Colorado Front Range, large boulders (>1 m diameter) are most numerous in the steepest channel reaches; their distribution seems to reflect autogenic channel-hillslope feedback between incision rate and block delivery (Shobe et al., 2016, GRL). It is clear that the processes, rates of production, and delivery of large blocks from hillslopes into channels are critical to our understanding of steep terrain evolution. Fundamental questions are 1) whether block production or block delivery is rate limiting, 2) what mechanisms release blocks, and 3) how block production and transport affect slope morphology. As a first step, we map rock outcrops on the granodiorite hillslopes lining Boulder Creek within Boulder Canyon using a high resolution DEM. Our algorithm uses high ranges of curvature values in conjunction with slopes steeper than the angle of repose to quickly identify rock outcrops. We field verified mapped outcrop and sediment-mantled locations on hillslopes above and below the channel knickzone. We find a greater abundance of exposed rock outcrops on steeper hillslopes in Boulder Canyon. Additionally, we find that channel reaches with large in-channel blocks are located at the base of hillslopes with large areas of exposed bedrock, while reaches lacking large in-channel blocks tend to be at the base of predominately soil mantled and forested hillslopes. These observations support the model of block delivery and channel incision of Shobe et al. (2016, GRL). Moreover, these results highlight the conundrum of how rapid channel incision is

  9. Signatures of Late Pleistocene fluvial incision in an Alpine landscape

    Science.gov (United States)

    Leith, Kerry; Fox, Matthew; Moore, Jeffrey R.

    2018-02-01

    Uncertainty regarding the relative efficacy of fluvial and glacial erosion has hindered attempts to quantitatively analyse the Pleistocene evolution of alpine landscapes. Here we show that the morphology of major tributaries of the Rhone River, Switzerland, is consistent with that predicted for a landscape shaped primarily by multiple phases of fluvial incision following a period of intense glacial erosion after the mid-Pleistocene transition (∼0.7 Ma). This is despite major ice sheets reoccupying the region during cold intervals since the mid-Pleistocene. We use high-resolution LiDAR data to identify a series of convex reaches within the long-profiles of 18 tributary channels. We propose these reaches represent knickpoints, which developed as regional uplift raised tributary bedrock channels above the local fluvial baselevel during glacial intervals, and migrated upstream as the fluvial system was re-established during interglacial periods. Using a combination of integral long-profile analysis and stream-power modelling, we find that the locations of ∼80% of knickpoints in our study region are consistent with that predicted for a fluvial origin, while the mean residual error over ∼100 km of modelled channels is just 26.3 m. Breaks in cross-valley profiles project toward the elevation of former end-of-interglacial channel elevations, supporting our model results. Calculated long-term uplift rates are within ∼15% of present-day measurements, while modelled rates of bedrock incision range from ∼1 mm/yr for low gradient reaches between knickpoints to ∼6-10 mm/yr close to retreating knickpoints, typical of observed rates in alpine settings. Together, our results reveal approximately 800 m of regional uplift, river incision, and hillslope erosion in the lower half of each tributary catchment since 0.7 Ma.

  10. Watershed-scale modeling of streamflow change in incised montane meadows

    Science.gov (United States)

    Essaid, Hedeff I.; Hill, Barry R.

    2014-01-01

    Land use practices have caused stream channel incision and water table decline in many montane meadows of the Western United States. Incision changes the magnitude and timing of streamflow in water supply source watersheds, a concern to resource managers and downstream water users. The hydrology of montane meadows under natural and incised conditions was investigated using watershed simulation for a range of hydrologic conditions. The results illustrate the interdependence between: watershed and meadow hydrology; bedrock and meadow aquifers; and surface and groundwater flow through the meadow for the modeled scenarios. During the wet season, stream incision resulted in less overland flow and interflow and more meadow recharge causing a net decrease in streamflow and increase in groundwater storage relative to natural meadow conditions. During the dry season, incision resulted in less meadow evapotranspiration and more groundwater discharge to the stream causing a net increase in streamflow and a decrease in groundwater storage relative to natural meadow conditions. In general, for a given meadow setting, the magnitude of change in summer streamflow and long-term change in watershed groundwater storage due to incision will depend on the combined effect of: reduced evapotranspiration in the eroded meadow; induced groundwater recharge; replenishment of dry season groundwater storage depletion in meadow and bedrock aquifers by precipitation during wet years; and groundwater storage depletion that is not replenished by precipitation during wet years.

  11. Stratigraphic architecture of back-filled incised-valley systems: Pennsylvanian-Permian lower Cutler beds, Utah, USA

    Science.gov (United States)

    Wakefield, Oliver J. W.; Mountney, Nigel P.

    2013-12-01

    The Pennsylvanian to Permian lower Cutler beds collectively form the lowermost stratigraphic unit of the Cutler Group in the Paradox Basin, southeast Utah. The lower Cutler beds represent a tripartite succession comprising lithofacies assemblages of aeolian, fluvial and shallow-marine origin, in near equal proportion. The succession results from a series of transgressive-regressive cycles, driven by repeated episodes of climatic variation and linked changes in relative sea-level. Relative sea-level changes created a number of incised-valleys, each forming through fluvial incision during lowered base-level. Aeolian dominance during periods of relative sea-level lowstand aids incised-valley identification as the erosive bounding surface juxtaposes incised-valley infill against stacked aeolian faces. Relative sea-level rises resulted in back-flooding of the incised-valleys and their infill via shallow-marine and estuarine processes. Back-flooded valleys generated marine embayments within which additional local accommodation was exploited. Back-filling is characterised by a distinctive suite of lithofacies arranged into a lowermost, basal fill of fluvial channel and floodplain architectural elements, passing upwards into barform elements with indicators of tidal influence, including inclined heterolithic strata and reactivation surfaces. The incised-valley fills are capped by laterally extensive and continuous marine limestone elements that record the drowning of the valleys and, ultimately, flooding and accumulation across surrounding interfluves (transgressive surface). Limestone elements are characterised by an open-marine fauna and represent the preserved expression of maximum transgression.

  12. Seismic evidence of glacial-age river incision into the Tahaa barrier reef, French Polynesia

    Science.gov (United States)

    Toomey, Michael; Woodruff, Jonathan D.; Ashton, Andrew D.; Perron, J. Taylor

    2016-01-01

    Rivers have long been recognized for their ability to shape reef-bound volcanic islands. On the time-scale of glacial–interglacial sea-level cycles, fluvial incision of exposed barrier reef lagoons may compete with constructional coral growth to shape the coastal geomorphology of ocean islands. However, overprinting of Pleistocene landscapes by Holocene erosion or sedimentation has largely obscured the role lowstand river incision may have played in developing the deep lagoons typical of modern barrier reefs. Here we use high-resolution seismic imagery and core stratigraphy to examine how erosion and/or deposition by upland drainage networks has shaped coastal morphology on Tahaa, a barrier reef-bound island located along the Society Islands hotspot chain in French Polynesia. At Tahaa, we find that many channels, incised into the lagoon floor during Pleistocene sea-level lowstands, are located near the mouths of upstream terrestrial drainages. Steeper antecedent topography appears to have enhanced lowstand fluvial erosion along Tahaa's southwestern coast and maintained a deep pass. During highstands, upland drainages appear to contribute little sediment to refilling accommodation space in the lagoon. Rather, the flushing of fine carbonate sediment out of incised fluvial channels by storms and currents appears to have limited lagoonal infilling and further reinforced development of deep barrier reef lagoons during periods of highstand submersion.

  13. Vertical compared with transverse incisions in abdominal surgery

    DEFF Research Database (Denmark)

    Grantcharov, T P; Rosenberg, J

    2001-01-01

    , and late complications (incisional hernia). RESULTS: Eleven randomised controlled trials and seven retrospective studies were identified. The transverse incision offers as good an access to most intra-abdominal structures as a vertical incision. The transverse incision results in significantly less......OBJECTIVE: To reach an evidence-based consensus on the relative merits of vertical and transverse laparotomy incisions. DESIGN: Review of all published randomised controlled trials that compared the postoperative complications after the two main types of abdominal incisions, vertical and transverse....... SETTING: Teaching hospital, Denmark. SUBJECTS: Patients undergoing open abdominal operations. INTERVENTIONS: For some of the variables (burst abdomen and incisional hernia) it was considered adequate to include retrospective studies. Studies were identified through Medline, Cochrane library, Embase...

  14. Electrocautery skin incision for neurosurgery procedures--technical note.

    Science.gov (United States)

    Nitta, Naoki; Fukami, Tadateru; Nozaki, Kazuhiko

    2011-01-01

    The reluctance to incise skin with electrocautery is partly attributable to concerns about excessive scarring and poor wound healing. However, recently no difference was reported in wound complications between the cold scalpel and electrocautery scalpel. We assessed the safety and efficacy of electrocautery skin incision in 22 scalp incisions, including 4 cases of reoperation. Electrocautery skin incisions were created using a sharp needle electrode. The generator unit was set on cutting mode, with power of 6 W and 330 kHz sinusoid waveform. Subcutaneous dissections also used the sharp needle electrode, set on coagulating mode, with power of 10 W and 1 MHz pulse-modulated waveform. Galea incisions used a standard blade tip, set on coagulating mode, with power of 20 W and 1 MHz pulse-modulated waveform. Skin incision with the sharp needle electrode caused no charring of the wound. Little bleeding or oozing were observed and skin clips were not necessary. No wound complication such as necrosis or infection occurred. Electrocautery skin incisions for re-operations were also performed safely without complications. Electrocautery skin incision is sufficiently safe procedure not only for first operation but also for re-operation. Electrocautery skin incision is efficacious, especially for extended operation times, because of little blood loss from the edges of skin incision and possible avoidance of skin edge necrosis or alopecia caused by skin clips.

  15. River longitudinal profiles and bedrock incision models: Stream power and the influence of sediment supply

    Science.gov (United States)

    Sklar, Leonard; Dietrich, William E.

    The simplicity and apparent mechanistic basis of the stream power river incision law have led to its wide use in empirical and theoretical studies. Here we identify constraints on its calibration and application, and present a mechanistic theory for the effects of sediment supply on incision rates which spotlights additional limitations on the applicability of the stream power law. On channels steeper than about 20%, incision is probably dominated by episodic debris flows, and on sufficiently gentle slopes, sediment may bury the bedrock and prevent erosion. These two limits bound the application of the stream power law and strongly constrain the possible combination of parameters in the law. In order to avoid infinite slopes at the drainage divide in numerical models of river profiles using the stream power law it is commonly assumed that the first grid cell is unchanneled. We show, however, that the size of the grid may strongly influence the calculated equilibrium relief. Analysis of slope-drainage area relationships for a river network in a Northern California watershed using digital elevation data and review of data previously reported by Hack reveal that non-equilibrium profiles may produce well defined slope-area relationships (as expected in equilibrium channels), but large differences between tributaries may point to disequilibrium conditions. To explore the role of variations in sediment supply and transport capacity in bedrock incision we introduce a mechanistic model for abrasion of bedrock by saltating bedload. The model predicts that incision rates reach a maximum at intermediate levels of sediment supply and transport capacity. Incision rates decline away from the maximum with either decreasing supply (due to a shortage of tools) or increasing supply (due to gradual bed alluviation), and with either decreasing transport capacity (due to less energetic particle movement) or increasing transport capacity (due less frequent particle impacts per unit bed

  16. Primary closure of equine laryngotomy incisions

    DEFF Research Database (Denmark)

    Lindegaard, C.; Karlsson, L.; Ekstrøm, Claus Thorn

    2016-01-01

    incision between January 1995 and June 2012 were reviewed. Horses with a laryngotomy incision closed in three layers for primary healing were included. Descriptive data on healing characteristics and complications of laryngotomy wounds were collected from the medical records and via follow......The objective was to report healing characteristics and complications after primary closure of equine laryngotomies and analyse factors potentially associated with complications. This retrospective case series of the medical records of horses (n = 180) undergoing laryngoplasty and laryngotomy...... after primary closure of equine laryngotomy incisions are infrequent and considered of minimal severity and can be performed safely when paying careful attention to the closure of the cricothyroid membrane....

  17. Comparison of surgically induced astigmatism in various incisions in manual small incision cataract surgery.

    Science.gov (United States)

    Jauhari, Nidhi; Chopra, Deepak; Chaurasia, Rajan Kumar; Agarwal, Ashutosh

    2014-01-01

    To determine the surgically induced astigmatism (SIA) in Straight, Frown and Inverted V shape (Chevron) incisions in manual small incision cataract surgery (SICS). A prospective cross sectional study was done on a total of 75 patients aged 40y and above with senile cataract. The patients were randomly divided into three groups (25 each). Each group received a particular type of incision (Straight, Frown or Inverted V shape incisions). Manual SICS with intraocular lens (IOL) implantation was performed. The patients were compared 4wk post operatively for uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA) and SIA. All calculations were performed using the SIA calculator version 2.1, a free software program. The study was analyzed using SPSS version 15.0 statistical analysis software. The study found that 89.5% of patients in Straight incision group, 94.2% in Frown incision group and 95.7% in Inverted V group attained BCVA post-operatively in the range of 6/6 to 6/18. Mean SIA was minimum (-0.88±0.61D×90 degrees) with Inverted V incision which was statistically significant. Inverted V (Chevron) incision gives minimal SIA.

  18. A feasibility of single-incision laparoscopic percutaneous extraperitoneal closure for treatment of incarcerated inguinal hernia in children: our preliminary outcome and review of the literature.

    Science.gov (United States)

    Murase, Naruhiko; Uchida, Hiroo; Seki, Takashi; Hiramatsu, Kiyoshi

    2016-02-01

    The purpose of this study is to examine the feasibility of single-incision laparoscopic percutaneous extraperitoneal closure (LPEC) for incarcerated inguinal hernia (IIH) repair. 6 single-incision LPEC procedures were performed for IIH repair and 60 procedures were performed for reducible inguinal hernia (RIH) in the same period of time in one hospital. The laparoscope and one pair of grasping forceps were placed through the same umbilical incision. In IIH repair, the herniated organ was gently pulled using the grasping forceps with external manual pressure. If it was difficult to reduce the herniated organ with one pair of forceps, another pair of forceps were inserted through a multi-channel port without extending the umbilical incidion. Using the LPEC needle, the hernia orifice was closed extraperitoneally. We performed a retrospective analysis to compare the outcomes of single-incision LPEC for IIH repair or reducible inguinal hernia. All procedures were completed by single-incision without open conversion. A multi-channel port with another pair of forceps was needed in three cases. The operation time and the length of stay were significantly longer with IIH repair than with RIH repair. There were no major complications and there was no evidence of early recurrence in any patient. In conclusion, single-incision LPEC with a multi-channel port is feasible and safe for IIH repair.

  19. COMPARISON OF POSTOP SIA IN MSICS WITH STRAIGHT INCISION VERSUS FROWN INCISION

    Directory of Open Access Journals (Sweden)

    Shayana Bhumbla

    2017-05-01

    Full Text Available BACKGROUND Surgically-Induced Astigmatism (SIA is one of the commonest causes of poor postoperative vision even after uneventful cataract surgery. Recent advances have led to a newer concept of “refractive cataract surgery.” The aim of the study is to study the comparison of postop SIA in Manual Small Incision Cataract Surgery (MSICS with straight versus frown incision. MATERIALS AND METHODS 50 patients of cataract were divided into 2 groups (25 each - group A underwent MSICS with 6 mm straight incision, group B underwent MSICS with 6 mm frown incision. BCVA, keratometry readings were recorded with auto kerato-refractometer preop, at 1 week, 1 month, 3 months and SIA was calculated with SIA calculator version 2.1, a free software program. RESULTS Mean SIA in group A and B were - 1.14D versus 0.92D at 1 week; 1.26D versus 0.97D at 1 month; 1.29D versus 0.95D at 3 months. The difference was statistically significant at each follow up visit (p<0.05. CONCLUSION Frown incision gives lesser SIA than straight incision in MSICS.

  20. Mast Quadrant-assisted Minimally Invasive Modified Transforaminal Lumbar Interbody Fusion: Single Incision Versus Double Incision

    Directory of Open Access Journals (Sweden)

    Xin-Lei Xia

    2015-01-01

    Full Text Available Background: The concept of minimally invasive techniques is to make every effort to reduce tissue damage. Certainly, reducing skin incision is an important part of these techniques. This study aimed to investigate the clinical feasibility of Mast Quadrant-assisted modified transforaminal lumbar interbody fusion (TLIF with a small single posterior median incision. Methods: During the period of March 2011 to March 2012, 34 patients with single-segment degenerative lumbar disease underwent the minimally invasive modified TLIF assisted by Mast Quadrant with a small single posterior median incision (single incision group. The cases in this group were compared to 37 patients with single-segment degenerative lumbar disease in the double incision group. The perioperative conditions of patients in these two groups were statistically analyzed and compared. The Oswestry Disability Index (ODI scores, Visual Analog Scale (VAS scores, and sacrospinalis muscle damage evaluation indicators before operation and 3, 12 months postoperation were compared. Results: A total of 31 and 35 cases in the single incision and double incision groups, respectively, completed at least 12 months of systemic follow-up. The differences in perioperative conditions between the two groups were not statistically significant. The incision length of the single incision group was significantly shorter than that of the double incision group (P < 0.01. The ODI and VAS scores of patients in both groups improved significantly at 3 and 12 months postoperation. However, these two indicators at 3 and 12 months postoperation and the sacrospinalis muscle damage evaluation indicators at 3 months postoperation did not differ significantly between the two groups (P ≥ 0.05. Conclusions: Mast Quadrant-assisted modified TLIF with a small single posterior median incision has excellent clinical feasibility compared to minimally invasive TLIF with a double paramedian incision.

  1. Historical Channel Adjustment and Estimates of Selected Hydraulic Values in the Lower Sabine River and Lower Brazos River Basins, Texas and Louisiana

    Science.gov (United States)

    Heitmuller, Franklin T.; Greene, Lauren E.

    2009-01-01

    The U.S. Geological Survey, in cooperation with the Texas Water Development Board, evaluated historical channel adjustment and estimated selected hydraulic values at U.S. Geological Survey streamflow-gaging stations in the lower Sabine River Basin in Texas and Louisiana and lower Brazos River Basin in Texas to support geomorphic assessments of the Texas Instream Flow Program. Channel attributes including cross-section geometry, slope, and planform change were evaluated to learn how each river's morphology changed over the years in response to natural and anthropogenic disturbances. Historical and contemporary cross-sectional channel geometries at several gaging stations on each river were compared, planform changes were assessed, and hydraulic values were estimated including mean flow velocity, bed shear stress, Froude numbers, and hydraulic depth. The primary sources of historical channel morphology information were U.S. Geological Survey hard-copy discharge-measurement field notes. Additional analyses were done using computations of selected flow hydraulics, comparisons of historical and contemporary aerial photographs, comparisons of historical and contemporary ground photographs, evaluations of how frequently stage-discharge rating curves were updated, reviews of stage-discharge relations for field measurements, and considerations of bridge and reservoir construction activities. Based on historical cross sections at three gaging stations downstream from Toledo Bend Reservoir, the lower Sabine River is relatively stable, but is subject to substantial temporary scour-and-fill processes during floods. Exceptions to this characterization of relative stability include an episode of channel aggradation at the Sabine River near Bon Wier, Texas, during the 1930s, and about 2 to 3 feet of channel incision at the Sabine River near Burkeville, Texas, since the late 1950s. The Brazos River, at gaging stations downstream from Waco, Texas, has adjusted to a combination of

  2. Comparison of electrocautery incision with scalpel incision in midline abdominal surgery - A double blind randomized controlled trial.

    Science.gov (United States)

    Prakash, Lalgudi Dorairajan; Balaji, Nitesh; Kumar, Sathasivam Suresh; Kate, Vikram

    2015-07-01

    To compare the electrocautery incision with scalpel incision in patients undergoing abdominal surgery using a midline incision with respect to incision time, blood loss during incision, postoperative incision site pain and wound infection. Patients undergoing midline abdominal surgery were randomized into electrocautery and scalpel groups. The incision dimensions, incision time and blood loss during incision were noted intraoperatively. Postoperative pain and wound infection were recorded on every postoperative day for one week. 41 patients in each of the two groups were analyzed. Gender and age distribution was similar in both the groups. The mean incision time per unit wound area in the electrocautery group and scalpel group was 9.40 ± 3.37 s/cm(2) and 9.07 ± 3.40 s/cm(2) (p = 0.87) respectively. The mean blood loss per unit wound area was significantly lower in the electrocautery group at 6.46 ± 3.94 ml when compared to that of 23.40 ± 15.28 ml in the scalpel group (p= electrocautery and scalpel groups (14.63% vs. 12.19%; p = 0.347). With a comparable Postoperative incision site pain, wound infection rate and significantly lower blood loss with the equal time taken for the incision, electrocautery can be considered safe and effective in making skin incision in midline laparotomy compared to scalpel incision. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

  3. The ‘Grand Canyon’ of the Da'an River, Taiwan - Influences on Ultra-Rapid Incision and Knickpoint Propagation

    Science.gov (United States)

    Cook, K. L.; Suppe, J.

    2009-12-01

    The 1999 magnitude 7.6 Chi-Chi earthquake resulted in significant surface uplift along the rupture zone in western Taiwan. At northeastern-most end of the rupture zone, near the town of Cholan, motion on the Chelungpu fault was accommodated by growth of the Tungshi Anticline, resulting in up to 10m of surface uplift in the channel of the Da’an River. Where the river crosses the anticline, the zone of uplift is approximately 1 km wide, with a gently sloping downstream (western) limb about 400 m long and an abrupt upstream (eastern) limb less than 50 m long. The bedrock consists of the Pliocene Cholan Formation, composed of alternating sandstone, siltstone, and mudstone beds. The bedrock is quite weak and is also pervasively fractured, making it extremely easy to erode. In response to the 1999 uplift, the Da’an River has cut a dramatic gorge, with more than 20 m of incision over a very short period. The rapid pace of incision allows us to directly observe how factors such as lithology, structure, and discharge influence the evolution of an actively incising gorge. We use a series of aerial photographs to map out the development of the gorge since 1999. We monitor the more recent evolution of the system with RTK GPS surveys to measure channel profiles, laser rangefinder measurements of channel width, and terrestrial LIDAR surveys to quantify changes in the gorge walls. The channel can currently be divided into four segments: 1) A broad network of braided alluvial channels upstream of the gorge with an average slope of 1.5 cm/km, 2) A steep knickzone about 600 m long with an average slope of 2.7 cm/km, about 8 meters of ‘excess’ incision, and abundant bedrock in the channel, 3) A lower gorge zone with low slopes, averaging between 0.6 and 1.1 cm/km, a significant amount of aggradation, and relatively narrow width, as flow is confined to the incised gorge, and 4) A broad network of braided alluvial channels downstream of the gorge with an average slope of 1.5 cm

  4. Craniosynostosis incision: scalpel or cautery?

    Science.gov (United States)

    Wood, Jeyhan S; Kittinger, Benjamin J; Perry, Victor L; Adenola, Adeyemi; van Aalst, John A

    2014-07-01

    There is an ongoing debate regarding the optimal instrument for scalp incisions: the scalpel or electrocautery. The argument generally focuses on improved healing after an incision made with a knife and decreased bleeding when using electrocautery. This study compares the use of scalpel and electrocautery in making coronal incisions for patients undergoing surgical correction of craniosynostosis. The outcome metric used is wound healing within 6 months after surgery. All patients presenting to the University of North Carolina Children's Hospital with craniosynostosis between July 1, 2007 and January 1, 2010 requiring a coronal incision for surgical correction were prospectively enrolled. In all of these patients, half of the coronal incision was made with knife; the other half, with needle tip cautery. Side of the incision was specified at the time of surgery in the operative report. Patients were excluded from the study if the instrument for incision was not specified or if only 1 modality was used for the entire incision. Sixty-eight patients underwent cranial vault reconstruction, of which 58 met inclusion criteria. Of the 58 matched pairs, 55 were analyzed statistically. The 3 excluded cases were those who had midline complications. There were 17 wound complications (15%): 8 in the knife group, 6 in the cautery group, and 3 at midline (with indeterminate side for the problem). We found no statistically significant difference in wound healing between incisions made with a knife or with electrocautery.

  5. Double-gate junctionless transistor model including short-channel effects

    International Nuclear Information System (INIS)

    Paz, B C; Pavanello, M A; Ávila-Herrera, F; Cerdeira, A

    2015-01-01

    This work presents a physically based model for double-gate junctionless transistors (JLTs), continuous in all operation regimes. To describe short-channel transistors, short-channel effects (SCEs), such as increase of the channel potential due to drain bias, carrier velocity saturation and mobility degradation due to vertical and longitudinal electric fields, are included in a previous model developed for long-channel double-gate JLTs. To validate the model, an analysis is made by using three-dimensional numerical simulations performed in a Sentaurus Device Simulator from Synopsys. Different doping concentrations, channel widths and channel lengths are considered in this work. Besides that, the series resistance influence is numerically included and validated for a wide range of source and drain extensions. In order to check if the SCEs are appropriately described, besides drain current, transconductance and output conductance characteristics, the following parameters are analyzed to demonstrate the good agreement between model and simulation and the SCEs occurrence in this technology: threshold voltage (V TH ), subthreshold slope (S) and drain induced barrier lowering. (paper)

  6. Mini transverse versus longitudinal incision in carpal tunnel syndrome

    International Nuclear Information System (INIS)

    Korkmaz, M.; Cepoglu, M.C.

    2013-01-01

    Objective: To evaluate the effectiveness of mini-transverse compared with mini-longitudinal incision for carpal tunnel release (CTR) with reference to postoperative functional capacity, symptom severity and complication rate. Study Design: Analytical study. Place and Duration of Study: Cumhuriyet University Medical Faculty, Department of Orthopaedics, Tokat State Hospital, Department of Orthopaedics and Medical Park Tokat Hospital, Department of Neurosurgery, from January 2007 to January 2009. Methodology: This study included 93 hands of 79 patients with carpal tunnel syndrome (CTS), which were operated between 2007 and 2009. Patients were divided according to incision types into Group-1 (undergoing mini-longitudinal incision) and Group-2 (undergoing mini-transverse incision). Patients were evaluated initially and at 3 weeks after treatment according to symptom severity and functional status of Boston Questionnaire (BQ). Demographic and clinical data were analyzed and compared statistically between two groups. Results: Statistically significant differences were observed in BQ symptom and functional scores between the pre- and postoperative period (p < 0.0001). BQ symptom and functional scores at postoperative period were better in Group-1 than Group-2 (p = 0.044 and p = 0.023 respectively). The scar hypersensitivity (p = 0.258) and tenderness (p = 1.00) associated with the incision sites were not statistically different. Conclusion: Longitudinal incision is more effective on symptom and functional conditions than transverse incision. However, there was less scar formation with transverse incision. (author)

  7. Geomorphic Response of a Low-Gradient Channel to Modern, Progressive Base-Level Lowering: Nahal HaArava, the Dead Sea

    Science.gov (United States)

    Dente, Elad; Lensky, Nadav G.; Morin, Efrat; Grodek, Tamir; Sheffer, Nathan A.; Enzel, Yehouda

    2017-12-01

    The geomorphic response of channels to base-level fall is an important factor in landscape evolution. To better understand the complex interactions between the factors controlling channel evolution in an emerging continental shelf setting, we use an extensive data set (high-resolution digital elevation models, aerial photographs, and Landsat imagery) of a newly incising, perennial segment of Nahal (Wadi) HaArava, Israel. This channel responds to the rapid and progressive lowering of its base-level, the Dead Sea (>30 m in 35 years; 0.5-1.3 m yr-1). Progressively evolving longitudinal profiles, channel width, sinuosity, and knickpoint retreat during the last few decades were documented or reconstructed. The results indicate that even under fast base-level fall, rapid delta progradation on top of the shelf and shelf edge can moderate channel mouth slopes and, therefore, largely inhibit channel incision and knickpoint propagation. This channel elongation stage ends when the delta reaches an extended accommodation within the receiving basin and fails to keep the channel mouth slopes as low as the channel bed slopes. Then, processes of incision, narrowing, and meandering begin to shape the channel and expand upstream. When the down-cutting channel encounters a more resistant stratum within the channel substrate, these processes are restricted to a downstream reach by formation of a retreating vertical knickpoint. When the knickpoint and the channel incise to a level below this stratum, a spatially continuous, diffusion-like evolution characterizes the channel's response and source-to-sink transport can be implemented. These results emphasize the mouth slope and channel substrate resistance as the governing factors over long-term channel evolution, whereas flash floods have only local and short-lived impacts in a confined, continuously incising channel. The documented channel response applies to eustatic base-level fall under steepening basin bathymetry, rapid delta

  8. Long-Term Incisal Relationships After Palatoplasty in Patients With Isolated Cleft Palate.

    Science.gov (United States)

    Odom, Elizabeth B; Woo, Albert S; Mendonca, Derick A; Huebener, Donald V; Nissen, Richard J; Skolnick, Gary B; Patel, Kamlesh B

    2016-06-01

    Various palatoplasty techniques have limited incisions in the hard palate due to concerns that these incisions may limit maxillary growth. There is little convincing long-term evidence to support this. Our purpose is to determine incisal relationships, an indicator for future orthognathic procedure, in patients after repair of an isolated cleft of the secondary palate. Our craniofacial database was used to identify patients aged 10 years or greater with an isolated cleft of the secondary palate who underwent palatoplasty between 1985 and 2002. Data collected included age at palatoplasty and follow-up, cleft type, associated syndrome, Robin sequence, surgeon, repair technique, number of operations, and occlusion. Incisal relationship was determined through clinical observation by a pediatric dentist and orthodontist. Seventy eligible patients operated on by 9 surgeons were identified. Class III incisal relationship was seen in 5 patients (7.1%). Palatoplasty techniques over the hard palate (63 of 70 patients) included 2-flap palatoplasty, VY-pushback, and Von Langenbeck repair. There was an association between class III incisal relationship and syndromic diagnosis (P <0.001). Other study variables were not associated with class III incisal relationships. In patients with an isolated cleft of the secondary palate, there was no association between class III incisal relationship and surgeon, age at repair, cleft type, palatoplasty technique, or number of operations. Increased likelihood of class III incisal relationship was associated primarily with syndromic diagnosis.

  9. Response of the Apodi-Mossoró estuary-incised valley system (NE Brazil to sea-level fluctuations

    Directory of Open Access Journals (Sweden)

    Helenice Vital

    2010-01-01

    Full Text Available This study focuses on the Quaternary sea level changes in the Apodi-Mossoró Estuary and adjacent shelf, Northeastern Brazil, based on the analysis of high-resolution seismic profiles, integrated with echosounder, SRTM and satellite image data. We use these data to develop a relative stratigraphy. An incised-valley extending from the Apodi-Mossoró Estuary onto the shelf dominates the investigated area. In very shallow waters (down to 10 m depth the channel lies mainly in a NW-SE direction, changing to NE-SW in waters below10 m, in the form of a J-shaped valley. The southern flank of the shallow channel presents an abrupt morphology, probably determined by a residual scarp due to neotectonic reactivation of a pre-existing fault. This incised-valley can be correlated with a former river valley formed during the late Pleistocene fall in sea-level. The base-level change related to this drop in sea level can be regionally expressed on seismic lines as a laterally-continuous stratigraphic surface named Horizon I, interpreted as representing the sub-aerial exposure of the continental shelf. Many incised valleys were excavated on this exposed shelf, including that of the Apodi-Mossoró Estuary and its incised valley system. This incised valley has lain buried since the Holocene transgression. The Holocene sediments present sub-horizontal layers, or they have filled the incised valley with oblique features.Este estudo utiliza a integração de dados sísmicos de alta resolução, batimétricos, SRTM e imagens de satélite para desenvolvimento da estratigrafia relativa visando entender as variações do nível do mar durante o Quaternário no estuário do rio Apodi-Mossoró e plataforma adjacente, nordeste do Brasil. A principal feição identificada foi um canal submerso, na plataforma interna, parcialmente preenchido, provavelmente relacionado com o sistema de vales incisos formado durante o rebaixamento do nível do mar no Pleistoceno. O canal

  10. Two Late Pleistocene climate-driven incision/aggradation rhythms in the middle Dnieper River basin, west-central Russian Plain

    DEFF Research Database (Denmark)

    Panin, Andrei; Adamiec, Grzegorz; Buylaert, Jan-Pieter

    2017-01-01

    Pleistocene - Holocene climate cycle. The following events were detected. (1) Late MIS 5 - early MIS 4: aggradation of Terrace T1 following the deep incision at the end of MIS 6. (2) Late MIS 4 (40-30 ka): incision into Terrace T1 below the present-day river, formation of the main scarp in the bottom...... of the valley between Terrace T1 and Terrace T0/Floodplain levels. (3) MIS 2: aggradation of Terrace T0, lateral migrations of a shallow braided channel located few meters above the present-day river since ∼25 ka through the LGM. (4) 18-13 ka: incision into Terrace T0 below the modern river. Multiple...

  11. Postoperative Granulomas at Liposuction Incision Sites.

    Science.gov (United States)

    Weniger, Frederick G; White, Peter F; Barrero Castedo, Carlos E

    2016-02-01

    Since most liposuction incisions heal uneventfully, difficult healing in such incisions must be investigated. In the cases of two gynecomastia liposuction patients in which a water-based lubricating gel was used on the liposuction incisions, the incisions failed to heal. For both patients, workup uncovered palisading granulomas at the lateral inframammary fold incision sites several months after otherwise successful surgeries. These two cases are presented and the previous literature is reviewed, with consideration given to the etiology and prevention of such granulomas. LEVEL OF EVIDENCE 5: Risk. © 2015 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

  12. The similarity of river evolution at the initial stage of channel erosion

    Science.gov (United States)

    Lin, Jiun-Chuan

    2014-05-01

    The study deals with a comparison study of two types of rocks at the initial stage of channel erosion in Taiwan. It is interesting that channel erosion at different types of rocks shows some similarity. There are two types of rocks: sandstone at Ta-an River, central Taiwan where river channel erosion from the nick point because of earthquake uplifting and mud rock at Tainan, southern Taiwan where rill erosion on a flat surface after artificial engineering. These two situations are both at the beginning stage of channel erosion, there are some similar landform appeared on channels. However the rate of erosion and magnitude of erosion are different. According to the using of photogrammetry method to reconstruct archive imageries and field surveying by total station and 3D scanner at different stages. The incision rate is high both at the Ta-an River and the bank erosion and it is even more obvious at mud rock area because of erodibility of mud rock. The results show that bank erosion and incision both are obvious processes. Bank erosion made channel into meander. The bank erosion cause slope in a asymmetric channel profile. The incision process will start at the site where land is relatively uplifted. This paper demonstrates such similarity and landform characters.

  13. Thermal study of bare tips with various system parameters and incision sizes.

    Science.gov (United States)

    Osher, Robert H; Injev, Valentine P

    2006-05-01

    To identify major and minor surgeon-controlled parameters that affect incision temperature when performing microincision lens removal using the Alcon Infiniti Vision System. In vitro research and development laboratory, Alcon Research, Irvine, California, USA. Phacoemulsification was performed in eye-bank cadaver eyes and the following parameters evaluated: incision, duty cycle, ultrasound (US) power, aspiration flow rate (AFR), vacuum, pulse, bottle height and balanced salt solution temperature, and tip design/size. Each parameter was varied while the others remained constant. The resulting temperature of the incision and US tip was measured using a thermal camera. Major contributors to elevated incision temperature included incision size, US power, duty cycle, AFR, vacuum setting, tip design, and presence of an ophthalmic viscosurgical device (OVD). Minor contributors included pulse frequency, bottle height, and temperature of the infusate. Microincision lens removal can be performed at safe temperatures with the knowledgeable selection of surgeon-controlled parameters.

  14. Single incision pediatric endoscopic surgery: advantages of relatively large incision

    International Nuclear Information System (INIS)

    Yilmaz, E.; Afsarlar, E.; Karaman, I.

    2015-01-01

    To describe Single Incision Pediatric Endoscopic Surgery (SIPES) performed on children with various diagnoses, emphasizing its advantages. Study Design: An observational case series. Place and Duration of Study: Department of Pediatric Surgery, Dr. Sami Ulus Maternity and Child Health Hospital, Ankara, Turkey, from January 2011 to November 2014. Methodology: A review of patient charts was conducted in which SIPES was preferred as the surgical procedure. Patient demographics, operative details, operative time, clinical outcomes, postoperative pain and cosmesis were analyzed. Results: SIPES was performed on 45 patients (21 girls, 24 boys). Thirty-three appendectomies, 5 varicocelectomies, 3 oophorectomies, 2 ovarian and one paratubal cyst excision, and one fallopian tube excision were performed. All except one procedures were performed through our standard 2cm umbilical vertical or smile incision. In 18 cases, abdominal irrigation/aspiration was easily performed through the existing larger incision, as is done with open surgical technique. None of the patients had early postoperative shoulder/back pain since complete disinflation of CO/sub 2/ could be ensured. All of the patients/parents were satisfied with the cosmesis. Conclusion: SIPES has the advantages of limiting the surgical scar to within the umbilicus and providing easy disinflation of CO/sub 2/, allowing intraabdominal cleaning and extraction of large volume tissue samples through a single large umbilical incision. (author)

  15. Assessment of corneal astigmatism following frown and straight incision forms in sutureless manual small incision cataract surgery

    Directory of Open Access Journals (Sweden)

    Amedo AO

    2016-04-01

    Full Text Available Angela Ofeibea Amedo, Kwadwo Amoah, Nana Yaa Koomson, David Ben Kumah, Eugene Appenteng Osae Department of Optometry and Visual Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana Abstract: To investigate which of two tunnel incision forms (frown versus straight in sutureless manual small incision cataract surgery creates more corneal astigmatism. Sixty eyes of 60 patients who had consented to undergo cataract surgery and to partake in this study were followed from baseline through >12-week postoperative period. Values of preoperative and postoperative corneal astigmatism for the 60 eyes, measured with a Bausch and Lomb keratometer, were extracted from the patients’ cataract surgery records. Residual astigmatism was computed as the difference between preoperative and postoperative keratometry readings. Visual acuity was assessed during the preoperative period and at each postoperative visit with a Snellen chart at 6 m. Fifty eyes of 50 patients were successfully followed-up on. Overall, the mean residual astigmatism was 0.75±0.12 diopters. The differences in mean residual astigmatism between the two different incision groups were statistically significant (t [48]=6.33, P<0.05; frown incision group recorded 1.00±0.12 diopters, whereas the straight incision group recorded 0.50±0.12 diopters. No significant difference was observed between male and female groups (t [48]=0.24, P>0.05. Residual corneal astigmatism in the frown incision group was significantly higher than in the straight incision group. Fisher’s exact test did not reveal a significant association between incision forms and visual acuity during the entire postoperative period (P>0.05. Keywords: cataract, residual corneal astigmatism, frown incision, straight incision

  16. Small Incision Cataract Surgery (SICS with Clear Corneal Incision and SICS with Scleral Incision – A Comparative Study

    Directory of Open Access Journals (Sweden)

    Md Shafiqul Alam

    2014-01-01

    Full Text Available Background: Age related cataract is the leading cause of blindness and visual impairment throughout the world. With the advent of microsurgical facilities simple cataract extraction surgery has been replaced by small incision cataract surgery (SICS with posterior chamber intra ocular lens implant, which can be done either with clear corneal incision or scleral incision. Objective: To compare the post operative visual outcome in these two procedures of cataract surgery. Materials and method: This comparative study was carried out in the department of Ophthalmology, Delta Medical College & Hospital, Dhaka, Bangladesh, during the period of January 2010 to December 2012. Total 60 subjects indicated for age related cataract surgery irrespective of sex with the age range of 40-80 years with predefined inclusion and exclusion criteria were enrolled in the study. Subjects were randomly and equally distributed in 2 groups; Group A for SICS with clear corneal incision and group B for SICS with scleral incision. Post operative visual out come was evaluated by determining visual acuity and astigmatism in different occasions and was compared between groups. Statistical analysis was done by SPSS for windows version12. Results: The highest age incidence (43.3% was found between 61 to 70 years of age group. Among study subjects 40 were male and 20 were female. Preoperative visual acuity and astigmatism were evenly distributed between groups. Regarding postoperative unaided visual outcome, 6/12 or better visual acuity was found in 19.98% cases in group A and 39.6% cases in group B at 1st week. At 6th week 6/6 vision was found in 36.3% in Group A and 56.1% in Group B and 46.2% in group A and 66% in group B without and with correction respectively. With refractive correction, 6/6 vision was attained in 60% subjects of group A and 86.67% of group B at 8th week. Post operative visual acuity was statistically significant in all occasions. Postoperative astigmatism of

  17. Modified incision for maxillectomy: our experience.

    Science.gov (United States)

    Bhavana, Kranti; Tyagi, Isha; Ramani, Mukesh Kumar

    2012-06-01

    Radical maxillectomy has usually been done by the classical Weber Ferguson incision since age old times and still is being used widely due to its advantage of excellent exposure and minimal scarring as the incision follows the natural skin crease. In our modification of radical maxillectomy incision we avoid a scar on the midface by performing a midface degloving and combining it with a subconjunctival eye incision thus avoiding any cosmetic deformity and associated eye complication. It also avoids the late complication of cutaneous fistula following radiotherapy to these areas and due to early healing of the wound, early radiotherapy can be started.

  18. Penetrating and Intrastromal Corneal Arcuate Incisions in Rabbit and Human Cadaver Eyes: Manual Diamond Blade and Femtosecond Laser-Created Incisions.

    Science.gov (United States)

    Gray, Brad; Binder, Perry S; Huang, Ling C; Hill, Jim; Salvador-Silva, Mercedes; Gwon, Arlene

    2016-07-01

    To compare morphologic differences between freehand diamond or femtosecond laser-assisted penetrating and intrastromal arcuate incisions. Freehand diamond blade, corneal arcuate incisions (180° apart, 60° arc lengths) and 150 kHz femtosecond laser (80% scheimpflug pachymetry depth corneal thickness) arcuate incisions were performed in rabbits. Intrastromal arcuate incisions (100 μm above Descemet's membrane, 100 μm below epithelium) were performed in rabbit corneas (energy 1.2 μJ, spot line separation 3 × 3 μm, 90° side cut angle). Eyes were examined by slit lamp and light microscopy up to 47 days post-procedure. Freehand diamond blade penetrating incisions, and femtosecond laser penetrating and intrastromal arcuate incisions (energy 1.8 μJ, spot line separation 2 × 2 μm) were performed in cadaver eyes. Optical coherence tomography was performed immediately after surgery and the corneas were fixed for light scanning and transmission electron microscopy. The rabbit model showed anterior stromal inflammation with epithelial hyperplasia in penetrating blade and laser penetrating wounds. The laser intrastromal and penetrating incisions showed localized constriction of the stromal layers of the cornea near the wound. In cadaver eyes, penetrating wound morphology was similar between blade and laser whereas intrastromal wounds did not affect the cornea above or below incisions. Penetrating femtosecond laser arcuate incisions have more predictable and controlled outcomes shown by less post-operative scarring than incisions performed with a diamond blade. Intrastromal incisions do not affect uncut corneal layers as demonstrated by histopathology. The femtosecond laser has significant advantages in its ability to make intrastromal incisions which are not achievable by traditional freehand or mechanical diamond blades.

  19. Influence of Incision Location on Transmitter Loss, Healing, Incision Lengths, Suture Retention, and Growth of Juvenile Chinook Salmon

    Energy Technology Data Exchange (ETDEWEB)

    Panther, Jennifer L.; Brown, Richard S.; Gaulke, Greggory L.; Woodley, Christa M.; Deters, Katherine A.

    2010-05-11

    In this study, conducted by Pacific Northwest National Laboratory for the U.S. Army Corps of Engineers, Portland District, we measured differences in survival and growth, incision openness, transmitter loss, wound healing, and erythema among abdominal incisions on the linea alba, lateral and parallel to the linea alba (muscle-cutting), and following the underlying muscle fibers (muscle-sparing). A total of 936 juvenile Chinook salmon were implanted with both Juvenile Salmon Acoustic Tracking System transmitters (0.43 g dry) and passive integrated transponder tags. Fish were held at 12°C (n = 468) or 20°C (n = 468) and examined once weekly over 98 days. We found survival and growth did not differ among incision groups or between temperature treatment groups. Incisions on the linea alba had less openness than muscle-cutting and muscle-sparing incisions during the first 14 days when fish were held at 12°C or 20°C. Transmitter loss was not different among incision locations by day 28 when fish were held at 12°C or 20°C. However, incisions on the linea alba had greater transmitter loss than muscle-cutting and muscle-sparing incisions by day 98 at 12°C. Results for wound closure and erythema differed among temperature groups. Results from our study will be used to improve fish-tagging procedures for future studies using acoustic or radio transmitters.

  20. Channel erosion in a rapidly urbanizing region of Tijuana, Mexico: Enlargement downstream of channel hardpoints

    Science.gov (United States)

    Taniguchi, Kristine; Biggs, Trent; Langendoen, Eddy; Castillo, Carlos; Gudiño, Napoleon; Yuan, Yongping; Liden, Douglas

    2016-04-01

    Urban-induced erosion in Tijuana, Mexico, has led to excessive sediment deposition in the Tijuana Estuary in the United States. Urban areas in developing countries, in contrast to developed countries, are characterized by much lower proportions of vegetation and impervious surfaces due to limited access to urban services such as road paving and landscaping, and larger proportions of exposed soils. In developing countries, traditional watershed scale variables such as impervious surfaces may not be good predictors of channel enlargement. In this research, we surveyed the stream channel network of an erodible tributary of the Tijuana River Watershed, Los Laureles Canyon, at 125 locations, including repeat surveys from 2008. Structure from Motion (SfM) and 3D photo-reconstruction techniques were used to create digital terrain models of stream reaches upstream and downstream of channel hardpoints. Channels are unstable downstream of hardpoints, with incision up to 2 meters and widening up to 12 meters. Coordinated channelization is essential to avoid piece-meal approaches that lead to channel degradation. Watershed impervious area is not a good predictor of channel erosion due to the overriding importance of hardpoints and likely to the high sediment supply from the unpaved roads which prevents channel erosion throughout the stream network.

  1. Discussion on the Relevant Factors of General Surgery Incision Infection and Prevention Methods

    Directory of Open Access Journals (Sweden)

    Jin Baotao

    2017-01-01

    Full Text Available There are many reasons that can lead to incision infection of general surgical patients. The main reasons include weight, age, body albumin level, surgical time, observation ward, etc. This paper analyzes the clinic data of patients with incision infection after general surgery based on clinic practice and study on the reasons that have impact on general surgical incision infection and gives relevant prevention countermeasures.

  2. Current Status of Single-incision Laparoscopic Surgery

    DEFF Research Database (Denmark)

    Ahmed, Irfan; Ciancio, Fabio; Ferrara, Vincenzo

    2012-01-01

    Recent advances in minimally invasive surgery have centered on reducing the number of incisions required, which has led to the development of the single-incision laparoscopic technique. A panel of European single-incision laparoscopy experts met to discuss the current status of, and the future...

  3. Modeling Long-Term Fluvial Incision : Shall we Care for the Details of Short-Term Fluvial Dynamics?

    Science.gov (United States)

    Lague, D.; Davy, P.

    2008-12-01

    Fluvial incision laws used in numerical models of coupled climate, erosion and tectonics systems are mainly based on the family of stream power laws for which the rate of local erosion E is a power function of the topographic slope S and the local mean discharge Q : E = K Qm Sn. The exponents m and n are generally taken as (0.35, 0.7) or (0.5, 1), and K is chosen such that the predicted topographic elevation given the prevailing rates of precipitation and tectonics stay within realistic values. The resulting topographies are reasonably realistic, and the coupled system dynamics behaves somehow as expected : more precipitation induces increased erosion and localization of the deformation. Yet, if we now focus on smaller scale fluvial dynamics (the reach scale), recent advances have suggested that discharge variability, channel width dynamics or sediment flux effects may play a significant role in controlling incision rates. These are not factored in the simple stream power law model. In this work, we study how these short- term details propagate into long-term incision dynamics within the framework of surface/tectonics coupled numerical models. To upscale the short term dynamics to geological timescales, we use a numerical model of a trapezoidal river in which vertical and lateral incision processes are computed from fluid shear stress at a daily timescale, sediment transport and protection effects are factored in, as well as a variable discharge. We show that the stream power law model might still be a valid model but that as soon as realistic effects are included such as a threshold for sediment transport, variable discharge and dynamic width the resulting exponents m and n can be as high as 2 and 4. This high non-linearity has a profound consequence on the sensitivity of fluvial relief to incision rate. We also show that additional complexity does not systematically translates into more non-linear behaviour. For instance, considering only a dynamical width

  4. Comparison of the Keratometric Corneal Astigmatic Power after Phacoemulsification: Clear Temporal Corneal Incision versus Superior Scleral Tunnel Incision

    Directory of Open Access Journals (Sweden)

    Yongqi He

    2009-01-01

    Full Text Available Objective. This is prospective randomized control trial to compare the mean keratometric corneal astigmatism diopter power (not surgical induced astigmatism among preop and one-month and three-month postop phacoemulcification of either a clear temporal corneal incision or a superior scleral tunnel Incision, using only keratometric astigmatic power reading to evaluate the difference between the two cataract surgery incisions. Methods. 120 patients (134 eyes underwent phacoemulcification were randomly assigned to two groups: Group A, the clear temporal corneal incision group, and Group B, the superior scleral tunnel incision group. SPSS11.5 Software was used for statistical analysis to compare the postsurgical changes of cornea astigmatism on keratometry. Results. The changes of corneal astigmatic diopter in Groups A and B after 3 month postop from keratometric reading were 1.04 + 0.76 and 0.94 + 0.27, respectively (=.84>.05, which showed no statistic significance difference. Conclusion. The incision through either temporal clear cornea or superior scleral tunnel in phacoemulcification shows no statistic difference in astigmatism change on keratometry 3-month postop.

  5. Cosmetic effects of skin-crease camouflage incision versus longitudinal incision following carotid endarterectomy.

    Science.gov (United States)

    Kazimierczak, Arkadiusz; Rybicka, Anita; Rynio, Pawel; Gutowski, Piotr; Wiernicki, Ireneusz

    2018-03-01

    Despite the increasing use of carotid angioplasty and stenting (CAS), carotid endarterectomy (CEA) nonetheless remains a more medically beneficial method of treatment for carotid artery stenosis. Therefore, one possibility for progress within this procedure may be to use minimally invasive carotid surgery, especially when the scar is in plain sight: the use of the natural wrinkles (skin crease) as a camouflage of the skin incision provides significant cosmetic improvements. To compare the cosmetic effects of classic and trans-wrinkle CEA. To assess the distance between the carotid artery bifurcation (CAB) and the skin-crease incision whilst attempting CEA. It was a randomized prospective study with two groups: patients undergoing classic surgery (control group; n = 100) and skin-crease trans-wrinkle camouflaged CEA (study group; n = 100). Follow-up was at 2 months and 1 year. The medical results of the treatment were similar in both groups. The cumulative count of strokes and myocardial infarctions was 0.5% within 30 days, and after one year 3.5% (and 5.5% including cases of death). The superiority of the transverse crease being hidden compared to the conventional longitudinal technique was proven in the Patient and Observer Scar Assessment Scale (POSAS) score, respectively 11.4 ±1.0 vs. 14.1 ±3.4 (p = 0.0001) after 2 months and 13.5 ±2.8 vs. 14.1 ±3.4 (p = 0.039) after a year. Trans-wrinkle incision gives better cosmetic results, can be safely performed in most cases, and offers a comfortable approach during CEA.

  6. Single scrotal incision orchiopexy - a systematic review

    Directory of Open Access Journals (Sweden)

    Hugo Fabiano Fernandes Novaes

    2013-06-01

    Full Text Available Objective To conduct a systematic review on single scrotal incision orchiopexy. Materials and Methods A search was performed using Pubmed, through which 16 articles were selected out of a total of 133. The following conditions were considered exclusion criteria: other surgical methods such as an inguinal procedure or a laparoscopic approach, retractile testes, or patients with previous testicular or inguinal surgery. Results A total of 1558 orchiopexy surgeries initiated with a transcrotal incision were analyzed. Patients' ages ranged between 5 months and 21 years. Thirteen studies used high scrotal incisions, and low scrotal incisions were performed in the remainder of the studies. In 55 cases (3.53%, there was a need for inguinal incision. Recurrence was observed in 9 cases, testicular atrophy in 3, testicular hypotrophy in 2, and surgical site infections in 13 cases. High efficacy rates were observed, varying between 88% and 100%. Conclusions Single scrotal incision orchiopexy proved to be an effective technique and is associated with low rates of complications.

  7. Flexible single-incision surgery: a fusion technique.

    Science.gov (United States)

    Noguera, José F; Dolz, Carlos; Cuadrado, Angel; Olea, José; García, Juan

    2013-06-01

    The development of natural orifice transluminal endoscopic surgery has led to other techniques, such as single-incision surgery. The use of the flexible endoscope for single-incision surgery paves the way for further refinement of both surgical methods. To describe a new, single-incision surgical technique, namely, flexible single-incision surgery. Assessment of the safety and effectiveness of endoscopic cholecystectomy in a series of 30 patients. This technique consists of a single umbilical incision through which a flexible endoscope is introduced and consists of 2 parallel entry ports that provide access to nonarticulated laparoscopic instruments. The technique was applied in all patients for whom it was prescribed. No general or surgical wound complications were noted. Surgical time was no longer than usual for single-port surgery. Flexible single-incision surgery is a new single-site surgical technique offering the same level of patient safety, with additional advantages for the surgeon at minimal cost.

  8. The width of the incisive canal and labial alveolar bone of the incisive canal: an assessment on CT images

    International Nuclear Information System (INIS)

    Roh, Yang Gyun; Jang, Hyun Seon; Kim, Byung Ock; Kim, Jin Soo

    2006-01-01

    To assess the width of the labial alveolar bone of the incisive canal and the width of the incisive canal on spiral computed tomographic images of the anterior portion of the maxilla. Study materials included 38 CT scans taken for preoperative planning of implant placement. Axial cross-sectioned image entirely showing the incisive canal at an orifice to the oral cavity, middle portion, and an orifice to the nasal cavity and the diameter of the incisive canal at the middle portion were determined by two specialist using Digora for Windows 2.1. The statistical analyses were carried out using SPSS 12.0.1. When the maxillary central incisors remained, the mean labial alveolar bone width were 6.81±1.41 mm, 6.46±1.33 mm, and 7.91±1.33 mm. When the maxillary central incisors were missed the mean width were 5.42±2.20 mm, 6.23±2.29 mm, and 7.89±2.13 mm. The labial alveolar bone width at middle portion and an orifice to the nasal cavity were of no statistical significant difference according to presence of the maxillary central incisors (P>0.05). The width between oral cavity and nasal cavity, middle portion and to masal cavity revealed statistically significant difference (P<0.05)

  9. Transient river response, captured by channel steepness and its concavity

    Science.gov (United States)

    Vanacker, Veerle; von Blanckenburg, Friedhelm; Govers, Gerard; Molina, Armando; Campforts, Benjamin; Kubik, Peter W.

    2015-01-01

    Mountain rivers draining tropical regions are known to be great conveyor belts carrying efficiently more than half of the global sediment flux to the oceans. Many tropical mountain areas are located in tectonically active belts where the hillslope and stream channel morphology are rapidly evolving in response to changes in base level. Here, we report basin-wide denudation rates for an east-west transect through the tropical Andes. Hillslope and channel morphology vary systematically from east to west, reflecting the transition from high relief, strongly dissected topography in the escarpment zones into relatively low relief topography in the inter-Andean valley. The spatial pattern of differential denudation rates reflects the transient adjustment of the landscape to rapid river incision following tectonic uplift and river diversion. In the inter-Andean valley, upstream of the wave of incision, slopes and river channels display a relatively smooth, concave-up morphology and denudation rates (time scale of 104-105 a) are consistently low (3 to 200 mm/ka). In contrast, slopes and river channels of rejuvenated basins draining the eastern cordillera are steep to very steep; and the studied drainage basins show a wide range of denudation rate values (60 to 400 mm/ka) that increase systematically with increasing basin mean slope gradient, channel steepness, and channel convexity. Drainage basins that are characterised by strong convexities in their river longitudinal profiles systematically have higher denudation rates. As such, this is one of the first studies that provides field-based evidence of a correlation between channel concavity and basin mean denudation rates, consistent with process-based fluvial incision models.

  10. Meta-analysis of the effectiveness of surgical scalpel or diathermy in making abdominal skin incisions.

    LENUS (Irish Health Repository)

    Ahmad, Nasir Zaheer

    2012-02-01

    BACKGROUND: Surgical scalpels are traditionally used to make skin incisions. Diathermy incisions on contrary are less popular among the surgeons. The aim of this meta-analysis was to compare the effectiveness of both techniques and address the common fallacies about diathermy incisions. METHODS: A literature search of MEDLINE and Cochrane databases was done, using the keywords diathermy, cold scalpel, and incisions. Eleven clinical trials comparing both methods of making skin incisions were selected for meta-analysis. The end points compared included postoperative wound infection, pain in first 24 hours after surgery, time taken to complete the incisions, and incision-related blood loss. RESULTS: Postoperative wound infection rate was comparable in both techniques (P = 0.147, odds ratio = 1.257 and 95% CI = 0.923-1.711). Postoperative pain was significantly less with diathermy incisions in first 24 hours (P = 0.031, weighted mean difference = 0.852 and 95% CI = 0.076-1.628). Similarly, the time taken to complete the incision and incision-related blood loss was significantly less with diathermy incisions (95% CI = 0.245-0.502 and 0.548-1.020, respectively). CONCLUSION: Diathermy incisions are equally prone to get wound infection, as do the incisions made with scalpel. Furthermore, lower incidence of early postoperative pain, swiftness of the technique, and a reduced blood loss are the encouraging facts supporting routine use of diathermy for abdominal skin incisions after taking careful precautions.

  11. Systematic review and meta-analysis of electrocautery versus scalpel for surgical skin incisions.

    Science.gov (United States)

    Aird, Lisa N F; Brown, Carl J

    2012-08-01

    The creation of surgical skin incisions has historically been performed using a cold scalpel. The use of electrocautery for this purpose has been controversial with respect to patient safety and surgical efficacy. A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to compare skin incisions made by electrocautery and a scalpel. A systematic electronic literature search was performed using 2 electronic databases (MEDLINE and PubMed), and the methodological quality of included publications was evaluated. Six RCTs were identified comparing electrocautery (n = 606) and a scalpel (n = 628) for skin incisions. No significant difference in wound infection rates or scar cosmesis was identified between the treatment groups. Electrocautery significantly reduced the incision time and postoperative wound pain. A trend toward less incisional blood loss from skin incisions made with electrocautery was noted. Electrocautery is a safe and effective method for performing surgical skin incisions. Copyright © 2012 Elsevier Inc. All rights reserved.

  12. De Qeurvian Tenosynovitis: Clinical Outcomes of Surgical Treatment with Longitudinal and Transverse Incision

    Directory of Open Access Journals (Sweden)

    Arefah Dehghani Tafti

    2011-03-01

    Full Text Available AbstractObjectives: De Quervain disease is a mechanical tenosynovitis due to inadequacy volume between abductor pollicis longus, extensor pollicis brevis and their tunnel. Treatment methods include immobilization, steroid injections, and operation. For the first time Fritz De Quervain described surgical treatment of this disease. Since then, various ways of treatment have been reported. The purpose of this study is to compare the clinical outcomes of a longitudinal incision with a transverse incision in De Quervain disease.Methods: This was a randomized controlled clinical trial conducted in three hospitals in Iran, Yazd from March 2003 to September 2008. One hundred-twenty patients with De Quervain disease who did not respond to conservative treatment were operated with two different incisions. The patients were followed for three months to compare the surgical outcomes.Results: During a three month follow-up, a significant difference was shown between the two methods (p=0.03. Results of surgical treatment with longitudinal incision were excellent (only 5 hypertrophic scars, but there were 13 postoperative complaints with transverse incision.Conclusion: According to our findings, longitudinal incision in surgical treatment of De Quervain disease is better than transverse incision.

  13. Two-Step Incision for Periarterial Sympathectomy of the Hand

    Directory of Open Access Journals (Sweden)

    Seung Bae Jeon

    2015-11-01

    Full Text Available BackgroundSurgical scars on the palmar surface of the hand may lead to functional and also aesthetic and psychological consequences. The objective of this study was to introduce a new incision technique for periarterial sympathectomy of the hand and to compare the results of the new two-step incision technique with those of a Koman incision by using an objective questionnaire.MethodsA total of 40 patients (17 men and 23 women with intractable Raynaud's disease or syndrome underwent surgery in our hospital, conducted by a single surgeon, between January 2008 and January 2013. Patients who had undergone extended sympathectomy or vessel graft were excluded. Clinical evaluation of postoperative scars was performed in both groups one year after surgery using the patient and observer scar assessment scale (POSAS and the Wake Forest University rating scale.ResultsThe total patient score was 8.59 (range, 6-15 in the two-step incision group and 9.62 (range, 7-18 in the Koman incision group. A significant difference was found between the groups in the total PS score (P-value=0.034 but not in the total observer score. Our analysis found no significant difference in preoperative and postoperative Wake Forest University rating scale scores between the two-step and Koman incision groups. The time required for recovery prior to returning to work after surgery was shorter in the two-step incision group, with a mean of 29.48 days in the two-step incision group and 34.15 days in the Koman incision group (P=0.03.ConclusionsCompared to the Koman incision, the new two-step incision technique provides better aesthetic results, similar symptom improvement, and a reduction in the recovery time required before returning to work. Furthermore, this incision allows the surgeon to access a wide surgical field and a sufficient exposure of anatomical structures.

  14. Treatment for incarcerated indirect hernia with "Cross-Internal Ring" inguinal oblique incision in children.

    Science.gov (United States)

    Yan, Xue-Qiang; Yang, Jun; Zheng, Nan-Nan; Kuang, Hou-Fang; Duan, Xu-Fei; Bian, Hong-Qiang

    2017-01-01

    This study aims to evaluate the utility of the "Cross-Internal Ring" inguinal oblique incision for the surgical treatment of incarcerated indirect hernia (IIH) complicated with severe abdominal distension. Patients of IIH complicated with severe abdominal distension were reviewed retrospectively. All patients received operation through the "Cross-Internal Ring" inguinal oblique incision. There were totally 13 patients were included, male to female ratio was 9-4. The time for patients to resume oral feeding varying from 2 to 5 days after operation, no complications include delayed intestinal perforation, intra-abdominal abscess, and incision infection happened. Average postoperative hospital stay was 5.2 days. All cases were followed up for 6-18 months. No recurrence or iatrogenic cryptorchidism happened. "Cross-Internal Ring" inguinal oblique incision is a simple, safe, and reliable surgical method to treat pediatric IIH complicated with severe abdominal distension.

  15. Liquid in the major incision

    International Nuclear Information System (INIS)

    Herrera Jaramillo, Diego Alberto; Ortega Jaramillo, Hector

    2003-01-01

    We present the case of a patient with spill pleural extending in the left major incision. In the chest thorax PA, we could observe one of the complex radiographic appearances that take the reconfiguration of fluid in this localization, being this appearance dependent of the patient's position. Some points are also discussed on the anatomy of the major incisions and some of their radiographic characteristics

  16. Effects of post-treatment incubation on recombinogenesis in incision-proficient and incision-deficient strains of saccharomyces cerevisiae, 2

    International Nuclear Information System (INIS)

    Saeki, Tetsuya; Machida, Isamu

    1991-01-01

    After the photoaddition of mono- and bifunctional furocoumarins to G1 phase cells, most gene conversion and crossing-over occurred without post-irradiation incubation of these cells in incision-proficient strains. In contrast, incision-deficient cells showed marked induction of both recombinational events only after treated cells had been incubated for several hours before selection. These results indicate that when furocoumarins are photoadded to G1 cells, initiation of recombinational events occurs during the same G1 phase in the incision-proficient cells; whereas, it occurs only after post-irradiation DNA replication in incision-deficient cells. The action of the PSO2 gene product specific for the repair of DNA crosslinks in recombination induction is discussed and compared to the actions of the excision repair genes RAD1 and RAD2. (author)

  17. DNA Methylation Modulates Nociceptive Sensitization after Incision.

    Directory of Open Access Journals (Sweden)

    Yuan Sun

    Full Text Available DNA methylation is a key epigenetic mechanism controlling DNA accessibility and gene expression. Blockade of DNA methylation can significantly affect pain behaviors implicated in neuropathic and inflammatory pain. However, the role of DNA methylation with regard to postoperative pain has not yet been explored. In this study we sought to investigate the role of DNA methylation in modulating incisional pain and identify possible targets under DNA methylation and contributing to incisional pain. DNA methyltranferase (DNMT inhibitor 5-Aza-2'-deoxycytidine significantly reduced incision-induced mechanical allodynia and thermal sensitivity. Aza-2'-deoxycytidine also reduced hindpaw swelling after incision, suggesting an anti-inflammatory effect. Global DNA methylation and DNMT3b expression were increased in skin after incision, but none of DNMT1, DNMT3a or DNMT3b was altered in spinal cord or DRG. The expression of proopiomelanocortin Pomc encoding β-endorphin and Oprm1 encoding the mu-opioid receptor were upregulated peripherally after incision; moreover, Oprm1 expression was further increased under DNMT inhibitor treatment. Finally, local peripheral injection of the opioid receptor antagonist naloxone significantly exacerbated incision-induced mechanical hypersensitivity. These results suggest that DNA methylation is functionally relevant to incisional nociceptive sensitization, and that mu-opioid receptor signaling might be one methylation regulated pathway controlling sensitization after incision.

  18. Incision extension is the optimal method of difficult gallbladder extraction at laparoscopic cholecystectomy.

    Science.gov (United States)

    Bordelon, B M; Hobday, K A; Hunter, J G

    1992-01-01

    An unsolved problem of laparoscopic cholecystectomy is the optimal method of removing the gallbladder with thick walls and a large stone burden. Proposed solutions include fascial dilatation, stone crushing, and ultrasonic, high-speed rotary, or laser lithotripsy. Our observation was that extension of the fascial incision to remove the impacted gallbladder was time efficient and did not increase postoperative pain. We reviewed the narcotic requirements of 107 consecutive patients undergoing laparoscopic cholecystectomy. Fifty-two patients required extension of the umbilical incision, and 55 patients did not have their fascial incision enlarged. Parenteral meperidine use was 39.5 +/- 63.6 mg in the patients requiring fascial incision extension and 66.3 +/- 79.2 mg in those not requiring fascial incision extension (mean +/- standard deviation). Oral narcotic requirements were 1.1 +/- 1.5 doses vs 1.3 +/- 1.7 doses in patients with and without incision extension, respectively. The wide range of narcotic use in both groups makes these apparent differences not statistically significant. We conclude that protracted attempts at stone crushing or expensive stone fragmentation devices are unnecessary for the extraction of a difficult gallbladder during laparoscopic cholecystectomy.

  19. Better outcome from arthroscopic partial meniscectomy than skin incisions only?

    DEFF Research Database (Denmark)

    Roos, Ewa M; Hare, Kristoffer Borbjerg; Nielsen, Sabrina Mai

    2018-01-01

    . In total, nine participants experienced 11 adverse events; six in the surgery group and three in the skin-incisions-only group. CONCLUSION: We found greater improvement from arthroscopic partial meniscectomy compared with skin incisions only at 2 years, with the statistical uncertainty of the between......-group difference including what could be considered clinically relevant. Because of the study being underpowered, nearly half in the sham group being non-blinded and one-third crossing over to surgery, the results cannot be generalised to the greater patient population. TRIAL REGISTRATION NUMBER: NCT01264991....

  20. Single Incision Laparoscopic Splenectomy: Our First Experiences

    Directory of Open Access Journals (Sweden)

    Umut Barbaros

    2011-06-01

    Full Text Available Objective: Most laparoscopic surgeons have attempted to reduce incisional morbidity and improve cosmetic outcomes by using less and smaller trocars. Single incision laparoscopic splenectomy is a new laparoscopic procedure. Herein we would like to present our experiences.Material and Methods: Between January 2009 and June 2009, data of the 7 patients who underwent single incision laparoscopic splenectomy were evaluated retrospectively.Results: There were 7 patients (5 females and 2 males with a mean age of 29.9 years. The most common splenectomy indication was idiopathic thrombocytopenic purpura. Single incision laparoscopic splenectomy was performed successfully in 6 patients. In one patient the operation was converted to an open procedure.Conclusion: With surgeons experienced in minimally invasive surgery, single incision laparoscopic splenectomy could be performed successfully. However, in order to demonstrate the differneces between standard laparoscopic splenectomy and SILS splenetomy, prospective randomized comparative studies are required.

  1. Landscape evolution models using the stream power incision model show unrealistic behavior when m ∕ n equals 0.5

    Directory of Open Access Journals (Sweden)

    J. S. Kwang

    2017-12-01

    Full Text Available Landscape evolution models often utilize the stream power incision model to simulate river incision: E = KAmSn, where E is the vertical incision rate, K is the erodibility constant, A is the upstream drainage area, S is the channel gradient, and m and n are exponents. This simple but useful law has been employed with an imposed rock uplift rate to gain insight into steady-state landscapes. The most common choice of exponents satisfies m ∕ n = 0.5. Yet all models have limitations. Here, we show that when hillslope diffusion (which operates only on small scales is neglected, the choice m ∕ n = 0.5 yields a curiously unrealistic result: the predicted landscape is invariant to horizontal stretching. That is, the steady-state landscape for a 10 km2 horizontal domain can be stretched so that it is identical to the corresponding landscape for a 1000 km2 domain.

  2. Full-Thickness Retinochoroidal Incision in the Management of Central Retinal Vein Occlusion

    Directory of Open Access Journals (Sweden)

    San-Ni Chen

    2015-01-01

    Full Text Available Purpose. To evaluate the clinical outcomes in patients with central retinal vein occlusion (CRVO treated with full-thickness retinochoroidal incisions and to compare whether there is difference in treatment response in ischemic and nonischemic CRVO. Methods. Retrospective study of patients of CRVO receiving full-thickness retinochoroidal incisions in Changhua Christian Hospital. Fluorescein angiography (FA, slit-lamp biomicroscopy, indirect funduscopy, best corrected visual acuity, and central macular thickness (CMT measured by optical coherence tomography were performed pre- and postoperatively. Patients were divided into an ischemic and nonischemic group according to the findings of FA. Patients were followed up for at least 1 year. Results. Twenty-eight eyes (14 ischemic and 14 nonischemic CRVO were included. Functional retinochoroidal venous anastomosis (RCVA was achieved in 48 of the 65 retinochoroidal incisions (73.8%. Central macular thickness (CMT and retinal hemorrhage decreased significantly after the surgery. Significant visual gain was observed postoperatively in the nonischemic group, but not in the ischemic group. Postoperative complications included vitreous hemorrhage (17.8%, neovascular glaucoma (7.1%, and preretinal fibrovasular membrane (10.7%, all of which were in the ischemic group. Conclusions. RCVA formation induced by retinochoroidal incisions could improve venous flow, and decrease CMT and retinal hemorrhage. However, only eyes with nonischemic CRVO showed visual improvement.

  3. Treatment for incarcerated indirect hernia with “Cross-Internal Ring” inguinal oblique incision in children

    Directory of Open Access Journals (Sweden)

    Xue-Qiang Yan

    2017-01-01

    Full Text Available Background: This study aims to evaluate the utility of the “Cross-Internal Ring” inguinal oblique incision for the surgical treatment of incarcerated indirect hernia (IIH complicated with severe abdominal distension. Materials and Methods: Patients of IIH complicated with severe abdominal distension were reviewed retrospectively. All patients received operation through the “Cross-Internal Ring” inguinal oblique incision. Results: There were totally 13 patients were included, male to female ratio was 9-4. The time for patients to resume oral feeding varying from 2 to 5 days after operation, no complications include delayed intestinal perforation, intra-abdominal abscess, and incision infection happened. Average postoperative hospital stay was 5.2 days. All cases were followed up for 6–18 months. No recurrence or iatrogenic cryptorchidism happened. Conclusion: “Cross-Internal Ring” inguinal oblique incision is a simple, safe, and reliable surgical method to treat pediatric IIH complicated with severe abdominal distension.

  4. Influence of Gully Erosion Control on Amphibian and Reptile Communities within Riparian Zones of Channelized Streams

    Science.gov (United States)

    Riparian zones of streams in northwestern Mississippi have been impacted by agriculture, channelization, channel incision, and gully erosion. Riparian gully formation has resulted in the fragmentation of remnant riparian zones within agricultural watersheds. One widely used conservation practice for...

  5. Techniques for creating inconspicuous face-lift scars: avoiding visible incisions and loss of temporal hair.

    Science.gov (United States)

    Kridel, Russell W H; Liu, Edmund S

    2003-01-01

    Patients seeking rhytidectomy desire an improved neckline, jawline, and midface, but rarely at the price of signs that betray a face-lift, namely, visible incisions. We describe our face-lift incisional planning and the rationale behind specific surgical maneuvers for preventing unwanted sequelae. The telltale signs of poorly placed incisions include temporal hair loss, conspicuous scars, an unnatural appearance to the tragus, and a posterior hairline distorsion. Special considerations are given to the male patient and to the salvage of readily visible incision lines from previous surgery.

  6. Minimal incision surgery in strabismus: Modified fornix-based approach.

    Science.gov (United States)

    Pérez-Flores, I

    2016-07-01

    To evaluate the modified fornix-based technique as an approach for minimal incision surgery in strabismus. The medical records of all consecutive patients that underwent strabismus surgery with fornix-based conjunctival incision between 2007 and 2012 were retrospectively reviewed. As a primary variable, an analysis was made of the wound size depending on the number of stitches. A descriptive study was performed on the variables related to patients and to the type of strabismus and surgery. Out of 153patients identified, 138 with 294 surgeries were included. In 200 (68%) interventions, the incision was sutured with one stitch, in 77 (26.2%) with 2, in 13 (4.4%) with 3, and in 4 (1.4%) with 4, with the mean number of stitches being 1.39±0.64. The mean age of the patients was 39years (2-80), and 36 (26.1%) had previous strabismus surgery, with topical anaesthesia being used in 35 (25.4%) cases. At 3months after surgery deviation was ≤10DP in 114 (82.6%) patients. There were no wound-related complications. The modified fornix-based technique is an effective and safe approach for minimal incision surgery in strabismus, in patients at all ages, with previous history of strabismus surgery and with topical anaesthesia. Copyright © 2015 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  7. Transverse versus Longitudinal Incisions for Femoral Artery Exposure in Treating Patients with Peripheral Vascular Disease.

    Science.gov (United States)

    Parikh, Punam P; Rubio, Gustavo A; Patel, Kunal; Gupta, Kapil; Jones, Keith; Rey, Jorge; Robinson, Handel

    2018-02-01

    This study evaluates differences in wound complication rate when transverse versus longitudinal incision is utilized to expose femoral vessels in managing patients with peripheral vascular disease. A retrospective review from 2013 to 2015 was conducted of 150 patients undergoing 156 lower extremity revascularizations with femoral artery exposure through a groin incision. Patients were stratified into 2 groups, transverse versus longitudinal groin incision. Data were reviewed for 3 surgeons that utilize either transverse or longitudinal groin incision in patients undergoing common or iliofemoral endarterectomies, or where femoral artery was used as inflow and/or outflow vessel for limb revascularization. Each group had a comparative outcomes analysis based on incision type. The primary outcome was wound complication, defined as any wound infection, lymphocele, hematoma, dehiscence, pseudoaneurysm, or necrosis. Other outcomes studied included unplanned return to operating room for wound complication, wound vacuum therapy, and soft-tissue flap closure. Data were analyzed using 2-tailed chi-squared test and Student's t-test. Patients in the transverse (n = 85 cases) versus longitudinal (n = 71 cases) cohorts were similar in relation to demographics and comorbidities. Overall mean follow-up was 220 days. Patients with a transverse as compared to longitudinal incision had a significantly lower overall wound complication rate, 7% vs. 42%, respectively (P transverse incisions were associated with lower incidence of unplanned return to the operating room to manage wound complications than patients with a longitudinal incision (5% vs. 23%, respectively; P Transverse versus longitudinal incisions were also associated with significantly lower need for wound vacuum therapy (6% vs. 15%, respectively; P Transverse groin incisions for femoral artery exposure may offer a lower risk of wound complications for open procedures as compared to a longitudinal incision

  8. Cutting electrocautery versus scalpel for surgical incisions: a systematic review and meta-analysis.

    Science.gov (United States)

    Ismail, Ammar; Abushouk, Abdelrahman Ibrahim; Elmaraezy, Ahmed; Menshawy, Amr; Menshawy, Esraa; Ismail, Mahmoud; Samir, Esraa; Khaled, Anas; Zakarya, Hagar; El-Tonoby, Abdelrahman; Ghanem, Esraa

    2017-12-01

    Although cutting electrocautery can be superior to the scalpel in reducing blood loss and incisional time, several reports associated electrocautery with higher rates of wound infection, impaired healing, and worse cosmesis. We performed this systematic review and meta-analysis to compare cutting electrocautery versus scalpel for surgical incisions. We conducted a computerized literature search of five electronic databases and included all published original studies comparing cutting electrocautery and scalpel surgical incisions. Relevant data were extracted from eligible studies and pooled as odds ratios (ORs) or standardized mean difference (SMD) values in a meta-analysis model, using RevMan and Comprehensive Meta-analysis software. Forty-one studies (36 randomized trials, four observational, and one quasirandom study) were included in the pooled analysis (6422 participants). Compared with the scalpel incision, cutting electrocautery resulted in significantly less blood loss (SMD = -1.16, 95% CI [-1.60 to -0.72]), shorter incisional (SMD = -0.63, 95% CI [-0.96 to -0.29]) and operative times (SMD = -0.59, 95% CI [-1.12 to -0.05]), and lower pain scores (SMD = -0.91, 95% CI [-1.27 to -0.55]) with no significant differences in terms of wound infection rates (OR = 0.92, 95% CI [0.74-1.15]) or overall subjective scar score (SMD = -0.49, 95% CI [-1.72 to 0.75]). Surgical incision using electrocautery can be quicker with less blood loss and postoperative pain scores than the scalpel incision. No statistically significant difference was found between both techniques in terms of postoperative wound complications, hospital stay duration, and wound cosmetic characteristics. Therefore, we recommend routine use of cutting electrocautery for surgical incisions. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Channel response in a semiarid stream to removal of tamarisk and Russian olive

    Science.gov (United States)

    Jaeger, Kristin L.; Wohl, Ellen

    2011-02-01

    We report observed short-term (3 years) channel adjustment in an incised, semiarid stream to the removal of invasive plants, tamarisk (Tamarix spp.) and Russian olive (Elaeagnus angustifolia) by (1) removing the above-ground portion of the plant (cut-stump method) and (2) removing the entire plant (whole-plant method). The stream flows through Canyon de Chelly National Monument in Arizona, USA., draining an ˜1500 km2 catchment. Average channel width is 13 m; average thalweg depth is 2-3 m, although channel banks exceed 8 m locally. Channels adjusted primarily through widening, with significantly larger changes occurring in whole-plant removal reaches; however, neither plant removal method elicited large-scale bank destabilization, and the channels remained entrenched. Particular site conditions limiting large-scale destabilization include the absence of sufficient streamflow magnitudes, the presence of clay layers at the bank toe, the remaining presence of native vegetation, and the entrenched morphology. Our findings serve as a cautionary note regarding the temporal and spatial variability in channel response to invasive plant removal and underscore the importance of considering site-specific conditions in future restoration projects that include invasive plant removal.

  10. Incisive canal deflation for correct implant placement: case report.

    Science.gov (United States)

    Spin-Neto, Rubens; Bedran, Telma Blanca Lombardo; de Paula, Wagner Nunes; de Freitas, Rubens Moreno; de Oliveira Ramalho, Lizeti Toledo; Marcantonio, Elcio

    2009-12-01

    This article is a case report of a patient in whom the prosthetic planning indicated the necessity of an incisive canal deflation for the correct installation of an implant that is to be osseointegrated. In the reopening phase after the bone graft installation, the incisive canal deflation (biopsy of its content) was done and titanium implants were installed with one of them invading the anatomical space occupied previously by the incisive canal. The biopsy analysis showed fragments of the incisive artery and nerve, which are responsible for the anterior upper-tooth pulp, the periodontium vascularization and the innervation. From the anastomosis present along with other structures allied with the absence of teeth in the region, there was no detriment to the patient caused by the deflation. Incisive canal deflation is a viable technique in implantology. It can permit ideal prosthetic planning with no detriment to the patient.

  11. Higher Incision at Upper Part of Lower Segment Caesarean Section

    Directory of Open Access Journals (Sweden)

    Yong Shao

    2014-06-01

    Conclusions: An incision at the upper part of the lower segment reduces blood loss, enhances uterine retraction, predisposes to fewer complications, is easier to repair, precludes bladder adhesion to the suture line and reduces operation time. Keywords: caesarean section; higher incision technique; traditional uterine incision technique.

  12. Seismic Facies of Pleistocene–Holocene Channel-fill Deposits in Bawean Island and Adjacent Waters, Southeast Java Sea

    Directory of Open Access Journals (Sweden)

    Ali Albab

    2017-08-01

    Full Text Available The late Pleistocene-Holocene stratigraphic architecture of the Bawean Island and surrounding waters, southeast Java Sea has been analyzed by using sparker seismic profiles. Geological interpretation of these seismic profiles revealed the widespread distribution of paleochannels with different shape and size in the present-day Java Sea. Two channel types can be distinguished based on its morphology: U-shaped channels in the western part and V-shaped channels in the eastern part. The stratigraphic successions were grouped into two major seismic units separated by different seismic boundaries. Characters of marine and fluvial deposits were determined based on seismic boundaries and internal reflectors. Three seismic facies can be identified within late Pleistocene – Holocene incised channel fills associated with SB2. The internal structure of incised-channels consist of chaotic reflector at the bottom, covered by parallel–sub parallel and almost reflection-free indicating the homogenous sediment deposited during the succession.

  13. Clear corneal incision leakage after phacoemulsification--detection using povidone iodine 5%.

    Science.gov (United States)

    Chee, Soon-Phaik

    2005-01-01

    The purpose of this work was to study the incidence of clear corneal wound leakage at the conclusion of standard co-axial phacoemulsification in a prospective observational series of 100 consecutive cataract cases in a single surgeon's institutional practice. At the conclusion of standard co-axial phacoemulsification using a 2.75 mm temporal single plane clear corneal incision with a 1 mm clear corneal side-port incision, the wounds were hydrated and checked for water-tightness. Povidone iodine 5% (P-I) was then evenly dripped over the cornea and the wounds were inspected visually. Any leakage of aqueous observed was recorded. The amount of leakage was graded as small or large from each wound. Leaky wounds were further hydrated and retested with P-I until sealed. Wound integrity was reassessed on the first postoperative day by use of fluorescein. Of the 100 cases, wound leakage was observed for 31 eyes (31%)-ten main incisions, nineteen side-port incisions, and both incisions in two cases. Wound leakage was easily detected as a ribbon of clear fluid streaming from the incision amid a pool of brown solution. Povidone iodine was not observed within the tract in any incision. All wound leakage was small except for one from the main incision and two from the side-port incision. None of the eyes developed wound leakage the day after surgery and none developed endophthalmitis. In conclusion, leakage from clear corneal incisions at the conclusion of phacoemulsification occurs in almost a third of cases, predominantly from the side incision. It is easily detected by use of the P-I test.

  14. Effects of two different incision phacoemulsification on corneal astigmatism

    Directory of Open Access Journals (Sweden)

    Lu Huo

    2014-12-01

    Full Text Available AIM:To compare the effect of different incision in corneal astigmatism after phacoemulsification. METHODS: Totally 88 cases(122 eyeswith pure cataract were randomly divided into two groups. Forty cases(60 eyeswere clarity corneal incision in group A, and 48 cases(62 eyeswere sclera tunnel incision in group B. Mean corneal astigmatism, surgically induced astigmatism(SIA, uncorrected visual acuity(UCVAand best correct vision acuity(BCVAwere observed in pre- and post-operation at 1d; 1wk; 1mo.RESULTS: The mean astigmatism had statistically significant difference between two groups at 1d; 1wk; 1mo after operation(PPP>0.05. UCVA≥0.5 and BCVA≥0.8 had statistically significant difference at 1d; 1wk(PP>0.05.CONCLUSION: Phacoemulsification with scleral tunnel incision remove combined intraocular lens(IOLimplantation has small changes to corneal astigmatism. By selecting personalized corneal incision according to the corneal topography might be more beneficial.

  15. Single incision laparoscopic colorectal resection: Our experience

    Directory of Open Access Journals (Sweden)

    Chinnusamy Palanivelu

    2012-01-01

    Full Text Available Background: A prospective case series of single incision multiport laparoscopic colorectal resections for malignancy using conventional laparoscopic trocars and instruments is described. Materials and Methods: Eleven patients (seven men and four women with colonic or rectal pathology underwent single incision multiport laparoscopic colectomy/rectal resection from July till December 2010. Four trocars were placed in a single transumblical incision. The bowel was mobilized laparoscopically and vessels controlled intracorporeally with either intra or extracorporeal anastomosis. Results: Three patients had carcinoma in the caecum, one in the hepatic flexure, two in the rectosigmoid, one in the descending colon, two in the rectum and two had ulcerative pancolitis (one with high grade dysplasia and another with carcinoma rectum. There was no conversion to standard multiport laparoscopy or open surgery. The median age was 52 years (range 24-78 years. The average operating time was 130 min (range 90-210 min. The average incision length was 3.2 cm (2.5-4.0 cm. There were no postoperative complications. The average length of stay was 4.5 days (range 3-8 days. Histopathology showed adequate proximal and distal resection margins with an average lymph node yield of 25 nodes (range 16-30 nodes. Conclusion: Single incision multiport laparoscopic colorectal surgery for malignancy is feasible without extra cost or specialized ports/instrumentation. It does not compromise the oncological radicality of resection. Short-term results are encouraging. Long-term results are awaited.

  16. Diathermy versus scalpel incisions for open cholecystectomy comparative study

    International Nuclear Information System (INIS)

    Ali, M.A.; Niazi, W.A.K.

    2014-01-01

    The aim of the study was to make a comparison between skin incisions made with electrocautery versus scalpel in terms of their safety, efficacy and post-operative complications. Design: A randomized controlled study. Setting: The study was conducted in Combined Military Hospital (CMH) Kharian, Pakistan airforce (PAF) Hospital Sargodha. Duration of Study: May 2008 to August 2011. Patients and Methods: Ninety seven patients who underwent open cholecystectomy were randomly divided into two groups on the basis of the use of electrocautery versus steel scalpel for making skin incision and sub-cutaneous tissue dissection. Parameters recorded were, time taken from skin incision to full incising of the peritoneum, length of the wound, amount of blood loss during this step of surgery in each group. Post-operative pain scoring using visual analogue scale was done. Wound complications such as infection, haematoma/seroma and dehiscence were noted too. One month of follow up was recorded in each group. Subsequently a comparison of these findings was done. Results: Incision time (sec/cm/sub 2/) was longer in scalpel group than in diathermy group (p = 0.001), whereas, incision blood loss (ml/cm/sub 2/) was significantly less in diathermy group than in scalpel group (p = 0.03). There was no difference in post-operative pain perception as delineated by visual pain analogue scoring system between the two groups (p = 0.57). Post-operative wound complications and the final healing of wound at 01 month of follow-up were almost similar in both groups. Conclusion: Electrocautery may be used safely without any untoward complication in making skin incision and sub-cutaneous tissue dissection with an advantage of reduced incision time and and less blood loss. (author)

  17. Lithologic and hydrologic controls of mixed alluvial-bedrock channels in flood-prone fluvial systems: bankfull and macrochannels in the Llano River watershed, central Texas, USA

    Science.gov (United States)

    Heitmuller, Frank T.; Hudson, Paul F.; Asquith, William H.

    2015-01-01

    The rural and unregulated Llano River watershed located in central Texas, USA, has a highly variable flow regime and a wide range of instantaneous peak flows. Abrupt transitions in surface lithology exist along the main-stem channel course. Both of these characteristics afford an opportunity to examine hydrologic, lithologic, and sedimentary controls on downstream changes in channel morphology. Field surveys of channel topography and boundary composition are coupled with sediment analyses, hydraulic computations, flood-frequency analyses, and geographic information system mapping to discern controls on channel geometry (profile, pattern, and shape) and dimensions along the mixed alluvial-bedrock Llano River and key tributaries. Four categories of channel classification in a downstream direction include: (i) uppermost ephemeral reaches, (ii) straight or sinuous gravel-bed channels in Cretaceous carbonate sedimentary zones, (iii) straight or sinuous gravel-bed or bedrock channels in Paleozoic sedimentary zones, and (iv) straight, braided, or multithread mixed alluvial–bedrock channels with sandy beds in Precambrian igneous and metamorphic zones. Principal findings include: (i) a nearly linear channel profile attributed to resistant bedrock incision checkpoints; (ii) statistically significant correlations of both alluvial sinuosity and valley confinement to relatively high f (mean depth) hydraulic geometry values; (iii) relatively high b (width) hydraulic geometry values in partly confined settings with sinuous channels upstream from a prominent incision checkpoint; (iv) different functional flow categories including frequently occurring events (high f values (most ≤ 0.45) that develop at sites with unit stream power values in excess of 200 watts per square meter (W/m2); and (vi) downstream convergence of hydraulic geometry exponents for bankfull and macrochannels, explained by co-increases of flood magnitude and noncohesive sandy sediments that collectively

  18. Enhanced UWB Radio Channel Model for Short-Range Communication Scenarios Including User Dynamics

    DEFF Research Database (Denmark)

    Kovacs, Istvan Zsolt; Nguyen, Tuan Hung; Eggers, Patrick Claus F.

    2005-01-01

    channel model represents an enhancement of the existing IEEE 802.15.3a/4a PAN channel model, where antenna and user-proximity effects are not included. Our investigations showed that significant variations of the received wideband power and time-delay signal clustering are possible due the human body...

  19. Impact of selective pituitary gland incision or resection on hormonal function after adenoma or cyst resection.

    Science.gov (United States)

    Barkhoudarian, Garni; Cutler, Aaron R; Yost, Sam; Lobo, Bjorn; Eisenberg, Amalia; Kelly, Daniel F

    2015-12-01

    With the resection of pituitary lesions, the anterior pituitary gland often obstructs transsphenoidal access to the lesion. In such cases, a gland incision and/or partial gland resection may be required to obtain adequate exposure. We investigate this technique and determine the associated risk of post-operative hypopituitarism. All patients who underwent surgical resection of a pituitary adenoma or Rathke cleft cyst (RCC) between July 2007 and January 2013 were analyzed for pre- and post-operative hormone function. The cohort of patients with gland incision/resection were compared to a case-matched control cohort of pituitary surgery patients. Total hypophysectomy patients were excluded from outcome analysis. Of 372 operations over this period, an anterior pituitary gland incision or partial gland resection was performed in 79 cases (21.2 %). These include 53 gland incisions, 12 partial hemi-hypophysectomies and 14 resections of thinned/attenuated anterior gland. Diagnoses included 64 adenomas and 15 RCCs. New permanent hypopituitarism occurred in three patients (3.8 %), including permanent DI (3) and growth hormone deficiency (1). There was no significant difference in the rate of worsening gland dysfunction nor gain of function. Compared to a control cohort, there was a significantly lower incidence of transient DI (1.25 vs. 11.1 %, p = 0.009) but no significant difference in permanent DI (3.8 vs. 4.0 %) in the gland incision group. Selective gland incisions and gland resections were performed in over 20 % of our cases. This technique appears to minimize traction on compressed normal pituitary gland during removal of large lesions and facilitates better visualization and removal of cysts, microadenomas and macroadenomas.

  20. Distinctive channel geometry and riparian vegetation: A geomorphic classification for arid ephemeral streams

    Science.gov (United States)

    Sutfin, N.; Shaw, J. R.; Wohl, E. E.; Cooper, D.

    2012-12-01

    Interactions between hydrology, channel form, and riparian vegetation along arid ephemeral streams are not thoroughly understood and current stream classifications do not adequately represent variability in channel geometry and associated riparian communities. Relatively infrequent hydrologic disturbances in dryland environments are responsible for creation and maintenance of channel form that supports riparian communities. To investigate the influence of channel characteristics on riparian vegetation in the arid southwestern United States, we develop a geomorphic classification for arid ephemeral streams based on the degree of confinement and the composition of confining material that provide constraints on available moisture. Our conceptual model includes five stream types: 1) bedrock channels entirely confined by exposed bedrock and devoid of persistent alluvium; 2) bedrock with alluvium channels at least partially confined by bedrock but containing enough alluvium to create bedforms that persist through time; 3) incised alluvium channels bound only by unconsolidated alluvial material into which they are incised; 4) braided washes that exhibit multi-thread, braided characteristics regardless of the composition of confining material; and 5) piedmont headwater 0-2nd order streams (Strahler) confined only by unconsolidated alluvium and which initiate as secondary channels on piedmont surfaces. Eighty-six study reaches representing the five stream types were surveyed on the U.S. Army Yuma Proving Ground in the Sonoran Desert of southwestern Arizona. Non-parametric multivariate analysis of variance (PERMANOVA) indicates significant differences between the five stream types with regards to channel geometry (i.e., stream gradient, width-to-depth ratio, the ratio between valley width and channel width (Wv/Wc), shear stress, and unit stream power) and riparian vegetation (i.e., presence and canopy coverage by species, canopy stratum, and life form). Discriminant analysis

  1. Single-incision laparoscopic cholecystectomy with needle graspers.

    Science.gov (United States)

    Sumiyoshi, Kinjiro; Sato, Norihiro; Akagawa, Shin; Hirano, Tatsuya; Koikawa, Kazuhiro; Horioka, Kohei; Ozono, Keigo; Fujiwara, Kenji; Tanaka, Masao; Sada, Masayuki

    2012-01-01

    Single-incision laparoscopic cholecystectomy (SILC) is a promising alternative to standard multi-incision laparoscopic cholecystectomy (LC). However, generalization of SILC is still hampered by technical difficulties mainly associated with the lack of trocars used for retraction of the gallbladder. We therefore developed a modified method of SILC with the use of needle graspers (SILC-N) for optimal retraction and exposure. In addition to two trocars inserted through a single transumbilical incision, two needle ports were placed on the right subcostal and lateral abdominal wall, through which needle graspers were used for retraction of the gallbladder. Since December, 2009, 12 patients with symptomatic cholelithiasis were treated by SILC-N. SILC-N was successfully performed in all but one patient requiring a conversion to the 4-port LC with a mean operative time of 71.5 (48-107) minutes. None of the patients experienced intraoperative or postoperative complications. The transumbilical incision and pinholes for needle graspers were almost invisible on discharge. Our preliminary results suggest that SILC-N is a simple, safe and feasible technique of cholecystectomy offering similar postoperative recovery and better cosmetic outcome as compared to conventional LC.

  2. Single-incision laparoscopic surgery for pyloric stenosis.

    Science.gov (United States)

    Kozlov, Yury; Novogilov, Vladimir; Podkamenev, Alexey; Rasputin, Andrey; Weber, Irina; Solovjev, Alexey; Yurkov, Pavel

    2012-04-01

    Laparoscopy is the most common procedure for correction of congenital pyloric stenosis. The standard laparoscopic approach is based on the three-port technique. In contrast to the standard laparoscopic technique, the single-incision laparoscopic surgery (SILS) requires only one incision. We report on our experience with this surgical approach. Between September 2009 and August 2010 a total of 24 children underwent a laparoscopic pyloromyotomy, 12 in SILS technique. The single incision was carried through the center of the umbilicus. The working instruments were introduced in a two-dimensional direction into the peritoneal cavity via the same umbilical incision. The two groups were compared for patients' demographics, operative report and early postoperative outcomes. All SILS procedures were performed successfully with no conversion rate. There were no differences in the preoperative parameters between the two groups regarding age before surgery and body weight at operation. Operative time and time of full enteral intake was similar to comparable procedures with usage of a standard laparoscopic approach. There were no operative or postoperative complications. The early experience described in this study confirms that SILS can be applied for treatment of pyloric stenosis with outcomes similar to the standard laparoscopic surgery.

  3. Can post-sternotomy mediastinitis be prevented by a closed incision management system?

    Directory of Open Access Journals (Sweden)

    Dohmen, Pascal M.

    2014-09-01

    Full Text Available [english] Post-sternotomy mediastinitis is a serious complication after cardiothoracic surgery and contribute significantly to post-operative morbidity, mortality, and healthcare costs. Negative pressure wound therapy is today’s golden standard for post-sternotomy mediastinitis treatment. A systematic literature search was conducted at PubMed until October 2012 to analyse whether vacuum-assisted closure technique prevents mediastinitis after clean surgical incisions closure. Today’s studies showed reduction of post-sternotomy mediastinitis including a beneficial socio-economic impact. Current studies, however included only high-risk patients, hence furthermore, larger randomised controlled trials are warranted to clarify the benefit for using surgical incision vacuum management systems in the general patient population undergoing sternotomy and clarify risk factor interaction.

  4. A Precise 6 Ma Start Date for Fluvial Incision of the Northeastern Colorado Plateau Canyonlands

    Science.gov (United States)

    Thomson, S. N.; Soreghan, G. S.; Reiners, P. W.; Peyton, S. L.; Murray, K. E.

    2015-12-01

    Outstanding questions regarding late Cenozoic Colorado Plateau landscape evolution include: (1) the relative roles of isostatic rebound as result Colorado River incision versus longer-term geodynamic processes in driving overall rock uplift of the plateau; and (2) whether incision was triggered by river integration or by a change in deep-seated mantle lithosphere dynamics. A key to answering these questions is to date more precisely the onset of incision to refine previous estimates of between 6 and 10 Ma. We present new low-temperature thermochronologic results from bedrock and deep borehole samples in the northeastern Colorado Plateau to show that rapid river incision began here at 6 Ma (5.93±0.66 Ma) with incision rates increasing from 15-50 m/Myr to 160-200 m/Myr. The onset time is constrained independently by both inverse time-temperature modeling and by the break-in-slope in fission track age-elevation relationships. This new time constraint has several important implications. First, the coincidence in time with 5.97-5.3 Ma integration of the lower Colorado River through the Grand Canyon to the Gulf of California strongly favors downstream river integration triggering carving of the canyonlands of the upper Colorado River system. Second, it implies integration of the entire Colorado River system in less than 2 million years. Third, rock uplift of the plateau driven by the flexural isostatic response to river incision is restricted to just the last 6 Ma, as is associated increased sediment budget. Fourth, incision starting at 6 Ma means that previous estimates of upper Colorado River incision rates based on 10-12 Ma basalt datum levels are too low. This also changes the dependency of measured time interval on incision rate from a non-steady-state negative power-law dependence (exponent of -0.24) to a near steady-state dependence (exponent of 0.07) meaning that long-term upper Colorado river incision rates can provide a reliable proxy for rock uplift rates.

  5. Feasibility of Performing Total Skin-Sparing Mastectomy in Patients With Prior Circumareolar Mastopexy or Reduction Mammoplasty Incisions.

    Science.gov (United States)

    Vaughn, Carolyn J; Peled, Anne Warren; Esserman, Laura J; Foster, Robert D

    2013-06-19

    Total skin-sparing mastectomy (TSSM) techniques with preservation of the nipple-areolar complex (NAC) skin are becoming increasingly popular due to improved cosmesis without compromise in oncologic safety. However, these techniques are not routinely offered to patients who have undergone previous breast surgery involving circumareolar incisions due to concern for NAC viability. We reviewed the outcomes of TSSM in 11 patients who underwent 21 TSSM procedures at our institution between 2008 and 2011. All patients had undergone previous breast surgery including reduction mammaplasty (7 breasts), mastopexy (4 breasts), augmentation (3 breasts), and combined mastopexy-augmentation (7 breasts). Incisions from previous breast surgery included circumareolar (11 cases) and Wise pattern (10 cases) incisions. All patients underwent TSSM through an inframammary incision followed by immediate tissue expander reconstruction and subsequent implant exchange. Patient demographics, previous breast surgery details, tumor and treatment characteristics, and postoperative complications were reviewed. Mean patient age was 43 years (range, 35-53 years) and mean body mass index was 24 kg/m (range, 19-32 kg/m). Mean follow-up was 10.2 months (range, 3-20 months).Indications for TSSM included prophylactic risk reduction in 10 cases, in situ cancer in 2 cases, and invasive cancer in 9 cases. Mean time from previous breast surgery to mastectomy was 6.9 years (range, 6 months-26 years). Major complications requiring operative reintervention included 1 (4.8%) case of cellulitis requiring expander removal and 2 (9.5%) cases of wound breakdown requiring operative closure. There were no complications involving the NAC. Total skin-sparing mastectomy with immediate reconstruction can safely be performed in patients who have undergone previous breast surgery involving circumareolar incisions. Our preferred technique in this group of patients is to perform TSSM through an inframammary incision with 2

  6. Single-incision laparoscopic bariatric surgery

    Directory of Open Access Journals (Sweden)

    Huang Chih-Kun

    2011-01-01

    Full Text Available Background: Bariatric surgery has been established as the best option of treatment for morbid obesity. In recent years single-incision laparoscopic surgery (SILS has emerged as another modality of carrying out the bariatric procedures. While SILS represents an advance, its application in morbid obesity at present is limited. In this article, we review the technique and results of SILS in bariatric surgery. Methods: The PubMed database was searched and totally 11 series reporting SILS in bariatric surgery were identified and analyzed. The case reports were excluded. Since 2008, 114 morbidly obese patients receiving SILS bariatric surgeries were reported. Results: The procedures performed included SILS gastric banding, sleeve gastrectomy and gastric bypass. No mortality was reported in the literatures. Sixteen patients (14.05% needed an additional incision for a liver retractor, a trocar or for conversion. Only one complication of wound infection was reported in these series. All the surgeons reported that the patients were highly satisfied with the scar. Conclusion: Because of abundant visceral and subcutaneous fat and multiple comorbidities in morbid obesity, it is more challenging for surgeons to perform the procedures with SILS. It is clear that extensive development of new instruments and technical aspects of these procedures as well as randomized studies to compare them with traditional laparoscopy are essential before these procedures can be utilized in day-to-day clinical practice.

  7. Transurethral incision of urethral diverticulum in the female

    DEFF Research Database (Denmark)

    Miskowiak, J; Honnens de Lichtenberg, M

    1989-01-01

    A new technique of transurethral incision of urethral diverticulum was successfully used in two women. The method described is safe, simple and shortens operating time.......A new technique of transurethral incision of urethral diverticulum was successfully used in two women. The method described is safe, simple and shortens operating time....

  8. "Meniscus Sign" to Identify the Lenticule Edge in Small-Incision Lenticule Extraction.

    Science.gov (United States)

    Titiyal, Jeewan S; Kaur, Manpreet; Brar, Anand S; Falera, Ruchita

    2018-06-01

    To describe our technique of lenticule edge identification in small-incision lenticule extraction using the "meniscus sign" to prevent lenticule misdissection. Femtosecond laser application for small-incision lenticule extraction was performed. A "double ring" was visible, signifying the edge of the cap cut (outer ring) and lenticule cut (inner ring). The anterior and posterior lamellar planes were delineated in 2 different directions. During creation of the posterior lamellar channel, the lenticule edge was slightly pushed away from the surgeon to create a gap between the inner ring (diameter of the lenticule cut) and the lenticule edge. The lenticule edge assumed a frilled wavy appearance, and the meniscus sign was observed as a gap between the lenticule edge and the inner ring. The meniscus-shaped gap served as a landmark to identify the lenticule edge, and the relationship between the frilled lenticule edge and surgical instruments further acted as a guide to identify the correct plane of dissection. This technique was successfully undertaken in 50 eyes of 25 patients. The meniscus sign was observed in all cases, and no case had cap lenticular adhesions. The meniscus sign helps to identify the lenticule edge and correct dissection planes and provides a visual landmark during the entire surgical procedure.

  9. In vitro conjunctival incision repair by temperature-controlled laser soldering.

    Science.gov (United States)

    Norman, Galia; Rabi, Yaron; Assia, Ehud; Katzir, Abraham

    2009-01-01

    The common method of closing conjunctival incisions is by suturing, which is associated with several disadvantages. It requires skill to apply and does not always provide a watertight closure, which is required in some operations (e.g., glaucoma filtration). The purpose of the present study was to evaluate laser soldering as an alternative method for closing conjunctival incisions. Conjunctival incisions of 20 ex vivo porcine eyes were laser soldered using a temperature-controlled fiberoptic laser system and an albumin mixed with indocyanine green as a solder. The control group consisted of five repaired incisions by a 10-0 nylon running suture. The leak pressure of the repaired incisions was measured. The mean leak pressure in the laser-soldered group was 132 mm Hg compared to 4 mm Hg in the sutured group. There was no statistically significant difference in both the incision's length and distance from the limbus between the groups, before and after the procedure, indicating that there was no severe thermal damage. These preliminary results clearly demonstrate that laser soldering may be a useful method for achieving an immediate watertight conjunctival wound closure. This procedure is faster and easier to apply than suturing.

  10. Minimal abdominal incisions

    Directory of Open Access Journals (Sweden)

    João Carlos Magi

    2017-04-01

    Full Text Available Minimally invasive procedures aim to resolve the disease with minimal trauma to the body, resulting in a rapid return to activities and in reductions of infection, complications, costs and pain. Minimally incised laparotomy, sometimes referred to as minilaparotomy, is an example of such minimally invasive procedures. The aim of this study is to demonstrate the feasibility and utility of laparotomy with minimal incision based on the literature and exemplifying with a case. The case in question describes reconstruction of the intestinal transit with the use of this incision. Male, young, HIV-positive patient in a late postoperative of ileotiflectomy, terminal ileostomy and closing of the ascending colon by an acute perforating abdomen, due to ileocolonic tuberculosis. The barium enema showed a proximal stump of the right colon near the ileostomy. The access to the cavity was made through the orifice resulting from the release of the stoma, with a lateral-lateral ileo-colonic anastomosis with a 25 mm circular stapler and manual closure of the ileal stump. These surgeries require their own tactics, such as rigor in the lysis of adhesions, tissue traction, and hemostasis, in addition to requiring surgeon dexterity – but without the need for investments in technology; moreover, the learning curve is reported as being lower than that for videolaparoscopy. Laparotomy with minimal incision should be considered as a valid and viable option in the treatment of surgical conditions. Resumo: Procedimentos minimamente invasivos visam resolver a doença com o mínimo de trauma ao organismo, resultando em retorno rápido às atividades, reduções nas infecções, complicações, custos e na dor. A laparotomia com incisão mínima, algumas vezes referida como minilaparotomia, é um exemplo desses procedimentos minimamente invasivos. O objetivo deste trabalho é demonstrar a viabilidade e utilidade das laparotomias com incisão mínima com base na literatura e

  11. Disposable skin staplers for closure of linear gastrointestinal incisions in dogs.

    Science.gov (United States)

    Schwartz, Zeev; Coolman, Bradley R

    2018-02-01

    To report the clinical features and outcomes of linear gastrointestinal incisions closed with skin staples in dogs. Historical cohort study. 333 client-owned dogs. Medical records from 1 private referral hospital were searched for dogs that underwent gastrointestinal surgery between November 1999 and October 2015. Cases were included if skin staplers were used to close linear gastrointestinal incisions. Information regarding preoperative, surgical, and postoperative factors was collected. Complications were diagnosed in 8 of 245 (3.27%) dogs, including 3 of 245 (1.22%) dogs that died or were euthanized, 3 of 245 (1.22%) dogs with incisional dehiscence, and 2 of 245 (0.81%) dogs with attachment of a linear foreign body to the staples at the intestinal lumen. Dehiscence was noted at the enterotomy sites in 3 dogs at a mean time of 44 hours after surgery (SD ± 6.93). Two dogs presented with another linear foreign body that was attached to the staples in the intestinal lumen at postoperative days 24 and 42. The risk factors associated with incisional dehiscence included multiple gastrointestinal incisions performed in 1 surgery (χ 2 , P indication for surgical intervention, surgery location in the gastrointestinal tract, or surgeon experience and incisional dehiscence. Skin staplers provide safe and effective closure of gastrotomies, enterotomies, and colonotomies in dogs. This method is reliable, efficient, and affordable in the hands of veterinary surgeons with varying skill levels. © 2017 The American College of Veterinary Surgeons.

  12. Smaller incision size leads to higher predictability in microcoaxial cataract surgery.

    Science.gov (United States)

    Klamann, Matthias K J; Gonnermann, Johannes; Maier, Anna-Karina B; Torun, Necip; Bertelmann, Eckart

    2013-01-01

    The aim of the study was to compare the clinical outcomes of a 1.8 mm, 2.2 mm, and 2.75 mm microcoaxial cataract surgery system. METHODS. In this retrospective study, 129 eyes of 129 patients were included. Patients underwent phacoemulsification using a Stellaris system or an Infiniti system. The incision size was 1.8 mm, 2.2 mm, or 2.75 mm, respectively. Subjects were examined before surgery and 4 weeks after. The surgically induced astigmatism (SIA) was examined. The SIA in the 1.8 mm group was statistically lower compared to the 2.2 mm group (p=0.046) and the 2.75 mm group (p=0.017). There was no significant difference between the 2.2 mm group and the 2.75 mm group. With the use of appropriate support systems, 1.8 mm incisions appear to result in less SIA than 2.2 mm and 2.75 mm incisions. Advantages may arise from this, especially in the implantation of aspheric, toric, or multifocal lenses.

  13. Lithologic and hydrologic controls of mixed alluvial-bedrock channels in flood-prone fluvial systems: bankfull and macrochannels in the Llano River watershed, central Texas, USA

    Science.gov (United States)

    Heitmuller, Frank T.; Hudson, Paul F.; Asquith, William H.

    2015-01-01

    The rural and unregulated Llano River watershed located in central Texas, USA, has a highly variable flow regime and a wide range of instantaneous peak flows. Abrupt transitions in surface lithology exist along the main-stem channel course. Both of these characteristics afford an opportunity to examine hydrologic, lithologic, and sedimentary controls on downstream changes in channel morphology. Field surveys of channel topography and boundary composition are coupled with sediment analyses, hydraulic computations, flood-frequency analyses, and geographic information system mapping to discern controls on channel geometry (profile, pattern, and shape) and dimensions along the mixed alluvial-bedrock Llano River and key tributaries. Four categories of channel classification in a downstream direction include: (i) uppermost ephemeral reaches, (ii) straight or sinuous gravel-bed channels in Cretaceous carbonate sedimentary zones, (iii) straight or sinuous gravel-bed or bedrock channels in Paleozoic sedimentary zones, and (iv) straight, braided, or multithread mixed alluvial–bedrock channels with sandy beds in Precambrian igneous and metamorphic zones. Principal findings include: (i) a nearly linear channel profile attributed to resistant bedrock incision checkpoints; (ii) statistically significant correlations of both alluvial sinuosity and valley confinement to relatively high f (mean depth) hydraulic geometry values; (iii) relatively high b (width) hydraulic geometry values in partly confined settings with sinuous channels upstream from a prominent incision checkpoint; (iv) different functional flow categories including frequently occurring events (< 1.5-year return periods) that mobilize channel-bed material and less frequent events that determine bankfull channel (1.5- to 3-year return periods) and macrochannel (10- to 40-year return periods) dimensions; (v) macrochannels with high f values (most ≤ 0.45) that develop at sites with unit stream power values in excess

  14. Midline versus transverse incision for cesarean delivery in low-income countries

    DEFF Research Database (Denmark)

    Maaløe, Nanna; Aabakke, Anna J M; Secher, Niels J

    2014-01-01

    While transverse incision is the recommended entry technique for cesarean delivery in high-income countries, it is our experience that midline incision is still used routinely in many low-income settings. Accordingly, international guidelines lack uniformity on this matter. Although evidence...... is limited, the literature suggests important advantages of the transverse incision, with lower risk of long-term disabilities such as wound disruption and hernia. Also, potential extra time spent on this incision appears not to impact neonatal outcome. Therefore, we suggest that it is time for a change...

  15. In vivo architectural analysis of clear corneal incisions using anterior segment optical coherence tomography.

    Science.gov (United States)

    Dupont-Monod, Sylvère; Labbé, Antoine; Fayol, Nicolas; Chassignol, Alexis; Bourges, Jean-Louis; Baudouin, Christophe

    2009-03-01

    To use anterior segment optical coherence tomography (AS-OCT) to analyze the in vivo architecture of clear corneal incisions after phacoemulsification using different techniques. Department of Ophthalmology, Quinze-Vingts National Ophthalmology Hospital, Paris, France. This prospective observational study analyzed clear corneal incisions used in phacoemulsification. All wounds were evaluated 1 day and 8 days postoperatively by AS-OCT (Visante). Incision architecture and pachymetry at the wound level were analyzed. Thirty-five clear corneal incisions were analyzed. Six eyes had 2.75 mm coaxial phacoemulsification, 19 had 2.20 mm microincision coaxial phacoemulsification, and 10 had 1.30 mm bimanual microincision phacoemulsification. The 1.30 mm incision had a straight-line configuration. The 2.20 mm and 2.75 mm incisions had an arcuate configuration. The angles of incidence of 1.30 mm incisions were greater than those of 2.20 mm incisions (P<.001). All incisions had slight corneal edema limited to the incision area. The edema was slightly greater around 1.30 mm incisions (mean pachymetry 1143 microm +/- 140 [SD]) than around 2.20 mm incisions (mean 1012 +/- 101 microm) (P = .001). Bimanual procedures had satisfactory endothelial apposition in the enlarged areas, where stromal edema was less than that surrounding the unenlarged 1.30 mm incisions. The 3 phacoemulsification techniques induced gaping of the endothelial edge, minor inadequate endothelial apposition, and mild stromal edema in the area of the clear corneal incisions. Bimanual microincision sleeveless phacoemulsification may alter the wound slightly more than coaxial 2.75 mm and microcoaxial 2.20 mm sleeved-tip phacoemulsification.

  16. Longitudinal Variation in Paleo-channel Complex Geometry and Associated Fill: Offshore South Carolina

    Science.gov (United States)

    Long, A. M.; Hill, J. C.

    2017-12-01

    In northeastern South Carolina, several shallow (migration of the ancestral Pee Dee River system along the southern limb of the Cape Fear Arch since the Pliocene. These paleo-channel complexes can be traced 80 km across the continental shelf via Boomer and Chirp subbottom data. The Murrells Inlet paleo-channel complex is the most well imaged offshore; and this data coverage provides an opportunity for a detailed seismic stratigraphic interpretation and analysis of downstream variability. Initial observations from this case study indicate that inner shelf incisions, where bedrock is folded and faulted, tend to be shallow with numerous channels, while the incisions across the middle shelf appear to be deeper and contains larger, more sinuous channels that are cut into broadly tilted strata with a gentle south-southeastward dip. This suggests the geometry and spatial distribution of the incisions were a function of the inherited fabric of the underlying basement, which created local deflection and areas of aggradation and degradation. The inner shelf paleo-channel complex fill is dominated by fluvial cut and fill seismic facies, while the middle shelf contains a wide variety of seismic facies (i.e. transparent, layered, chaotic, etc). This overall longitudinal fill pattern is most likely due to each location's general proximity to base level. The variation in the cut and fill seismic facies may be driven by substantial changes in discharge, driven locally by the joining of another major river or by climatic changes in the drainage basin. There also appears to be preferential reoccupation of previously filled paleo-channels, as the basement in this region is Tertiary and Cretaceous carbonates and siliciclastic rocks that are more resistant to erosion. The most recent occupation in any given paleo-channel tends to be on the southern margin, which may imply tectonic forcing from the uplift of the Cape Fear Arch. Preliminary results from this case study suggest that first

  17. Type of incision does not predict abdominal wall outcome after emergency surgery for colonic anastomotic leakage

    DEFF Research Database (Denmark)

    Jensen, Kristian Kiim; Oma, Erling; Harling, Henrik

    2017-01-01

    for anastomotic leakage were included with a median follow-up of 5.4 years. Incisional hernia occurred in 41 of 227 (15.3%) patients undergoing midline incision compared with 14 of 81 (14.7%) following transverse incision, P = 1.00. After adjusting for confounders, there was no association between the type...... not predict abdominal wall outcome after emergency surgery for colonic anastomotic leakage....

  18. Radiological findings after endoscopic incision of ureterocele

    International Nuclear Information System (INIS)

    Cheon, Jung Eun; Kim, In One; Seok, Eul Hye; Cha, Joo Hee; Choi, Gook Myung; Kim, Woo Sun; Yeon, Kyung Mo; Kim, Kwang Myung; Choi, Hwang; Cheon, Jung Eun; Seok, Eul Hye; Cha, Joo Hee; Choi, Guk Myung

    2001-01-01

    Endoscopic incision of ureterocele is considered a simple and safe method for decompression of urinary tract obstruction above ureterocele. The purpose of this study was to evaluate the radiological findings after endoscopic incision of ureterocele. We retrospectively reviewed the radiological findings (ultrasonography (US), intravenous urography, and voiding cystourethrography(VCU)) in 16 patients with ureterocele who underwent endoscopic incision (mean age at surgery, 15 months; M:F 3:13; 18 ureteroceles). According to the postoperative results, treatment was classified as successful when medical treatment was still required, and second operation when additional surgical treatment was required. Postoperative US (n=10) showed that in all patients, urinary tract obstruction was relieved: the kidney parenchima was thicker and the ureterocele was smaller. Intravenous urography (n=8), demonstrated that in all patients, urinary tract obstruction and the excretory function of the kidney had improved. Postoperative VCU indicated that in 92% of patients (12 of 13), endoscopic incision of the ureterocele led to vesicoureteral reflux(VUR). Of these twelve, seven (58%) showed VUR of more than grade 3, while newly developed VUR was seen in five of eight patients (63%) who had preoperative VCU. Surgery was successful in four patients (25%), partially successful in three (19%), and a second operation-on account of recurrent urinary tract infection and VUR of more than grase 3 during the follow-up period-was required by nine (56%). Although endoscopic incision of a ureterocele is a useful way of relieving urinary tract obstruction, an ensuing complication may be VUR. Postoperative US and intravenous urography should be used to evaluate parenchymal change in the kidney and improvement of uronary tract obstructon, while to assess the extend of VUR during the follow-up period , postoperative VCU is required

  19. Nuclear management in manual small incision cataract surgery by snare technique

    Directory of Open Access Journals (Sweden)

    Bhattacharya Debasish

    2009-01-01

    Full Text Available Manual small incision cataract surgery has evolved into a popular method of cataract surgery in India. However, in supra hard cataract, bringing out the whole nucleus through the sclerocorneal flap valve incision becomes difficult. A bigger incision required in such cataracts loses its value action, as the internal incision and corneal valve slips beyond the limbus into sclera. Struggling with the supra hard cataracts through a regular small incision. Phacofracture in the anterior chamber becomes a useful option in these cases. In the snare technique, a stainless steel wire loop when lassoed around the nucleus in the anterior chamber constricts from the equator, easily dividing the hardest of the nuclei into two halves. The wire loop constricts in a controlled way when the second cannula of snare is pulled. The divided halves can easily be brought out by serrated crocodile forceps. This nuclear management can be safely performed through a smaller sclerocorneal flap valve incision where the corneal valve action is retained within the limbus without sutures, and the endothelium or the incision is not disturbed. However, the technique requires space in the anterior chamber to maneuver the wire loop and anterior chamber depth more than 2.5 mm is recommended. Much evidence to this wonderful technique is not available in literature, as its popularity grew through live surgical workshops and small interactive conferences.

  20. Temporal versus Superior Limbal Incision: Any difference in visual ...

    African Journals Online (AJOL)

    Aim: To compare the visual outcome of a superiorly placed limbal incision with a temporal limbal incision in extracapsular cataract surgery. The main outcome measures are visual acuity and the degree of stigmatism based on refraction. Method: A retrospective non randomized comparative study. Medical records of 40 ...

  1. Single scrotal incision orchidopexy for palpable undescended

    International Nuclear Information System (INIS)

    Ahmad, A.; Safdar, C.A.; Yasir, U.; Rasool, N.; Kanwal, S.; Boota, M.; Rehman, J.U.

    2014-01-01

    To retrospectively asses the results of single scrotal incision orchidopexy (SSIO) performed at our centre with ligation of the patent processus vaginalis in children having palpable undescended testes (UDT). Study Design: Quasi-experimental with retrospective data. Place and Duration of Study: Department of Paediatric surgery Military Hospital Rawalpindi, from April 2007 to December 2011. Patients and Methods: After making a single transverse incision at superior scrotal border, the testis was identified; gubernaculums and the sac were dissected to the highest level and divided. The testis was placed into the scrotum and fixed to the scrotal fascia/skin. All patients were assessed at 2 weeks, 2 months and 6 months post operatively, and then yearly. Results: A total of 38 orchidopexies were performed in 33 patients. The patients age ranged from 14 months to 7 years (mean:2.1 years). Bilateral UDT were found in 5 patients (15.1%). Operative time ranged from 20 to 45 minutes (mean: 36 minutes). The single scrotal incision technique was successful in all 38 cases (100%). All testes were easily fixed in the scrotum. Two patients (5.2%) developed scrotal haematoma and one patient (2.6%) developed stitch abscess. All showed good an atomical and cosmetic results up to a minimum of six months of follow-up. Conclusion: Single scrotal incision orchidopexy for palpable undescended testis is a simple and safe technique. It has shown to consume shorter time and give good cosmetic results. (author)

  2. Uranium in tertiary stream channels, Lake Frome area, South Australia

    International Nuclear Information System (INIS)

    Brunt, D.A.

    1978-01-01

    Uranium exploration over a wide area of the Southern Frome Embayment, South Australia, has defined a number of Lower Tertiary fluvial palacochannels incised in older rocks. The buried channels contain similar stratigraphic sequences of interbedded sand, silt, and clay, probably derived from the adjacent uranium-rich Olary Province. Uranium mineralization is pervasive within two major palacochannels, and four small uranium deposits have been found in the basal sands of these channel sequences, at the margins of extensive tongues of limonitic sand. A genetic model is proposed suggesting formation by a uraniferous geochemical cell which migrated down the stream gradient and concentrated uranium on its lateral margins adjacent to the channel bank

  3. Incision of the heart during meat inspection of fattening pigs - A risk-profile approach.

    Science.gov (United States)

    Leps, J; Fries, R

    2009-01-01

    Meat inspection in the EU is based on Regulation (EC) 854/2004. Accordingly a risk based meat inspection should be implemented. In this paper, the incision of the heart in pig meat inspection is discussed with respect to efficacy. The incision especially can reveal the presence of endocarditis. Here, Erysipelothrixrhusiopathiae (E. rhusiopathiae) and/or Streptococcussuis (S. suis) are of particular concern. Both agents are regarded to be zoonotic agents. There is some evidence for infection of humans via an alimentary pathway. Hence, the occurrence of E. rhusiopathiae and S. suis is a concern of public health (PH) as well as veterinary public health (VPH). However, other measures, including on-farm disease prevention and diagnosis, seem to be more important for food safety. It is concluded that the incision and inspection of the heart is not justifiable with respect to PH aspects.

  4. Laparoscopic surgery for esophageal achalasia: Multiport vs single-incision approach.

    Science.gov (United States)

    Fukuda, Shuichi; Nakajima, Kiyokazu; Miyazaki, Yasuhiro; Takahashi, Tsuyoshi; Makino, Tomoki; Kurokawa, Yukinori; Yamasaki, Makoto; Miyata, Hiroshi; Takiguchi, Shuji; Mori, Masaki; Doki, Yuichiro

    2016-02-01

    SILS can potentially improve aesthetic outcomes without adversely affecting treatment outcomes, but these outcomes are uncertain in laparoscopic Heller-Dor surgery. We determined if the degree of patient satisfaction with aesthetic outcomes progressed with the equivalent treatment outcomes after the introduction of a single-incision approach to laparoscopic Heller-Dor surgery. We retrospectively reviewed 20 consecutive esophageal achalasia patients (multiport approach, n = 10; single-incision approach, n = 10) and assessed the treatment outcomes and patient satisfaction with the aesthetic outcomes. In the single-incision approach, thin supportive devices were routinely used to gain exposure to the esophageal hiatus. No statistically significant differences in the operating time (210.2 ± 28.8 vs 223.5 ± 46.3 min; P = 0.4503) or blood loss (14.0 ± 31.7 vs 16.0 ± 17.8 mL; P = 0.8637) were detected between the multiport and single-incision approaches. We experienced no intraoperative complications. Mild dysphagia, which resolved spontaneously, was noted postoperatively in one patient treated with the multiport approach. The reduction rate of the maximum lower esophageal sphincter pressure was 25.1 ± 34.4% for the multiport approach and 21.8 ± 19.2% for the single-incision approach (P = 0.8266). Patient satisfaction with aesthetic outcomes was greater for the single-incision approach than for the multiport approach. When single-incision laparoscopic Heller-Dor surgery was performed adequately and combined with the use of thin supportive devices, patient satisfaction with the aesthetic outcomes was higher and treatment outcomes were equivalent to those of the multiport approach. © 2015 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and John Wiley & Sons Australia, Ltd.

  5. Comparison of incision and drainage against needle aspiration for the treatment of breast abscess.

    Science.gov (United States)

    Naeem, Muhammad; Rahimnajjad, Muhammad Kazim; Rahimnajjad, Nasir Ali; Ahmed, Qazi Jalaluddin; Fazel, Pyar Ali; Owais, Muhammad

    2012-11-01

    We aim to compare the incision and drainage against ultrasound-guided aspiration for the treatment of breast abscesses. Sixty-four patients were randomly allocated to Group A (incision and drainage) and Group B (needle aspiration). Incision and drainage was done under general, whereas aspiration was done under local anesthesia with antibiotic coverage after the pus sample was taken for cultures. Time taken to resolve symptoms including point tenderness, erythema and hyperthermia, recurrence of breast abscess, and healing time was recorded. Patients were followed until 8 weeks. Culture and sensitivity of the pus were done. Data were analyzed in SPSS 16.0. The mean difference of healing time was significant (P = 0.001). A total of 93.3 per cent were healed in Group B and 76.6 per cent in Group A (P = 0.033). Twenty-two samples (34.37%) had no bacterial yield and the remaining 42 samples (65.6%) yielded 11 anaerobic cultures (17.18%) and 31 aerobic cultures (48.4%). Ultrasound-guided aspiration of breast abscesses with the judicious use of antibiotics is a better treatment modality than incision and drainage.

  6. Small incision guarded hydroaspiration of iris lesions.

    Science.gov (United States)

    Singh, Arun D

    2017-11-01

    To describe the technique and results of a minimally invasive surgical technique for resection of small iris lesions. Consecutive case series of 22 patients with localised, small iris lesions that were resected using the described surgical technique that composed of multiple, small corneal incisions created to allow for internal iris resection with 23-gauge horizontal vitrectomy scissors, followed by guarded tumour aspiration through a clear plastic tubing (diameter 3.5 mm) primed with viscoelastic agent. The mean largest basal diameter was 3.0 mm (range 1.5-5.0 mm; median 3.0 mm) and mean thickness was 1.3 mm (range 0.5-2.5 mm; median 1.0 mm). Use of multiple (2-4) small corneal incisions (range 2.0-3.0 mm; mean 2.8 mm) allowed reduced postoperative morbidity (significant hyphema (0%), hypotony (0%), wound leak (0%), >2 line change in best corrected visual acuity at postoperative 1 week (4.5%) and mean corneal astigmatism of 1.0 D (range 0.14-2.99 D; median 0.8 D) at postoperative 4-12 weeks. The tumour could be resected with clear surgical margins in all neoplastic cases (benign (2), borderline (1) and malignant (16)). Local recurrence or metastases were not observed in any melanoma case over a mean follow-up of 33.0 months (range 1.0-90.0 months; median 33.5 months). Small incision guarded hydroaspiration is a minimally invasive surgical technique for resection of select small iris lesions. Use of multiple small corneal incisions avoids morbidity associated with a single large corneoscleral incision, and use of guarded aspiration may eliminate the risk of wound contamination by the malignant tumour. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  7. Single incision laparoscopic cholecystectomy using the one-incision three-trocar technique with all straight instruments: how I do it?

    Institute of Scientific and Technical Information of China (English)

    Hongyi Cui

    2011-01-01

    Single incision laparoscopic surgery (SILS) is a novel minimally invasive surgical technique that is gaining popularity around the world.One of the most commonly performed procedures is single incision laparoscopic cholecystectomy (SILC).Most reported techniques utilize special purpose-made access port and articulating instruments,rendering the procedure costly and difficult to learn.This article provides a stepwise description of SILC technique using all straight instruments without the need for a special port.It aims to shorten the learning curve for surgeons wishing to adopt a safe and cost-effective SILC technique to their practice.

  8. Laser incising of wood: Impregnation of columns with water-soluble dye

    International Nuclear Information System (INIS)

    Hattori, N.; Ando, K.; Kitayama, S.; Nakamura, Y.

    1994-01-01

    To know whether or not laser incising is a useful pre-treatment technique in impregnating a chemical fluid into lumber, pin holes were made in columns of hinoki (Chamaecyparis obtusa Endl.), sugi (Cryptomeria japonica D. Don), karamatsu (Larix leptolepis Gordon) and douglas-fir (Pseudo-tsuga menziesii Franco) with 1.7 kW CO2 laser, and a water-soluble dye was impregnated into these columns with a local pressure impregnation device. Retentions, and lengths and widths of penetrations from each hole were measured quantitatively. Referring to the results of the preparatory experiment mentioned above, incising patterns for sugi and douglas-fir were designed, and the same water-soluble dye was impregnated into the laser-incised columns as well as into non-incised ones with the vacuum-pressure method to obtain penetrated layers with the target depths completely. As a result, a retention of 200 kg/m3 of dye could be achieved for a column of douglas-fir even if it is a species difficult to impregnate. The penetrated layer also could be formed completely at the depth of the laser incision. Therefore, it is concluded that laser incising can be used for the pre-treatment before impregnation of wood columns. (author)

  9. Diathermy vs. scalpel skin incisions in general surgery: double-blind, randomized, clinical trial.

    Science.gov (United States)

    Shamim, Muhammad

    2009-08-01

    This prospective, double-blind, randomized, controlled trial was designed to compare the outcome of diathermy incisions versus scalpel incisions in general surgery. A total of 369 patients who underwent diathermy incision (group A: 185 patients) or scalpel incision (group B: 184 patients) were analyzed. Variables analyzed were: surgical wound classification, length and depth of incision, incision time, duration of operation, incisional blood loss, postoperative pain, duration of hospital stay, duration of healing, and postoperative complications. The inclusion criteria were all patients who underwent elective or emergency general surgery. The exclusion criteria were only cases with incomplete patients' data and patients who were lost to follow-up. This study was conducted at Fatima Hospital-Baqai Medical University and Shamsi Hospital (Karachi), from January 2006 to December 2007. Incision time was significantly longer for patients in group B (p = 0.001). Incisional blood loss also was more for patients in group B (p = 0.000). Pain perception was found to be markedly reduced during the first 48 h in group A (p = 0.000). Total period of hospital stay (p = 0.129) and time for complete wound healing (p = 0.683) were almost the same for both groups. Postoperative complication rate by wound classification did not differ markedly between the two groups (p = 0.002 vs. p = 0.000). Diathermy incision has significant advantages compared with the scalpel because of reduced incision time, less blood loss, & reduced early postoperative pain.

  10. A study of incisive canal using a cone beam computed tomography

    International Nuclear Information System (INIS)

    Kim, Gyu Tae; Hwang, Eui Hwan; Lee, Sang Rae

    2004-01-01

    To investigate the anatomical structure of the incisive canal radiographically by a cone beam computed tomography. 38 persons (male 26, female 12) were chosen to take images of maxillary anterior region in dental CT mode using a cone beam computed tomography. The tube voltage were 65, 67, and 70 kVp, the tube current was 7 mA, and the exposure time was 13.3 seconds. The FH plane of each person was parallel to the floor. The images were analysed on the CRT display. The mean length of incisive canal was 15.87 mm ± 2.92. The mean diameter at the side of palate and nasal fossa were 3.49 mm ± 0.76 and 3.89 mm ± 1.06, respectively. In the cross-sectional shape of incisive canal, 50% were round, 34.2% were ovoid, and 15.8% were lobulated. 87% of incisive canal at the side of nasal fossa have one canal, 10.4% have two canals, and 2.6% have three canals, but these canals were merged into one canal in the middle portion of palate. The mean angles of the long axis of incisive canal and central incisor to the FH plane were 110.3 ± 6.96 and 117.45 ± 7.41, respectively. The angles of the long axis of incisive canal and central incisor to the FH plane were least correlated (r 0.258). This experiment suggests that a cone beam computed radiography will be helpful in surgery or implantation on the maxillary incisive area.

  11. A study of incisive canal using a cone beam computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Gyu Tae; Hwang, Eui Hwan; Lee, Sang Rae [Kyunghee University College of Medicine, Seoul (Korea, Republic of)

    2004-03-15

    To investigate the anatomical structure of the incisive canal radiographically by a cone beam computed tomography. 38 persons (male 26, female 12) were chosen to take images of maxillary anterior region in dental CT mode using a cone beam computed tomography. The tube voltage were 65, 67, and 70 kVp, the tube current was 7 mA, and the exposure time was 13.3 seconds. The FH plane of each person was parallel to the floor. The images were analysed on the CRT display. The mean length of incisive canal was 15.87 mm {+-} 2.92. The mean diameter at the side of palate and nasal fossa were 3.49 mm {+-} 0.76 and 3.89 mm {+-} 1.06, respectively. In the cross-sectional shape of incisive canal, 50% were round, 34.2% were ovoid, and 15.8% were lobulated. 87% of incisive canal at the side of nasal fossa have one canal, 10.4% have two canals, and 2.6% have three canals, but these canals were merged into one canal in the middle portion of palate. The mean angles of the long axis of incisive canal and central incisor to the FH plane were 110.3 {+-} 6.96 and 117.45 {+-} 7.41, respectively. The angles of the long axis of incisive canal and central incisor to the FH plane were least correlated (r 0.258). This experiment suggests that a cone beam computed radiography will be helpful in surgery or implantation on the maxillary incisive area.

  12. A skin abscess model for teaching incision and drainage procedures.

    Science.gov (United States)

    Fitch, Michael T; Manthey, David E; McGinnis, Henderson D; Nicks, Bret A; Pariyadath, Manoj

    2008-07-03

    Skin and soft tissue infections are increasingly prevalent clinical problems, and it is important for health care practitioners to be well trained in how to treat skin abscesses. A realistic model of abscess incision and drainage will allow trainees to learn and practice this basic physician procedure. We developed a realistic model of skin abscess formation to demonstrate the technique of incision and drainage for educational purposes. The creation of this model is described in detail in this report. This model has been successfully used to develop and disseminate a multimedia video production for teaching this medical procedure. Clinical faculty and resident physicians find this model to be a realistic method for demonstrating abscess incision and drainage. This manuscript provides a detailed description of our model of abscess incision and drainage for medical education. Clinical educators can incorporate this model into skills labs or demonstrations for teaching this basic procedure.

  13. High transverse skin incisions may reduce wound complications in obese women having cesarean sections: a pilot study.

    Science.gov (United States)

    Walton, Robert B; Shnaekel, Kelsey L; Ounpraseuth, Songthip T; Napolitano, Peter G; Magann, Everett F

    2017-11-01

    Women having cesarean section have a high risk of wound complications. Our objective was to determine whether high transverse skin incisions are associated with a reduced risk of cesarean wound complications in women with BMI greater than 40. A retrospective cohort study was undertaken of parturients ages 18-45 with BMI greater than 40 having high transverse skin incisions from January 2010 to April 2015 at a tertiary maternity hospital. Temporally matched controls had low transverse skin incisions along with a BMI greater than 40. The primary outcome, wound complication, was defined as any seroma, hematoma, dehiscence, or infection requiring opening and evacuating/debriding the wound. Secondary outcomes included rates of endometritis, number of hospital days, NICU admission, Apgar scores, birth weight, and gestational age at delivery. Analysis of outcomes was performed using two-sample t-test or Wilcoxon rank-sum test for continuous variables and Fisher's exact test for categorical variables. Thirty-two women had high transverse incisions and were temporally matched with 96 controls (low transverse incisions). The mean BMI was 49 for both groups. There was a trend toward reduced wound complications in those having high transverse skin incisions, but this did not reach statistical significance (15.63% versus 27.08%, p = .2379). Those having high transverse skin incisions had lower five minute median Apgar scores (8.0 versus 9.0, p = .0021), but no difference in umbilical artery pH values. The high transverse group also had increased NICU admissions (28.13% versus 5.21%, p = .0011), and early gestational age at delivery (36.8 versus 38.0, p = .0272). High transverse skin incisions may reduce the risk of wound complications in parturients with obesity. A study with more power should be considered.

  14. Canyon incision chronology based on ignimbrite stratigraphy and cut-and-fill sediment sequences in SW Peru documents intermittent uplift of the western Central Andes

    Science.gov (United States)

    Thouret, Jean-Claude; Gunnell, Yanni; Jicha, Brian R.; Paquette, Jean-Louis; Braucher, Régis

    2017-12-01

    Based on an 40Ar/39Ar- and U/Pb-based chronostratigraphy of ignimbrite sheets and the geomorphological features of watersheds, river profiles and slope deposits in the Ocoña-Cotahuasi-Marán (OCM) and Colca valleys of southwest Peru, we reconstruct the valley incision history of the western Central Andes over the last c. 25 Myr. We further document the Pleistocene and Holocene evolution of deep valleys on the basis of 14 10Be surface-exposure ages obtained on debris-avalanche deposits and river straths. The data suggest that uplift was gradual over the past 25 Myr, but accelerated after c. 9 Ma. Valley incision started around 11-9 Ma and accelerated between 5 and 4 Ma. Incision was followed by several pulses of valley cut-and-fill after 2.3 Ma. Evidence presented suggest that the post-5 Ma sequence of accelerated canyon incision probably resulted from a combination of drainage piracy from the Cordilleran drainage divide towards the Altiplano, accentuated flexural tilting of the Western Cordillera towards the SE, and increased rainfall on the Altiplano after late Miocene uplift of the Eastern Cordillera. The valley deepening and slope steepening driven by tectonic uplift gave rise to large occurrences of rockslope failure. The collapsed rock masses periodically obstructed the canyons, thus causing abrupt changes in local base levels and interfering with the steadiness of fluvial incision. As a result, channel aggradation has prevailed in the lower-gradient, U-shaped Pacific-rim canyons, whereas re-incision through landslide deposits has occurred more rapidly across the steeper V-shaped, upper valleys. Existing canyon knickpoints are currently arrested at the boundary between the plutonic bedrock and widespread outcrops of middle Miocene ignimbritic caprock, where groundwater sapping favouring rock collapse may be the dominant process driving headward erosion.

  15. The evolution of a colluvial hollow to a fluvial channel with periodic steps following two transformational disturbances: A wildfire and a historic flood

    Science.gov (United States)

    Rengers, Francis K.; McGuire, Luke; Ebel, Brian A.; Tucker, G. E.

    2018-01-01

    The transition of a colluvial hollow to a fluvial channel with discrete steps was observed after two landscape-scale disturbances. The first disturbance, a high-severity wildfire, changed the catchment hydrology to favor overland flow, which incised a colluvial hollow, creating a channel in the same location. This incised channel became armored with cobbles and boulders following repeated post-wildfire overland flow events. Three years after the fire, a record rainstorm produced regional flooding and generated sufficient fluvial erosion and sorting to produce a fluvial channel with periodically spaced steps. An analysis of the step spacing shows that after the flood, newly formed steps retained a similar spacing to the topographic roughness spacing in the original colluvial hollow (prior to channelization). This suggests that despite a distinct change in channel form roughness and bedform morphology, the endogenous roughness periodicity was conserved. Variations in sediment erodibility helped to create the emergent steps as the largest particles ( >D84) remained immobile, becoming step features, and downstream soil was easily winnowed away.

  16. The evolution of a colluvial hollow to a fluvial channel with periodic steps following two transformational disturbances: A wildfire and a historic flood

    Science.gov (United States)

    Rengers, F. K.; McGuire, L. A.; Ebel, B. A.; Tucker, G. E.

    2018-05-01

    The transition of a colluvial hollow to a fluvial channel with discrete steps was observed after two landscape-scale disturbances. The first disturbance, a high-severity wildfire, changed the catchment hydrology to favor overland flow, which incised a colluvial hollow, creating a channel in the same location. This incised channel became armored with cobbles and boulders following repeated post-wildfire overland flow events. Three years after the fire, a record rainstorm produced regional flooding and generated sufficient fluvial erosion and sorting to produce a fluvial channel with periodically spaced steps. An analysis of the step spacing shows that after the flood, newly formed steps retained a similar spacing to the topographic roughness spacing in the original colluvial hollow (prior to channelization). This suggests that despite a distinct change in channel form roughness and bedform morphology, the endogenous roughness periodicity was conserved. Variations in sediment erodibility helped to create the emergent steps as the largest particles (>D84) remained immobile, becoming step features, and downstream soil was easily winnowed away.

  17. Modification of the Nuss Procedure: The Single-incision Technique

    Directory of Open Access Journals (Sweden)

    Tetsushi Aizawa, MD

    2014-11-01

    Full Text Available Summary: The Nuss procedure is a prevalent minimally invasive surgery for pectus excavatum. Although the Nuss procedure has the advantage of leaving less obtrusive scars, the standard technique requires at least 3 skin incisions to insert several instruments. We experienced 7 cases of the modified Nuss procedure using a single incision during a 7-year period. To facilitate passing of the bar, a traction guide was created according to our unique method. There was no need for a bar stabilizer, and no severe intraoperative complications occurred. All patients exhibited satisfactory short-term results; however, 1 patient suffered from bar rotation and required repeat surgery for fixation. Two patients underwent bar removal via the same single incision without any difficulties.

  18. Spatial Correlation of PAN UWB-MIMO Channel Including User Dynamics

    DEFF Research Database (Denmark)

    Wang, Yu; Kovacs, Istvan Zsolt; Pedersen, Gert Frølund

    . It is found the channel shows spatial correlated wideband power, and spatial uncorrelated complex channel coefficients at different frequencies and delays with respect to a correlation coefficient threshold of 0.7. The Kronecker model is proved not suitable for the investigated scenarios. The MIMO UWB channel......In this paper we present and analyze spatial correlation properties of indoor 4x2 MIMO UWB channels in personal area network (PAN) scenarios. The presented results are based on measurement of radio links between an access point like device and a hand held or belt mounted device with dynamic user...

  19. Superficial parotidectomy via facelift incision

    NARCIS (Netherlands)

    Lohuis, Peter J. F. M.; Tan, M. Liane; Bonte, Katrien; van den Brekel, Michiel W. M.; Balm, Alfons J. M.; Vermeersch, Hubert B.

    2009-01-01

    The stigma of a visually prominent facial scar following parotid surgery can be distressing to a young patient. The surgical technique of parotidectomy via a facelift incision is described and evaluated. Thirty patients with a benign lesion of the parotid gland underwent a partial superficial

  20. Does pilonidal abscess heal quicker with off-midline incision and drainage?

    Science.gov (United States)

    Webb, P M; Wysocki, A P

    2011-06-01

    No clinical trials have been done to guide the surgeon in the optimal technique of draining a pilonidal abscess. The aim of our study was to investigate whether the location of the incision influences wound healing. Electronic records from the surgical database at our 200-bed district general hospital were reviewed for operative technique (midline vs. lateral) for patients who underwent incision and drainage for acute pilonidal abscess between January 2003 and February 2010. These patients were admitted from the Emergency Department with a pilonidal abscess, underwent operative drainage, and returned for follow-up. The main outcome measure was wound healing time. Two hundred and forty-three pilonidal abscesses were drained, 134 with a lateral and 74 with a midline incision. All patients underwent simple longitudinal incision. No patient underwent de-roofing, marsupialisation, or closure. Forty-eight patients with midline drainage who returned for follow-up were matched for gender, age, and microbiology culture results with patients who underwent lateral drainage. Almost all were drained under general anesthesia with a median postoperative stay of 1 day. The overall length of follow-up was the same in both groups (P = 0.13). Abscesses that did not heal were followed-up for the same period of time irrespective of incision type (P = 0.48). Abscesses that healed after midline incision took approximately 3 weeks longer than those drained via a lateral incision (P = 0.02). Our study has limitations since it was a retrospective study that did not capture patients whose abscess drained spontaneously or were drained in the emergency department. Pilonidal abscess should be drained away from the midline.

  1. Modelling the flooding capacity of a Polish Carpathian river: A comparison of constrained and free channel conditions

    Science.gov (United States)

    Czech, Wiktoria; Radecki-Pawlik, Artur; Wyżga, Bartłomiej; Hajdukiewicz, Hanna

    2016-11-01

    The gravel-bed Biała River, Polish Carpathians, was heavily affected by channelization and channel incision in the twentieth century. Not only were these impacts detrimental to the ecological state of the river, but they also adversely modified the conditions of floodwater retention and flood wave passage. Therefore, a few years ago an erodible corridor was delimited in two sections of the Biała to enable restoration of the river. In these sections, short, channelized reaches located in the vicinity of bridges alternate with longer, unmanaged channel reaches, which either avoided channelization or in which the channel has widened after the channelization scheme ceased to be maintained. Effects of these alternating channel morphologies on the conditions for flood flows were investigated in a study of 10 pairs of neighbouring river cross sections with constrained and freely developed morphology. Discharges of particular recurrence intervals were determined for each cross section using an empirical formula. The morphology of the cross sections together with data about channel slope and roughness of particular parts of the cross sections were used as input data to the hydraulic modelling performed with the one-dimensional steady-flow HEC-RAS software. The results indicated that freely developed cross sections, usually with multithread morphology, are typified by significantly lower water depth but larger width and cross-sectional flow area at particular discharges than single-thread, channelized cross sections. They also exhibit significantly lower average flow velocity, unit stream power, and bed shear stress. The pattern of differences in the hydraulic parameters of flood flows apparent between the two types of river cross sections varies with the discharges of different frequency, and the contrasts in hydraulic parameters between unmanaged and channelized cross sections are most pronounced at low-frequency, high-magnitude floods. However, because of the deep

  2. Minimizing surgical skin incision scars with a latex surgical glove.

    Science.gov (United States)

    Han, So-Eun; Ryoo, Suk-Tae; Lim, So Young; Pyon, Jai-Kyung; Bang, Sa-Ik; Oh, Kap-Sung; Mun, Goo-Hyun

    2013-04-01

    The current trend in minimally invasive surgery is to make a small surgical incision. However, the excessive tensile stress applied by the retractors to the skin surrounding the incision often results in a long wound healing time and extensive scarring. To minimize these types of wound problems, the authors evaluated a simple and cost-effective method to minimize surgical incision scars based on the use of a latex surgical glove. The tunnel-shaped part of a powder-free latex surgical glove was applied to the incision and the dissection plane. It was fixed to the full layer of the dissection plane with sutures. The glove on the skin surface then was sealed with Ioban (3 M Health Care, St. Paul, MN, USA) to prevent movement. The operation proceeded as usual, with the retractor running through the tunnel of the latex glove. It was possible to complete the operation without any disturbance of the visual field by the surgical glove, and the glove was neither torn nor separated by the retractors. The retractors caused traction and friction during the operation, but the extent of damage to the postoperative skin incision margin was remarkably less than when the operation was performed without a glove. This simple and cost-effective method is based on the use of a latex surgical glove to protect the surgical skin incision site and improve the appearance of the postoperative scar. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

  3. Modified tubularized incised plate urethroplasty

    Directory of Open Access Journals (Sweden)

    Shivaji Mane

    2013-01-01

    Full Text Available Aim: To share our experience of doing tubularized incised plate urethroplasty with modifications. Materials and Methods: This is a single surgeon personal series from 2004 to 2009. One hundred patients of distal hypospadias were subjected for Snodgrass urethroplasty with preputioplasty. The age range was 1 to 5 year with mean age of 2.7 years. Selection criteria were good urethral plate, without chordee and torsion needing complete degloving. Main technical modification from original Snodgrass procedure was spongioplasty, preputioplasty, and dorsal slit when inability to retract prepuce during surgery. Results: Average follow-up period is 23 months. Seven (7% patients developed fistula and one patient had complete preputial dehiscence. Phimosis developed in three (3% patients and required circumcision. Dorsal slit was required in seven patients. One patient developed meatal stenosis in postoperative period. All other patients are passing single urinary stream and have cosmesis that is acceptable. Conclusions: Modified tubularized incised plate urethroplasty with preputioplasty effectively gives cosmetically normal looking penis with low complications.

  4. Cochlear implantation with Pulsar Med El: a novel small incision technique.

    Science.gov (United States)

    Cuda, D

    2009-04-01

    Although still widely implanted, Pulsar Med-El is rarely considered for small incision approach. Overall, 30 teen-age and adult patients were operated upon with a novel small incision (4-5 cm). Full insertion of the electrode array was achieved in all cases. No major intra-operative complications occurred. At follow-up, no flap-related complications and no migration of the receiver-stimulator were observed in the "device suture" (14 patients) or "no device suture" groups (16 patients). All patients are full-time users of the device. In conclusion, a small incision for the Pulsar Med-El cochlear implant is feasible, safe and reproducible. Ligature fixation of the device is not critical with this operation. Also with this device, in adult and teen-age patients, it is, therefore, possible to retain several typical advantages of small incision approaches.

  5. European Hernia Society guidelines on the closure of abdominal wall incisions

    DEFF Research Database (Denmark)

    Muysoms, F E; Antoniou, S A; Bury, K

    2015-01-01

    using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach and methodological guidance was taken from Scottish Intercollegiate Guidelines Network (SIGN). The literature search included publications up to April 2014. The guidelines were written using the AGREE II...... of rapidly absorbable sutures. It is suggested using a slowly absorbable monofilament suture in a single layer aponeurotic closure technique without separate closure of the peritoneum. A small bites technique with a suture to wound length (SL/WL) ratio at least 4/1 is the current recommended method......, it is suggested using the smallest trocar size adequate for the procedure and closure of the fascial defect if trocars larger or equal to 10 mm are used. For single incision laparoscopic surgery, we suggest meticulous closure of the fascial incision to avoid an increased risk of incisional hernias....

  6. New alternative Mitrofanoff channel based on spiral intestinal lengthening and tailoring.

    Science.gov (United States)

    Cervellione, Raimondo M; Hajnal, Daniel; Varga, Gabriella; Rakoczy, George; Kubiak, Rainer; Kaszaki, Jozsef; Boros, Mihaly; Harwood, Rachel; Dickson, Alan P; Cserni, Tamas

    2015-06-01

    The occasional lack of appendix and the increasing use of the Malone anterograde continence enema (MACE) procedure have expanded the need for alternative Mitrofanoff channels. The Monti procedure does not always provide adequate length, the anastomosis of the double Monti, and the potential kink of the Casale channel is not ideal for smooth catheterisation. We tested the concept of spiral intestinal lengthening and tailoring (SILT), we developed originally for short bowel syndrome, to create a long and straight alternative Mitrofanoff channel (Figure). After ethical approval five mini-pigs underwent spiral intestinal lengthening and tailoring (SILT) without any previous bowel dilatation procedure. (Mean bowel width was 20.5 ± 0.57 mm). The spiral line was marked on a 6-8-cm-long ileum approximately 15 mm apart with a 60° angle to the longitudinal axis of the bowel. When the incision was completed, the mesentery was incised perpendicularly where the spiral incision line met the mesentery. The maximum length segment hanging on a single 1.5-cm-wide well-vascularised mesentery was detached. The capillary red blood cell velocity (RBCV) and perfusion rate (PR) was measured at the edges of the opened bowel strip by in vivo microscopy using orthogonal polarising spectral imaging (Cytoscan A/R, Cytometrics, Philadelphia, PA, USA). The bowel strips have been reconstructed in spiral fashion over a 12F catheter and were implanted into the bladder. Viability, patency, and microcirculation were assessed 4 weeks later. Conventional microscopy with HE staining was performed. The mean length of the spiral channel (100 ± 26.4 mm) was longer than could have been achieved with the double Monti or Casale procedure (4 times the bowel width). A 17% and 8.3% reduction was measured in the median values of the RBCV and the PR at the edges of the bowel strip at the primary surgery. All implanted channels remained viable, straight, patent, and easily catheterisable after 4 weeks, with full

  7. Temperature-controlled laser-soldering system and its clinical application for bonding skin incisions

    Science.gov (United States)

    Simhon, David; Gabay, Ilan; Shpolyansky, Gregory; Vasilyev, Tamar; Nur, Israel; Meidler, Roberto; Hatoum, Ossama Abu; Katzir, Abraham; Hashmonai, Moshe; Kopelman, Doron

    2015-12-01

    Laser tissue soldering is a method of repairing incisions. It involves the application of a biological solder to the approximated edges of the incision and heating it with a laser beam. A pilot clinical study was carried out on 10 patients who underwent laparoscopic cholecystectomy. Of the four abdominal incisions in each patient, two were sutured and two were laser soldered. Cicatrization, esthetical appearance, degree of pain, and pruritus in the incisions were examined on postoperative days 1, 7, and 30. The soldered wounds were watertight and healed well, with no discharge from these wounds or infection. The total closure time was equal in both methods, but the net soldering time was much shorter than suturing. There was no difference between the two types of wound closure with respect to the pain and pruritus on a follow-up of one month. Esthetically, the soldered incisions were estimated as good as the sutured ones. The present study confirmed that temperature-controlled laser soldering of human skin incisions is clinically feasible, and the results obtained were at least equivalent to those of standard suturing.

  8. The DNA Repair Repertoire of Mycobacterium smegmatis FenA Includes the Incision of DNA 5' Flaps and the Removal of 5' Adenylylated Products of Aborted Nick Ligation.

    Science.gov (United States)

    Uson, Maria Loressa; Ghosh, Shreya; Shuman, Stewart

    2017-09-01

    We characterize Mycobacterium smegmatis FenA as a manganese-dependent 5'-flap endonuclease homologous to the 5'-exonuclease of DNA polymerase I. FenA incises a nicked 5' flap between the first and second nucleotides of the duplex segment to yield a 1-nucleotide gapped DNA, which is then further resected in dinucleotide steps. Initial FenA cleavage at a Y-flap or nick occurs between the first and second nucleotides of the duplex. However, when the template 3' single strand is eliminated to create a 5'-tailed duplex, FenA incision shifts to between the second and third nucleotides. A double-flap substrate with a mobile junction (mimicking limited strand displacement synthesis during gap repair) is preferentially incised as the 1-nucleotide 3'-flap isomer, with the scissile phosphodiester shifted by one nucleotide versus a static double flap. FenA efficiently removes the 5' App(dN) terminus of an aborted nick ligation reaction intermediate, thereby highlighting FenA as an agent of repair of such lesions, which are formed under a variety of circumstances by bacterial NAD + -dependent DNA ligases and especially by mycobacterial DNA ligases D and C. IMPORTANCE Structure-specific DNA endonucleases are implicated in bacterial DNA replication, repair, and recombination, yet there is scant knowledge of the roster and catalytic repertoire of such nucleases in Mycobacteria This study identifies M. smegmatis FenA as a stand-alone endonuclease homologous to the 5'-exonuclease domain of mycobacterial DNA polymerase 1. FenA incises 5' flaps, 5' nicks, and 5' App(dN) intermediates of aborted nick ligation. The isolated N-terminal domain of M. smegmatis Pol1 is also shown to be a flap endonuclease. Copyright © 2017 American Society for Microbiology.

  9. No-Drain Single Incision Liposuction Pull-Through Technique for Gynecomastia.

    Science.gov (United States)

    Khalil, Ashraf A; Ibrahim, Amr; Afifi, Ahmed M

    2017-04-01

    Several different methods have been proposed for treatment of gynecomastia, depending on the amount of breast enlargement and skin redundancy. The liposuction pull-through technique has been proposed as an efficacious treatment for many gynecomastia cases. This work aims to study the outcome of this technique when applied as an outpatient procedure, without the use of drains and through a single incision. Fifty-two patients with bilateral gynecomastia without significant skin excess were included in this study. The liposuction pull-through technique was performed through a single incision just above the inframammary fold and without the use of drains. Patients were followed up for 6 months. The proposed technique was able to treat the gynecomastia in all patients, with a revision rate of 1.9% to remove residual glandular tissues. There were no seromas, hematomas, nipple distortion, permanent affection of nipple sensation or wound healing problems. The liposuction pull-through technique is an effective treatment for gynecomastia without significant skin redundancy. It combines the benefits of the direct excision of glandular tissues, with the minimally invasive nature of liposuction. Performing the procedure through a single incision without the use of drains and without general anesthesia is a safe alternative. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266 .

  10. Mouse preferential incising force orientation changes during jaw closing muscle hyperalgesia and is sex dependent.

    Science.gov (United States)

    Widmer, C G; Morris-Wiman, J

    2016-12-01

    Mouse incising is controlled by a central pattern generator and this activity can change in the presence of pain. The incising frequency and maximum force generation decreases with pain. In this study, we used repetitive acidic injections in the left masseter muscle of male and female mice to determine differences between baseline and jaw muscle pain conditions and the effect of sex on preferential incising direction. A within subject design was used to evaluate data previously acquired using multi-axis force data (X, Y and Z) from the 4th baseline recording day and day 7 post-injection (day of maximal pain response) for each mouse of each sex. A total of 34 female and male (age 3-9months) CD-1 mice were evaluated. After mathematically rotating the X and Y axes to align the Y axis to be parallel to the wire struts of the cage top, data were analyzed to determine incising direction preference during baseline (non-pain) and pain (day 7) conditions and between sex. Radar plots of X-Y, X-Z and Y-Z axes depicted the average direction of incising preference between baseline and pain conditions for each sex. Statistical differences among groups were tested using a mixed model ANOVA. Similar to previous findings, female mice had a more robust difference in incising direction preference when comparing male and female pain conditions and this was most evident in the X-Z axes. The incising frequencies most commonly affected were 5.3, 6.2 and 7.6Hz. Male mice varied little in their incising direction preference between the baseline and pain conditions. In addition, statistical comparison of ratios of the percent of time spent incising in the Z versus X axes for each incising frequency found that the incising preference was not different when comparing 5.3 and 7.6Hz frequencies. Finally, female mice used a novel approach to minimize pain while incising by rotating their head and body nearly 180 degrees while males did not use this strategy as frequently. The preferred incising

  11. Channel Responses and Hydromodification in Southern California

    Science.gov (United States)

    Hawley, R. J.; Dust, D. W.; Bledsoe, B. P.

    2007-12-01

    Hydromodification (changes in watershed hydrologic characteristics, and the resulting hydraulics and channel forms due to urbanization) is ubiquitous in Southern California. In this region, the effects of hydromodification are driven and compounded by the arid/semiarid climate, high relief, erodible soils, high urbanization rates, and relatively low frequency of retention/detention. We conducted a preliminary survey of over 50 stream reaches along a gradient from least disturbed to fully urbanized. All stages of the Channel Evolution Model (CEM) of Schumm et al. (1984) were observed, from stable to degrading, widening, aggrading, and quasi-equilibrium channels. Several sites have CEM stages II through V in close proximity due to headcutting, hardpoints, and infrastructure. We also observed channels in undeveloped watersheds impacted by downstream urbanization via headcutting. A range of intervention measures was observed, with the frequent evolutionary endpoint as a concrete engineered flood control channel. We also observed multiple channel evolution sequences that deviate from the CEM for single-thread, incising channels. An alternative channel response, particularly on smaller urbanized streams is a stabilized, vegetation encroached low-flow channel with regular baseflow supplied by residential irrigation runoff. The limited cases of unimpacted streams that remain tend to be high gradient, high energy systems that are naturally proximate to the transition between braided and meandering form for a given sediment size.

  12. Vector analysis of high (≥3 diopters) astigmatism correction using small-incision lenticule extraction and laser in situ keratomileusis.

    Science.gov (United States)

    Chan, Tommy C Y; Wang, Yan; Ng, Alex L K; Zhang, Jiamei; Yu, Marco C Y; Jhanji, Vishal; Cheng, George P M

    2018-06-13

    To compare the astigmatic correction in high myopic astigmatism between small-incision lenticule extraction and laser in situ keratomileusis (LASIK) using vector analysis. Hong Kong Laser Eye Center, Hong Kong. Retrospective case series. Patients who had correction of myopic astigmatism of 3.0 diopters (D) or more and had either small-incision lenticule extraction or femtosecond laser-assisted LASIK were included. Only the left eye was included for analysis. Visual and refractive results were presented and compared between groups. The study comprised 105 patients (40 eyes in the small-incision lenticule extraction group and 65 eyes in the femtosecond laser-assisted LASIK group.) The mean preoperative manifest cylinder was -3.42 D ± 0.55 (SD) in the small-incision lenticule extraction group and -3.47 ± 0.49 D in the LASIK group (P = .655). At 3 months, there was no significant between-group difference in uncorrected distance visual acuity (P = .915) and manifest spherical equivalent (P = .145). Ninety percent and 95.4% of eyes were within ± 0.5 D of the attempted cylindrical correction for the small-incision lenticule extraction and LASIK group, respectively (P = .423). Vector analysis showed comparable target-induced astigmatism (P = .709), surgically induced astigmatism vector (P = .449), difference vector (P = .335), and magnitude of error (P = .413) between groups. The absolute angle of error was 1.88 ± 2.25 degrees in the small-incision lenticule extraction group and 1.37 ± 1.58 degrees in the LASIK group (P = .217). Small-incision lenticule extraction offered astigmatic correction comparable to LASIK in eyes with high myopic astigmatism. Copyright © 2018 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  13. Relaxation incisions of venomous snake "Japanese mamushi" bites to the hand

    Directory of Open Access Journals (Sweden)

    Sugamata A

    2011-12-01

    Full Text Available Akira Sugamata, Naoki Yoshizawa, Takahiro OkadaDepartment of Plastic and Reconstructive Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, JapanAbstract: Gloydius blomhoffii, commonly known as Japanese mamushi, is a venomous viper species found widely in Japan. The most frequently bitten regions are the fingers and toes, and severe swelling causes compression of peripheral arteries and/or compartment syndrome of the extremities. We experienced four cases of mamushi bites to the hand, and undertook relaxation incision in the hands of three of these patients. As a result, the patients who underwent relaxation incision did not show any skin necrosis or permanent sensory disturbance in the affected fingers. Relaxation incision can be useful to not only decompress subcutaneous and compartment pressure of the hand, but also to wash out the venom from the bitten region by improving venous and lymphatic drainage.Keywords: mamushi, snakebite, viper, relaxation incision

  14. The Pleistocene rivers of the English Channel region

    Science.gov (United States)

    Antoine, Pierre; Coutard, Jean-Pierre; Gibbard, Philip; Hallegouet, Bernard; Lautridou, Jean-Pierre; Ozouf, Jean-Claude

    2003-02-01

    The Pleistocene history of river systems that enter the English Channel from northern France and southern England is reviewed. During periods of low sea-level (cold stages) these streams were tributaries of the Channel River. In southern England the largest, the River Solent, is an axial stream that has drained the Hampshire Basin from the Early Pleistocene or late Pliocene. Other streams of southern England may be of similar antiquity but their records are generally short and their sedimentary history have been destroyed, as in northern Brittany, by coastal erosion and valley deepening as a consequence of tectonic uplift. In northern France, the Seine and Somme rivers have very well developed terrace systems recording incision that began at around 1 Ma. The uplift rate, deduced from the study of these terrace systems, is of 55 to 60 m myr-1 since the end of the Early Pleistocene. Generally the facies and sedimentary structures indicate that the bulk of the deposits in these rivers accumulated in braided river environments under periglacial climates in all the area around the Channel. Evolution of the rivers reflects their responses to climatic change, local geological structure and long-term tectonic activity. In this context the Middle Somme valley is characterised by a regular pattern in which incision occurs at the beginning of each glacial period within a general background of uplift. Nevertheless the response of the different rivers to climatic variations, uplift and sea-level changes is complex and variable according to the different parts of the river courses.

  15. Towards achieving small-incision cataract surgery 99.8% of the time.

    Directory of Open Access Journals (Sweden)

    Thomas R

    2000-01-01

    Full Text Available A surgical approach designed to reliably attain the modern goal of small incision cataract surgery 99.8% of the time is described. Phacoemulsification as well as a manual small incision technique is utilised to achieve the desired outcome as often as possible and for all types of cataracts. The logic, and required surgical steps are described and illustrated. This surgical technique allows the advantages of small incision surgery to be reliably achieved. The method is flexible and allows decisions and steps to be modified depending on the skill and comfort zone of the individual surgeon.

  16. Circumareolar incision-subdermal tunneling dissection for excision of multiple breast fibroadenomata

    Directory of Open Access Journals (Sweden)

    S O Agodirin

    2017-01-01

    Full Text Available Excision of multiple fibroadenomas (MF in separate breast quadrants presents difficulties of number and location of incision(s and extent of tissue dissection and may be associated with more complications and poorer cosmetic outcome. This is a report of excision of MF in multiple quadrants of the breast using a modification of subcutaneous dissection technique dubbed the circumareolar incision and subdermal tunneling (CAST dissection. After exposure of the superficial fascia with circumareolar incision, subdermal cone-wise dissection was made to allow mobilization of the segment bearing the lump(s. The lump(s were enucleated and removed. MF were removed from four breasts in three young unmarried females. The first patient had multiple adenomas removed from three quadrants of both breasts: 14 on the right and six on the left. The second patient had excision of three lumps in three separate quadrants, and the third patient had excision of two lumps in two separate quadrants. All patients had edema and bruising. One breast had wound infection and dehiscence. There were no skin necrosis, no nipple loss, and no breast distortion. All ensuing scars were camouflaged. CAST dissection was used for excision of MF in multiple quadrants of the breast with preservation of excellent cosmetic outcome of a single circumareolar incision.

  17. Nd:YAG laser incision of the vesical neck in obstructive BPH

    Science.gov (United States)

    Gilbert, Peter T. O.

    2003-06-01

    From February, 1995 through June, 2002, 68 patients underwent laser incision of the prostate at our clinic. By means of a 23 F cytoscope and a 600 micrometer lateral firing quartz fiber the vesical neck was incised at the 5 and 7 o'clock position at 60 W power. Total energy averaged 13648 J. Operative time did not exceed 15 minutes. General anesthesia was employed in all but one patient. 38 patients remained catheter-free whereas 30 patients were catheterized for two hours. Except for three cases, all patients were discharged on the same day, usually after the first micturition. Anti-inflammatory treatment was administered for two weeks, Cotrimoxazole for 5 days. No serious complications were encountered. Minor side effects included urinary retention (1 pat.), urinary infection (3 pat.) and retrograde ejaculation (1 pat.). Considering a mean follow-up of 21 months, the average Qmax improved enormously (25.4 ml/s versus 10.9 ml/s), as did residual urine volume (35 ml versus 95 ml) and IPSS (7.1 versus 20.5). Three patients required TUR-P 2-3 years after laser surgery and one patient underwent radical retropubic prostatectomy for prostate cancer 2 years later. In conclusion, Nd:YAG laser incision of the prostate is a simple, safe, reliable and cost-effective outpatient procedure.

  18. Longitudinal profile of channels cut by springs

    OpenAIRE

    Devauchelle , O.; PETROFF , A. P.; LOBKOVSKY , A. E.; Rothman , D. H.

    2011-01-01

    International audience; We propose a simple theory for the longitudinal profile of channels incised by groundwater flow. The aquifer surrounding the stream is represented in two dimensions through Darcy's law and the Dupuit approximation. The model is based on the assumption that, everywhere in the stream, the shear stress exerted on the sediment by the flow is close to the minimal intensity required to displace a sand grain. Because of the coupling of the stream discharge with the water tabl...

  19. Morphology of the last subaerial unconformity on a shelf: insights into transgressive ravinement and incised valley occurrence in the Gulf of Cádiz

    Science.gov (United States)

    Lobo, F. J.; García, M.; Luján, M.; Mendes, I.; Reguera, M. I.; Van Rooij, D.

    2018-02-01

    The main aim of this study is to explore the spatial patterns of the shelf-scale erosional unconformity related to the last glacial maximum (LGM), particularly in terms of the role of underlying geology and the presumed primary influence of sea-level changes. This involved a detailed mapping of the most recent and widespread erosional shelf surface in a sector of the northern margin of the Gulf of Cádiz (northeast Atlantic Ocean) located adjacent to a major fluvial source. A dense network of high-resolution seismic profiles collected in the 1990s and 2013 off the Guadiana River revealed two distinct geomorphological domains on the LGM shelf-scale subaerial surface. The outer domain exhibits a widespread occurrence of erosional truncations, with a rugged, erosional pattern over the most distal shelf setting that evolves landward into a planar unconformity. The inner domain is more extensive and is characterized by the common occurrence of highly reflective, localized mounded seismic facies that laterally evolve into an irregular surface and in places may develop a channelized morphology. Significant fluvial incision is limited to a major straight valley and a secondary distributary channel. A distinct partition of the lowstand surface is documented, and attributed to a well-marked lithological change. A coarse-grained inner shelf comprises underlying lithified coastal deposits, whereas a fine-grained outer shelf is regarded as the uppermost expression of regressive prodeltaic wedges. The influence of regional indurated surfaces is also expressed in (1) the pattern of erosion, this being more patchy on the inner shelf due to lateral changes of erodibility, whereas on the outer shelf it shows laterally continuous bands, owing to different modes of transgressive ravinement; (2) the spatial and temporal variability of fluvial incision. Inner shelf armoring by indurated deposits prevents reoccupation of previously incised valleys.

  20. Infra Patellar Branch of Saphenous Nerve Injury during Hamstring Graft Harvest: Vertical versus Oblique Incisions.

    Science.gov (United States)

    Joshi, A; Kayasth, N; Shrestha, S; Kc, B R

    2016-09-01

    Autologous hamstring grafts are commonly used for anterior cruciate ligament reconstruction. The injury of infrapatellar branch of saphenous nerve is one of the concerns leading to various pattern of sensory loss in the operated leg. An oblique incision to harvest the graft has been reported to be better than the vertical one.The aim of this study was to compare the incidence, recovery of nerve injury and final outcome in patients with hamstring harvest of vertical or oblique incision. A total of 146 patients who underwent hamstring graft harvest for anterior cruciate ligament reconstruction, were included in the study. They were randomized into two (Vertical and Oblique) groups as per the incisions used. The sensory loss along the Infra Patellar Branch of Saphenous Nerve was documented on 3rd day. Recovery of the nerve injury was monitoredat three, six and 12 months follow-ups. At final follow up Tegner Lysholm score and scale was recorded to compare between two groups. The incidence of infrapatellar branch of saphenous nerve injury was 25% in vertical group and 16.36% in oblique group. Recovery of nerve injury started earlier in oblique group compared to vertical group. The mean TegnerLyshom score was not significantly different in both the groups. Oblique incision to harvest hamstring graft has lesser incidence of infrapatellar branch of saphenous nerve injury, recovers earlier and does not have any adverse effect on final outcome compared to the vertical incision.

  1. [External periareolar incision for subdermal mastectomy in men with gynecomastia].

    Science.gov (United States)

    Montiel-Jarquín, Alvaro; Reyes-Páramo, Pedro; Ramos-Alvarez, Gloria; López-Colombo, Aurelio; Tinajero-Esquivel, Magdalena; Ruiz-León, Betzabé

    2007-01-01

    Gynecomastia describes a benign increase of the mammary gland in men. When medical treatment fails, symptoms and psychological alterations persist. Subdermal mastectomy is the definitive treatment and can be achieved by different incisions, each with potential complications. We undertook this study to present clinical characteristics of 11 patients with gynecomastia and the results obtained with subdermal mastectomy by means of external periareolar incision. A descriptive cohort study in male patients with gynecomastia was carried out in a third-level medical care hospital. Patients were treated with subdermal mastectomy by means of external periareolar incision. There were 11 male patients with an average age of 19 years (range: 11-60 years), 3 patients (27.2%) with bilateral gynecomastia and 8 patients (72.7%) with unilateral gynecomastia. Average time of evolution was 22 months (range: 16-48 months), 9 patients (81.8%) reported pain, 11 patients (100%) reported psychological alterations with cutaneous alteration, 11 patients (100%) had normal secondary sexual characteristics, 1 patient (9%) had supernumerary nipple development, and 11 patients (100%) had well-defined lesions. According to Simon's classification: seven patients (63.6%) were classified as grade 1, three patients (27.2%) as grade 2 and one patient (9.09%) as grade 3. Each patient had a subdermal mastectomy with external periareolar incision, 11 patients (100%) had a histopathological report of gynecomastia; 1 patient (9.09%) displayed keloid healing and none displayed complications inherent to the surgical procedure. Mastectomy by means of external periareolar incision is useful in the treatment of gynecomastia.

  2. Force modeling for incisions into various tissues with MRF haptic master

    Science.gov (United States)

    Kim, Pyunghwa; Kim, Soomin; Park, Young-Dai; Choi, Seung-Bok

    2016-03-01

    This study proposes a new model to predict the reaction force that occurs in incisions during robot-assisted minimally invasive surgery. The reaction force is fed back to the manipulator by a magneto-rheological fluid (MRF) haptic master, which is featured by a bi-directional clutch actuator. The reaction force feedback provides similar sensations to laparotomy that cannot be provided by a conventional master for surgery. This advantage shortens the training period for robot-assisted minimally invasive surgery and can improve the accuracy of operations. The reaction force modeling of incisions can be utilized in a surgical simulator that provides a virtual reaction force. In this work, in order to model the reaction force during incisions, the energy aspect of the incision process is adopted and analyzed. Each mode of the incision process is classified by the tendency of the energy change, and modeled for realistic real-time application. The reaction force model uses actual reaction force information with three types of actual tissues: hard tissue, medium tissue, and soft tissue. This modeled force is realized by the MRF haptic master through an algorithm based on the position and velocity of a scalpel using two different control methods: an open-loop algorithm and a closed-loop algorithm. The reaction forces obtained from the proposed model are compared with a desired force in time domain.

  3. Force modeling for incisions into various tissues with MRF haptic master

    International Nuclear Information System (INIS)

    Kim, Pyunghwa; Kim, Soomin; Park, Young-Dai; Choi, Seung-Bok

    2016-01-01

    This study proposes a new model to predict the reaction force that occurs in incisions during robot-assisted minimally invasive surgery. The reaction force is fed back to the manipulator by a magneto-rheological fluid (MRF) haptic master, which is featured by a bi-directional clutch actuator. The reaction force feedback provides similar sensations to laparotomy that cannot be provided by a conventional master for surgery. This advantage shortens the training period for robot-assisted minimally invasive surgery and can improve the accuracy of operations. The reaction force modeling of incisions can be utilized in a surgical simulator that provides a virtual reaction force. In this work, in order to model the reaction force during incisions, the energy aspect of the incision process is adopted and analyzed. Each mode of the incision process is classified by the tendency of the energy change, and modeled for realistic real-time application. The reaction force model uses actual reaction force information with three types of actual tissues: hard tissue, medium tissue, and soft tissue. This modeled force is realized by the MRF haptic master through an algorithm based on the position and velocity of a scalpel using two different control methods: an open-loop algorithm and a closed-loop algorithm. The reaction forces obtained from the proposed model are compared with a desired force in time domain. (paper)

  4. Single incision laparoscopic pancreas resection for pancreatic metastasis of renal cell carcinoma.

    Science.gov (United States)

    Barbaros, Umut; Sümer, Aziz; Demirel, Tugrul; Karakullukçu, Nazlı; Batman, Burçin; Içscan, Yalın; Sarıçam, Gülay; Serin, Kürçsat; Loh, Wei-Liang; Dinççağ, Ahmet; Mercan, Selçuk

    2010-01-01

    Transumbilical single incision laparoscopic surgery (SILS) offers excellent cosmetic results and may be associated with decreased postoperative pain, reduced need for analgesia, and thus accelerated recovery. Herein, we report the first transumbilical single incision laparoscopic pancreatectomy case in a patient who had renal cell cancer metastasis on her pancreatic corpus and tail. A 59-year-old female who had metastatic lesions on her pancreas underwent laparoscopic subtotal pancreatectomy through a 2-cm umbilical incision. Single incision pancreatectomy was performed with a special port (SILS port) and articulated equipment. The procedure lasted 330 minutes. Estimated blood loss was 100mL. No perioperative complications occurred. The patient was discharged on the seventh postoperative day with a low-volume (20mL/day) pancreatic fistula that ceased spontaneously. Pathology result of the specimen was renal cell cancer metastases. This is the first reported SILS pancreatectomy case, demonstrating that even advanced surgical procedures can be performed using the SILS technique in well-experienced centers. Transumbilical single incision laparoscopic pancreatectomy is feasible and can be performed safely in experienced centers. SILS may improve cosmetic results and allow accelerated recovery for patients even with malignancy requiring advanced laparoscopic interventions.

  5. Manual small incision extracapsular cataract surgery in Australia.

    Science.gov (United States)

    van Zyl, Lourens; Kahawita, Shyalle; Goggin, Michael

    2014-11-01

    Examination of the results and describing the technique of manual small incision extracapsular cataract extraction on patients with advanced cataracts in urban Australia. A descriptive case series. Thirty-eight patients at three public hospitals, one tertiary and two secondary ophthalmic units in urban Australia. Forty eyes with dense mature cataracts with hand movement vision or worse underwent a planned manual small incision extracapsular cataract extraction instead of traditional phaco-emulsification. Postoperative visual aquity, surgically induced astigmatism and complications. Seventy-eight per cent of patients had an uncorrected visual acuity of 6/12 or better on the first postoperative day. Eighty-three per cent of patients had a distance corrected visual acuity of 6/9 or better 3 months postoperatively. One case was complicated by a posterior capsule rupture. No cases of endophthalmitis were reported. The summated vector mean of the surgically induced astigmatism was 0.089D at 93°. Manual small incision extracapsular cataract extraction is an efficacious cataract surgery technique with good visual outcome and is a safe alternative to phaco-emulsification in suitable cases in a first-world setting. © 2014 Royal Australian and New Zealand College of Ophthalmologists.

  6. Surgically induced astigmatism after 3.0 mm temporal and nasal clear corneal incisions in bilateral cataract surgery

    Directory of Open Access Journals (Sweden)

    Je Hwan Yoon

    2013-01-01

    Full Text Available Aims: To compare the corneal refractive changes induced after 3.0 mm temporal and nasal corneal incisions in bilateral cataract surgery. Materials and Methods: This prospective study comprised a consecutive case series of 60 eyes from 30 patients with bilateral phacoemulsification that were implanted with a 6.0 mm foldable intraocular lens through a 3.0 mm horizontal clear corneal incision (temporal in the right eyes, nasal in the left eyes. The outcome measures were surgically induced astigmatism (SIA and uncorrected visual acuity (UCVA 1 and 3 months, post-operatively. Results: At 1 month, the mean SIA was 0.81 diopter (D for the temporal incisions and 0.92 D for nasal incisions (P = 0.139. At 3 months, the mean SIA were 0.53 D for temporal incisions and 0.62 D for nasal incisions (P = 0.309. The UCVA was similar in the 2 incision groups before surgery, and at 1 and 3 months post-operatively. Conclusion: After bilateral cataract surgery using 3.0 mm temporal and nasal horizontal corneal incisions, the induced corneal astigmatic change was similar in both incision groups. Especially in Asian eyes, both temporal and nasal incisions (3.0 mm or less would be favorable for astigmatism-neutral cataract surgery.

  7. Aorta-atria-septum combined incision for aortic valve re-replacement

    Science.gov (United States)

    Xu, Yiwei; Ye, Xiaofeng; Li, Zhaolong

    2018-01-01

    This case report illustrates a patient who underwent supra-annular mechanical aortic valve replacement then suffered from prosthesis dysfunction, increasing pressure gradient with aortic valve. She was successfully underwent aortic valve re-replacement, sub-annular pannus removing and aortic annulus enlargement procedures through combined cardiac incision passing through aortic root, right atrium (RA), and upper atrial septum. This incision provides optimal visual operative field and simplifies dissection. PMID:29850170

  8. Outcomes of single-stage total arch replacement via clamshell incision

    Directory of Open Access Journals (Sweden)

    Ishizaka Toru

    2011-09-01

    Full Text Available Abstract Background Treatment of complex aortic pathologies involving the transverse arch with extensive involvement of the descending aorta remains a surgical challenge. Since clamshell incision provides superior exposure of the entire thoracic aorta, we evaluated the use of this technique for single-stage total arch replacement by arch vessel reconstruction. Methods The arch-first technique combined with clamshell incision was used in 38 cases of aneurysm and aortic disease in 2008 and 2009. Extensive total arch replacement was used with clamshell incision for reconstruction of arch vessels under deep hypothermic circulatory arrest. Results Overall 30-day mortality was 13%. The mean operating time was approximately 8 hours. Deep hypothermia resulted in mean CPB time exceeding 4.5 hours and mean duration of circulatory arrest was 25 minutes. The overall postoperative temporary and permanent neurologic dysfunction rates were 3% and 3% for elective and 3% and 0% for emergency surgery, respectively. All patients except the five who died in hospital were discharged without nursing care after an average post-operative hospital stay of 35 days. Conclusions The arch-first technique, combined with clamshell incision, provides expeditious replacement of the thoracic aorta with an acceptable duration of hypothermic circulatory arrest and minimizes the risk of retrograde atheroembolism by using antegrade perfusion.

  9. Evaluation of a new disposable silicon limbal relaxing incision knife by experienced users.

    Science.gov (United States)

    Albanese, John; Dugue, Geoffrey; Parvu, Valentin; Bajart, Ann M; Lee, Edwin

    2009-12-21

    Previous research has suggested that the silicon BD Atomic Edge knife has superior performance characteristics when compared to a metal knife and performance similar to diamond knife when making various incisions. This study was designed to determine whether a silicon accurate depth knife has equivalent performance characteristics when compared to a diamond limbal relaxing incision (LRI) knife and superior performance characteristics when compared to a steel accurate depth knife when creating limbal relaxing incision. Sixty-five ophthalmic surgeons with limbal relaxing incision experience created limbal relaxing incisions in ex-vivo porcine eyes with silicon and steel accurate depth knives and diamond LRI knives. The ophthalmic surgeons rated multiple performance characteristics of the knives on Visual Analog Scales. The observed differences between the silicon knife and diamond knife were found to be insignificant. The mean ratio between the performance of the silicon knife and the diamond knife was shown to be greater than 90% (with 95% confidence). The silicon knife's mean performance was significantly higher than the performance of the steel knife for all characteristics. (p-value knife was found to be equivalent in performance to the diamond LRI knife and superior to the steel accurate depth knife when making limbal relaxing incisions in ex vivo porcine eyes. Disposable silicon LRI knives may be an alternative to diamond LRI knives.

  10. Groundwater Discharge along a Channelized Coastal Plain Stream

    Energy Technology Data Exchange (ETDEWEB)

    LaSage, Danita M [Ky Dept for natural resources, Div of Mine Permits; Sexton, Joshua L [JL Sexton and Son; Mukherjee, Abhijit [Univ of Tx, Jackson School of Geosciences, Bur of Econ. Geology; Fryar, Alan E [Univ of KY, Dept of Earth and Geoligical Sciences; Greb, Stephen F [Univ of KY, KY Geological Survey

    2015-10-01

    In the Coastal Plain of the southeastern USA, streams have commonly been artificially channelized for flood control and agricultural drainage. However, groundwater discharge along such streams has received relatively little attention. Using a combination of stream- and spring-flow measurements, spring temperature measurements, temperature profiling along the stream-bed, and geologic mapping, we delineated zones of diffuse and focused discharge along Little Bayou Creek, a channelized, first-order perennial stream in western Kentucky. Seasonal variability in groundwater discharge mimics hydraulic-head fluctuations in a nearby monitoring well and spring-discharge fluctuations elsewhere in the region, and is likely to reflect seasonal variability in recharge. Diffuse discharge occurs where the stream is incised into the semi-confined regional gravel aquifer, which is comprised of the Mounds Gravel. Focused discharge occurs upstream where the channel appears to have intersected preferential pathways within the confining unit. Seasonal fluctuations in discharge from individual springs are repressed where piping results in bank collapse. Thereby, focused discharge can contribute to the morphological evolution of the stream channel.

  11. Comparison of the effects of 23-gauge and 25-gauge microincision vitrectomy blade designs on incision architecture

    Directory of Open Access Journals (Sweden)

    Inoue M

    2014-11-01

    Full Text Available Makoto Inoue,1 Dina Joy K Abulon,2 Akito Hirakata1 1Kyorin Eye Center, School of Medicine, Kyorin University, Tokyo, Japan; 2Alcon Research, Ltd., Irvine, CA, USA Purpose: To compare the effects of different 23- and 25-gauge microincision vitrectomy trocar cannula entry systems on incision architecture.Methods: We tested one ridged microvitreoretinal (MVR, one non-ridged MVR, one pointed beveled, and one round-tipped beveled blade (n=10 per blade design per incision type. Each blade’s straight and oblique incision architecture was assessed in a silicone disc simulating the sclera. Wound leakage under pressure and endoscopic observations were conducted on sclerotomy sites of isolated porcine eyes (n=4 per blade design after simulated vitrectomy.Results: Differences in blade design created distinct incision architecture. Incisions were linear with the ridged MVR blade, flattened “M-shaped” with the non-ridged MVR blade, asymmetrical chevron-shaped with the pointed beveled blade, and curved with the round-tipped beveled blade. With the exception of oblique entry incision thickness, both MVR blade designs created thinner incisions than the beveled blades at entry and exit sites. Only the ridged MVR blade created incisions with no leakage. Vitreous incarceration was observed with all trocar cannula systems.Conclusion: Wound closure in porcine eyes was similar with all blades despite differences in incision architecture. Wound leakage occurred at low to moderate infusion pressures with most blades; no wound leakage was observed with ridged MVR blades. Keywords: entry system, incision closure, leakage, pars plana incision, sclerotomy, trocar blade 

  12. Influence of different phacoemulsification incision on postoperative corneal astigmatism for cataract patients

    Directory of Open Access Journals (Sweden)

    Zhao-Rong Zeng

    2014-05-01

    Full Text Available AIM: To compare the effect of different phacoemulsification incision on postoperative corneal astigmatism for cataract patients. METHODS: The cataract patients were selected in our hospital. The patients were divided into control group(corneal limbus opposite curved scleral tunnel incision groupand observation group(above the top of cornea or temporal transparent corneal incision grouprandomly. At 1wk; 1 and 3mo after surgery, the change of corneal astigmatism and vision of the patients in two groups were compared and analyzed. RESULTS:Compared with control group, 1wk; 1 and 3mo after surgery, the average corneal astigmatism and surgically induced corneal astigmatism of the patients in observation group were decreased significantly. The visual acuity and corrected visual acuity were increased significantly. There was statistically significant(PPCONCLUSION: Center distance and small incision corneal phacoemulsification can reduce postoperative astigmatism and improve postoperative visual acuity for cataract patients. It provides guarantee for further strengthen the clinical treated effect for cataract patients.

  13. [Surgical treatment for incisions fat colliquation or infections at early stage after operation of lumbar disc herniation].

    Science.gov (United States)

    Guan, Ting-Jin; Zheng, Liang-Guo; Sun, Peng; Li, Xing-Xue

    2014-05-01

    To explore the reason, key diagnosic point and therapeutic method of the incisions fat colliquation or infections at early stage after operation of lumbar disc herniation. From July 2007 to May 2012, clinical data of 11 patients with incision fat liquefaction or early infection after lumbar discectomy were retrospectively analyzed. There were 5 males and 6 females with an average age of 43.1 years, and the mean time of incisions fat colliquation or infection was 5 days and a half after operation. The main clinical features included local wound pain aggravating, fervescence, fresh seepage in the wound, and blood inflammatory index increased, etc. The wound could heal at the first treatment stage or not was an evaluation standard of curative effect. All patients were followed up with an average period of 21 months. The wounds of 10 cases healed at the first stage without recurrence and complications. In 1 case infected by staphylococcus aureus, distal part of the wound present local red, swelling and with wave motion at 2 months after operation, staphylococcus aureus infection was confirmed after puncture and bacterial culture, and 1 thrum was found after local incision. The wound healed after change dressings for 1 week, without recurrence after followed up for 13 months. Preventing the risk factors before operation, minimizing invasive technique during operation reasonable antibiotics application for the lumbar operation reguiring placement objects, and correctly handling with wound after operation could prevent and reduce the incidence of incisions fat liquefaction or infection after operation of lumbar disc herniation. For incision fat liquefaction or infection, early diagnosis, debridement, VSD negative pressure irrigation and drainage, to choosing sensitive antibiotics according to the results of drug sensitivity, may contribute to wound early healing and decrease complication.

  14. What can we learn from fluvial incision in high mountains?

    Science.gov (United States)

    Fuchs, Margret; Gloaguen, Richard; Krbetschek, Matthias

    2013-04-01

    High and actively deforming mountain ranges attract the attention of geoscientists as they provide natural laboratories of fast evolving process-response systems. Tectonic compressional settings, often linked to perpendicular extension, control the topographic growth and hence, erosion, transport pathways and sedimentation. High altitude differences within short horizontal distances promote material re-organisation and high rates of surface processes. Furthermore, high mountains constitute orographic barriers that affect atmospheric circulations as well as host different climate regimes similar to those of widely separated latitudinal belts. Both cause a high sensitivity of surface processes to changes in climatic conditions. However, feedbacks between climatic and tectonic forcing are complex. Additionally, the dominance of one or the other varies in space and also over time, inheriting various traces of the paleo-morphodynamic conditions to the subsequent process regimes. To unravel the forces driving the evolution of relief in active mountains, numerous studies employ the drainage network of the corresponding mountains as a proxy of landscape evolution. Especially the rates of river incision provide a powerful tool to characterize the surface response and infer causes behind it. Several parameters of river incision are available to describe the fluvial incision at individual sites (e.g. terrace incision rates), along the river course (e.g. longitudinal river profiles, Hack index) and in its perpendicular dimension (e.g. valley cross sections, valley shape ratios). But they require careful interpretation. They are sensitive to both, climatic and tectonic forcing. Therefore, the synopsis of such indices for fluvial incision is essential to evaluate the role of climatic versus tectonic forcing. Here, we use the Panj river system, the major river draining the Pamir mountains of Central Asia, as an example. The Panj experiences high altitude changes of more than 4000

  15. Kualitas Pengeringan Kayu Mahoni pada Berbagai Variasi Kerapatan Incising dengan Dua Skedul Pengeringan Suhu tinggi

    Directory of Open Access Journals (Sweden)

    Tomy Listyanto

    2016-11-01

    Full Text Available Tujuan dari penelitian ini adalah untuk mengetahui pengaruh interaksi variasi kerapatan incising dan dua skedul pengeringan terhadap kecepatan dan cacat-cacat pengeringan kayu mahoni, serta mengetahui pengaruh variasi kerapatan incising terhadap kekuatan lengkung statik kayu mahoni yang telah dikeringkan. Tiga pohon mahoni (Swietenia mahagony berdiameter 300-350 mm ditebang dan selanjutnya dibelah dan dibuat menjadi balok dengan ukuran 60 mm × 100 mm dengan panjang 500 mm untuk dijadikan sampel pengeringan. Di antara masing-masing bagian tersebut, dibuat sampel ukuran 20 mm × 20 mm × 25 mm, yang digunakan untuk penentu kadar air awal dan distribusinya. Sampel pengeringan selanjutnya dibagi menjadi 5 variasi kerapatan incising, yaitu 0 lubang/m2 (tanpa incising, 1000 lubang/m2, 2000 lubang/m2, 3000 lubang/m2, dan 4000 lubang/m2. Setiap variasi kerapatan incising selanjutnya akan dikeringkan dengan 2 skedul pengeringan, yaitu suhu pengeringan 100°C sampai tercapai kadar air akhir 12% dan suhu 60°C pada 8 jam pertama dan selanjutnya dilanjutkan 100°C, sampai tercapai kadar air akhir 12%. Paramater yang diamati adalah kecepatan pengeringan, cacat retak permukaan, dan distribusi kadar air akhir. Hasil analisis menunjukkan bahwa kerapatan incising 3000-4000 lubang/m2 memberikan pengaruh yang cukup nyata di dalam mempercepat proses pengeringan dan distribusi kadar air akhir. Skedul pengeringan dan variasi kerapatan incising tidak berpengaruh pada retak permukaan. Pra perlakuan incising sampai batas 4000 lubang/m2 ini dapat diterapkan untuk mempercepat proses pengeringan dengan penurunan nilai modulus elastisitas dan modulus patah yang tidak berbeda nyata. Kata kunci: incising, pengeringan suhu tinggi, mahoni, lengkung statik, skedul pengeringan   Drying Quality of Mahoni Wood in Various Incising Densities and Two High Temperature-Drying Schedules Abstract The aims of this research were to investigate the effects of interaction

  16. 3D reconstruction of the source and scale of buried young flood channels on Mars.

    Science.gov (United States)

    Morgan, Gareth A; Campbell, Bruce A; Carter, Lynn M; Plaut, Jeffrey J; Phillips, Roger J

    2013-05-03

    Outflow channels on Mars are interpreted as the product of gigantic floods due to the catastrophic eruption of groundwater that may also have initiated episodes of climate change. Marte Vallis, the largest of the young martian outflow channels (Mars hydrologic activity during a period otherwise considered to be cold and dry. Using data from the Shallow Radar sounder on the Mars Reconnaissance Orbiter, we present a three-dimensional (3D) reconstruction of buried channels on Mars and provide estimates of paleohydrologic parameters. Our work shows that Cerberus Fossae provided the waters that carved Marte Vallis, and it extended an additional 180 kilometers to the east before the emplacement of the younger lava flows. We identified two stages of channel incision and determined that channel depths were more than twice those of previous estimates.

  17. Evaluation of a new disposable silicon limbal relaxing incision knife by experienced users

    Directory of Open Access Journals (Sweden)

    Parvu Valentin

    2009-12-01

    Full Text Available Abstract Background Previous research has suggested that the silicon BD Atomic Edge™ knife has superior performance characteristics when compared to a metal knife and performance similar to diamond knife when making various incisions. This study was designed to determine whether a silicon accurate depth knife has equivalent performance characteristics when compared to a diamond limbal relaxing incision (LRI knife and superior performance characteristics when compared to a steel accurate depth knife when creating limbal relaxing incision. Methods Sixty-five ophthalmic surgeons with limbal relaxing incision experience created limbal relaxing incisions in ex-vivo porcine eyes with silicon and steel accurate depth knives and diamond LRI knives. The ophthalmic surgeons rated multiple performance characteristics of the knives on Visual Analog Scales. Results The observed differences between the silicon knife and diamond knife were found to be insignificant. The mean ratio between the performance of the silicon knife and the diamond knife was shown to be greater than 90% (with 95% confidence. The silicon knife's mean performance was significantly higher than the performance of the steel knife for all characteristics. (p-value Conclusions For experienced users, the silicon accurate depth knife was found to be equivalent in performance to the diamond LRI knife and superior to the steel accurate depth knife when making limbal relaxing incisions in ex vivo porcine eyes. Disposable silicon LRI knives may be an alternative to diamond LRI knives.

  18. Uptake of gallium-67 citrate in clean surgical incisions after colorectal surgery

    International Nuclear Information System (INIS)

    Lin Wanyu; Wang Shyhjen; Tsai Shihchuan; Chao Tehsin

    2001-01-01

    Non-specific accumulation of gallium-67 citrate (gallium) in uncomplicated surgical incisions is not uncommon. It is important to know the normal pattern of gallium uptake at surgical incision sites in order to properly interpret the gallium scan when investigating possible wound infection in patients who have undergone abdominal surgery. We studied 42 patients without wound infection after colorectal surgery and performed gallium scans within 40 days after surgery. Patients were divided into three groups according to the interval between the operation and the scan. In group A (26 patients) gallium scan was performed within 7 days after surgery, in group B (8 patients) between 8 and 14 days after surgery, and in group C (8 patients) between 15 and 40 days after surgery. Our data showed that in group A, 61.5% had gallium accumulation at the surgical incision site. In group B, 50% had accumulation of gallium at the surgical incision site, while in group C only one patient (12.5%) showed gallium uptake. It is concluded that the incidence of increased gallium uptake at clean surgical incision sites is high after colorectal surgery. Nuclear medicine physicians should bear in mind the high incidence of non-specific gallium uptake at such sites during the interpretation of possible wound infection in patients after colorectal surgery. (orig.)

  19. Single-incision laparoscopic surgery through an ostomy site: a natural approach by an unnatural orifice.

    Science.gov (United States)

    Lopez, Nicole E; Peterson, Carrie Y; Ramamoorthy, Sonia L; McLemore, Elisabeth C; Sedrak, Michael F; Lowy, Andrew M; Horgan, Santiago; Talamini, Mark A; Sicklick, Jason K

    2015-02-01

    Single-incision laparoscopic surgery (SILS) is gaining popularity for a wide variety of surgical operations and capitalizes on the benefits of traditional laparoscopic surgery without incurring multiple incision sites. Traditionally, SILS is performed by a midline periumbilical approach. However, such a minimally invasive approach may be utilized in patients who already have an abdominal incision. Our series retrospectively reviews 7 cases in which we utilized the fascial defect at the time of after ostomy reversal as our SILS incision site. In turn, we performed a variety of concurrent intra-abdominal procedures with excellent technical success and outcomes. Our study is the largest single-institution case series of this novel approach and suggests that utilizing an existing ostomy-site abdominal incision is a safe and effective location for SILS port placement and should be considered in patients undergoing concurrent procedures.

  20. Steady incision of Grand Canyon at the million year timeframe: a case for mantle-driven differential uplift

    Science.gov (United States)

    Crow, Ryan S.; Karl Karlstrom,; Laura Crossey,; Richard Young,; Michael Ort,; Yemane Asmerom,; Victor Polyak,; Andrew Darling,

    2014-01-01

    The Grand Canyon region provides an excellent laboratory to examine the interplay between river incision, magmatism, and the geomorphic and tectonic processes that shape landscapes. Here we apply U-series, Ar–Ar, and cosmogenic burial dating of river terraces to examine spatial variations in incision rates along the 445 km length of the Colorado River through Grand Canyon. We also analyze strath terrace sequences that extend to heights of several hundred meters above the river, and integrate these with speleothem constrained maximum incision rates in several reaches to examine any temporal incision variations at the million-year time frame. This new high-resolution geochronology shows temporally steady long-term incision in any given reach of Grand Canyon but significant variations along its length from 160 m/Ma in the east to 101 m/Ma in the west. Spatial and temporal patterns of incision, and the long timescale of steady incision rule out models where geomorphic controls such as climate oscillations, bedrock strength, sediment load effects, or isostatic response to differential denudation are the first order drivers of canyon incision. The incision pattern is best explained by a model of Neogene and ongoing epeirogenic uplift due to an eastward propagating zone of increased upper mantle buoyancy that we infer from propagation of Neogene basaltic volcanism and a strong lateral gradient in modern upper mantle seismic structure.

  1. Results of computer assisted mini-incision subvastus approach for total knee arthroplasty.

    Science.gov (United States)

    Turajane, Thana; Larbpaiboonpong, Viroj; Kongtharvonskul, Jatupon; Maungsiri, Samart

    2009-12-01

    Mini-incision subvastus approach is soft tissue preservation of the knee. Advantages of the mini-incision subvastus approach included reduced blood loss, reduced pain, self rehabilitation and faster recovery. However, the improved visualization, component alignment, and more blood preservation have been debatable to achieve the better outcome and preventing early failure of the Total Knee Arthroplasty (TKA). The computer navigation has been introduced to improve alignment and blood loss. The purpose of this study was to evaluate the short term outcomes of the combination of computer assisted mini-incision subvastus approach for Total Knee Arthroplasty (CMS-TKA). A prospective case series of the initial 80 patients who underwent computer assisted mini-incision subvastus approach for CMS-TKA from January 2007 to October 2008 was carried out. The patients' conditions were classified into 2 groups, the simple OA knee (varus deformity was less than 15 degree, BMI was less than 20%, no associated deformities) and the complex deformity (varus deformity was more than 15 degrees, BMI more was than 20%, associated with flexion contractor). There were 59 patients in group 1 and 21 patients in group 2. Of the 80 knees, 38 were on the left and 42 on the right. The results of CMS-TKA [the mean (range)] in group 1: group 2 were respectively shown as the incision length [10.88 (8-13): 11.92 (10-14], the operation time [118 (111.88-125.12): 131 (119.29-143.71) minutes, lateral releases (0 in both groups), postoperative range of motion in flexion [94.5 (90-100): 95.25 (90-105) degree] and extension [1.75 (0-5): 1.5 (0-5) degree] Blood loss in 24 hours [489.09 (414.7-563.48): 520 (503.46-636.54) ml] and blood transfusion [1 (0-1) unit? in both groups], Tibiofemoral angle preoperative [Varus = 4 (varus 0-10): Varus = 17.14 (varus 15.7-18.5) degree, Tibiofemoral angle postoperative [Valgus = 1.38 (Valgus 0-4): Valgus = 2.85 (valgus 2.1-3.5) degree], Tibiofemoral angle outlier (85% both

  2. Efficiency of soft tissue incision with a novel 445-nm semiconductor laser.

    Science.gov (United States)

    Braun, Andreas; Kettner, Moritz; Berthold, Michael; Wenzler, Johannes-Simon; Heymann, Paul Günther Baptist; Frankenberger, Roland

    2018-01-01

    Using a 445-nm semiconductor laser for tissue incision, an effective cut is expected due to the special absorption properties of blue laser light in soft tissues. The aim of the present study was the histological evaluation of tissue samples after incision with a 445-nm diode laser. Forty soft tissue specimens were obtained from pork oral mucosa and mounted on a motorized linear translation stage. The handpiece of a high-frequency surgery device, a 970-nm semiconductor laser, and a 445-nm semiconductor laser were connected to the slide, allowing a constant linear movement (2 mm/s) and the same distance of the working tip to the soft tissue's surface. Four incisions were made each: (I) 970-nm laser with conditioned fiber tip, contact mode at 3-W cw; (II-III): 445-nm laser with non-conditioned fiber tip, contact mode at 2-W cw, and non-contact mode (1 mm) at 2 W; and (IV): high-frequency surgery device with straight working tip, 90° angulation, contact mode at 50 W. Histological analysis was performed after H&E staining of the embedded specimens at 35-fold magnification. The comparison of the incision depths showed a significant difference depending on the laser wavelength and the selected laser parameters. The highest incision depth was achieved with the 445-nm laser contact mode (median depth 0.61 mm, min 0.26, max 1.17, interquartile range 0.58) (p laser, a higher cutting efficiency can be expected when compared with a 970-nm diode laser and high-frequency surgery. Even the 445-nm laser application in non-contact mode shows clinically acceptable incision depths without signs of extensive soft tissue denaturation.

  3. Single incision laparoscopic liver resection (SILL – a systematic review

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    Benzing, Christian

    2015-12-01

    Full Text Available Background: Today, minimally invasive liver resections for both benign and malignant tumors are routinely performed. Recently, some authors have described single incision laparoscopic liver resection (SILL procedures. Since SILL is a relatively young branch of laparoscopy, we performed a systematic review of the current literature to collect data on feasibility, perioperative results and oncological outcome.Methods: A literature research was performed on Medline for all studies that met the eligibility criteria. Titles and abstracts were screened by two authors independently. A study was included for review if consensus was obtained by discussion between the authors on the basis of predefined inclusion criteria. A thorough quality assessment of all included studies was performed. Data were analyzed and tabulated according to predefined outcome measures. Synthesis of the results was achieved by narrative review. Results: A total of 15 eligible studies were identified among which there was one prospective cohort study and one randomized controlled trial comparing SILL to multi incision laparoscopic liver resection (MILL. The rest were retrospective case series with a maximum of 24 patients. All studies demonstrated convincing results with regards to feasibility, morbidity and mortality. The rate of wound complications and incisional hernia was low. The cosmetic results were good.Conclusions: This is the first systematic review on SILL including prospective trials. The results of the existing studies reporting on SILL are favorable. However, a large body of scientific evidence on the field of SILL is missing, further randomized controlled studies are urgently needed.

  4. Incision and stress regulation in borderline personality disorder: neurobiological mechanisms of self-injurious behaviour.

    Science.gov (United States)

    Reitz, Sarah; Kluetsch, Rosemarie; Niedtfeld, Inga; Knorz, Teresa; Lis, Stefanie; Paret, Christian; Kirsch, Peter; Meyer-Lindenberg, Andreas; Treede, Rolf-Detlef; Baumgärtner, Ulf; Bohus, Martin; Schmahl, Christian

    2015-08-01

    Patients with borderline personality disorder frequently show non-suicidal self-injury (NSSI). In these patients, NSSI often serves to reduce high levels of stress. Investigation of neurobiological mechanisms of NSSI in borderline personality disorder. In total, 21 women with borderline personality disorder and 17 healthy controls underwent a stress induction, followed by either an incision into the forearm or a sham treatment. Afterwards participants underwent resting-state functional magnetic resonance imaging while aversive tension, heart rate and heart rate variability were assessed. We found a significant influence of incision on subjective and objective stress levels with a stronger decrease of aversive tension in the borderline personality disorder group following incision than sham. Amygdala activity decreased more and functional connectivity with superior frontal gyrus normalised after incision in the borderline personality disorder group. Decreased stress levels and amygdala activity after incision support the assumption of an influence of NSSI on emotion regulation in individuals with borderline personality disorder and aids in understanding why these patients use self-inflicted pain to reduce inner tension. © The Royal College of Psychiatrists 2015.

  5. Is Kasei Valles (Mars) the largest volcanic channel in the solar system?

    Science.gov (United States)

    Leverington, David W.

    2018-02-01

    With a length of more than 2000 km and widths of up to several hundred kilometers, Kasei Valles is the largest outflow system on Mars. Superficially, the scabland-like character of Kasei Valles is evocative of terrestrial systems carved by catastrophic aqueous floods, and the system is widely interpreted as a product of outbursts from aquifers. However, as at other Martian outflow channels, clear examples of fluvial sedimentary deposits have proven difficult to identify here. Though Kasei Valles lacks several key properties expected of aqueous systems, its basic morphological and contextual properties are aligned with those of ancient volcanic channels on Venus, the Moon, Mercury, and Earth. There is abundant evidence that voluminous effusions of low-viscosity magmas occurred at the head of Kasei Valles, the channel system acted as a conduit for associated flows, and mare-style volcanic plains developed within its terminal basin. Combined mechanical and thermal incision rates of at least several meters per day are estimated to have been readily achieved at Kasei Valles by 20-m-deep magmas flowing with viscosities of 1 Pa s across low topographic slopes underlain by bedrock. If Kasei Valles formed through incision by magma, it would be the largest known volcanic channel in the solar system. The total volume of magma erupted at Kasei Valles is estimated here to have possibly reached or exceeded ∼5 × 106 km3, a volume comparable in magnitude to those that characterize individual Large Igneous Provinces on Earth. Development of other large outflow systems on Mars is expected to have similarly involved eruption of up to millions of cubic kilometers of magma.

  6. A single incision transaxillary thoracoscopic sympathectomy

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    Marić Nebojša

    2014-01-01

    Full Text Available Background/Aim. Primary hyperhidrosis causes are unknown. The disorder begins in early childhood. It intensifies in puberty and maturity. It is equally present in both sexes. The symptoms exacerbate when the body temperature rises and due to emotional stimuli affecting the sympathetic nerve system. The aim of this study was to demonstrate that videoassisted thoracoscopic surgery (VATS sympathectomy is a method for primary focal hyperhidrosis permanent treatment. The single incision method in properly selected patients maximizes the intervention effectiveness and minimizes aesthetic side effects. Methods. This prospective study analysed the findings in patients who had been operated on due to primary focal hyperhidrosis (face, palms, and armpits using a single small transaxilarry incision in the third inter-rib space at the level of the anterior axillary line with two 5 mm flexible ports. All the patients, with T2-T5 thoracoscopic sympathectomy of the sympathetic chain using a single small incision in the third inter-rib space in the anterior axillary line, were analysed in the period from September 2009 to November 2010 regarding the postoperative morbidity and outcomes of the operation (clinical evaluation and visual analogue scale with a view to assessing the effectiveness of the surgery conducted in this manner. Results. A total of 47 patients (18 men, 29 women, 18 to 48 years old (29 on average had underwent 94 bilateral video-assisted thoracoscopic sympathectomies. The sympathectomy was indicated in cases of facial blushing and sweating (6.38%, palmary sweating (34.04%, axillary sweating (14.89% or both palmary and axillary sweating (44.68%. The largest percentage of patients (98.6% had left the hospital the following day. The postoperative 30 day’s mortality was 0 and the conversion into open surgery was not necessary. As for complications, there had been an occurrence of partial pneumothorax in two patients treated by means of

  7. Ultrasonographic evaluation of the healing of ventral midline abdominal incisions in the horse.

    Science.gov (United States)

    Wilson, D A; Badertscher, R R; Boero, M J; Baker, G J; Foreman, J H

    1989-06-01

    Ultrasonography was used to evaluate the ventral midline incisions of 21 ponies following exploratory laparotomy. The incisions were evaluated before surgery and at weekly intervals from one to seven weeks after surgery. Both 5.0 and 7.5 MHz linear array and 7.5 MHz sector transducers were used for the evaluations. The incisional complications observed were drainage, oedema, suture sinus formation, suture abscess, superficial dehiscence and incisional hernia. Ultrasonographic imaging of the ventral midline incision was an easy, reliable and objective method for detecting and monitoring the progression of incisional complications in a non-invasive manner.

  8. Panoramic radiographs underestimate extensions of the anterior loop and mandibular incisive canal

    International Nuclear Information System (INIS)

    De Brito, Ana Caroline Ramos; Nejaim, Yuri; De Freitas, Deborah Queiroz; De Oliveira Santos, Christiano

    2016-01-01

    The purpose of this study was to detect the anterior loop of the mental nerve and the mandibular incisive canal in panoramic radiographs (PAN) and cone-beam computed tomography (CBCT) images, as well as to determine the anterior/mesial extension of these structures in panoramic and cross-sectional reconstructions using PAN and CBCT images. Images (both PAN and CBCT) from 90 patients were evaluated by 2 independent observers. Detection of the anterior loop and the incisive canal were compared between PAN and CBCT. The anterior/mesial extension of these structures was compared between PAN and both cross-sectional and panoramic CBCT reconstructions. In CBCT, the anterior loop and the incisive canal were observed in 7.7% and 24.4% of the hemimandibles, respectively. In PAN, the anterior loop and the incisive canal were detected in 15% and 5.5% of cases, respectively. PAN presented more difficulties in the visualization of structures. The anterior/mesial extensions ranged from 0.0 mm to 19.0 mm on CBCT. PAN underestimated the measurements by approximately 2.0 mm. CBCT appears to be a more reliable imaging modality than PAN for preoperative workups of the anterior mandible. Individual variations in the anterior/mesial extensions of the anterior loop of the mental nerve and the mandibular incisive canal mean that is not prudent to rely on a general safe zone for implant placement or bone surgery in the interforaminal region

  9. Panoramic radiographs underestimate extensions of the anterior loop and mandibular incisive canal

    Energy Technology Data Exchange (ETDEWEB)

    De Brito, Ana Caroline Ramos; Nejaim, Yuri; De Freitas, Deborah Queiroz [Dept. of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Sao Paulo (Brazil); De Oliveira Santos, Christiano [Dept. of Stomatology, Public Oral Health and Forensic Dentistry, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Sao Paulo (Brazil)

    2016-09-15

    The purpose of this study was to detect the anterior loop of the mental nerve and the mandibular incisive canal in panoramic radiographs (PAN) and cone-beam computed tomography (CBCT) images, as well as to determine the anterior/mesial extension of these structures in panoramic and cross-sectional reconstructions using PAN and CBCT images. Images (both PAN and CBCT) from 90 patients were evaluated by 2 independent observers. Detection of the anterior loop and the incisive canal were compared between PAN and CBCT. The anterior/mesial extension of these structures was compared between PAN and both cross-sectional and panoramic CBCT reconstructions. In CBCT, the anterior loop and the incisive canal were observed in 7.7% and 24.4% of the hemimandibles, respectively. In PAN, the anterior loop and the incisive canal were detected in 15% and 5.5% of cases, respectively. PAN presented more difficulties in the visualization of structures. The anterior/mesial extensions ranged from 0.0 mm to 19.0 mm on CBCT. PAN underestimated the measurements by approximately 2.0 mm. CBCT appears to be a more reliable imaging modality than PAN for preoperative workups of the anterior mandible. Individual variations in the anterior/mesial extensions of the anterior loop of the mental nerve and the mandibular incisive canal mean that is not prudent to rely on a general safe zone for implant placement or bone surgery in the interforaminal region.

  10. Postcataract endophthalmitis prophylaxis using irrigation, incision hydration, and eye pressurization with vancomycin

    Directory of Open Access Journals (Sweden)

    Schelonka LP

    2015-07-01

    Full Text Available Lee P Schelonka,1 Margaret A SaBell2 1Department of Opthalmology, Kaiser Permanente Lone Tree Medical Offices, Lone Tree, 2Department of Infection Control, Kaiser Permanente Lone Tree Medical Offices, Lone Tree, Denver, CO, USA Purpose: This study aimed to determine whether switching from balanced salt solution (BSS to vancomycin 20 g/mL BSS for incision hydration and eye pressurization reduces the rate of postcataract endophthalmitis.Methods: This was a patient safety/quality improvement project, including all patients undergoing cataract surgery at the Kaiser Permanente Colorado Ophthalmology Department from January 2002 to December 2014. Throughout the study, patients received vancomycin 20 µg/mL in the irrigating solution. During the baseline period from 2002 to 2005, surgeons pressurized eyes and hydrated incisions with plain BSS. During the intervention period from 2006 through 2014, surgeons switched from BSS to the vancomycin/BSS irrigating solution for eye pressurization and incision hydration.Results: A total of 57,263 cataract operations were performed by 24 surgeons at seven surgical centers: 12,400 in the baseline period and 44,863 in the intervention period. The rate of postcataract endophthalmitis declined significantly from 5/12,400 (rate: 0.4/1,000 in the baseline period to 1/44,863 (rate: 0.022/1,000 during the intervention period (odds ratio [OR]: 18.1, 95% confidence interval [CI]: 2.11–154.9; χ2=13.5, P=0.00024. Accounting for an estimated 2.05-fold risk reduction due to confounding variables, the risk reduction attributed to the intervention remained significant: (adjusted OR: 8.78, 95% CI: 1.73–44.5; χ2=10.06, P=0.0015. Since 2009, we have not experienced any cases of postcataract endophthalmitis after 32,753 operations.Conclusion: We experienced a significant reduction in postcataract endophthalmitis when we switched from BSS to the vancomycin/BSS irrigating solution for incision hydration and eye pressurization

  11. Short-term outcomes of small incision cataract surgery provided by a regional population in the Pacific.

    Science.gov (United States)

    Bhikoo, Riyaz; Vellara, Hans; Lolokabaira, Salome; Murray, Neil; Sikivou, Biu; McGhee, Charles

    2017-11-01

    This study aims to describe patient demographics, visual and surgical outcomes of a cohort undergoing small incision cataract surgery at a Pacific regional ophthalmic training facility. This is a prospective, longitudinal study conducted at the Pacific Eye Institute, Fiji. One hundred fifty-six patients underwent small incision cataract surgery. Preoperatively, a complete ophthalmic examination, including pachymetry and macular optical coherence tomography performed by two independent investigators. Temporal small incision cataract surgery with intraocular lens insertion was performed by ophthalmologists, and trainee ophthalmologists. Follow-up occurred at day one, four weeks and 3 months. Patient characteristics, visual outcomes including surgically induced astigmatism and complications. Ninety-one per cent (142/156) attended 3-month follow-up with median age 63 years (range 19-82), 52% female (81/156) and 58% (90/156) Fijian ethnicity. In 37% (57/156), the contralateral eye was pseudophakic. Mean preoperative best spectacle-corrected visual acuity was logMAR 1.44 (6/165). At 3 months, 74% (105/142) achieved ≥6/18 unaided vision (94% [133/142] best spectacle-corrected visual acuity). Mean postoperative spherical equivalent was -0.78 (SD 0.95) D and mean surgically induced astigmatism 1.04 (0.57) D. Complications included posterior capsular rupture with vitreous loss (4% [6/156]), optical coherence tomography confirmed macular oedema (8% [12/152] at 4 weeks), significant posterior capsular opacity (23% [31/136]) and >5% increase in preoperative pachymetry (1% [1/142]) at 3 months. Reduction in preoperative best spectacle-corrected visual acuity occurred in 2% (3/142). No cases of endophthalmitis. Small incision cataract surgery provided to a regional population is effective with 94% achieving the World Health Organisation's definition of 'Good Vision' (≥6/18). Refinements in biometric and surgical techniques may allow a greater proportion of patients to

  12. Channel aggradation by beaver dams on a small agricultural stream in Eastern Nebraska

    Science.gov (United States)

    M.C. McCullough; J.L. Harper; D.E. Eisenhauer; M.G. Dosskey

    2004-01-01

    We assessed the effect of beaver dams on channel gradation of an incised stream in an agricultural area of eastern Nebraska. A topographic survey was conducted of a reach of Little Muddy Creek where beaver are known to have been building dams for twelve years. Results indicating that over this time period the thalweg elevation has aggraded an average of 0.65 m by...

  13. The "Propeller" incision for transpalatal advancement pharyngoplasty: a new approach to reduce post-operative oronasal fistulae.

    Science.gov (United States)

    Shine, Neville Patrick; Lewis, Richard Hamilton

    2008-09-01

    To present a new soft tissue approach for transpalatal advancement pharyngoplasty (TPA), the propeller incision, and to compare the rates of post-operative oronasal fistula in those undergoing TPA with the traditional "Gothic Arch" incision described by Woodson and those with the propeller incision. A prospectively maintained adult sleep apnoea surgery database was used to identify those patients undergoing TPA, either alone or in combination with other procedures, for obstructive sleep apnoea syndrome (OSAS) between February 2001 and September 2006 in a tertiary referral centre by a single surgeon (RHL). In addition to the incision used during TPA, patient demographic data, previous surgery of the upper airways, smoking history, pre-operative body mass index, respiratory disturbance index, oxygen saturation index and the occurrence of oronasal fistula post-operatively, were recorded. The propeller incision technique is described. A total of 89 patients who underwent TPA were identified. A total of 49 patients had a "Gothic Arch" incision and 40 had a "Propeller" incision. The two groups of patients were comparable in age, sex, previous tonsillar and uvulopalatopharyngoplasty surgery, smoking histories and pre-operative disease severity. In the "Gothic Arch" group, eight patients (16%) developed oronasal fistulae in the post-operative period versus only one patient (2.5%) in the "Propeller" group. The difference between the two groups was statistically significant (P=0.038, Fisher's exact test). Of the total cases with post-operative oronasal fistula (n=9), only one patient (from the Gothic Arch incision group) required operative closure which was performed under local anesthesia and healed without complication. The propeller incision provides an anatomically sensible axial-based flap that provides adequate access to perform TPA. It is associated with a lower incidence of oronasal fistula and is recommended by the authors.

  14. An Alternative to Channel-Centered Views of the Landscape for Understanding Modern Streams in the Mid-Atlantic Piedmont Region, Eastern USA

    Science.gov (United States)

    Merritts, D. J.; Walter, R. C.; Rahnis, M. A.; Oberholtzer, W.

    2008-12-01

    Stream channels generally are the focus of conceptual models of valley bottom geomorphology. The channel-centered model prevalent in the tectonically inactive eastern U. S. invokes meandering stream channels migrating laterally across valley floors, eroding one bank while depositing relatively coarse sediment in point bars on the other. According to this model, overbank deposition during flooding deposits a veneer of fine sediment over the gravel substrate. Erosion is considered normal, and the net volume of sediment is relatively constant with time. A dramatic change in conditions-land-clearing during European settlement--led to widespread aggradation on valley bottoms. This historic sedimentation was incorporated in the channel-centered view by assuming that meandering streams were overwhelmed by the increased sediment load and rapidly aggraded vertically. Later, elevated stream channels cut through these deposits because of decreased sediment supply and increased stormwater runoff accompanying urbanization. This view can be traced to early ideas of stream equilibrium in which incoming sediment supply and runoff determine stream-channel form. We propose a different conceptual model. Our trenching and field work along hundreds of km of stream length in the mid-Atlantic Piedmont reveal no point bars prior to European settlement. Instead, a polygenetic valley-bottom landscape underlies the drape of historic sediment. The planar surface of this veneer gives the appearance of a broad floodplain generated by long-term meandering and overbank deposition, but the "floodplain" is a recent aggradational surface from regional base-level rise due to thousands of early American dams that spanned valley bottoms. As modern streams incise into the historic fine-grained slackwater sediment, they expose organic-rich hydric soils along original valley bottom centers; talus, colluvium, bedrock, and saprolite with forest soils along valley margins; and weathered Pleistocene (and

  15. Transverse Skin Crease versus Vertical Midline Incision versus Laparoscopy for Right Hemicolectomy: A Systematic Review—Current Status of Right Hemicolectomy

    Directory of Open Access Journals (Sweden)

    Alberto Santoro

    2014-01-01

    Full Text Available Purpose. The right hemicolectomy may be conducted through laparoscopic or laparotomic surgery, transverse or midline incisions. The transverse laparotomy offers some advantages compared to the midline laparotomy and laparoscopy. A literature review was performed to evaluate the possible advantages of the transverse incision versus midline incision or laparoscopic right hemicolectomy. Methods. A systematic research was performed in Medline, Embase, Cochrane Central Register of Controlled Trials, CINAHL, BioMed Central, and the Science Citation Index. Results. Laparotomic right hemicolectomy with transverse incision is preferable to laparotomic hemicolectomy with midline incision. A transverse incision offers a lessened postoperative pain following physical activity, a lessened need to administer analgesic therapy during the post-operative time, better aesthetic results, and a better post-operative pulmonary function. Open surgery with transverse or midline incision ensured a shorter operative time, lower costs and a greater length of the incision compared to the laparoscopic. However, there are no differences in the oncological outcomes. Conclusions. It was not possible to identify significant differences between the open right hemicolectomy with transverse incision versus the open right hemicolectomy with midline incision or laparoscopic hemicolectomy.

  16. Minimal Nasolabial Incision Technique for Nasolabial Fold Modification in Patients With Facial Paralysis.

    Science.gov (United States)

    Faris, Callum; Heiser, Alyssa; Jowett, Nate; Hadlock, Tessa

    2018-03-01

    Creation of symmetrical nasolabial folds (NLFs) is important in the management of the paralyzed face. Established techniques use a linear incision in the NLF, and technical refinements now allow the linear incision to be omitted. This retrospective case series was conducted in a tertiary care setting from February 2, 2017, to June 7, 2017. Participants were all patients (N = 21) with peripheral facial paralysis who underwent NLF modification that used the minimal nasolabial incision technique at the Massachusetts Eye and Ear Infirmary Facial Nerve Center from February 1, 2015, through August 31, 2016. Patient-reported outcome measures using the validated, quality-of-life Facial Clinimetric Evaluation (FaCE) Scale; clinician-reported facial function outcomes using a validated electronic clinician-graded facial paralysis assessment (eFACE); layperson assessment of the overall aesthetic outcome of the NLF; and expert-clinician scar assessment of the NLF. Of the 21 patients who underwent NLF modification that used the minimal nasolabial incision technique, 9 patients (43%) were female and 12 (57%) were male. The mean age was 41 (range, 9-90) years; 17 patients (81%) were adults (≥18 years) and 4 (19%) were children (<18 years). Overall, significant improvements were observed after NLF modification in all outcome measures as graded by both clinicians and patients. The mean (SD) scores for total eFACE were 60.7 (14.9) before the operation and 77.2 (8.9) after the operation (mean difference, 16.5 [95% CI, 8.5-24.2]; P < .001). The mean (SD) static eFACE scores were 61.4 (20.6) before the operation and 82.7 (12.4) after the operation (mean difference, 21.3 [95% CI, 10.7-31.9]; P < .001). The mean (SD) FaCE quality-of-life scores were 51.3 (20.1) before the operation and 70.3 (12.6) after the operation (mean difference, 19.0 [95% CI, 6.5-31.6]; P  =  .001). The layperson self-assessment of the overall aesthetic outcome of the NLF modification was

  17. Association between incision technique for hamstring tendon harvest in anterior cruciate ligament reconstruction and the risk of injury to the infra-patellar branch of the saphenous nerve: a meta-analysis.

    Science.gov (United States)

    Grassi, Alberto; Perdisa, Francesco; Samuelsson, Kristian; Svantesson, Eleonor; Romagnoli, Matteo; Raggi, Federico; Gaziano, Teide; Mosca, Massimiliano; Ayeni, Olufemi; Zaffagnini, Stefano

    2018-02-08

    To determine how the incision technique for hamstring tendon (HT) harvest in anterior cruciate ligament (ACL) reconstruction affects the risk of injury to the IPBSN and clinical outcome. A systematic literature search of the MEDLINE/Pubmed, Cochrane Central Register of Controlled Trials (CENTRAL) and EBSCOhost electronic databases and clinicaltrials.gov for unpublished studies was performed to identify comparative studies investigating injury to the IPBSN after HT ACL reconstruction by comparing at least two different incision techniques. Data were extracted for the number of patients with evidence of any neurologic deficit corresponding to injury to the IPBSN, area of sensory deficit, the Lysholm score and patient satisfaction. The mean difference (MD) in study outcome between incision groups was assessed. The relative risk (RR) and the number needed to treat (NNT) were calculated. The Chi-square and Higgins' I 2 tests were applied to test heterogeneity. Data were pooled using a Mantel-Haenszel random-effects model if the statistical heterogeneity was > 50% and a fixed-effects model if the statistical heterogeneity was < 50%. The risk of bias was evaluated according to the Cochrane Database questionnaire and the quality of evidence was graded according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines. A total of eight studies (three randomized controlled trials (RCTs) and five comparative studies) were included, of which six compared vertical and oblique incisions, one horizontal and vertical incisions, and one compared all three techniques. HT harvest was performed through a vertical incision in 329 patients, through an oblique incision in 195 patients and through a horizontal incision in 151 patients. Considering the meta-analysis of the RCTs, the performance of a vertical incision significantly increased the risk of causing IPBSN deficiency compared with both oblique and horizontal incision [RR 1.65 (CI 1

  18. Radiological assessment of 50 cases of incisive or maxillary neoplasia in the dog

    International Nuclear Information System (INIS)

    Frew, D.G.; Dobson, J.M.

    1992-01-01

    This paper reviews the radiological features of 50 canine incisive or maxillary tumours and discusses the value of radiological assessment in the diagnosis and staging of these tumours. The 50 tumours examined included 21 sarcomas, 15 carcinomas, three melanomas and an assortment of benign tumours of the oral cavity. There was not any site specificity for the different histological tumour types within the upper dental arcade, although fibrosarcomas had a tendency to be maxillary whereas the squamous cell carcinomas were equally distributed between the incisive and maxillary regions. Seventy-eight per cent of fibrosarcomas, 82 per cent of squamous cell carcinoma and all three melanomas examined showed radiological evidence of bone involvement. Radiographic changes were also seen in the benign tumours. The pattern of growth of tumours correlated with the radiological changes observed. Malignant tumours showed a tendency to irregular or aggressive bone loss whereas bone production predominated in the benign tumours

  19. Single-incision laparoscopic cecectomy for low-grade appendiceal mucinous neoplasm after laparoscopic rectectomy

    Science.gov (United States)

    Fujino, Shiki; Miyoshi, Norikatsu; Noura, Shingo; Shingai, Tatsushi; Tomita, Yasuhiko; Ohue, Masayuki; Yano, Masahiko

    2014-01-01

    In this case report, we discuss single-incision laparoscopic cecectomy for low-grade appendiceal neoplasm after laparoscopic anterior resection for rectal cancer. The optimal surgical therapy for low-grade appendiceal neoplasm is controversial; currently, the options include appendectomy, cecectomy, right hemicolectomy, and open or laparoscopic surgery. Due to the risk of pseudomyxoma peritonei, complete resection without rupture is necessary. We have encountered 5 cases of low-grade appendiceal neoplasm and all 5 patients had no lymph node metastasis. We chose the appendectomy or cecectomy without lymph node dissection if preoperative imaging studies did not suspect malignancy. In the present case, we performed cecectomy without lymph node dissection by single-incision laparoscopic surgery (SILS), which is reported to be a reduced port surgery associated with decreased invasiveness and patient stress compared with conventional laparoscopic surgery. We are confident that SILS is a feasible alternative to traditional surgical procedures for borderline tumors, such as low-grade appendiceal neoplasms. PMID:24868331

  20. DNA polymerase. beta. reaction with ultraviolet-irradiated DNA incised by correndonuclease

    Energy Technology Data Exchange (ETDEWEB)

    Nowak, R; Zarebska, Z [Instytut Onkologii, Warsaw (Poland); Zmudzka, B [Polska Akademia Nauk, Warsaw. Inst. Biochemii i Biofizyki

    1980-09-19

    Covalently closed circular Col E1 DNA was ultraviolet-irradiated with a dose of 60 J/m/sup 2/, thus introducing about 3.2 pyrimidine dimers per DNA molecule. Treatment of irradiated Col E1 DNA with Micrococcus luteus correndonuclease resulted, in the vicinity of pyrimidine dimers, in an average of 3.3 incisions per DNA molecule, and converted DNA to the open circular form. Incised Col E1 DNA stimulated no reaction with calf thymus DNA polymerase ..cap alpha.. but was recognized as a template by DNA polymerase ..beta... The latter enzyme incorporated about 1.6 molecules of dTMP (corresponding to 6 molecules of dNMP) per one correndonuclease incision. The length of the DNA polymerase ..beta.. product was comparable to the anticipated length of the DNA region within which the hydrogen bonds were disrupted owing to dimer formation. The enzyme required Mg/sup 2 +/ and four dNTPs for reaction and was resistant to N-ethylmaleimide or p-mercuribenzoate.

  1. Human FAN1 promotes strand incision in 5'-flapped DNA complexed with RPA.

    Science.gov (United States)

    Takahashi, Daisuke; Sato, Koichi; Hirayama, Emiko; Takata, Minoru; Kurumizaka, Hitoshi

    2015-09-01

    Fanconi anaemia (FA) is a human infantile recessive disorder. Seventeen FA causal proteins cooperatively function in the DNA interstrand crosslink (ICL) repair pathway. Dual DNA strand incisions around the crosslink are critical steps in ICL repair. FA-associated nuclease 1 (FAN1) is a DNA structure-specific endonuclease that is considered to be involved in DNA incision at the stalled replication fork. Replication protein A (RPA) rapidly assembles on the single-stranded DNA region of the stalled fork. However, the effect of RPA on the FAN1-mediated DNA incision has not been determined. In this study, we purified human FAN1, as a bacterially expressed recombinant protein. FAN1 exhibited robust endonuclease activity with 5'-flapped DNA, which is formed at the stalled replication fork. We found that FAN1 efficiently promoted DNA incision at the proper site of RPA-coated 5'-flapped DNA. Therefore, FAN1 possesses the ability to promote the ICL repair of 5'-flapped DNA covered by RPA. © The Authors 2015. Published by Oxford University Press on behalf of the Japanese Biochemical Society. All rights reserved.

  2. Femtosecond laser effect on the self-sealing properties of the corneal incision of various lengths and profile (experimental trial

    Directory of Open Access Journals (Sweden)

    Yulduz Shavkatovna Nizametdinova

    2015-06-01

    Full Text Available An experimental investigation was carried out to study self-sealing properties of corneal incisions of different profile and length carried out with femtosecond laser Victus (Technolas Perfect Vision/Bausch&Lomb. Using femtosecond laser for this purpose allows creating corneal incisions of high precision and predictability. Reproducibility and standardization of the incision profile and length are an advantage of this technology. Obtained results showed that single-profile incisions are less stable and safe when compared to multi-profile ones. It was noted that incision length increase promotes its self-sealing properties.

  3. Modified Lengthening Temporalis Myoplasty Involving an Extended Lazy-S Incision to Avoid Facial Scar Formation.

    Science.gov (United States)

    Oji, Tomito; Hayashi, Akiteru; Ogino, Akihiro; Onishi, Kiyoshi

    2018-05-01

    Lengthening temporalis myoplasty is a faster and less invasive alternative to free muscle transfer for smile reconstruction. However, it requires a nasolabial fold incision, which leaves a midfacial scar. Based on esthetic considerations, a modified approach, involving an extended lazy-S (parotidectomy) incision instead of a nasolabial fold incision, was developed. A cadaveric study involving 10 hemifaces was conducted. From February 2013 to March 2016, the modified lengthening temporalis myoplasty procedure was employed in 10 patients. The results were graded from 1 (poor) to 5 (excellent) according to the Terzis grading system. The excursion of the oral commissure was also measured. The extended lazy-S incision provides easy and safe access to the coronoid process and good visibility. The patients' mean age was 56.5 years, and the mean duration of the postoperative follow-up period was 22.2 months. The patients' underlying conditions included acoustic neuroma (n = 2), Bell palsy (n = 3), congenital conditions (n = 2), brain infarction (n = 1), Ramsay Hunt syndrome (n = 1), and malignant parotid lymphoma (n = 1). One patient suffered a surgical site infection, which was successfully treated with irrigation. All the patients achieved improvements in smile symmetry: 2, 5, and 3 patients obtained excellent, good, and moderate results, respectively. The excursion of the oral commissure ranged from 5 to 10 mm. The modified lengthening temporalis myoplasty procedure provides satisfactory functional outcomes without causing significant complications. It does not leave a facial scar and is a preferable option, especially for young and female patients, and patients who have undergone ablative surgery involving the parotid region.

  4. Transversal incision of the vagina favors the remaining of the tape in the middle-third urethra compared to longitudinal incision during transobturator sling procedures for stress urinary incontinence.

    Science.gov (United States)

    Pirtea, L; Sas, I; Ilina, Razvan; Grigoraș, D; Mazilu, O

    2015-07-17

    To describe a new type of incision of the vagina during transobturator sling procedure and to evaluate by ultrasound the tape position at 3, 6 and 12 months after surgery. We conducted a prospective study including 51 patients with urinary stress incontinence who underwent sling procedure using the transversal vaginal incision. Tape position was evaluated by ultrasound at 3, 6 and 12 months after surgery and expressed as a percentage of the urethral length (the proximal third of the urethral length 0-39 %, the middle third 40-60 %, and the distal third 60-100 %). Informed consent was obtained from all patients prior to their inclusion in the study. All procedures have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments and were approved by the Institutional Review Board and Ethical Committee of "Victor Babeş" University of Medicine and Pharmacy Timisoara before the beginning of the study (no 7/17.04.2012). At 3 months after surgery, 3.92 % of the slings were located in the proximal third of the urethra, 88.23 % in the middle third of the urethra and 7.84 % in the distal third. At 6 and 12 months after surgery we obtained similar results: 9.81 % of the slings were located in the proximal third of the urethra, 82.35 % in the middle third and 7.84 % in the distal third of the urethra. The transversal incision of the vagina offers a minimal dissection along the long axis of the urethra favoring the remaining of the tape in the middle third of the urethra.

  5. A new technique, combined plication-incision (CPI, for correction of penile curvature

    Directory of Open Access Journals (Sweden)

    Hamed Abdalla Hamed

    Full Text Available ABSTRACT Introduction Penile curvature (PC can be surgically corrected by either corporoplasty or plication techniques. These techniques can be complicated by post-operative: penile shortening, recurrent PC, painful/palpable suture knots and erectile dysfunction. Objective To avoid the complications of corporoplasty and plication techniques using a new technique: combined plication-incision (CPI. Materials and Methods Two groups (1&2 were operated upon: group 1 using CPI and group 2 using the 16-dot technique. In CPI, dots were first marked as in 16 dot technique. In each group of 4 dots the superficial layer of tunica albuginea was transversely incised (3-6mm at the first and last dots. Ethibond 2/0, passed through the interior edge of the first incision plicating the intermediate 2 dots and passed out of the interior edge of the last incision, was tightened and ligated. Vicryle 4/0, passed through the exterior edges of the incisions, was tightened and ligated to cover the ethibond knot. Results Twelve (57.1 % participants in group 2 complained of a bothering palpable knot compared to none in group 1 with statistically significant difference (P=0.005. Postoperative shortening (5mm of erect penis, encountered in 9 participants, was doubled in group 2 but with insignificant difference (P>0.05. Post-operative recurrence of PC, was encountered in only 1 (4.8% participant in group 2, compared to none in group 1, with insignificant difference (P>0.05. Post-operative erectile rigidity was normally maintained in all participants. Conclusion The new technique was superior to the 16-dot technique for correction of PC.

  6. The Evolution of the Appendectomy: From Open to Laparoscopic to Single Incision

    Directory of Open Access Journals (Sweden)

    Noah J. Switzer

    2012-01-01

    Full Text Available Beginning with its initial description by Fitz in the 19th century, acute appendicitis has been a significant long-standing medical challenge; today it remains the most common gastrointestinal emergency in adults. Already in 1894, McBurney advocated for the surgical removal of the inflamed appendix and is credited with the initial description of an Open Appendectomy (OA. With the introduction of minimally invasive surgery, this classic approach evolved into a procedure with multiple, smaller incisions; a technique termed Laparoscopic Appendectomy (LA. There is much literature describing the advantages of this newer approach. To name a few, patients have significantly less wound infections, reduced pain, and a reduction in ileus compared with the OA. In the past few years, Single Incision Laparoscopic Appendectomy (SILA has gained popularity as the next major evolutionary advancement in the removal of the appendix. Described as a pioneer in the era of “scarless surgery,” it involves only one transumbilical incision. Patients are postulated to have reduced post-operative complications such as infection, hernias, and hematomas, as well as a quicker recovery time and less post-operative pain scores, in comparison to its predecessors. In this review, we explore the advancement of the appendectomy from open to laparoscopic to single incision.

  7. Performance of fast-absorbable suture and histo-glue in closing incisions in Brown trout

    DEFF Research Database (Denmark)

    Jepsen, Niels; Larsen, Martin Hage; Aarestrup, Kim

    2017-01-01

    , growth, tag expulsion rate and incision healing was compared among three groups of dummy transmitter-tagged wild brown trout Salmo trutta where incisions were closed with two types of suture material (absorbable vs. fast absorbable) and Histo-glue. The tagged fish were kept in semi-natural ponds for 20...

  8. The boomerang incision for periareolar breast malignancies.

    Science.gov (United States)

    Tan, Mona P

    2007-11-01

    Breast-conservation surgery has been shown to be equivalent to mastectomy in terms of long-term survival for the treatment of breast cancer. Various techniques have been described on how to achieve clear margins and good cosmetic outcomes and therefore expand the indications for breast conservation. A novel incision is detailed to augment the options already available.

  9. Outcomes of small incision lenticule extraction (SMILE) in low myopia.

    Science.gov (United States)

    Reinstein, Dan Z; Carp, Glenn I; Archer, Timothy J; Gobbe, Marine

    2014-12-01

    To report the visual and refractive outcomes of small incision lenticule extraction for low myopia using the VisuMax femtosecond laser (Carl Zeiss Meditec, Jena, Germany). A retrospective analysis of 120 consecutive small incision lenticule extraction procedures was performed for low myopia. Inclusion criteria were preoperative spherical equivalent refraction up to -3.50 diopters (D), cylinder up to 1.50 D, and corrected distance visual acuity of 20/20 or better. Outcomes analysis was performed for all eyes with 1-year follow-up according to the Standard Graphs for Reporting Refractive Surgery, and also including mesopic contrast sensitivity. One-year data were available for 110 eyes (92%). Preoperatively, mean spherical equivalent refraction was -2.61 ± 0.54 D (range: -1.03 to -3.50 D) and mean cylinder was 0.55 ± 0.38 D (range: 0.00 to 1.50 D). Postoperatively, mean spherical equivalent refraction was -0.05 ± 0.36 D (range: -0.94 to +1.25 D) and mean cylinder was ± 0.50 D in 84% and ± 1.00 D in 99% of eyes. Uncorrected distance visual acuity was 20/20 or better in 96% of eyes and 20/25 or better in 100% of eyes. One line of corrected distance visual acuity was lost in 9%, but no eyes lost two or more lines. There was an initial overcorrection in mean spherical equivalent refraction on day 1 (+0.37 D) as expected, which regressed to +0.10 D at 1 month and -0.05 D at 3 months, after which stability was reached (mean spherical equivalent refraction was -0.05 D at 1 year). Contrast sensitivity at 1 year was slightly increased at 3, 6, 12, and 18 cycles per degree (P < .05). Small incision lenticule extraction for low myopia was found to be safe and effective with outcomes similar to those previously reported for LASIK. Copyright 2014, SLACK Incorporated.

  10. Incisional hernia after upper abdominal surgery: A randomised controlled trial of midline versus transverse incision

    NARCIS (Netherlands)

    J.A. Halm (Jens); H. Lip (Harm); P.I.M. Schmitz (Paul); J. Jeekel (Hans)

    2009-01-01

    textabstractObjectives: To determine whether a transverse incision is an alternative to a midline incision in terms of incisional hernia incidence, surgical site infection, postoperative pain, hospital stay and cosmetics in cholecystectomy. Summary background data: Incisional hernias after midline

  11. Phenomenon of mucous retention in the incisive canal.

    Science.gov (United States)

    Keith, D A

    1979-11-01

    Mucous glands are rarely found in the anterior palate but may be observed in the incisive canal. A case history is presented of a lesion that resembled a nasopalatine cyst both clinically and radiographically but which was in fact an intra-bony extravasation phenomenon.

  12. Comparison of first-intention healing of carbon dioxide laser, 4.0-MHz radiosurgery, and scalpel incisions in ball pythons (Python regius).

    Science.gov (United States)

    Hodshon, Rebecca T; Sura, Patricia A; Schumacher, Juergen P; Odoi, Agricola; Steeil, James C; Newkirk, Kim M

    2013-03-01

    To evaluate first-intention healing of CO(2) laser, 4.0-MHz radiowave radiosurgery (RWRS), and scalpel incisions in ball pythons (Python regius). 6 healthy adult ball pythons. A skin biopsy sample was collected, and 2-cm skin incisions (4/modality) were made in each snake under anesthesia and closed with surgical staples on day 0. Incision sites were grossly evaluated and scored daily. One skin biopsy sample per incision type per snake was obtained on days 2, 7, 14, and 30. Necrotic and fibroplastic tissue was measured in histologic sections; samples were assessed and scored for total inflammation, histologic response (based on the measurement of necrotic and fibroplastic tissues and total inflammation score), and other variables. Frequency distributions of gross and histologic variables associated with wound healing were calculated. Gross wound scores were significantly greater (indicating greater separation of wound edges) for laser incisions than for RWRS and scalpel incisions at all evaluated time points. Necrosis was significantly greater in laser and RWRS incisions than in scalpel incision sites on days 2 and 14 and days 2 and 7, respectively; fibroplasia was significantly greater in laser than in scalpel incision sites on day 30. Histologic response scores were significantly lower for scalpel than for other incision modalities on days 2, 14, and 30. In snakes, skin incisions made with a scalpel generally had less necrotic tissue than did CO(2) laser and RWRS incisions. Comparison of the 3 modalities on the basis of histologic response scores indicated that use of a scalpel was preferable, followed by RWRS and then laser.

  13. The origin and significance of sinuosity along incising bedrock rivers

    Science.gov (United States)

    Barbour, Jonathan Ross

    Landscapes evolve through processes acting at the earth's surface in response to tectonics and climate. Rivers that cut into bedrock are particularly important since they set the local baselevel and communicate changes in boundary conditions across the landscape through erosion and deposition; the pace of topographic evolution depends on both the rate of change of the boundary conditions and the speed of the bedrock channel network response. Much of the work so far has considered the effects of tectonically-controlled changes in slope and climatically-controlled changes in discharges to the rate of channel bed erosion while considering bank erosion, if active at all, to be of at best secondary importance to landscape evolution. Sprinkled throughout the literature of the past century are studies that have recognized lateral activity along incising rivers, but conflicting interpretations have left many unanswered questions about how to identify and measure horizontal erosion, what drives it, what effect it has on the landscape, and how it responds to climate and tectonics. In this thesis, I begin to answer some of these questions by focusing on bedrock river sinuosity and its evolution through horizontal erosion of the channel banks. An analysis of synoptic scale topography and climatology of the islands of eastern Asia reveals a quantitative signature of storm frequency in a regional measure of mountain river sinuosity. This is partly explained through a study of the hydro- and morphodynamics of a rapidly evolving bedrock river in Taiwan which shows how the erosive forces vary along a river to influence the spatiotemporal distribution of downcutting, sidecutting, and sediment transport. Through these analyses, I also present evidence that suggests that the relative frequency of erosive events is far more important than the absolute magnitude of extreme events in setting the erosion rate, and I show that the horizontal erosion of bedrock rivers is an important

  14. A STUDY ON EFFICACY OF MANUAL SMALL INCISION CATARACT SURGERY BY TEMPORAL APPROACH

    Directory of Open Access Journals (Sweden)

    Vinodhini Kannan

    2018-01-01

    Full Text Available BACKGROUND Manual Small Incision Cataract Surgery (MSICS is a well-known technique of cataract surgery owing to its advantage of a selfsealing suture less incision with least surgically induced astigmatism at a low cost. It is a safe, simple, consistent, stable and cost-effective technique with various modifications that involve site, size, type of incision and method of nucleus delivery. One such modification is Temporal Incision MSICS, where the cataract surgery is done by a temporal approach, which is equally good compared to the superior incision. This study was done retrospectively to analyse the visual outcome of patients operated by Manual SICS - Temporal Approach, using the WHO criteria and to establish its efficacy as a good surgical technique. MATERIALS AND METHODS Records of patients operated for senile cataract by a single surgeon by Temporal MSICS using a temporal sclerocorneal incision of 6-6.5 mm, during a 1-year period, were analysed retrospectively. Post-operative followup records of POD-1 and subsequent follow-ups at 1 st week and 6 th week were recorded for visual outcome. RESULTS Out of the 83 cases analysed retrospectively, majority of them were found to be between 61-70 years with a female Preponderance. Most of the cases were found to have senile immature cataract (55 patients, with Grade III nuclear sclerosis (52 cases. The pre-operative visual acuity was poor <6/60 in 72 cases (86.7% and borderline in 11 cases (14.5%. 55 cases (66.3% had a 6.5 mm scleral incision and the remaining 28 cases (33.7% had a 6 mm incision. Average duration of surgery noted was 8.35 minutes. Striate Keratopathy was the most common 1 st POD complication followed by corneal oedema. Striate keratopathy was the most common complication at the 1 st week followup followed by pigment dispersion. Majority of cases (76 cases were found to have been complication free at the end of 6 weeks. At the end of 6 weeks post-operatively as per records, 80 cases

  15. Oral subcutaneous midline leiomyomatous hamartoma presenting as congenital incisive papilla overgrowth in a toddler

    Directory of Open Access Journals (Sweden)

    Ashish Loomba

    2017-01-01

    Full Text Available Congenital soft-tissue tumors of oral cavity are mostly hyperplastic and benign in nature. This article presents an unusual case of congenital subcutaneous hamartoma of incisive papilla in a 2-year-old female child causing feeding and breathing difficulty. Total excisional biopsy was done under local anesthesia. Histopathology of tissue in reticulin-stained slide showed the presence of immature muscle fibers whereas Masson's trichrome stain revealed collagen fibers and smooth muscles confirming the diagnosis of oral midline subcutaneous smooth muscle (leiomyomatous hamartoma of incisive papilla. It is important for dental professionals to be aware of this oral lesion present from birth mimicking overgrowth of incisive papilla, by its presentation, differential diagnosis, histopathology, and management.

  16. S-shaped versus conventional straight skin incision: Impact on primary functional maturation, stenosis and thrombosis of autogenous radiocephalic arteriovenous fistula: Impact of incision on maturation, stenosis & failure of RCAVF. Study design: Prospective observational comparative.

    Science.gov (United States)

    Kordzadeh, Ali; Panayiotopolous, Yiannis

    2017-10-01

    The objective of this study is to test the null hypothesis that an S-shaped surgical incision versus conventional (straight) skin incision in the creation of autogenous radiocephalic arteriovenous fistulas (RCAVFs) have no impact on the primary end-point of primary functional maturation and secondary end points of stenosis and thrombosis. A prospective observational comparative consecutive study with intention-to-treat on individuals undergoing only radiocephalic arteriovenous fistula (RCAVFs) over a period of 12 months was conducted. Variables on patient's demographics, comorbidities, anesthesia type, mean arterial blood pressure, thrill, laterality, cephalic vein and radial artery diameter were collated. The test of probability was assessed through Chi-Square, Kaplan-Meier survival estimator and Log-Rank analysis. Total of n = 83 individuals with median age of 67 years (IQR, 20-89) and male predominance 83% during this period were subjected to RCAVF formation. Total of n = 45 patients in straight skin incision were compared to n = 38 individuals in S-shaped group. Despite equal prevalence of demographics, comorbidities, anesthesia type, mean arterial blood pressure (MAP), thrill, laterality, cephalic vein and radial artery diameter ( p  > 0.05) higher incidence of juxta-anastomotic stenosis was noted in the straight skin incision group ( p  = 0.029) in comparative and survival analysis (Log-Rank, p  = 0.036). The maturation of the entire cohort was 69% (S-shaped 76% vs. straight group 62%) (p > 0.05). The outcome of this study demonstrates that S-shaped surgical skin incision is associated with a lower incidence of stenosis in comparison to straight incision type in RCAVF formation.

  17. Evaluation of a new disposable silicon limbal relaxing incision knife by experienced users

    OpenAIRE

    Parvu Valentin; Dugue Geoffrey; Albanese John; Bajart Ann M; Lee Edwin

    2009-01-01

    Abstract Background Previous research has suggested that the silicon BD Atomic Edge™ knife has superior performance characteristics when compared to a metal knife and performance similar to diamond knife when making various incisions. This study was designed to determine whether a silicon accurate depth knife has equivalent performance characteristics when compared to a diamond limbal relaxing incision (LRI) knife and superior performance characteristics when compared to a steel accurate dept...

  18. Characteristics of Bone Injuries Resulting from Knife Wounds Incised with Different Forces.

    Science.gov (United States)

    Humphrey, Caitlin; Kumaratilake, Jaliya; Henneberg, Maciej

    2017-11-01

    The aim of this research was to experimentally determine the characteristics of incised bone wounds, which are commonly found in defense injuries. A specially constructed pivoting arm device was used to inflict wounds with controlled forces and direction. Five knives were selected to inflict the wounds on porcine forelimbs. Eight incised wounds were made per knife per force. A larger knife and a greater force caused longer and wider bone wounds. Comparisons of individual knives at the two forces produced varying results in the bone wounds. A correlation was seen between the force and the length (r = 0.69), width (r = 0.63), and depth (r = 0.57) of bone wounds. Serrated-edge and nonserrated knives can be distinguished from the appearance of the wound. The outcomes may be applicable in forensic investigations to ascertain the forces associated with incised wounds and identify the specific knife used. © 2017 American Academy of Forensic Sciences.

  19. Small-incision lenticule extraction (SMILE)

    DEFF Research Database (Denmark)

    Hansen, Rasmus Søgaard; Lyhne, Niels; Grauslund, Jakob

    2016-01-01

    surgery was 0.07 ± 0.03 (logMAR). However, 12 eyes (1.6 %) lost 2 or more lines of CDVA from before surgery to 3 months postoperatively. Simultaneous treatment of up to 3.00 D of astigmatism was not associated with less predictable refractive outcomes. CONCLUSIONS: In the short term, SMILE seemed......PURPOSE: To study the outcomes of small-incision lenticule extraction (SMILE) for treatment of myopia and myopic astigmatism. METHODS: Retrospective study of patients treated for myopia or myopic astigmatism with SMILE, using a VisuMax(®) femtosecond laser (Carl Zeiss Meditec, Jena, Germany...

  20. Single incision thoracoscopic sympathectomy for palmar and axillary hyperhidrosis

    Directory of Open Access Journals (Sweden)

    Aram Baram

    2014-02-01

    Full Text Available Background: Primary hyperhidrosis is characterized by excessive sweating beyond physiological needs. It is a common disease (incidence 2.8% that causes intense discomfort for patients. In the last decade, advantages of Single-Incision Thoracoscopic Sympathectomy have become clear, particularly in decreasing morbidity of sympathectomy. Patients and methods: From January 2010 to December 2012, 39 patients (29 females and 10 males with primary palmar or axillary hyperhidrosis were treated by thoracoscopic sympathectomy. The age ranged from 18 to 40 years with a mean of 26.28 years. We used single incision thoracoscopic electrocoagulation through 10 mm incision for thoracic sympathetic chain (T2–T4. Results: The mean follow-up was 23.6 ± 14.2 months (range = 4–24 months. A total of 97.42% of patients were satisfied with the results. A total of 72.5% of patients had cure, one patient (2.5% and another patient (2.5% presented with recurrent axillary hyperhidrosis. The morbidity was 10.2% with no mortality. Percentage of compensatory sweating and gustatory sweating were 5.1% (p = .353 and 2.5% (p = .552, respectively. The result of sympathectomy in patients with both palmar and axillary hyperhidrosis was significantly better (17, 43.58% compared to palmar type (14, 35.89% or axillary type (7, 17.94%. Conclusion: Thoracoscopic sympathectomy is a simple, safe, and cost-effective therapy with good results and low complications.

  1. Tubularized incised plate technique for recurrent hypospadias: a ...

    African Journals Online (AJOL)

    management of recurrent hypospadias. Summary background ... The potential advantages of tubularized incised plate .... after a mean duration of 4.9 ± 3.1 years from the previous repair (Table 2). .... erection and the risk of infection, especially in patients older than 15 .... However, previous surgery often limits the availability ...

  2. Effects of Bank Vegetation and Incision on Erosion Rates in an Urban Stream

    Directory of Open Access Journals (Sweden)

    Emily Arnold

    2018-04-01

    Full Text Available Changing land-use associated with urbanization has resulted in shifts in riparian assemblages, stream hydraulics, and sediment dynamics leading to the degradation of waterways. To combat degradation, restoration and management of riparian zones is becoming increasingly common. However, the relationship between flora, especially the influence of invasive species, on sediment dynamics is poorly understood. Bank erosion and turbidity were monitored in the Tookany Creek and its tributary Mill Run in the greater Philadelphia, PA region. To evaluate the influence of the invasive species Reynoutria japonica (Japanese knotweed on erosion, reaches were chosen based on their riparian vegetation and degree of incision. Bank pins and turbidity loggers were used to estimate sediment erosion. Erosion calculations based on bank pins suggest greater erosion in reaches dominated by knotweed than those dominated by trees. For a 9.5-month monitoring period, there was 29 cm more erosion on banks that were also incised, and 9 cm more erosion in banks with little incision. Turbidity responses to storm events were also higher (77 vs. 54 NTU (nephelometric turbidity unit in reaches with knotweed, although this increase was found when the reach dominated by knotweed was also incised. Thus, this study linked knotweed to increased erosion using multiple methods.

  3. Early Postoperative Nociceptive Threshold and Production of Brain-Derived Neurotrophic Factor Induced by Plantar Incision Are Not Influenced with Minocycline in a Rat: Role of Spinal Microglia

    Directory of Open Access Journals (Sweden)

    Eiji Masaki

    2016-03-01

    Full Text Available Background: Brain-derived neurotrophic factor (BDNF from spinal microglia is crucial for aberrant nociceptive signaling in several pathological pain conditions, including postoperative pain. We assess the contribution of spinal microglial activation and associated BDNF overexpression to the early post-incisional nociceptive threshold. Methods: Male Sprague-Dawley rats were implanted with an intrathecal catheter. A postoperative pain model was established by plantar incision. Thermal and mechanical nociceptive responses were assessed by infrared radiant heat and von Frey filaments before and after plantar incision. Rats were injected intrathecally the microglial activation inhibitor minocycline before incision, 24 h after incision, or both. Other groups were subjected to the same treatments and the L4-L5 spinal cord segment removed for immunohistochemical analysis of microglia activation and BNDF expression. Results: Plantar incision reduced both thermal latency and mechanical threshold, indicating thermal hypersensitivity and mechanical allodynia. Minocycline temporally reduced thermal withdrawal latency but had no effect on mechanical withdrawal threshold, spinal microglial activity, or dorsal horn BDNF overexpression during the early post-incision period. Conclusion: These results suggest that spinal microglia does not contribute substantially to post-incisional nociceptive threshold. The BDNF overexpression response that may contribute to postoperative hyperalgesia and allodynia is likely derived from other sources.

  4. Cost assessment of instruments for single-incision laparoscopic cholecystectomy

    DEFF Research Database (Denmark)

    Henriksen, Nadia A; Al-Tayar, Haytham; Rosenberg, Jacob

    2012-01-01

    Specially designed surgical instruments have been developed for single-incision laparoscopic surgery, but high instrument costs may impede the implementation of these procedures. The aim of this study was to compare the cost of operative implements used for elective cholecystectomy performed...

  5. Tubularized proximally-incised plate in distal/midshaft hypospadias repair

    Directory of Open Access Journals (Sweden)

    Antonio Marte

    2017-06-01

    Full Text Available The aim of this study was to verify the validity, feasibility, and the functional results, by uroflowmetry, of Tubularized proximallyincised plate technique in selected case of distal/midshaft hypospadias. Out of 120 patients scheduled to undergo TIP (or Snodgrass procedure, 23 were selected between January 2013 and January 2016 (19.1%. This case series comprised 16 patients with distal and 7 with midshaft hypospadias. Mean age at surgery was 2.9 years. The inclusion criteria were a deep and wide glandular groove and a proximal narrow urethral plate. The procedure was carried out as described by Snodgrass but the incision of the urethral plate, including the mucosal and submucosal tissue, was made only proximally, between the original meatus and the glandular groove in no case extending to the entire length of the plate. Postoperatively a foley catheter was left in place from 4 to 7 days. Uroflowmetry was performed when the patients age ranged from 2.5 to 5.7 years (mean age 3.11 years and mean follow-up 1.8 years, body surface 2. No patient presented fistulas nor perioperative complications. At uroflowmetry, eighteen patients presented values above the 25th percentile and 5 showed a borderline flow. All patients in this group remained stable without urinary symptoms. In selected cases, the tubularized proximally-incised plate yields satisfactory cosmetic and functional results for the treatment of midshaft proximal hypospadias. A long-term follow-up study is needed for further evaluation. Patient selection is crucial for the success of this technique.

  6. How well do the rosgen classification and associated "natural channel design" methods integrate and quantify fluvial processes and channel response?

    Science.gov (United States)

    Simon, A.; Doyle, M.; Kondolf, M.; Shields, F.D.; Rhoads, B.; Grant, G.; Fitzpatrick, F.; Juracek, K.; McPhillips, M.; MacBroom, J.

    2005-01-01

    Over the past 10 years the Rosgen classification system and its associated methods of "natural channel design" have become synonymous (to many without prior knowledge of the field) with the term "stream restoration" and the science of fluvial geomorphology. Since the mid 1990s, this classification approach has become widely, and perhaps dominantly adopted by governmental agencies, particularly those funding restoration projects. For example, in a request for proposals for the restoration of Trout Creek in Montana, the Natural Resources Conservation Service required "experience in the use and application of a stream classification system and its implementation." Similarly, classification systems have been used in evaluation guides for riparian areas and U.S. Forest Service management plans. Most notably, many highly trained geomorphologists and hydraulic engineers are often held suspect, or even thought incorrect, if their approach does not include reference to or application of a classification system. This, combined with the para-professional training provided by some involved in "natural channel design" empower individuals and groups with limited backgrounds in stream and watershed sciences to engineer wholesale re-patterning of stream reaches using 50-year old technology that was never intended for engineering design. At Level I, the Rosgen classification system consists of eight or nine major stream types, based on hydraulic-geometry relations and four other measures of channel shape to distinguish the dimensions of alluvial stream channels as a function of the bankfull stage. Six classes of the particle size of the boundary sediments are used to further sub-divide each of the major stream types, resulting in 48 or 54 stream types. Aside from the difficulty in identifying bankfull stage, particularly in incising channels, and the issue of sampling from two distinct populations (beds and banks) to classify the boundary sediments, the classification provides a

  7. Microincision versus small-incision coaxial cataract surgery using different power modes for hard nuclear cataract.

    Science.gov (United States)

    Kim, Eun Chul; Byun, Yong Soo; Kim, Man Soo

    2011-10-01

    To compare the efficacy of microincision and small-incision coaxial phacoemulsification in treating hard cataracts using different ultrasound power modes. Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea. Randomized clinical trial. Eyes with hard cataract were randomized to have an initial incision of 1.80 mm, 2.20 mm, or 2.75 mm. The eyes in each group were equally randomized to treatment with burst, pulse, or continuous mode. Ultrasound time (UST), mean cumulative dissipated energy (CDE), corrected distance visual acuity (CDVA), surgically induced corneal astigmatism, incisional and central corneal thickness (CCT), and endothelial cell counts were evaluated. The study enrolled 180 eyes, 60 in each group. Two months postoperatively, there were no statistically significant differences in UST, CDE, CDVA, CCT, or percentage endothelial cell loss between the 3 incision groups. The 2.75 mm incision induced more astigmatism at 2 months and less incisional corneal edema at 1 week than the 1.80 mm or 2.20 mm incision (Phard cataract. The intraoperative energy use and ocular damage was less with the pulse and burst modes than with the continuous mode. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  8. Ultrasonic diagnosis and transurethral incision of ureterocele with hydronephrosis

    DEFF Research Database (Denmark)

    Waaddegaard, P; Miskowiak, J; Stage, P

    1991-01-01

    In a 65-year-old woman with right-sided loin pain, ultrasonography revealed a grossly dilated and obstructed right pyelogram due to a 50-mm ureterocele. After transurethral lateral incision of the ureterocele, there was complete recovery without vesicoureteric reflux. Ultrasonography is advantage...

  9. Do Knickpoints Unzip Watersheds? Longitudinal Observations of Terrace and Hillslope Response to Mainstem Incision along the South Fork Eel River, California

    Science.gov (United States)

    Wehrs, K.; Crosby, B. T.

    2017-12-01

    River response to changes in climate and relative base level often leave behind a legacy of transient landforms that enable the interpretation of past events. The dominant paradigm is that base level fall initiates a wave of mainstem incision that progressively transmits change upstream. Mainstem-adjacent hillslopes coupled to the channel subsequently respond as their toe slopes are steepened. To test this paradigm, we first use a longitudinal set of mainstem terrace ages to evaluate whether incision incrementally progresses upstream or is contemporaneous. Second, we explore longitudinal variations in mainstem-adjacent mass movements to evaluate whether they reflect a time and space progression in response. The South Fork Eel River in northern California contains over 600 mainstem-adjacent mass movements and 60 m tall, longitudinally extensive strath terraces that record a landscape response to river incision. We use Optically Stimulated Luminescence, with feldspars and coarse-grained sampling technique, to determine the depositional age of alluvial fill atop the strath terrace. If terrace abandonment progressively young upstream, this suggests that base level fall was not spatially contemporaneous, but rather time progressive. As a consequence, the age, form, and extent of mass wasting events should also vary longitudinally. Because terraces isolate hillslopes from the base level fall signal, we use these surfaces to quantify hillslope form and function independent of that forcing. Preliminary results using mainstem-parallel, 1 m LiDAR, show significant variation in size of mass movements throughout the basin, with planar, linearly moving translational landslides dominating throughout the catchment. In the lower basin, well downstream of the current knickzone, we see an increase in mass movement concentration, reactivation, and overall extent of mass movements. Multiple factors confound our interpretation of hillslope morphology and response, due to changes in

  10. Histomorphological and immunofluorescence evaluation of clear corneal incisions after microcoaxial phacoemulsification with 2.2 mm and 1.8 mm systems.

    Science.gov (United States)

    Vasavada, Abhay R; Johar, Kaid; Praveen, Mamidipudi R; Vasavada, Viraj A; Arora, Anshul I

    2013-04-01

    To compare changes in the incision's histomorphology and denaturation of collagen I in rabbit eyes having microcoaxial phacoemulsification through 2.2 mm and 1.8 mm incision-compatible systems. Randomized experimental trial. Iladevi Cataract & IOL Research Centre, Ahmedabad, India. Thirty rabbit eyes were randomized into Group 1 (microcoaxial phacoemulsification through 2.2 mm incisions using Infiniti system [torsional ultrasound]) and Group 2 (microcoaxial phacoemulsification through 1.8 mm incisions using Stellaris system [longitudinal ultrasound]). Each group was then divided into 3 subgroups of 5 eyes each based on 1 of the 3 intervention options: phacoemulsification only, intraocular lens (IOL) insertion only, and phacoemulsification with IOL insertion. Left eyes were randomized for microcoaxial phacoemulsification, and right eyes were treated as controls. After phacoemulsification, eyes in Group 1 showed loss of epithelium at the roof of the incisions and Descemet membrane detachment at the floor of the incisions. These findings did not change after IOL insertion. After phacoemulsification, eyes in Group 2 showed loss of epithelium, but Descemet membrane remained attached. There was a longitudinal split in the incision's stroma in the direction of internal entry. The stromal damage increased after IOL implantation. Immunofluorescence studies showed no obvious irregularities in the arrangement of collagen I in either group. A dot blot analysis showed significant denaturation of collagen I in Group 2. The histomorphology of the 2.2 mm system incision showed localized Descemet membrane detachment and endothelial cell loss. The 1.8 mm system incision showed exaggerated stromal damage after IOL insertion. Copyright © 2013 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  11. The effect of kidney morcellation on operative time, incision complications, and postoperative analgesia after laparoscopic nephrectomy

    Directory of Open Access Journals (Sweden)

    Affonso H. Camargo

    2006-06-01

    Full Text Available INTRODUCTION: Compare the outcomes between kidney morcellation and two types of open specimen extraction incisions, several covariates need to be taken into consideration that have not yet been studied. MATERIALS AND METHODS: We retrospectively reviewed 153 consecutive patients who underwent laparoscopic nephrectomy at our institution, 107 who underwent specimen morcellation and 46 with intact specimen removal, either those with connected port sites with a muscle-cutting incision and those with a remote, muscle-splitting incision. Operative time, postoperative analgesia requirements, and incisional complications were evaluated using univariate and multivariate analysis, comparing variables such as patient age, gender, body mass index (BMI, laterality, benign versus cancerous renal conditions, estimated blood loss, specimen weight, overall complications, and length of stay. RESULTS: There was no significant difference for operative time between the 2 treatment groups (p = 0.65. Incision related complications occurred in 2 patients (4.4% from the intact specimen group but none in the morcellation group (p = 0.03. Overall narcotic requirement was lower in patients with morcellated (41 mg compared to intact specimen retrieval (66 mg on univariate (p = 0.03 and multivariate analysis (p = 0.049. Upon further stratification, however, there was no significant difference in mean narcotic requirement between the morcellation and muscle-splitting incision subgroup (p = 0.14. CONCLUSION: Morcellation does not extend operative time, and is associated with significantly less postoperative pain compared to intact specimen retrieval overall, although this is not statistically significant if a remote, muscle-splitting incision is made. Morcellation markedly reduces the risk of incisional-related complications.

  12. Three-dimensional observations of the incisive canal and the surrounding bone using cone-beam computed tomography

    International Nuclear Information System (INIS)

    Asaumi, Rieko; Kawai, Taisuke; Sato, Iwao; Yoshida, Shunji; Yosue, Takashi

    2010-01-01

    The shape of the anterior region of the maxilla is critical when planning implant treatment. The purpose of the present study was to assess the typical morphology of the incisive canal and surrounding bone. In total, 70 maxillae of Japanese dry skulls were used after being divided into dentate and edentulous groups. Cone-beam computed tomography (CBCT) images of the maxilla were acquired by using standardized methods. Using the anterior nasal spine as a reference point, the change in position was measured and analyzed statistically. Also, three-dimensional (3-D) images of the incisive canal were classified into five subsets: cylinder, groove, penetration, bifurcation at the superior portion, and bifurcation at the inferior portion. The quantity of alveolar bone in the incisor region was greatly reduced from the alveolar ridge and labial surface. Moreover, the vertical position of the incisive foramen was significantly (P<0.05) superior in the edentulous groups. Regarding the classification of maxillae by the 3-D shape of the incisive canal, many canals were cylindrical. Horizontal bone reduction from the labial side and vertical bone reduction from the alveolar crest were conspicuous; thus, the angle of the anterior alveolar bone changed after the loss of teeth. The incisive canal diameter in the edentulous group was larger than in the dentate group. The nondestructive assessment of the incisive canals and surrounding bone with CBCT showed two typical shapes for the presence or absence of the incisors. These findings indicate the importance of image diagnosis before esthetic restoration. (author)

  13. Heterotopic ossification in abdominal incision : a case report

    Energy Technology Data Exchange (ETDEWEB)

    Yoo, Yoon Sik; Nam, Kung Sook; Hwang, Im Kyung; Kim, Heung Chul [College of Medicine, Hallym Univ., Chuncheon (Korea, Republic of)

    2001-08-01

    Heterotopic ossification in abdominal incision is a rare post-surgical sequala and a subtype of myositis ossificans traumatica. Recognition of this rare condition is important because it may be misinterpreted as a retained foreign body or incisional neoplastic recurrence. We report a case involving a 59-year-old man who presented with a palpable epigastric mass and pronounced fatigability.

  14. Carbonate Channel-Levee Systems Influenced by Mass-Transport Deposition, Browse Basin, Australia

    Science.gov (United States)

    Dunlap, D.; Janson, X.; Sanchez-Phelps, C.; Covault, J. A.

    2017-12-01

    Submarine channels are primary conduits for clastic sediment transport to deep-water basins, thereby controlling the location of marine depocenters and sediment bypass. The evolution and depositional character of submarine channels have broad implications to sediment dispersal, sediment quality, and hydrocarbon exploration potential. Siliciclastic channel systems have been extensively studied in modern environments, seismic and outcrop; however, carbonate channel-levee deposits have only recently been explored. Here we utilize newly released high-resolution (90 Hz) seismic-reflection data from the Australian Browse Basin to document the influence of mass-transport complex (MTC) deposition on the stratigraphic architecture of carbonate channel-levee systems. The 2014 vintage seismic survey is 2500 km2 and hosts numerous large Miocene-age carbonate channel-levee complexes basinward of the shelf edge. Regional horizons and individual channel forms were mapped. Channels range from 200-300 m wide and are bounded by high-relief levee-overbank wedges (>100 ms TWTT). These channels extend across the survey area >70 km. The leveed-channels were sourced from middle and late Miocene slope gullies linked to platform carbonates. Slope-attached and locally derived MTC's are evident throughout the Miocene section likely related to periods of basin inversion and shelf-edge gully incision. We interpret that regionally extensive (>1000 km2) slope-attached MTC's can shut down a channel-levee system and trigger the initiation of a new system, whereas more locally derived (wasting and turbidity currents, which informs depositional models of carbonate slope systems and calls for re-evaluation of the controls on stratigraphic patterns in mixed siliciclastic-carbonate deep-water basins.

  15. Lateral Nail Fold Incision Technique for Venous Anastomosis in Fingertip Replantation.

    Science.gov (United States)

    Jeon, Byung-Joon; Yang, Jae-Won; Roh, Si Young; Ki, Sae Hwi; Lee, Dong Chul; Kim, Jin Soo

    2016-01-01

    Successful venous anastomosis is one of the most important factors in fingertip replantation. Volar veins in the fingertip course proximally in a random pattern, which makes it difficult to find out the exact locations. Although dorsal veins in the lateral nail fold have constant location and adequate diameter for anastomosis, they have been known as hard to dissect from the immobile subcutaneous tissue. The authors present a new lateral nail fold incision technique for venous anastomosis in the fingertip amputations. From February 2010 to October 2010, 9 replantations using the new incision and venous anastomosis technique were performed in 9 patients. The levels of amputations were from the nail base to half of the nail bed. After repairing the proper digital arteries, a skin incision was made along the junction between the lateral nail fold and nail bed. Careful dissection was performed to isolate the veins in the lateral nail fold. After evaluation of the suitability of the vessel, venous anastomosis was performed. Seven male and 2 female patients were enrolled in this study. Appropriate dorsal veins for anastomosis could be found in 8 of 9 patients. All the replanted stumps survived without venous congestion and following additional procedures. A sizable volar or dorsal vein could not be found in 1 patient. The salvage technique was required in this patient. Dorsal veins in the lateral nail fold can be found easily because of the constant anatomical location. The new incision on the lateral nail fold provides not only sufficient operative field for anastomosis but also additional opportunity of successful venous anastomosis in the selected cases. The authors, therefore, propose this technique as an effective method for an alternative venous anastomosis in the zone I replantation.

  16. Minimal Incision Scar-Less Open Umbilical Hernia Repair in Adults - Technical Aspects and Short Term Results

    Directory of Open Access Journals (Sweden)

    Sanoop Koshy Zachariah

    2014-09-01

    Full Text Available Background: There is no gold standard technique for umbilical hernia repair .Conventional open umbilical hernia repair often produces an undesirable scar. Laparoscopic umbilical hernia repair requires multiple incisions beyond the umbilicus, specialized equipments, and expensive tissue separating mesh. We describe our technique of open umbilical hernia repair utilizing a small incision. The technique was derived from our experience with single incision laparoscopy. We report the technical details and short term results. Methods: This is a retrospective analysis of the first 20 patients who underwent minimal incision scar-less open umbilical hernia repair, from June 2011 to February 2014. A single intra-umbilical curved incision was used to gain access to the hernia sac. Primary suture repair was performed for defects upto 2cm.Larger defects were repaired using an onlay mesh. In patients with a BMI of 30 kg/m2 or greater, onlay mesh hernioplasty was performed irrespective of the defect size.Results: A total of 20 patients, 12 males and 8 females underwent the procedure. Mean age was 50 (range 29 - 82 years. Mean BMI was 26.27 (range 20. -33.1 kg/m2. Average size of the incision was 1.96 range (1.5 to 2.5 cm. Mesh hernioplasty was done in 9 patients. 11 patients underwent primary suture repair alone. There were no postoperative complications associated with his technique. Average post operative length of hospital stay was 3.9 (range 2-10 days. Mean follow-up was 29.94 months, (2 weeks to 2.78 years. On follow up there was no externally visible scar in any of the patients. There were no recurrences on final follow up. Conclusion: This technique provides a similar cosmetic effect as obtained from single port laparoscopy. It is easy to perform safe, offers good cosmesis, does not require incisions beyond the umbilicus and cost effective, with encouraging results on short term follow up. Further research is needed to assess the true potential of the

  17. Chemical weathering as a mechanism for the climatic control of bedrock river incision

    Science.gov (United States)

    Murphy, Brendan P.; Johnson, Joel P. L.; Gasparini, Nicole M.; Sklar, Leonard S.

    2016-04-01

    Feedbacks between climate, erosion and tectonics influence the rates of chemical weathering reactions, which can consume atmospheric CO2 and modulate global climate. However, quantitative predictions for the coupling of these feedbacks are limited because the specific mechanisms by which climate controls erosion are poorly understood. Here we show that climate-dependent chemical weathering controls the erodibility of bedrock-floored rivers across a rainfall gradient on the Big Island of Hawai‘i. Field data demonstrate that the physical strength of bedrock in streambeds varies with the degree of chemical weathering, which increases systematically with local rainfall rate. We find that incorporating the quantified relationships between local rainfall and erodibility into a commonly used river incision model is necessary to predict the rates and patterns of downcutting of these rivers. In contrast to using only precipitation-dependent river discharge to explain the climatic control of bedrock river incision, the mechanism of chemical weathering can explain strong coupling between local climate and river incision.

  18. Stratigraphy and paleohydrology of delta channel deposits, Jezero crater, Mars

    Science.gov (United States)

    Goudge, Timothy A.; Mohrig, David; Cardenas, Benjamin T.; Hughes, Cory M.; Fassett, Caleb I.

    2018-02-01

    The Jezero crater open-basin lake contains two well-exposed fluvial sedimentary deposits formed early in martian history. Here, we examine the geometry and architecture of the Jezero western delta fluvial stratigraphy using high-resolution orbital images and digital elevation models (DEMs). The goal of this analysis is to reconstruct the evolution of the delta and associated shoreline position. The delta outcrop contains three distinct classes of fluvial stratigraphy that we interpret, from oldest to youngest, as: (1) point bar strata deposited by repeated flood events in meandering channels; (2) inverted channel-filling deposits formed by avulsive distributary channels; and (3) a valley that incises the deposit. We use DEMs to quantify the geometry of the channel deposits and estimate flow depths of ∼7 m for the meandering channels and ∼2 m for the avulsive distributary channels. Using these estimates, we employ a novel approach for assessing paleohydrology of the formative channels in relative terms. This analysis indicates that the shift from meandering to avulsive distributary channels was associated with an approximately four-fold decrease in the water to sediment discharge ratio. We use observations of the fluvial stratigraphy and channel paleohydrology to propose a model for the evolution of the Jezero western delta. The delta stratigraphy records lake level rise and shoreline transgression associated with approximately continuous filling of the basin, followed by outlet breaching, and eventual erosion of the delta. Our results imply a martian surface environment during the period of delta formation that supplied sufficient surface runoff to fill the Jezero basin without major drops in lake level, but also with discrete flooding events at non-orbital (e.g., annual to decadal) timescales.

  19. Small incision corneal refractive surgery using the small incision lenticule extraction (SMILE) procedure for the correction of myopia and myopic astigmatism: results of a 6 month prospective study.

    Science.gov (United States)

    Sekundo, Walter; Kunert, Kathleen S; Blum, Marcus

    2011-03-01

    This 6 month prospective multi-centre study evaluated the feasibility of performing myopic femtosecond lenticule extraction (FLEx) through a small incision using the small incision lenticule extraction (SMILE) procedure. Prospective, non-randomised clinical trial. PARTICIPANTS; Ninety-one eyes of 48 patients with myopia with and without astigmatism completed the final 6 month follow-up. The patients' mean age was 35.3 years. Their preoperative mean spherical equivalent (SE) was −4.75±1.56 D. A refractive lenticule of intrastromal corneal tissue was cut utilising a prototype of the Carl Zeiss Meditec AG VisuMax femtosecond laser system. Simultaneously two opposite small ‘pocket’ incisions were created by the laser system. Thereafter, the lenticule was manually dissected with a spatula and removed through one of incisions using modified McPherson forceps. Uncorrected visual acuity (UCVA) and best spectacle corrected visual acuity (BSCVA) after 6 months, objective and manifest refraction as well as slit-lamp examination, side effects and a questionnaire. Six months postoperatively the mean SE was −0.01 D±0.49 D. Most treated eyes (95.6%) were within ±1.0 D, and 80.2% were within ±0.5 D of intended correction. Of the eyes treated, 83.5% had an UCVA of 1.0 (20/20) or better, 53% remained unchanged, 32.3% gained one line, 3.3% gained two lines of BSCVA, 8.8% lost one line and 1.1% lost ≥2 lines of BSCVA. When answering a standardised questionnaire, 93.3% of patients were satisfied with the results obtained and would undergo the procedure again. SMILE is a promising new flapless minimally invasive refractive procedure to correct myopia.

  20. A method of posterior fossa dural incision to minimize hemorrhage from the occipital sinus: the "mosquito" method.

    Science.gov (United States)

    Lee, Hee Chang; Lee, Ji Yeoun; Ryu, Seul Ki; Lim, Jang Mi; Chong, Sangjoon; Phi, Ji Hoon; Kim, Seung-Ki; Wang, Kyu-Chang

    2016-12-01

    The posterior fossa dural opening requires the ligation of the occipital sinus to gain successful exposure. However, there could be a prominent occipital sinus which is functioning as the main drainage route and is harboring the risk of unpredictable massive hemorrhage during the dural opening. We introduce a safe method of posterior fossa dural incision to minimize hemorrhage from the occipital sinus using four curved hemostat clamps. For the dural incision at the midline part of the posterior cranial fossa, we used four curved hemostat clamps to occlude the prominent occipital sinus: one pair of clamps at the proximal part and the other pair at the distal part to occlude the occipital sinus. Dural incision was made between the two pairs of the curved hemostat clamps. By clamping of the sinus, it allows observation of possible brain swelling after occlusion of the occipital sinus as well as minimizes hemorrhage during incision of the midline dura of the posterior fossa. This method allows observation of brain swelling after occipital sinus occlusion and is an easy and safe incision of the midline dura minimizing hemorrhage in selected cases with a prominent occipital sinus.

  1. Advantages of the modified double ring areolar incision over the traditional areolar incision in multicentric breast fibroadenoma surgery.

    Science.gov (United States)

    Zhang, Mingliang; Shen, Gongjin; Zhang, Song; Cui, Zhen; Qian, Jun

    2017-09-01

    This study was conducted to investigate the clinical advantages of modified double ring areola incision (MDRAI) compared to ordinary areola incision (OAI) in multicentric breast fibroadenoma in women. Sixty cases of multicentric benign breast tumor were recruited from the First Affiliated Hospital of Bengbu Medical College from January to December 2016. The cases were divided into two groups according to surgical approach: MDRAI (n = 20) and OAI (n = 40). The operation duration, intraoperative blood loss, drainage time, and postoperative recurrence rate in the first six months were compared. The mean age and tumor locations were not statistically different between the groups (P > 0.05). However, more lesions and larger tumor diameter were found in the MDRAI group than in the OAI group, with statistical difference (P  0.05). However, the intraoperative blood loss was statistically different between the two groups (P < 0.05). All 60 cases received six months of follow-up. Eight recurrent cases were found in the OAI group, but none in the MDRAI group. The recurrence rate was significantly different (χ 2  = 4.62, P < 0.05). Compared with OAI, MDRAI offers greater advantages in the aspects of blood loss and recurrence for the treatment of breast benign tumor, especially for multicentric larger lesions. © 2017 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.

  2. The Problem of the Pannus: Physician Preference Survey and a Review of the Literature on Cesarean Skin Incision in Morbidly Obese Women.

    Science.gov (United States)

    Smid, Marcela C; Smiley, Sarah G; Schulkin, Jay; Stamilio, David M; Edwards, Rodney K; Stuebe, Alison M

    2016-04-01

    This study aims to determine preferences of a nationally representative sample of obstetrician/gynecologists (OB/GYNs) regarding cesarean delivery (CD) incision practices for women with morbid obesity (body mass index ≥ 40 kg/m(2)). We conducted an online survey using the American College of Obstetricians and Gynecologists database. We compared physician demographics, practice characteristics, and CD incision type preference. After exclusion of ineligible participants, 247 OB/GYNs completed the survey (42% response rate). In nonemergency CD of morbidly obese women, 84% of physicians preferred a Pfannenstiel skin incision (67% preferring taping the pannus; 17% without taping the pannus). In emergency CD, 66% preferred a Pfannenstiel incision (46% without taping the pannus; 20% with taping the pannus) and 20% a vertical incision. For both emergency and nonemergency CD, there was no difference in incision type preferences by provider years in practice, practice scope, or number of CD performed each year. Given the preference of a Pfannenstiel incision with taping the pannus during CD of morbidly obese women, further investigation is needed to assess the risks and benefits of this incision and the practice of elevating the pannus. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  3. Gynecomastia: glandular-liposculpture through a single transaxillary one hole incision.

    Science.gov (United States)

    Lee, Yung Ki; Lee, Jun Hee; Kang, Sang Yoon

    2018-04-01

    Gynecomastia is characterized by the benign proliferation of breast tissue in men. Herein, we present a new method for the treatment of gynecomastia, using ultrasound-assisted liposuction with both conventional and reverse-cutting edge tip cannulas in combination with a pull-through lipectomy technique with pituitary forceps through a single transaxillary incision. Thirty patients were treated with this technique at the author's institution from January 2010 to January 2015. Ten patients were treated with conventional surgical excision of the glandular/fibrous breast tissue combined with liposuction through a periareolar incision before January 2010. Medical records, clinical photographs and linear analog scale scores were analyzed to compare the surgical results and complications. The patients were required to rate their cosmetic outcomes based on the linear analog scale with which they rated their own surgical results; the mean overall average score indicated a good or high level of satisfaction. There were no incidences of skin necrosis, hematoma, infection and scar contracture; however, one case each of seroma and nipple inversion did occur. Operative time was reduced overall using the new technique since it is relatively simple and straightforward. According to the evaluation by the four independent researchers, the patients treated with this new technique showed statistically significant improvements in scar and nipple-areolar complex (NAC) deformity compared to those who were treated using the conventional method. Glandular liposculpture through a single transaxillary incision is an efficient and safe technique that can provide aesthetically satisfying and consistent results.

  4. Triple pelvic osteotomy in Legg-Calve-Perthes disease using a single anterolateral incision: a 4-year review.

    LENUS (Irish Health Repository)

    Conroy, Eimear

    2010-07-01

    Femoral head incongruency at skeletal maturity is associated with the development of osteoarthritis in early adulthood. Containment of the femoral head provides a larger surface area for remodelling of the collapsed femoral head and the development of spherical congruency. Triple pelvic osteotomy has a role to play in Legg-Calve-Perthes\\' disease by improving femoral head containment and preventing subluxation. This is traditionally a two-incision approach with significant associated morbidity. In our unit we perform triple osteotomies through a single anterolateral incision. To retrospectively review the clinical and radiographic outcome of children who had triple osteotomies performed through a single incision over a 4-year period. In our unit from 2003 to 2006 we performed eight triple osteotomies through a single incision in children aged between 6 and 12 years with Legg-Calve-Perthes\\' disease. The procedure was performed through a single anterolateral incision made beneath the middle of the iliac crest and carried forward according to Salter\\'s osteotomy. Image intensification was used to confirm iliac, pubic and ischial cuts. After performing a standard Salter\\'s osteotomy the acetabular fragment was free to rotate anteriorly and laterally. None of the children were casted and all were allowed immediate mobilization nonweight bearing with crutches for 6 weeks. Clinical results and hip function were measured preoperatively and postoperatively using the modified Harris hip score. The average length of hospital stay was 4.7 days. None of the children had a nonunion. The centre edge angle of Wiberg was measured on all preoperative and postoperative anteroposterior pelvic radiographs. In all our patients there was an improvement in the centre edge angle of Wiberg and in the modified Harris hip score. The preoperative modified Harris hip scores ranged from 38 to 60 and postoperatively ranged from 77 to 92. The preoperative centre edge angle of Wiberg ranged

  5. In vivo architectural analysis of 3.2 mm clear corneal incisions for phacoemulsification using optical coherence tomography.

    Science.gov (United States)

    Torres, Luis F; Saez-Espinola, Fidelia; Colina, Juner M; Retchkiman, Myriam; Patel, Milan R; Agurto, Ricardo; Garcia, Gerardo; Diaz, Jose L; Huang, David; Schanzlin, David J; Chayet, Arturo S

    2006-11-01

    To analyze in vivo the architecture of clear corneal incisions (CCIs) for phacoemulsification using optical coherence tomography (OCT). Anterior Segment Department, Asociacion Para Evitar la Ceguera en Mexico, Hospital Dr Luis Sanchez Bulnes, Mexico. A prospective masked study analyzed 20 unsutured CCIs placed superiorly and created in a uniplanar fashion with a 3.2 mm slit-angled metal keratome. All wounds were evaluated with a retinal OCT model 1, 3, and 30 days postoperatively. Intraocular pressure (IOP) and incision leakage were checked. The architecture was described according to the angle of incidence, apposition of the epithelial and endothelial margins, and wound sealing. No leakage was detected. The angle varied from 33 to 85 degrees; angles greater than 75 degrees were done by a surgeon in training. Wound apposition at the epithelial margin was achieved in all cases. In contrast, imperfect apposition of the endothelial margin was seen in 45% of incisions on day 1 and in 15% on day 30. Incomplete sealing of the wound was seen by OCT in 25% of cases at 24 hours and persisted in 10% of all cases at 1 month. This gaping occurred on the endothelial side and never translated to the epithelial margin. No statistical correlation was found between gaping and the angle of the incision, IOP variations, or surgeon experience. Although in vivo CCIs caused minor anatomic imperfections, they were clinically stable independent of incision angle, IOP variation, and surgeon experience. Incision stability may be related to careful wound construction, epithelial viability, stromal edema, and efficient endothelial pumping.

  6. Quantitative analysis of the relationship between maxillary incisors and the incisive canal by cone-beam computed tomography in an adult Japanese population

    Directory of Open Access Journals (Sweden)

    Tomonari Matsumura

    2017-08-01

    Full Text Available Abstract Background In setting goals for orthodontic treatment, determining the morphologies of the alveolar bone and maxillary incisor root is important for avoiding root resorption, dehiscence, and fenestration. This study aimed to analyze the configurational relationships among maxillary incisors, the alveolar border, and the incisive canal by cone-beam computed tomography (CBCT. Methods Cone-beam CT images of 93 orthodontic patients were evaluated for length of the incisive canal (L; angles between the palatal plane and the maxillary alveolar border (θ1, the incisive canal (θ2, and maxillary incisor (θ3; distance from the left maxillary incisor to the incisive canal (D; and cross-sectional areas of the incisive canal (CSAs at three vertical levels. Comparison of variables between male and female patients was performed with the two-sample t test. Correlations between parameters were examined by Pearson’s correlation analysis and Bonferroni correction for multiple comparisons. Results Male patients exhibited significantly greater values of L than female patients. There were significant positive correlations between θ1 and θ2, θ2 and θ3, and θ3 and θ1. While the value of D was the lowest at the oral opening, that of the cross-sectional area of the incisive canal (CSA was the greatest at the incisal root apex. Conclusions This study demonstrated that the incisive canal had large inter-individual variability, and the proximity between the incisive canal and the incisal root could not be precisely predicted by the conventional cephalograms. Therefore, pre-treatment CBCT examination should be recommended when a large amount of maxillary anterior retraction and/or intrusion is planned in orthodontic diagnosis.

  7. Cervical and incisal marginal discrepancy in ceramic laminate veneering materials: A SEM analysis

    Directory of Open Access Journals (Sweden)

    Hemalatha Ranganathan

    2017-01-01

    Full Text Available Context: Marginal discrepancy influenced by the choice of processing material used for the ceramic laminate veneers needs to be explored further for better clinical application. Aims: This study aimed to evaluate the amount of cervical and incisal marginal discrepancy associated with different ceramic laminate veneering materials. Settings and Design: This was an experimental, single-blinded, in vitro trial. Subjects and Methods: Ten central incisors were prepared for laminate veneers with 2 mm uniform reduction and heavy chamfer finish line. Ceramic laminate veneers fabricated over the prepared teeth using four different processing materials were categorized into four groups as Group I - aluminous porcelain veneers, Group II - lithium disilicate ceramic veneers, Group III - lithium disilicate-leucite-based veneers, Group IV - zirconia-based ceramic veneers. The cervical and incisal marginal discrepancy was measured using a scanning electron microscope. Statistical Analysis Used: ANOVA and post hoc Tukey honest significant difference (HSD tests were used for statistical analysis. Results: The cervical and incisal marginal discrepancy for four groups was Group I - 114.6 ± 4.3 μm, 132.5 ± 6.5 μm, Group II - 86.1 ± 6.3 μm, 105.4 ± 5.3 μm, Group III - 71.4 ± 4.4 μm, 91.3 ± 4.7 μm, and Group IV - 123.1 ± 4.1 μm, 142.0 ± 5.4 μm. ANOVA and post hoc Tukey HSD tests observed a statistically significant difference between the four test specimens with regard to cervical marginal discrepancy. The cervical and incisal marginal discrepancy scored F = 243.408, P < 0.001 and F = 180.844, P < 0.001, respectively. Conclusion: This study concluded veneers fabricated using leucite reinforced lithium disilicate exhibited the least marginal discrepancy followed by lithium disilicate ceramic, aluminous porcelain, and zirconia-based ceramics. The marginal discrepancy was more in the incisal region than in the cervical region in all the groups.

  8. Relationship between peri-incisional dysesthesia and the vertical and oblique incisions on the hamstrings harvest in anterior cruciate ligament reconstruction

    Directory of Open Access Journals (Sweden)

    Marcos Laube Leite

    Full Text Available ABSTRACT OBJECTIVE: To compare the incidence of peri-incisional dysesthesia according to the skin incision technique for hamstring tendon graft harvest in anterior cruciate ligament reconstruction. METHODS: Thirty-three patients with ACL rupture were separated in two groups: group 1, with 19 patients submitted to the oblique skin incision to access the hamstrings and group 2-14 patients operated by vertical skin incision technique. The selected patients were assessed after surgery. Demographic data and prevalence of dysesthesia was measured by digital pressure around the skin incision and classified according to the Highet scale. RESULTS: The total rate of dysesthesia was 42% (14 patients. Five patients (26% on the oblique incision group reported dysesthesia symptoms. On the group submitted to the vertical incision technique, the involvement was 64% (nine patients. On the 33 knees evaluated, the superior lateral area was the most affected skin region, while the superior medial and inferior medial regions were affected in only one patient (7.1%. No statistical differences between both groups were observed regarding patients' weight, age, and height¸ as well as skin incision length. CONCLUSION: Patients who underwent reconstruction of the anterior cruciate ligament using the oblique access technique had five times lower incidence of peri-incisional dysesthesia when compared with those in whom the vertical access technique was used.

  9. [Is there a relation between mammaplasties incisions and the final shape of the breast?].

    Science.gov (United States)

    Moufarrège, R; Dionyssopoulos, A; Aymeric, A; Sauvageau, J

    2010-04-01

    The results of reduction mammoplasty and mastopexy demonstrate a great variety of shapes derived from the particularities inherent to each technique. More precisely, it has become apparent to us that the usage of an abnormally long vertical scar leads to a suboptimal final shape of the breast due to the excessive projection compared to its height. Although our clientele continually asks to minimize scars, we have noticed a resurgence in the literature of vertical incision mammoplasty techniques albeit with a scar of an excessive length. The multitude of publications leads to an evident and consistent conclusion: breasts reconstructed with an overly long vertical incision all suffer the same deformity characterized by a banana or squash-shaped breast. We studied the totality of publications on vertical incision technique mammoplasty from the last 15 years and realised they all presented the same problem: an abnormally low height/projection ratio. These numbers have been confronted by the golden ratio established by the first author (2005) [1]. The breast's golden ratio developed by Moufarrège is optimal at a number close to, or superior to 2. Results between 2 and 1.5 are acceptable. All height/projection ratios inferior to 1.5 correspond to suboptimal breast shapes. Furthermore, the totality of results in the vertical scar mammoplasty technique which displayed unsatisfying results had a height/projection ratio inferior to 1.5. Those who promote the vertical incision have the greatest drive to encourage other plastic surgeons to abandon the traditional mutilating boat anchor scar. Nevertheless, they should always remember the deforming effect caused by exaggerated vertical incisions which may be avoided by transforming it into an inverted T with short horizontal branches, a small price to pay to obtain a superior aesthetic result. Copyright 2009 Elsevier Masson SAS. All rights reserved.

  10. High-power diode laser in the circumvestibular incision for Le Fort I osteotomy in orthognathic surgery: a prospective case series study.

    Science.gov (United States)

    Jaeger, Filipe; Chiavaioli, Gustavo Marques; de Toledo, Guilherme Lacerda; Freire-Maia, Belini; Amaral, Marcio Bruno Figueiredo; Mesquita, Ricardo Alves

    2018-01-01

    The incisions during orthognathic surgery are classically performed with conventional scalpel or electrocautery. Considering that the high-power diode laser surgery may provide advantages when compared to conventional incision techniques, the current study aimed to present a prospective case series of patients submitted to circumvestibular incision for Le Fort I osteotomy. Ten patients with dentofacial deformities who underwent to rapid assisted maxillary expansion or bimaxillary orthognathic surgery were enrolled in the study. All incisions were performed by a single surgeon using an 808-nm diode laser, with an optical fiber of 600 μm, at a power of 2.5 W, in a continuous-wave mode. The performance of the incision was evaluated by incision velocity, bleeding, edema, secondary infection, clinical healing, and pain. The velocity of the incision ranged from 0.10 to 0.20 mm/s (mean 0.13 ± 0.03 mm/s). Considering bleeding during the soft tissue incision, all surgeries were classified as absent bleeding. All patients presented a clinical healing of the surgical wound in a period that range from 3 to 5 weeks and experienced swelling during the follow-up period. On average, approximately 50% of the swelling had resolved after the third postoperative week, and 28.8% of swelling remained after 2 months after the surgery. The pain decreased after 2 and 3 days, and 90.0% of the patients reported no pain after 7 postoperative days. High-power diode laser is effective and safety during circumvestibular incisions for Le Fort I osteotomy in orthognathic surgery decreasing bleeding, surgery time, pain, and edema after orthognathic surgery.

  11. CO2 temperature-controlled laser soldering of pig trachea incisions in vitro using flexible albumin bands

    Science.gov (United States)

    Sharvit, Dan; Vasilyev, Tamar; Vasserman, Irena; Simhon, David; Kariv, Naam; DeRowe, Ari; Katzir, Abraham

    2005-04-01

    Resection of a segment of the trachea is a procedure applied for the removal of cervical tumors invading the trachea, or for the treatment of severe tracheal stenosis. The current method of anastomosis is based on multiple sutures. The main drawbacks of this method are: 1) A long procedure time, 2) An air leakage, and 3) An inflammatory response to the sutures. In this study we evaluated the feasibility and effectiveness of the use of temperature controlled CO2 laser soldering of incisions in pig tracheas in vitro. A transverse incision was made in a separated pig trachea. A flexible albumin band was prepared and was laser soldered with albumin solder to the outer surface of the trachea, covering the incision. The soldered trachea ends were sealed and the burst pressure was measured. In a series of in vitro experiments, the mean burst pressure was found to be 230 mm Hg. These preliminary results demonstrated that laser soldering using a flexible albumin band may be a useful method for sealing an incision in the trachea.

  12. Single-incision laparoscopic distal gastrectomy for early gastric cancer through a homemade single port access device.

    Science.gov (United States)

    Jiang, Zhi-Wei; Zhang, Shu; Wang, Gang; Zhao, Kun; Liu, Jiang; Ning, Li; Li, Jieshou

    2015-01-01

    We presented a series of single-incision laparoscopic distal gastrectomies for early gastric cancer patients through a type of homemade single port access device and some other conventional laparoscopic instruments. A single-incision laparoscopic distal gastrectomy with D1 + α lymph node dissection was performed on a 46 years old male patient who had an early gastric cancer. This single port access device has facilitated the conventional laparoscopic instruments to accomplish the surgery and we made in only 6 minutes. Total operating time for this surgery was 240 minutes. During the operation, there were about 100 milliliters of blood loss, and 17 lymph-nodes were retrieved. This homemade single port access device shows its superiority in economy and convenience for complex single-incision surgeries. Single-incision laparoscopic distal gastrectomy for early gastric cancer can be conducted by experienced laparoscopic surgeons. Fully take advantage of both SILS and fast track surgery plan can bring to successful surgeries with minimal postoperative pain, quicker mobilization, early recovery of intestinal function, and better cosmesis effect for the patients.

  13. Normalized Urinary Flow at Puberty after Tubularized Incised Plate Urethroplasty for Hypospadias in Childhood.

    Science.gov (United States)

    Andersson, Marie; Doroszkiewicz, Monika; Arfwidsson, Charlotte; Abrahamsson, Kate; Sillén, Ulla; Holmdahl, Gundela

    2015-11-01

    An obstructive urinary flow pattern is frequently seen after tubularized incised plate urethroplasty for hypospadias. However, the significance of this finding has not been determined and long-term results are few. We describe postoperative long-term uroflowmetry results after puberty in males who underwent tubularized incised plate urethroplasty in childhood. A total of 126 boys underwent tubularized incised plate urethroplasty for distal penile to mid shaft hypospadias at Queen Silvia Children's Hospital in Gothenburg between 1999 and 2003. Of the patients 48 were toilet trained at surgery. We report on 40 patients who had data available at 2 and 12 months postoperatively, 7 years postoperatively and at puberty (median age 15.0 years, range 13.7 to 17.1). Of the patients 31 had distal and 9 had mid penile hypospadias. Clinical examination, urinary medical history, uroflowmetry and ultrasound measuring residual urine were performed. Maximum urinary flow was correlated to age and voided volume, using Miskolc nomograms for comparison of percentiles. At 1 year postoperatively 15 boys (37.5%) had normal urinary flow (above 25th percentile), compared to 16 (40%) at 7 years and 38 (95%) at puberty (p puberty for boys with hypospadias treated with tubularized incised plate urethroplasty. Unless symptoms occur, a conservative approach seems preferable. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  14. Comparison of short-term outcomes between laparoscopically-assisted vs. transverse-incision open right hemicolectomy for right-sided colon cancer: a retrospective study

    Directory of Open Access Journals (Sweden)

    Akaraviputh Thawatchai

    2007-05-01

    Full Text Available Abstract Background Laparoscopically-assisted right hemicolectomy (LRH is an acceptable alternative to open surgery for right-sided colon cancer which offers patients less pain and faster recovery. However, special equipment and substantial surgical experience are required. The aim of the study is to compare the short-term surgical outcomes of LRH and open right hemicolectomy through right transverse skin crease incision (ORHT for right-sided colon cancer. Patients and methods This retrospective study included 33 patients with right-sided colon cancer who underwent elective right hemicolectomy by laparoscopic or open approaches through right transverse skin crease incision between March 2004 and September 2006 at the Department of Surgery, Faculty of Medicine Siriraj Hospital. Operative details, postoperative requirement of narcotics, recovery of bowel function, and oncological parameters were analyzed. Results Thirteen patients underwent LRH and 20 patients underwent ORHT. Both approaches achieved adequate oncological resection of the tumor. The laparoscopic group were characterized by shorter average incision lengths (7.7 vs 10.3 cm; p Conclusion LRH and ORHT for right-sided colon cancer resulted in the same short-term surgical outcomes including postoperative bowel function, narcotics consumption and length of hospital stay. However, LRH required a significantly longer operating time.

  15. Seismic patterns and migration history of submarine fan channels in deep-water area, Niger Delta, West Africa

    Science.gov (United States)

    Zhang, Guotao; Zhang, Shangfeng; Li, Yuan

    2015-04-01

    The channels of deep-water submarine fan under Niger delta slope are characterized by large dimensions special deposition positions and complex formation processes, its geographical location and sedimentary environment also hinder the research and exploration development. According to the strata slicing, RMS amplitude attribute and other techniques, we exhibit the platforms patterns of channels at different period, and based on the analysis of internal architecture and deformation history of channel-leveed systems, migration and evolution process of channel systems could be understood accurately. A great quantity of isolated channels develop in middle Miocene and aggrading streams in late Miocene, which generating because of large scale of turbidity caused by the drop of second order sea-level, which characterized by vertical accretion at smooth channel, while vertical accretion and lateral migration at bend. Evolution of channel systems can be divided into three stages: the initial erosion, erosion and filling alternately, and abandoned stage. With these three stages, the sinuosity of channel change from moderate to high, then decrease. Incision and filling of channels, being during the three development phases, is the driving force of meander-loops migration, which promote three kinds of migration patterns: lateral, down-system and combination migration. The research provides theoretical basis for high-precision prediction and evaluation of deep-water reservoir.

  16. Virtual Incision Pattern Planning using Three-Dimensional Images for Optimization of Syndactyly Surgery

    Directory of Open Access Journals (Sweden)

    Inge A. Hoevenaren, MD

    2018-03-01

    Full Text Available Summary:. Syndactyly is a congenital condition characterized by fusion of the fingers. If not treated correctly during infancy, syndactyly may hinder the normal development of hand function. Many surgical techniques have been developed, with the main goal to create a functional hand with the smallest number of operative corrections. Therefore, exact preoperative planning of the reconstructive procedure is essential. An imaging method commonly used for preoperative planning is 3-dimensional (3D surface imaging. The goal of this study was to implement the use of this technique in hand surgery, by designing a virtual planning tool for a desyndactylization procedure based on 3D hand images. A 3D image of a silicon syndactyly model was made on which the incision pattern was virtually designed. A surgical template of this pattern was printed, placed onto the silicon model and delineated. The accuracy of the transfer from the virtual delineation toward the real delineation was calculated, resulting in a mean difference of 0.82 mm. This first step indicates that by using 3D images, a virtual incision pattern can be created and transferred back onto the patient successfully in an easy and accurate way by using a template. Thereafter, 3D hand images of 3 syndactyly patients were made, and individual virtual incision patterns were created. Each pattern was transferred onto the patient by using a 3D printed template. The resulting incision pattern needed minor modifications by the surgeon before the surgery was performed. Further research and validation are necessary to develop the virtual planning of desyndactylization procedures.

  17. Quantifying incision rates since the early Miocene: novelties, potentialities and limitations

    Science.gov (United States)

    Sartégou, A.; Braucher, R.; Blard, P. H.; Bourlès, D. L.; Zimmermann, L.; Tibari, B.; Voinchet, P.; Bahain, J. J.; Sorriaux, P.; Leanni, L.; Team, A.

    2017-12-01

    The rates and chronologies of valley incision are closely modulated by the tectonic uplift of active mountain ranges and were controlled by repeated climate changes during the Quaternary. The Pyrenees are a continental collision between the Iberian and Eurasian plates induced a double vergence orogen, which has been considered as a mature mountain range in spite of significant seismicity and evidence of neotectonics. Nevertheless, recent studies indicate that the range may have never reached a steady state. One option for resolving this controversy is to quantify the incision rates since the Miocene by reconstructing the vertical movement of geometric markers. However, the few available ages from the Pyrenean terrace systems do not exceed the middle Pleistocene. To enlarge the time span of this dataset, we studied alluvium-filled horizontal epiphreatic passages in limestone karstic networks, which represent former valley floors. They record the transient position of former local base levels during the process of valley deepening. We used various suitable geochronological methods (26Al/10Be, 10Be/21Ne, ESR and OSL burial durations on quartz) on intrakarstic alluvial deposits from three valleys of the central and eastern Pyrenees, as well as on a recent analogue. In the Pyrenean context, under particular conditions, these geochronometers allow us to document incision processes since 16-13 Ma, and to study influences of external forcing and eustatism. In comparison with other studies, it appears that incision rates are higher in the central Pyrenees and for the Spanish slope. However, the density of horizontal levels on an altimetric range, the geodynamical and paleoclimatic contexts, the reorganization of the drainage networks can make the filling stories of the networks more complex than expected. Indeed, these radiometric approaches may be limited when some formations are reworked inside and/or outside the karst. The validity of dosimetric methods in a mountainous

  18. Solo Single-Incision Laparoscopic Resectional Roux-en-Y Gastric Bypass for Morbid Obesity with Metabolic Syndrome.

    Science.gov (United States)

    Kang, So Hyun; Lee, Yoontaek; Park, Young Suk; Ahn, Sang-Hoon; Park, Do Joong; Kim, Hyung-Ho

    2017-12-01

    With the advancement of laparoscopic devices and surgical technology, the era of minimal invasive surgery has progressed to reduced-port surgery, and finally to single-incision laparoscopic surgery (SILS). Several reports show successful application of SILS to various types of bariatric surgery. Oftentimes, this requires a skilled and experienced scopist to perform the procedure. To overcome the technical difficulties of single-incision Roux-en-Y gastric bypass, a manual scope holder was used instead of an assistant scopist, greatly stabilizing the field of view. This allows the surgery to be performed at any time without being influenced by the need of a highly experienced scopist. In this report, we describe in detail the world's first solo single-incision laparoscopic resectional Roux-en-Y gastric bypass.

  19. Formation of Valley Networks in a Cold and Icy Early Mars Climate: Predictions for Erosion Rates and Channel Morphology

    Science.gov (United States)

    Cassanelli, J.

    2017-12-01

    Mars is host to a diverse array of valley networks, systems of linear-to-sinuous depressions which are widely distributed across the surface and which exhibit branching patterns similar to the dendritic drainage patterns of terrestrial fluvial systems. Characteristics of the valley networks are indicative of an origin by fluvial activity, providing among the most compelling evidence for the past presence of flowing liquid water on the surface of Mars. Stratigraphic and crater age dating techniques suggest that the formation of the valley networks occurred predominantly during the early geologic history of Mars ( 3.7 Ga). However, whether the valley networks formed predominantly by rainfall in a relatively warm and wet early Mars climate, or by snowmelt and episodic rainfall in an ambient cold and icy climate, remains disputed. Understanding the formative environment of the valley networks will help distinguish between these warm and cold end-member early Mars climate models. Here we test a conceptual model for channel incision and evolution under cold and icy conditions with a substrate characterized by the presence of an ice-free dry active layer and subjacent ice-cemented regolith, similar to that found in the Antarctic McMurdo Dry Valleys. We implement numerical thermal models, quantitative erosion and transport estimates, and morphometric analyses in order to outline predictions for (1) the precise nature and structure of the substrate, (2) fluvial erosion/incision rates, and (3) channel morphology. Model predictions are compared against morphologic and morphometric observational data to evaluate consistency with the assumed cold climate scenario. In the cold climate scenario, the substrate is predicted to be characterized by a kilometers-thick globally-continuous cryosphere below a 50-100 meter thick desiccated ice-free zone. Initial results suggest that, with the predicted substrate structure, fluvial channel erosion and morphology in a cold early Mars

  20. Mitigation of Flood Hazards Through Modification of Urban Channels and Floodplains

    Science.gov (United States)

    Miller, A. J.; Lee, G.; Bledsoe, B. P.; Stephens, T.

    2017-12-01

    Small urban watersheds with high percent impervious cover and dense road and storm-drain networks are highly responsive to short-duration high-intensity rainfall events that lead to flash floods. The Baltimore metropolitan area has some of the flashiest urban watersheds in the conterminous U.S., high frequency of channel incision in affected areas, and a large number of watershed restoration projects designed to restore ecosystem services through reconnection of the channel with the floodplain. A question of key importance in these and other urban watersheds is to what extent we can mitigate flood hazards and urban stream syndrome through restoration activities that modify the channel and valley floor. Local and state governments have invested resources in repairing damage caused by extreme events like the July 30, 2016 Ellicott City flood in the Tiber River watershed, as well as more frequent high flows in other local urban streams. Recent reports have investigated how much flood mitigation may be achieved through modification of the channel and floodplain to enhance short-term storage of flood waters on the valley floor or in other subsurface structures, as compared with increasing stormwater management in the headwaters. Ongoing research conducted as part of the UWIN (Urban Water Innovation Network) program utilizes high-resolution topographic point clouds derived by processing of photographs from hand-held cameras or video frames from drone overflights. These are used both to track geomorphic change and to assess flood response with 2d hydraulic modeling tools under alternative mitigation scenarios. Assessment metrics include variations in inundation extent, water depth, hydrograph attenuation, and temporal and spatial characteristics of the 2d depth-averaged velocity field. Examples from diverse urban watersheds are presented to illustrate the range of anticipated outcomes and potential constraints on the effectiveness of downstream vs. headwater mitigation

  1. [Antero-medial incision of knee joint for the treatment of intercondylar fracture of femur].

    Science.gov (United States)

    Yin, Zi-Fei; Sun, Bin-Feng; Yang, Xiao-Hai; Wang, Qing; Qian, Ping-Kang; Wu, Xiao-Feng; Xu, Feng

    2017-12-25

    To explore the clinical effect of antero-medial incision of knee joint in treating intercondylar fracture of femur. From September 2012 to March 2015, 24 patients with intercondylar fracture of femur were selected, including 17 males and 7 females, aged from 20 to 65 years old with an average of(38.3±9.5) years old. Among them, 12 cases were caused by traffic accident, 8 cases were caused by falling injury and 4 cases were caused by falling down. All patients were closed fractures. The time from injury to hospital was from 30 min to 8 h with an average of(2.2±0.3) h. According to AO classification, 4 cases were type B1, 3 type B2, 2 type B3, 5 type C1, 6 type C2 and 4 type C3. All patients were treated with antero-medial incision of knee joint. Operative time, blood loss and postoperative complications were observed and recovery of keen function was evaluated by Kolmert scoring. All patients were followed-up from 6 to 12 months with average of (9.0±1.7) months. Operative time ranged from 50 to 90 min with an average of (70.0±8.2) min; blood loss ranged from 90 to 400 ml with an average of (180±36) ml; negative pressure flow was from 30 to 90 ml, with an average of (50.0±7.1) ml. All fracture were healed at stage I without loosening of internal fixator, fracture nonunion, and deep vein thrombosis. According to Kolmert scoring, 16 patients got excellent result, 5 patients good and 3 fair. Antero-medial incision of knee joint in treating intercondylar fracture of femur, which has advantages of good fracture reduction, less injury of soft tissue and simple operation, could obtain good clinical results.

  2. Maternal infection rates after cesarean delivery by Pfannenstiel or Joel-Cohen incision: a multicenter surveillance study.

    Science.gov (United States)

    Dumas, Anne Marie; Girard, Raphaële; Ayzac, Louis; Caillat-Vallet, Emmanuelle; Tissot-Guerraz, Françoise; Vincent-Bouletreau, Agnès; Berland, Michel

    2009-12-01

    Our purpose was to evaluate maternal nosocomial infection rates according to the incision technique used for caesarean delivery, in a routine surveillance study. This was a prospective study of 5123 cesarean deliveries (43.2% Joel-Cohen, 56.8% Pfannenstiel incisions) in 35 maternity units (Mater Sud Est network). Data on routine surveillance variables, operative duration, and three additional variables (manual removal of the placenta, uterine exteriorization, and/or cleaning of the parieto-colic gutter) were collected. Multiple logistic regression analysis was used to identify independent risk factors for infection. The overall nosocomial infection and endometritis rates were higher for the Joel-Cohen than Pfannenstiel incision (4.5% vs. 3.3%, 0.8% vs. 0.3%, respectively). The higher rate of nosocomial infections with the Joel-Cohen incision was due to a greater proportion of patients presenting risk factors (i.e., emergency delivery, primary cesarean, blood loss > or =800 mL, no manual removal of the placenta and no uterine exteriorization). However, the Joel-Cohen technique was an independent risk factor for endometritis. The Joel-Cohen technique is faster than the Pfannenstiel technique but is associated with a higher incidence of endometritis.

  3. Addition of rectus sheath relaxation incisions to emergency midline laparotomy for peritonitis to prevent fascial dehiscence.

    Science.gov (United States)

    Marwah, Sanjay; Marwah, Nisha; Singh, Mandeep; Kapoor, Ajay; Karwasra, Rajender Kumar

    2005-02-01

    The incidence of fascial dehiscence and incisional hernia after two methods for abdominal wound closure (rectus sheath relaxation incisions and conventional mass closure) was studied in a randomized prospective clinical trial in a consecutive series of 100 patients undergoing midline laparotomy for peritonitis. The two groups were well matched for etiologies of peritonitis, the surgical procedures performed, and the presence of known risk factors for fascial dehiscence. Fifty patients each were randomized either to the conventional continuous mass closure procedure or the rectus sheath relaxation incision technique (designed to increase wound elasticity and decrease tension in the suture line) using identical polypropylene sutures. The incidence of postoperative complications such as duration of ileus, chest infection, and wound infection were not statistically different between the two groups. The intensity of postoperative pain in the rectus sheath relaxation incision group was significantly less. The incidence of wound hematoma was significantly increased in the rectus sheath relaxation incision group. The incidences of fascial dehiscence (16% vs,28%; p cases of peritonitis using the rectus sheath relaxation technique is safe and less painful, provides increased wound elasticity and decreased tension on the suture line, and significantly decreases the incidence of wound dehiscence.

  4. Feasibility of single-incision laparoscopic surgery for appendicitis in abnormal anatomical locations: A single surgeon′s initial experience

    Directory of Open Access Journals (Sweden)

    Sanoop K Zachariah

    2013-01-01

    Full Text Available Background: Single-incision laparoscopic surgery is considered as a more technically demanding procedure than the standard laparoscopic surgery. Based on an initial and early experience, single-incision laparoscopic appendectomy (LA was found to be technically advantageous for dealing with appendicitis in unusual anatomical locations. This study aims to highlight the technical advantages of single-incision laparoscopic surgery in dealing with the abnormally located appendixes and furthermore report a case of acute appendicitis occurring in a sub-gastric position, which is probably the first such case to be reported in English literature. Materials and Methods: A retrospective analysis of the first 10 cases of single-incision LA which were performed by a single surgeon is presented here. Results: There were seven females and three males. The mean age of the patients was 30.6 (range 18-52 years, mean BMI was 22.7 (range 17-28 kg/m 2 and the mean operative time was 85.5 (range 45-150 min. The mean postoperative stay was 3.6 (range 1-7 days. The commonest position of the appendix was retro-caecal (50% followed by pelvic (30%. In three cases the appendix was found to be in abnormal locations namely sub-hepatic, sub-gastric and deep pelvic or para-vesical or para-rectal. All these cases could be managed with this technique without any conversions Conclusion: Single-incision laparoscopic surgery appears to be a feasible and safe technique for dealing with appendicitis in rare anatomical locations. Appendectomy may be a suitable procedure for the initial training in single-incision laparoscopic surgery.

  5. Erosion and deposition by supercritical density flows during channel avulsion and backfilling: Field examples from coarse-grained deepwater channel-levée complexes (Sandino Forearc Basin, southern Central America)

    Science.gov (United States)

    Lang, Jörg; Brandes, Christian; Winsemann, Jutta

    2017-03-01

    Erosion and deposition by supercritical density flows can strongly impact the facies distribution and architecture of submarine fans. Field examples from coarse-grained channel-levée complexes from the Sandino Forearc Basin (southern Central America) show that cyclic-step and antidune deposits represent common sedimentary facies of these depositional systems and relate to the different stages of avulsion, bypass, levée construction and channel backfilling. During channel avulsion, large-scale scour-fill complexes (18 to 29 m deep, 18 to 25 m wide, 60 to > 120 m long) were incised by supercritical density flows. The multi-storey infill of the large-scale scour-fill complexes comprises amalgamated massive, normally coarse-tail graded or widely spaced subhorizontally stratified conglomerates and pebbly sandstones, interpreted as deposits of the hydraulic-jump zone of cyclic steps. The large-scale scour-fill complexes can be distinguished from small-scale channel fills based on the preservation of a steep upper margin and a coarse-grained infill comprising mainly amalgamated hydraulic-jump zone deposits. Channel fills include repeated successions deposited by cyclic steps with superimposed antidunes. The deposits of the hydraulic-jump zone of cyclic steps comprise regularly spaced scours (0.2 to 2.6 m deep, 0.8 to 23 m long) infilled by intraclast-rich conglomerates or pebbly sandstones, displaying normal coarse-tail grading or backsets. These deposits are laterally and vertically associated with subhorizontally stratified, low-angle cross-stratified or sinusoidally stratified sandstones and pebbly sandstones, which were deposited by antidunes on the stoss side of the cyclic steps during flow re-acceleration. The field examples indicate that so-called spaced stratified deposits may commonly represent antidune deposits with varying stratification styles controlled by the aggradation rate, grain-size distribution and amalgamation. The deposits of small-scale cyclic

  6. Beaver dams and channel sediment dynamics on Odell Creek, Centennial Valley, Montana, USA

    Science.gov (United States)

    Levine, Rebekah; Meyer, Grant A.

    2014-01-01

    Beaver dams in streams are generally considered to increase bed elevation through in-channel sediment storage, thus, reintroductions of beaver are increasingly employed as a restoration tool to repair incised stream channels. Here we consider hydrologic and geomorphic characteristics of the study stream in relation to in-channel sediment storage promoted by beaver dams. We also document the persistence of sediment in the channel following breaching of dams. Nine reaches, containing 46 cross-sections, were investigated on Odell Creek at Red Rock Lakes National Wildlife Refuge, Centennial Valley, Montana. Odell Creek has a snowmelt-dominated hydrograph and peak flows between 2 and 10 m3 s- 1. Odell Creek flows down a fluvial fan with a decreasing gradient (0.018-0.004), but is confined between terraces along most of its length, and displays a mostly single-thread, variably sinuous channel. The study reaches represent the overall downstream decrease in gradient and sediment size, and include three stages of beaver damming: (1) active; (2) built and breached in the last decade; and (3) undammed. In-channel sediment characteristics and storage were investigated using pebble counts, fine-sediment depth measurements, sediment mapping and surveys of dam breaches. Upstream of dams, deposition of fine (≤ 2 mm) sediment is promoted by reduced water surface slope, shear stress and velocity, with volumes ranging from 48 to 182 m3. High flows, however, can readily transport suspended sediment over active dams. Variations in bed-sediment texture and channel morphology associated with active dams create substantial discontinuities in downstream trends and add to overall channel heterogeneity. Observations of abandoned dam sites and dam breaches revealed that most sediment stored above beaver dams is quickly evacuated following a breach. Nonetheless, dam remnants trap some sediment, promote meandering and facilitate floodplain development. Persistence of beaver dam sediment

  7. Cannabidiol Is a Potential Therapeutic for the Affective-Motivational Dimension of Incision Pain in Rats

    Directory of Open Access Journals (Sweden)

    Karina Genaro

    2017-06-01

    Full Text Available Background: Pain involves different brain regions and is critically determined by emotional processing. Among other areas, the rostral anterior cingulate cortex (rACC is implicated in the processing of affective pain. Drugs that interfere with the endocannabinoid system are alternatives for the management of clinical pain. Cannabidiol (CBD, a phytocannabinoid found in Cannabis sativa, has been utilized in preclinical and clinical studies for the treatment of pain. Herein, we evaluate the effects of CBD, injected either systemically or locally into the rACC, on mechanical allodynia in a postoperative pain model and on the negative reinforcement produced by relief of spontaneous incision pain. Additionally, we explored whether CBD underlies the reward of pain relief after systemic or rACC injection.Methods and Results: Male Wistar rats were submitted to a model of incision pain. All rats had mechanical allodynia, which was less intense after intraperitoneal CBD (3 and 10 mg/kg. Conditioned place preference (CPP paradigm was used to assess negative reinforcement. Intraperitoneal CBD (1 and 3 mg/kg inverted the CPP produced by peripheral nerve block even at doses that do not change mechanical allodynia. CBD (10 to 40 nmol/0.25 μL injected into the rACC reduced mechanical allodynia in a dose-dependent manner. CBD (5 nmol/0.25 μL did not change mechanical allodynia, but reduced peripheral nerve block-induced CPP, and the higher doses inverted the CPP. Additionally, CBD injected systemically or into the rACC at doses that did not change the incision pain evoked by mechanical stimulation significantly produced CPP by itself. Therefore, a non-rewarding dose of CBD in sham-incised rats becomes rewarding in incised rats, presumably because of pain relief or reduction of pain aversiveness.Conclusion: The study provides evidence that CBD influences different dimensions of the response of rats to a surgical incision, and the results establish the rACC as a

  8. Elective gastropexy with a reusable single-incision laparoscopic surgery port in dogs: 14 cases (2012-2013).

    Science.gov (United States)

    Stiles, Mandy; Case, J Brad; Coisman, James

    2016-08-01

    OBJECTIVE To describe the technique, clinical findings, and short-term outcome in dogs undergoing laparoscopic-assisted incisional gastropexy with a reusable single-incision surgery port. DESIGN Retrospective case series. ANIMALS 14 client-owned dogs. PROCEDURES Medical records of dogs referred for elective laparoscopic gastropexy between June 2012 and August 2013 were reviewed. History, signalment, results of physical examination and preoperative laboratory testing, surgical procedure, duration of surgery, postoperative complications, duration of hospital stay, and short-term outcome were recorded. All patients underwent general anesthesia and were positioned in dorsal recumbency. After an initial limited laparoscopic exploration, single-incision laparoscopic-assisted gastropexy was performed extracorporeally in all dogs via a conical port placed in a right paramedian location. Concurrent procedures included laparoscopic ovariectomy (n = 4), gastric biopsy (2), and castration (7). Short-term outcome was evaluated. RESULTS Median duration of surgery was 76 minutes (range, 40 to 90 minutes). Intraoperative complications were minor and consisted of loss of pneumoperitoneum in 2 of 14 dogs. A postoperative surgical site infection occurred in 1 dog and resolved with standard treatment. Median duration of follow-up was 371 days (range, 2 weeks to 1.5 years). No dogs developed gastric dilation-volvulus during the follow-up period, and all owners were satisfied with the outcome. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that single-incision laparoscopic-assisted gastropexy with a reusable conical port was feasible and effective in appropriately selected cases. Investigation of the potential benefits of this reusable port versus single-use devices for elective gastropexy in dogs is warranted.

  9. The influence of lip form on incisal display with lips in repose on the esthetic preferences of dentists and lay people.

    Science.gov (United States)

    Kim, Jee; Topolski, Richard; Dickinson, Douglas; Ramos, Van

    2017-09-01

    Information is lacking for viewer preferences for incisal display with lips in repose. The purpose of this online survey was to establish measurement parameters to classify and define a lip form and to evaluate the influence of lip form on dentists' and laypersons' preferences for the amount of incisal display with lips in repose. Computer-generated male and female models were created using 3 different lip forms each, straight, moderate, and high. Three images of these models (frontal full face, zoomed-in frontal around the mouth, and oblique zoomed-in image of the mouth) were arranged in an interactive survey that was disseminated on the Websites Facebook, Instagram, DentalTown and by word-of-mouth. Respondents manipulated the incisal display of all 3 images in unison, using a slide bar, and the resulting incisal display was measured in millimeters and served as the primary dependent measure. Survey demographic data were obtained from an online survey site. Data were assessed for skewness, kurtosis, and outliers and analyzed with 5-way ANOVA: 2 sex levels for model, 2 levels for sex of respondent, 3 levels for lip height, 3 levels for occupation, and 5 levels of ethnicity, with multiple comparisons corrected with Bonferroni adjustments and post hoc comparisons performed using the Scheffé test (α=.05 for all comparisons). A total of 1039 individuals consented to the study. A final sample size of 687 respondents was obtained after excluding 352 who failed to complete the survey. The results indicated that lip form affected the esthetic perception of incisal display significantly (P<.001), with a preference for a greater amount of incisal display corresponding with increasing lip forms. Sex of the model was also significant, with greater incisal display being preferred for female faces. A significant difference was found for respondents' ethnicity, with African Americans generally preferring smaller incisal displays than other ethnic groups. No other main effects

  10. Transgressive systems tract development and incised-valley fills within a quaternary estuary-shelf system: Virginia inner shelf, USA

    Science.gov (United States)

    Foyle, A.M.; Oertel, G.F.

    1997-01-01

    High-frequency Quaternary glacioeustasy resulted in the incision of six moderate- to high-relief fluvial erosion surfaces beneath the Virginia inner shelf and coastal zone along the updip edges of the Atlantic continental margin. Fluvial valleys up to 5 km wide, with up to 37 m of relief and thalweg depths of up to 72 m below modern mean sea level, cut through underlying Pleistocene and Mio-Pliocene strata in response to drops in baselevel on the order of 100 m. Fluvially incised valleys were significantly modified during subsequent marine transgressions as fluvial drainage basins evolved into estuarine embayments (ancestral generations of the Chesapeake Bay). Complex incised-valley fill successions are bounded by, or contain, up to four stacked erosional surfaces (basal fluvial erosion surface, bay ravinement, tidal ravinement, and ebb-flood channel-base diastem) in vertical succession. These surfaces, combined with the transgressive oceanic ravinement that generally caps incised-valley fills, control the lateral and vertical development of intervening seismic facies (depositional systems). Transgressive stratigraphy characterizes the Quaternary section beneath the Virginia inner shelf where six depositional sequences (Sequences I-VI) are identified. Depositional sequences consist primarily of estuarine depositional systems (subjacent to the transgressive oceanic ravinement) and shoreface-shelf depositional systems; highstand systems tract coastal systems are thinly developed. The Quaternary section can be broadly subdivided into two parts. The upper part contains sequences consisting predominantly of inner shelf facies, whereas sequences in the lower part of the section consist predominantly of estuarine facies. Three styles of sequence preservation are identified. Style 1, represented by Sequences VI and V, is characterized by large estuarine systems (ancestral generations of the Chesapeake Bay) that are up to 40 m thick, have hemicylindrical wedge geometries

  11. [EFFECTIVENESS OF ADVANCED SKIN FLAP AND V-SHAPED VENTRAL INCISION ALONG THE ROOT OF PENILE SHAFT FOR CONCEALED PENIS].

    Science.gov (United States)

    Lin, Junshan; Li, Dumiao; Zhang, Jianxing; Wu, Qiang; Xu, Yali; Lin, Li

    2015-09-01

    To investigate effectiveness of advanced skin flap and V-shaped ventral incision along the root of penile shaft for concealed penis in children. Between July 2007 and January 2015, 121 boys with concealed penis were treated with advanced skin flap and V-shaped ventral incision along the root of penile shaft. The age varied from 18 months to 13 years (mean, 7.2 years). Repair was based on a vertical incision in median raphe, complete degloving of penis and tacking its base to the dermis of the skin. Advanced skin flap and a V-shaped ventral incision along the root of penile shaft were used to cover the penile shaft. The operation time ranged from 60 to 100 minutes (mean, 75 minutes). Disruption of wound occurred in 1 case, and was cured after dressing change; and primary healing of incision was obtained in the others. The follow-up period ranged from 3 months to 7 years (median, 24 months). All patients achieved good to excellent cosmetic results with a low incidence of complications. The results were satisfactory in exposure of penis and prepuce appearance. No obvious scar was observed. The penis had similar appearance to that after prepuce circumcision. A combination of advanced skin flap and V-shaped ventral incision along the root of penile shaft is a simple, safe, and effective procedure for concealed penis with a similar appearance result to the prepuce circumcision.

  12. Incisive papilla and positions of maxillary anterior teeth among ...

    African Journals Online (AJOL)

    Results: One hundred and twelve maxillary casts generated from participants aged 18-35 years (mean age 22.39±2.00 years), with well aligned arches were studied. The maxillary central incisor exhibited a mean of 14.93±1.52mm from the posterior limit of the incisive papilla while the inter-canine line scored a mean of ...

  13. A stepped leader model for lightning including charge distribution in branched channels

    Energy Technology Data Exchange (ETDEWEB)

    Shi, Wei; Zhang, Li [School of Electrical Engineering, Shandong University, Jinan 250061 (China); Li, Qingmin, E-mail: lqmeee@ncepu.edu.cn [Beijing Key Lab of HV and EMC, North China Electric Power University, Beijing 102206 (China); State Key Lab of Alternate Electrical Power System with Renewable Energy Sources, Beijing 102206 (China)

    2014-09-14

    The stepped leader process in negative cloud-to-ground lightning plays a vital role in lightning protection analysis. As lightning discharge usually presents significant branched or tortuous channels, the charge distribution along the branched channels and the stochastic feature of stepped leader propagation were investigated in this paper. The charge density along the leader channel and the charge in the leader tip for each lightning branch were approximated by introducing branch correlation coefficients. In combination with geometric characteristics of natural lightning discharge, a stochastic stepped leader propagation model was presented based on the fractal theory. By comparing simulation results with the statistics of natural lightning discharges, it was found that the fractal dimension of lightning trajectory in simulation was in the range of that observed in nature and the calculation results of electric field at ground level were in good agreement with the measurements of a negative flash, which shows the validity of this proposed model. Furthermore, a new equation to estimate the lightning striking distance to flat ground was suggested based on the present model. The striking distance obtained by this new equation is smaller than the value estimated by previous equations, which indicates that the traditional equations may somewhat overestimate the attractive effect of the ground.

  14. A stepped leader model for lightning including charge distribution in branched channels

    International Nuclear Information System (INIS)

    Shi, Wei; Zhang, Li; Li, Qingmin

    2014-01-01

    The stepped leader process in negative cloud-to-ground lightning plays a vital role in lightning protection analysis. As lightning discharge usually presents significant branched or tortuous channels, the charge distribution along the branched channels and the stochastic feature of stepped leader propagation were investigated in this paper. The charge density along the leader channel and the charge in the leader tip for each lightning branch were approximated by introducing branch correlation coefficients. In combination with geometric characteristics of natural lightning discharge, a stochastic stepped leader propagation model was presented based on the fractal theory. By comparing simulation results with the statistics of natural lightning discharges, it was found that the fractal dimension of lightning trajectory in simulation was in the range of that observed in nature and the calculation results of electric field at ground level were in good agreement with the measurements of a negative flash, which shows the validity of this proposed model. Furthermore, a new equation to estimate the lightning striking distance to flat ground was suggested based on the present model. The striking distance obtained by this new equation is smaller than the value estimated by previous equations, which indicates that the traditional equations may somewhat overestimate the attractive effect of the ground.

  15. Anterograde axonal transport and intercellular transfer of WGA-HRP in trigeminal-innervated sensory receptors of rat incisive papilla.

    Science.gov (United States)

    Chan, K Y; Byers, M R

    1985-04-08

    The ultrastructure and identification of WGA-HRP-labeled sensory receptors in the rat incisive papilla (the most anterior part of hard palate) were studied using semiserial thin sections. Various sensory receptors were organized according to three locations: dome region (ventral), chemosensory corpuscle region (medial to orifice of incisive canal), and lateral labium (apposing the incisive canal). In the dome region, the sensory receptors were localized in three sensory zones that were associated with surface ridges (one medial and two lateral). In each of these zones, intraepithelial receptor axons and Merkel receptors occurred in the epithelium, while simple unencapsulated corpuscles, glomerular-Meissner corpuscles, and incisive (encapsulated) corpuscles occurred in the lamina propria. In the chemosensory corpuscle region, chemosensory corpuscles and intraepithelial receptor axons were located in the epithelium, and incisive corpuscles were present in the lamina propria. In the lateral labium, only intraepithelial receptor axons were prominent. In all these sensory receptors, the preterminal axons and axon terminals were labeled with the tracer protein. In addition, some nonneuronal cells closely associated with the axon terminals were selectively labeled, e.g., terminal Schwann cells, lamellar Schwann cells, Merkel cells, corpuscular basal cells and chemosensory cells. Other adjacent cells were not labeled, e.g., unspecialized epithelial cells, capsular cells, corpuscular sustentacular cells, and fibroblasts. In both labeled axons and cells, WGA-HRP was incorporated into vesicles, tubules, and vacuolar organelles. The specific intercellular transfer of tracer protein may indicate trophic interactions between axon terminals and support cells in sensory receptors. The specific organization of multiple sensory receptors in the rat incisive papilla may provide a useful alternative system for studying somatosensory physiology.

  16. Distinction of infected and non-infected post-surgical incisions with In-111-WBC scintigraphy

    International Nuclear Information System (INIS)

    Abdel-Nabi, H.; Hinkle, G.H.; Olsen, J.O.

    1985-01-01

    To determine if In-111-WBCs scintigraphy can distinguish between healing and infection in post-surgical wounds, a prospective study was performed in patients with 3-14 day old surgical incisions. Eighteen patients (11 males and 7 females) were scanned 24 hrs after injection of 0.5 mCi of In-111 labeled autologous leukocytes. The scan findings were correlated with blood and/wound cultures results and diagnosis at time of discharge. Incisional uptake of In-111-WBCs was noted in 9 patients with infected surgical wounds and was absent in those 9 patients with non-infected surgical wounds. The results of the authors' study show that In-111-WBCs do not accumulate in non-infected surgical incisions. This confirms their previous findings in rats. The high specificity of In-111 leukocytes imaging makes it a valuable study in the evaluation of post-operative patients with suspected surgical wound infections. In-111 WBCs scintigraphy can distinguish between normal healing and infection at the site of recent (3-14 days) surgical incisions

  17. Comparative analysis of corneal morphological changes after transversal and torsional phacoemulsification through 2.2 mm corneal incision.

    Science.gov (United States)

    Assaf, Ahmed; Roshdy, Maged Maher

    2013-01-01

    This paper compares and evaluates the corneal morphological changes occurring after cataract surgery through a 2.2 mm corneal incision. We use two platforms for comparison and evaluation, transversal and torsional phacoemulsification. This study includes 139 consecutive cataractous eyes (nuclear color 2-4, according to the Lens Opacities Classification System III [LOCSIII]) of 82 patients undergoing cataract surgery through a 2.2 mm corneal incision. Two different phacoemulsification platforms were used and assigned randomly: we used the WhiteStar Signature(®) system with the Ellips™ FX transversal continuous ultrasound (US) mode for group I (mean age: 65.33 ± 6.97 years), and we used the Infiniti(®) system with the OZil(®) Intelligent Phaco (IP) torsional US mode for group II (mean age: 64.02 ± 7.55 years). The corneal endothelium and pachymetry were evaluated preoperatively and at 1 month postoperatively. Incision size changes were also evaluated. All surgeries were uneventful. Before intraocular lens implantation, the mean incision size was 2.24 ± 0.06 mm in both groups (P = 0.75). In terms of corneal endothelial cell density, neither preoperative (I vs II: 2304.1 ± 122.5 cell/mm(2) vs 2315.6 ± 83.1 cell/mm(2), P = 0.80) nor postoperative (I vs II: 2264.1 ± 124.3 cell/mm(2) vs 2270.3 ± 89.9 cell/mm(2), P = 0.98) differences between the groups were statistically significant. The mean endothelial cell density loss was 1.7% ± 1.6% and 2.0% ± 1.4% in groups I and II, respectively. Furthermore, no significant differences between groups I and II were found preoperatively (P = 0.40) and postoperatively (P = 0.68) in central pachymetry. With surgery, the mean increase in central pachymetry was 28.1 ± 23.6 μm and 24.0 ± 24.0 μm in groups I and II, respectively (P = 0.1). Ellips™ FX transversal and OZil(®) IP torsional phacoemulsification modes are safe for performing cataract surgery, inducing minimal corneal thickness and endothelial changes.

  18. Computed tomography contrast media extravasation: treatment algorithm and immediate treatment by squeezing with multiple slit incisions.

    Science.gov (United States)

    Kim, Sue Min; Cook, Kyung Hoon; Lee, Il Jae; Park, Dong Ha; Park, Myong Chul

    2017-04-01

    In our hospital, an adverse event reporting system was initiated that alerts the plastic surgery department immediately after suspecting contrast media extravasation injury. This system is particularly important for a large volume of extravasation during power injector use. Between March 2011 and May 2015, a retrospective chart review was performed on all patients experiencing contrast media extravasation while being treated at our hospital. Immediate treatment by squeezing with multiple slit incisions was conducted for a portion of these patients. Eighty cases of extravasation were reported from approximately 218 000 computed tomography scans. The expected extravasation volume was larger than 50 ml, or severe pressure was felt on the affected limb in 23 patients. They were treated with multiple slit incisions followed by squeezing. Oedema of the affected limb disappeared after 1-2 hours after treatment, and the skin incisions healed within a week. We propose a set of guidelines for the initial management of contrast media extravasation injuries for a timely intervention. For large-volume extravasation cases, immediate management with multiple slit incisions is safe and effective in reducing the swelling quickly, preventing patient discomfort and decreasing skin and soft tissue problems. © 2016 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

  19. Heat transfer including radiation and slag particles evolution in MHD channel-I

    International Nuclear Information System (INIS)

    Im, K.H.; Ahluwalia, R.K.

    1980-01-01

    Accurate estimates of convective and radiative heat transfer in the magnetohydrodynamic channel are provided. Calculations performed for a base load-size channel indicate that heat transfer by gas radiation almost equals that by convection for smooth walls, and amounts to 70% as much as the convective heat transfer for rough walls. Carbon dioxide, water vapor, and potassium atoms are the principal participating gases. The evolution of slag particles by homogeneous nucleation and condensation is also investigated. The particle-size spectrum so computed is later utilized to analyze the radiation enhancement by slag particles in the MHD diffuser. The impact of the slag particle spectrum on the selection of a workable and design of an efficient seed collection system is discussed

  20. Transient bedrock channel evolution across a precipitation gradient: A case study from Kohala, Hawaii.

    Science.gov (United States)

    Gasparini, N. M.; Han, J.; Johnson, J. P.; Menking, J. A.

    2011-12-01

    This study uses observations from the Kohala Peninsula, on the Big Island of Hawaii, and numerical modeling, to explore how precipitation gradients may affect fluvial bedrock incision and channel morphology. Orographic precipitation patterns result in over 4 m/yr of rainfall on the wet side of the peninsula and less than 0.5 m/yr on the dry side. These precipitation patterns likely strongly contribute to the observed channel morphology. Further, the region is subsiding, leading to prolonged transient channel evolution. We explore changes in a number of channel morphologic parameters with watershed averaged precipitation rate. We use PRISM precipitation data and data from isohyets developed from historic rain gauge data. Not surprisingly, valley depth, measured from a 10 meter DEM, increases with spatially averaged precipitation rate. We also find that channel profile form varies with precipitation rate, with drier channels exhibiting a straight to slightly concave channel form and wetter channels exhibiting a convex to concave channel form. The precipitation value at which this transition in channel profile form occurs depends on the precipitation data-set used, highlighting the need for more accurate measurements of precipitation in settings with extreme precipitation patterns similar to our study area. The downstream pattern in precipitation is likely significant in the development of the convex-concave profile form. Numerical modeling results support that precipitation patterns such as those observed on the wet-side of the Kohala Peninsula may contribute to the convex-concave profile form. However, we emphasize that while precipitation patterns may contribute to the channel form, these channel features are transient and not expected to be sustained in steady-state landscapes. We also emphasize that it is fluvial discharge, as driven by precipitation, rather than precipitation alone, that drives the processes shaping the channel form. Because fluvial discharge is

  1. Ultrasound guided aspiration of breast abscess as an alternative to surgical incision and drainage

    International Nuclear Information System (INIS)

    Naper, M.A.; Shaikh, M.S.; Dholia, K.R.

    2017-01-01

    To evaluate the outcome and assess the success rate of ultrasound guided aspiration of breast abscess as an alternative to surgical incision and drainage. Methodology: A prospective descriptive study was carried out at Department of Surgery, Chandka Medical College Hospital, Larkana, Pakistan, from January 2015 to December 2015. A total of 111 patients of breast abscess who underwent ultrasound guided aspiration without anesthesias with oral antibiotic cover were studied. Females with breast abscess within seven days, and the abscess size was <3cm were included in the study. Males, antibioma and inflammatory carcinoma were excluded from the study. Outcome of success or failure was observed within two weeks and recorded. Results: Out of 111 patients, 68.46% were lactating and 31.53% were non-lactating women, with ages ranging from 18 to 60 years (mean 36.5 years). The successful rate with complete resolution after ultrasound guided aspiration was observed in 94.5%. 80.82% responded after single aspiration, 12.38% after two times aspiration, and 6.66% after multiple aspirations, while 5.4% of patients required incision and drainage. Conclusion: Ultrasound guided aspiration of breast abscess is an effective treatment option with a diameter of <3cm, which can be recommended as a routine outpatient procedure. (author)

  2. Muscle sparing lateral thoracotomy: the standard incision for thoracic procedures

    Directory of Open Access Journals (Sweden)

    Mihai Dumitrescu

    2017-05-01

    Full Text Available Lateral thoracotomy is a versatile approach with many variations and is currently the most widely used incision in thoracic surgery. In the current article we are presenting the muscle-sparing lateral thoracotomy in the lateral decubitus position which we consider to be the “standard” for lateral thoracotomies. Indications, surgical technique and pitfalls are described alongside our experience with thoracic drainage. Although there is no consensus regarding the name of this incision, some authors call it “axillary thoracotomy” while others call it a “modified lateral thoracotomy”, they all agree on one aspect – the importance of muscle sparing – which makes it the go-to thoracotomy for both small and large procedures involving the lung. Lateral muscle sparing thoracotomy allows for good exposure of the pulmonary hilum, fissures, apex and diaphragm. The approach is easy and quick to perform while at the same time ensuring faster postoperative recovery by sparing the latissimus dorsi muscle, better cosmetics and lower postoperative pain score when compared to the posterolateral or classical lateral thoracotomies.

  3. The interaction of fentanyl on the Cp50 of propofol for loss of consciousness and skin incision.

    Science.gov (United States)

    Smith, C; McEwan, A I; Jhaveri, R; Wilkinson, M; Goodman, D; Smith, L R; Canada, A T; Glass, P S

    1994-10-01

    We have previously demonstrated that the minimum alveolar concentration of isoflurane at 1 atm that is required to prevent movement in 50% of patients or animals exposed to a maximal noxious stimulus is markedly reduced by increasing fentanyl concentrations. Total intravenous anesthesia with propofol is increasing in popularity, yet the propofol concentrations required for total intravenous anesthesia or the interaction between propofol and fentanyl have not yet been defined. Propofol and fentanyl were administered via computer-assisted continuous infusion to provide pseudo-steady-state concentrations and allow equilibration between plasma-blood concentration and their biophase concentration. For the induction of anesthesia patients were randomly allocated to receive propofol only or propofol plus fentanyl 0.2, 0.8, 1.5, 3.0, and 4.5 ng/ml. In each group patients were randomized to target propofol concentrations of 1.5-10 micrograms/ml. At 7 and 10 min arterial blood samples were taken for subsequent measurement of propofol and fentanyl concentrations. At 10 min loss of consciousness was assessed by the patients' ability to respond to a simple verbal command. Thereafter a new target concentration of propofol was entered to ensure loss of consciousness, and succinylcholine was administered to facilitate tracheal intubation. Patients were rerandomized to a new target concentration of propofol (1-19 micrograms/ml) until skin incision. Before skin incision and 1 min after skin incision, arterial blood samples were again obtained for subsequent measurement of fentanyl and propofol concentrations. At skin incision and for 1 min the patient was observed for purposeful movement. Only samples in which the pre- and poststimulus drug concentrations were within 35% of each other were included. The propofol blood concentration at which 50% or 95% of patients did not respond to verbal command (Cp50s and Cp95s, respectively) and to skin incision (Cp50i and Cp95i, respectively

  4. [One-stage Operation through the Same Skin Incision for Synchronous Double Primary Breast and Lung Cancer;Report of a Case].

    Science.gov (United States)

    Takahashi, Noriyuki; Kuga, Yoko; Uno, Satoko; Saito, Keita

    2018-02-01

    A 75-year-old woman noticed a small mass in the right side breast and consulted our hospital. The results of the detailed examination indicated the synchronous double primary right breast cancer and the same side lung cancer (rS5). One-stage operation from the same skin incision was scheduled. Volume rendering (VR) of computed tomography (CT)-scan was very useful in deciding the position and the length of the skin incision. The breast tumor resection and the right middle lobe resection were successfully performed through 6.5 cm skin incision.

  5. Formation and maintenance of single-thread tie channels entering floodplain lakes: Observations from three diverse river systems

    Science.gov (United States)

    Rowland, J. C.; Dietrich, W. E.; Day, G.; Parker, G.

    2009-06-01

    Tie channels connect rivers to floodplain lakes on many lowland rivers and thereby play a central role in floodplain sedimentology and ecology; yet they are generally unrecognized and little studied. Here we report the results of field studies focused on tie channel origin and morphodynamics in the following three contrasting systems: the Middle Fly River (Papua New Guinea), the Lower Mississippi River, and Birch Creek in Alaska. Across these river systems, tie channels vary by an order of magnitude in size but exhibit the same characteristic morphology and appear to develop and evolve by a similar set of processes. In all three systems, the channels are characterized by a narrow, leveed, single-thread morphology with maximum width approximately one tenth the width of the mainstem river. The channels typically have a V-shaped cross section, unlike most fluvial channels. These channels develop as lakes become isolated from the river by sedimentation. Narrowing of the connection between river and lake causes a sediment-laden jet to develop. Levees develop along the margins of the jet leading to channel emergence and eventual levee aggradation to the height of the mainstem levees. Bidirectional flow in these channels is common. Outflows from the lake scour sediment and prevent channel blockage. We propose that channel geometry and size are then controlled by a dynamic balance between channel narrowing by suspended sediment deposition and incision and widening by mass failure of banks during outflows. Tie channels are laterally stable and may convey flow for hundreds to a few thousand of years.

  6. Dam Breach Release of Non-Cohesive Sediments: Channel Response and Recovery Rates

    Science.gov (United States)

    Collins, M. J.; Boardman, G.; Banks, W.; Andrews, M.; Conlon, M.; Dillow, J. J. A.; Gellis, A.; Lowe, S.; McClain, S.; Miller, A. J.; Snyder, N. P.; Wilcock, P. R.

    2014-12-01

    Dam removals featuring unchecked releases of non-cohesive sediments are excellent opportunities to learn more about stream channel response to abrupt increases in bed material supply that can occur deliberately or by natural processes like landslides and volcanic eruptions. Understanding channel response to sediment pulses, including response rates, is essential because human uses of river channels and floodplains are impacted by these events as are aquatic habitats. We had the opportunity to study a dam removal site at the Simkins Dam in Maryland, USA, that shares many important geophysical attributes of another well-studied dam removal in the humid northeast United States [Merrimack Village Dam, New Hampshire; Pearson et al., 2011]. The watershed sizes are the same order of magnitude (102 km2), and at both sites relatively low head dams were removed (~ 3-4 m) and ~60,000 m3 of dominantly sand-sized sediments discharged to low-gradient reaches immediately downstream. Analyzing four years of repeat morphometry and bed sediment grain size surveys at the Simkins site on the Patapsco River, as well as continuous discharge and suspended sediment gaging data, we clearly document a two-phase response in the upstream reach as described by Pearson et al. [2011] for their New Hampshire site and noted at other dam removals [e.g., Major et al., 2012]. In the early phase, approximately 50% of the impounded sediment mass was eroded rapidly over a period of about three months when flows were very modest (Figure 1). After incision to base level and channel widening in the former impoundment, a second phase began when further erosion depended on floods large enough to access impounded sediments more distant from the newly-formed channel. We also found important differences in the upstream responses at the Maryland and New Hampshire sites that appear to be related to valley type (non-glaciated versus glaciated, respectively). Response variances immediately downstream between the

  7. Channel and Floodplain Change Analysis over a 100-Year Period: Lower Yuba River, California

    Directory of Open Access Journals (Sweden)

    Rolf Aalto

    2010-07-01

    Full Text Available Hydraulic gold mining in the Sierra Nevada, California (1853–1884 displaced ~1.1 billion m3 of sediment from upland placer gravels that were deposited along piedmont rivers below dams where floods can remobilize them. This study uses topographic and planimetric data from detailed 1906 topographic maps, 1999 photogrammetric data, and pre- and post-flood aerial photographs to document historic sediment erosion and deposition along the lower Yuba River due to individual floods at the reach scale. Differencing of 3 × 3-m topographic data indicates substantial changes in channel morphology and documents 12.6 × 106 m3 of erosion and 5.8 × 106 m3 of deposition in these reaches since 1906. Planimetric and volumetric measurements document spatial and temporal variations of channel enlargement and lateral migration. Over the last century, channels incised up to ~13 m into mining sediments, which dramatically decreased local flood frequencies and increased flood conveyance. These adjustments were punctuated by event-scale geomorphic changes that redistributed sediment and associated contaminants to downstream lowlands.

  8. Incision and Landsliding Lead to Coupled Increase in Sediment Flux and Grain Size Export

    Science.gov (United States)

    Roda-Boluda, D. C.; Brooke, S.; D'Arcy, M. K.; Whittaker, A. C.; Armitage, J. J.

    2017-12-01

    The rates and grain sizes of sediment fluxes modulate the dynamics and timing of landscape response to tectonics, and dictate the depositional patterns of sediment in basins. Over the last decades, we have gained a good quantitative understanding on how sediment flux and grain size may affect incision and basin stratigraphy. However, we comparably still have limited knowledge on how these variables change with varying tectonic rates. To address this question, we have studied 152 catchments along 8 normal fault-bounded ranges in southern Italy, which are affected by varying fault slip rates and experiencing a transient response to tectonics. Using a data set of 38 new and published 10Be erosion rates, we calibrate a sediment flux predictive equation (BQART), in order to estimate catchment sediment fluxes. We demonstrate that long-term sediment flux is governed by fault slip rates and the tectonically-controlled transient incision, and that sediment flux estimates from the BQART, steady-state assumptions, and incised volumes are highly correlated. This is supported by our 10Be erosion rates, which are controlled by fault slip and incision rates, and the associated landsliding. Based on a new landslide inventory, we show that erosion rate differences are likely due to differences in incision-related landslide activity across these catchments, and that landslides are a major component of sediment fluxes. From a data set of >13000 grain size counts on hillslope grain size supply and fluvial sediment at catchment outlets, we observe that landslides deliver material 20-200% coarser than other sediment sources, and that this coarse supply has an impact on the grain size distributions being exported from the catchments. Combining our sediment flux and grain size data sets, we are able to show that for our catchments, and potentially also for any areas that respond to changes in climate or tectonics via enhanced landsliding, sediment flux and grain size export increase

  9. The importance of sand in the formation of avulsion channels within experimental fans that develop from sediment mixtures of mud and sand

    Science.gov (United States)

    Iscen, N.; Strom, K.

    2017-12-01

    Autogenic channel migration and avulsion has long been recognized as important drivers of alluvial fan dynamics. In the literature, several field studies have documented that the presence and the amount of sand transport through a channel is important for channel incision in alluvial fans and deltas. In our experiments, we present the general autogenic avulsion cycle of experimental alluvial fans with mixtures of cohesive sediment and sand with a range of boundary conditions, and we detail the importance of mobile sand fraction in the development of channels that lead to avulsion. Experimental observations demonstrate that new channels form at topographically low regions within the floodplain providing that sand is transported to these topographic lows due to overbank flow or levee breaching. In addition to the sediment transported from upstream, erosion of a previous deposit and an ongoing backfilling nearby are observed as the possible sources of sand getting into the ghost channels. We explore whether the presence of sand is important for channel development because it increases abrasion of the channel or because it changes the roughness characteristics of the flow. We also examine the affect of sediment and water supply change on the newly described channelization process and link distinctive channel morphologies to different stages of described channel development and the avulsion process.

  10. Efficacy of a Buffered 4% Lidocaine Formulation for Incision and Drainage: A Prospective, Randomized, Double-blind Study.

    Science.gov (United States)

    Harreld, Taryn Kratz; Fowler, Sara; Drum, Melissa; Reader, Al; Nusstein, John; Beck, Mike

    2015-10-01

    Incision and drainage of symptomatic emergency patients with facial swelling is painful even after local anesthetics are administered. The purpose of this prospective, randomized, double-blind study was to compare the pain of infiltration and the pain of an incision and drainage procedure of a buffered versus a nonbuffered 4% lidocaine formulation in symptomatic emergency patients presenting with a diagnosis of pulpal necrosis, associated periapical area, and an acute clinical swelling. Eighty-eight emergency patients were randomly divided into 2 groups to receive 2 intraoral infiltration injections (mesial and distal to the swelling) of either 4% lidocaine with 1:100,000 epinephrine buffered with 0.18 mL 8.4% sodium bicarbonate using the Onpharma (Los Gatos, CA) buffering system or 4% lidocaine with 1:100,000 epinephrine. Subjects rated the pain of needle insertion, needle placement, and solution deposition for each injection using a 170-mm visual analog scale. An incision and drainage procedure was performed, and subjects rated the pain of incision, drainage, and dissection on a 170-mm visual analog scale. No significant differences between the buffered and nonbuffered 4% lidocaine formulations were found for needle insertion, placement, and solution deposition of the infiltration injections or for the treatment phases of incision, drainage, and dissection. Buffering a 4% lidocaine formulation did not significantly decrease the pain of infiltrations or significantly decrease the pain of the incision and drainage procedure when compared with a nonbuffered 4% lidocaine formulation in symptomatic patients with a diagnosis of pulpal necrosis and associated acute swelling. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  11. Resveratrol engages AMPK to attenuate ERK and mTOR signaling in sensory neurons and inhibits incision-induced acute and chronic pain

    Directory of Open Access Journals (Sweden)

    Tillu Dipti V

    2012-01-01

    Full Text Available Abstract Background Despite advances in our understanding of basic mechanisms driving post-surgical pain, treating incision-induced pain remains a major clinical challenge. Moreover, surgery has been implicated as a major cause of chronic pain conditions. Hence, more efficacious treatments are needed to inhibit incision-induced pain and prevent the transition to chronic pain following surgery. We reasoned that activators of AMP-activated protein kinase (AMPK may represent a novel treatment avenue for the local treatment of incision-induced pain because AMPK activators inhibit ERK and mTOR signaling, two important pathways involved in the sensitization of peripheral nociceptors. Results To test this hypothesis we used a potent and efficacious activator of AMPK, resveratrol. Our results demonstrate that resveratrol profoundly inhibits ERK and mTOR signaling in sensory neurons in a time- and concentration-dependent fashion and that these effects are mediated by AMPK activation and independent of sirtuin activity. Interleukin-6 (IL-6 is thought to play an important role in incision-induced pain and resveratrol potently inhibited IL-6-mediated signaling to ERK in sensory neurons and blocked IL-6-mediated allodynia in vivo through a local mechanism of action. Using a model of incision-induced allodynia in mice, we further demonstrate that local injection of resveratrol around the surgical wound strongly attenuates incision-induced allodynia. Intraplantar IL-6 injection and plantar incision induces persistent nociceptive sensitization to PGE2 injection into the affected paw after the resolution of allodynia to the initial stimulus. We further show that resveratrol treatment at the time of IL-6 injection or plantar incision completely blocks the development of persistent nociceptive sensitization consistent with the blockade of a transition to a chronic pain state by resveratrol treatment. Conclusions These results highlight the importance of signaling

  12. Incisal tooth wear and self-reported TMD pain in children and adolescents.

    Science.gov (United States)

    Hirsch, Christian; John, Mike T; Lobbezoo, Frank; Setz, Juergen M; Schaller, Hans-Guenter

    2004-01-01

    Incisal tooth wear may be a sign of long-term bruxing behavior. Bruxism is purported to be a risk factor for temporomandibular disorders (TMD). The aim of this population-based cross-sectional study was to determine if anterior tooth wear is associated with the self-report of TMD pain in children and adolescents. In a population sample of 1,011 children and adolescents (mean age 13.1 years, range 10 to 18 years; female 52%; response rate 85%), TMD cases were defined as subjects reporting pain in the face, jaw muscles, and temporomandibular joint during the last month according to RDC/TMD. All other subjects were considered controls. Incisal tooth wear was assessed in the clinical examination using a 0 to 2 scale (no wear, enamel wear, dentin wear) for every anterior permanent tooth. The mean wear score for the individuals was categorized into 0, 0.01 to 0.20, 0.21 to 0.40, and 0.41+. A multiple logistic regression analysis, controlling for the effects of age and gender, analyzed the association between the categorized summary wear score and TMD. Specifically, the hypothesis of a trend between higher tooth wear scores and higher risk of TMD was tested. An odds ratio of 1.1 indicated, after adjusting for gender and age, no statistically significantly higher risk of TMD pain with higher tooth wear scores. Incisal tooth wear was not associated with self-reported TMD pain in 10- to 18-year-old subjects.

  13. First experience with single incision laparoscopic surgery in Slovakia: concomitant cholecystectomy and splenectomy in an 11-year-old girl with hereditary spherocytosis.

    Science.gov (United States)

    Cingel, Vladimir; Zabojnikova, Lenka; Kurucova, Patricia; Varga, Ivan

    2014-09-01

    Hereditary spherocytosis is an autosomal dominant inheritance disorder of the red blood cell membrane characterized by the presence of spherical-shaped erythrocytes (spherocytes) in the peripheral blood. The main clinical features include haemolytic anemia, variable jaundice, splenomegaly and cholelithiasis caused by hyperbilirubinemia from erythrocyte hemolysis. Splenectomy does not solve the congenital genetic defect but it stops pathological hemolysis in the enlarged spleen. If gallstones are present, it is appropriate to perform cholecystectomy at the time of splenectomy, although the patient has symptoms of gall bladder disease. We present the case of single incision laparoscopic surgical (SILS) concomitant splenectomy and cholecystectomy performed with conventional laparoscopic instruments in an 11-year-old girl with the diagnosis of hereditary spherocytosis. A 2-3 cm umbilical incision was used for the placement of two 5 mm trocars and one 10 mm flexible videoscope. Conventional laparoscopic dissector, grasper, Ligasure, Harmonic Ace and hemoclips were the main tools during surgical procedure. We prefer Single Incision Laparoscopic Surgery Foam Port (Covidien) as the single umbilical device for introduction into the abdominal cavity. First, we performed cholecystectomy, then the gallbladder was put aside over the liver and after that we peformed splenectomy. To remove the detached spleen and gallbladder, a nylon extraction bag is introduced through one of the port sites. The spleen is than morcellated in the bag with forceps and removed in fragments. After that we removed them and the umbilical fascial incision was closed. Splenectomy is the only effective therapy for this disorder and often it is performed in combination with cholecystectomy. Conventional surgery requires a wide upper abdominal incision for correct exposure of the gallbladder and spleen. Our experience shows that SILS splenectomy and cholecystectomy is feasible even in young children and

  14. Treatment of bilateral mammary ptosis and pectus excavatum through the same incision in one surgical stage

    Directory of Open Access Journals (Sweden)

    Fernando Passos Rocha

    Full Text Available CONTEXT: Congenital deformities of the anterior thoracic wall are characterized by unusual development of the costal cartilages. All these medical conditions are frequently associated with a variety of breast deformities. Several surgical techniques have been described for correcting them, going from sternochondroplasty to, nowadays, minimally invasive techniques and silicone prosthesis implantation. CASE REPORT: The present article reports the case of a young female patient who presented bilateral mammary ptosis and moderate pectus excavatum that caused a protrusion between the eighth and the tenth ribs and consequent esthetic disharmony. The proposed surgical treatment included not only subglandular breast implants of polyurethane, but also resection of part of the rib cartilage and a bone segment from the eighth, ninth and tenth ribs by means of a single submammary incision in order to make the scar minimally visible. Correction through a single incision benefited the patient and provided an excellent esthetic result. CONCLUSIONS: The techniques used to repair bilateral mammary ptosis and pectus excavatum by plastic and thoracic surgery teams, respectively, have been shown to be efficient for correcting both deformities. An excellent esthetic and functional result was obtained, with consequent reestablishment of the patient's self-esteem.

  15. Do river channels decrease in width downstream on Distributive Fluvial Systems? An evaluation of modern mega-fans

    Science.gov (United States)

    Espinoza, T. N.; Scuderi, L. A.; Weissmann, G. S.; Hartley, A. J.

    2014-12-01

    Recent studies on aggradational continental sedimentary basins globally show that fluvial deposits in most modern sedimentary basins are dominated Distributive Fluvial Systems (DFS). DFS's are identified by: (1) pattern of channels and floodplain deposits that radiate outward from an apex located where the river enters the sedimentary basin, (2) deposition where an alluvial system becomes unconfined upon entering the sedimentary basin, (3) broadly fan shaped deposit that is convex upward across the DFS and concave upward down-fan, and (4) if the DFS is incised, an intersection point above which the alluvial system is held in an incised valley and below which it distributes sediment across an active depositional lobe. Several papers about DFS hypothesized that rivers on DFS decrease in size down-fan. We are testing this hypothesis through evaluation of LANDSAT and STRM data from large DFS described by Hartley et al (2010). We use ArcGIS to: (1) open the images and merge them together if there are more than one image corresponding to the DFS being studied, (2) use a Maximum Likelihood Analysis in six classes to segment different features on the DFS (e.g. exposed sands, water, vegetation, and other fan environments), (3) isolate the classes that correspond to the active channel belt (e.g., exposed sand bars and water), (4) divide the active channel belt into 1000 m long sections, (5) determine the area of active channel belt in each section, and (6) calculate the average width of the river in each section (e.g., W = area/1000m). We present our result for each DFS river on a graph that shows the change in width downstream. Our final product will be a dataset that contains width versus distance down-fan from the apex for as many of the large DFS from Hartley et al (2010) as possible. If the hypothesis is supported, the decrease in width could have a substantial predictive significance on sandstone geometry in fluvial successions.

  16. CHANNEL ESTIMATION TECHNIQUE

    DEFF Research Database (Denmark)

    2015-01-01

    A method includes determining a sequence of first coefficient estimates of a communication channel based on a sequence of pilots arranged according to a known pilot pattern and based on a receive signal, wherein the receive signal is based on the sequence of pilots transmitted over the communicat......A method includes determining a sequence of first coefficient estimates of a communication channel based on a sequence of pilots arranged according to a known pilot pattern and based on a receive signal, wherein the receive signal is based on the sequence of pilots transmitted over...... the communication channel. The method further includes determining a sequence of second coefficient estimates of the communication channel based on a decomposition of the first coefficient estimates in a dictionary matrix and a sparse vector of the second coefficient estimates, the dictionary matrix including...... filter characteristics of at least one known transceiver filter arranged in the communication channel....

  17. The formation and maintenance of single-thread tie channels entering floodplain lakes: observations from three diverse river systems

    Energy Technology Data Exchange (ETDEWEB)

    Rowland, Joel C [Los Alamos National Laboratory; Dietrich, William E [UC BERKELEY; Day, Geoff [NEWCREST MINING; Parker, Gary [UNIV OF ILLINOIS

    2009-01-01

    Tie channels connect rivers to floodplain lakes on many lowland rivers and thereby play a central role in floodplain sedimentology and ecology, yet they are generally unrecognized and little studied. here we report the results of field studies focused on tie channel origin and morphodynamics in three contrasting systems: the Middle Fly River, Papua New Guinea, the Lower Mississippi River, and Birch Creek in Alaska. Across these river systems, tie channels vary by an order of magnitude in size but exhibit the same characteristic morphology and appear to develop and evolve by a similar set of processes. In all three systems, the channels are characterized by a narrow, leveed single-thread morphology with maximum width approximately one tenth the width of the mainstem river. The channels typically have a V shaped cross-section, unlike most fluvial channels. These channels develop as lakes become isolated from the river by sedimentation. Narrowing of the connection between river and lake causes a sediment-laden jet to develop. Levees develop along the margins of the jet leading to channel emergence and eventual levee aggradation to the height of the mainstem levees. Bi-directional flow in these channels is common. Outflows from the lake scour sediment and prevent channel blockage. We propose that channel geometry and size are then controlled by a dynamic balance between channel narrowing by suspended sediment deposition and incision and widening by mass failure of banks during outflows. Tie channels are laterally stable and may convey flow for hundreds to a few thousand of years.

  18. Gully incision rates on the bedrock of a large dip-slope landslide revealed by multi-period LiDAR DEMs

    Science.gov (United States)

    Chan, Y. C.; Hsieh, Y. C.

    2017-12-01

    Recent advances in airborne laser scanning (ALS) technology have provided a great opportunity for characterizing surface erosion through developing improved methods in multi-period DEM differencing and geomorphometry. This study uses three periods of ALS digital elevation model (DEM) data to analyze the short-term erosional features of the Tsaoling landslide triggered by the 1999 Chi-Chi earthquake in Taiwan. Two methods for calculating the bedrock incision rate, the equal-interval cross section selection method and the continuous swath profiles selection method, were used in the study after nearly ten years of gully incision following the earthquake-triggered dip-slope landslide. Multi-temporal gully incision rates were obtained using the continuous swath profiles selection method, which is considered a practical and convenient approach in terrain change studies. After error estimation and comparison of the multi-period ALS DEMs, the terrain change in different periods can be directly calculated, reducing time-consuming fieldwork such as installation of erosion pins and measurement of topographic cross sections on site. In this study, the gully bedrock incision rates ranged between 0.23 and 3.98 m/year, remarkably higher than the typical results from the previous studies. By comparing the DEM data, aerial photos, and precipitation records of this area, the effects of erosion could be observed from the retreat of the Chunqiu Cliff outline during August 2011 to September 2012. It was inferred that the change in the topographic elevation during 2011-2012 was mainly due to the torrential rain brought by Typhoon Soula, which occurred on 30 July 2012. The local gully incision rate in the lower part of the landslide surface was remarkably faster than that of the other regions, suggesting that the fast incision of the toe area possibly contributes to the occurrence of repeated landslides in the Tsaoling area.

  19. Fingertip replantation using a single volar arteriovenous anastomosis and drainage with a transverse tip incision.

    Science.gov (United States)

    Yabe, T; Muraoka, M; Motomura, H; Ozawa, T

    2001-11-01

    Four cases of fingertip replantation using a single volar arteriovenous anastomosis and drainage with a transverse tip incision are reported. Because of lack of suitable arteries for anastomosis in the amputated finger, in each case a volar radial vein was anastomosed to the proximal digital artery and external drainage was performed through a transverse tip incision. In 3 cases the replanted fingertip survived completely; partial necrosis occurred in 1 case. Because veins are more superficial and larger than arteries, they are more available for anastomosis. The results indicate that this method is a useful alternative in fingertip replantation.

  20. Comparative analysis of corneal morphological changes after transversal and torsional phacoemulsification through 2.2 mm corneal incision

    Directory of Open Access Journals (Sweden)

    Assaf A

    2013-01-01

    Full Text Available Ahmed Assaf, Maged Maher RoshdyOphthalmology Department, Ain Shams University, Cairo, EgyptPurpose: This paper compares and evaluates the corneal morphological changes occurring after cataract surgery through a 2.2 mm corneal incision. We use two platforms for comparison and evaluation, transversal and torsional phacoemulsification.Patients and methods: This study includes 139 consecutive cataractous eyes (nuclear color 2–4, according to the Lens Opacities Classification System III [LOCSIII] of 82 patients undergoing cataract surgery through a 2.2 mm corneal incision. Two different phacoemulsification platforms were used and assigned randomly: we used the WhiteStar Signature® system with the Ellips™ FX transversal continuous ultrasound (US mode for group I (mean age: 65.33 ± 6.97 years, and we used the Infiniti® system with the OZil® Intelligent Phaco (IP torsional US mode for group II (mean age: 64.02 ± 7.55 years. The corneal endothelium and pachymetry were evaluated preoperatively and at 1 month postoperatively. Incision size changes were also evaluated.Results: All surgeries were uneventful. Before intraocular lens implantation, the mean incision size was 2.24 ± 0.06 mm in both groups (P = 0.75. In terms of corneal endothelial cell density, neither preoperative (I vs II: 2304.1 ± 122.5 cell/mm2 vs 2315.6 ± 83.1 cell/mm2, P = 0.80 nor postoperative (I vs II: 2264.1 ± 124.3 cell/mm2 vs 2270.3 ± 89.9 cell/mm2, P = 0.98 differences between the groups were statistically significant. The mean endothelial cell density loss was 1.7% ± 1.6% and 2.0% ± 1.4% in groups I and II, respectively. Furthermore, no significant differences between groups I and II were found preoperatively (P = 0.40 and postoperatively (P = 0.68 in central pachymetry. With surgery, the mean increase in central pachymetry was 28.1 ± 23.6 µm and 24.0 ± 24.0 µm in groups I and II, respectively (P = 0.1.Conclusion: Ellips™ FX transversal and OZil® IP torsional

  1. Infilling and flooding of the Mekong River incised valley during deglacial sea-level rise

    Science.gov (United States)

    Tjallingii, Rik; Stattegger, Karl; Wetzel, Andreas; Van Phach, Phung

    2010-06-01

    The abrupt transition from fluvial to marine deposition of incised-valley-fill sediments retrieved from the southeast Vietnamese shelf, accurately records the postglacial transgression after 14 ka before present (BP). Valley-filling sediments consist of fluvial mud, whereas sedimentation after the transgression is characterized by shallow-marine carbonate sands. This change in sediment composition is accurately marked in high-resolution X-ray fluorescence (XRF) core scanning records. Rapid aggradation of fluvial sediments at the river mouth nearly completely filled the Mekong incised valley prior to flooding. However, accumulation rates strongly reduced in the valley after the river-mouth system flooded and stepped back. This also affected the sediment supply to deeper parts of the southeast Vietnamese shelf. Comparison of the Mekong valley-filling with the East Asian sea-level history of sub- and inter-tidal sediment records shows that the transgressive surface preserved in the incised-valley-fill records is a robust sea-level indicator. The valley was nearly completely filled with fluvial sediments between 13.0 and 9.5 ka BP when sea-level rose rather constantly with approximately 10 mm/yr, as indicated by the East Asian sea-level record. At shallower parts of the shelf, significant sediment reworking and the establishment of estuarine conditions at the final stage of infilling complicates accurate dating of the transgressive surface. Nevertheless, incised-valley-fill records and land-based drill sites indicate a vast and rapid flooding of the shelf from the location of the modern Vietnamese coastline to the Cambodian lowlands between 9.5 ka and 8.5 ka BP. Fast flooding of this part of the shelf is related with the low shelf gradient and a strong acceleration of the East Asian sea-level rise from 34 to 9 meter below modern sea level (mbsl) corresponding to the sea-level jump of melt water pulse (MWP) 1C.

  2. Ultrasound-guided axillary nerve block for ED incision and drainage of deltoid abscess.

    Science.gov (United States)

    Lyons, Claire; Herring, Andrew A

    2017-07-01

    Deltoid abscesses are common and painful, often a consequence of injection drug use and seen frequently in emergency departments (EDs). The required incision and drainage can be completed successfully with effective pain relief using a peripheral nerve block. The brachial plexus nerve block works well, however it is technically complex with a low, but potentially serious, risk of complications such as phrenic nerve paralysis. Selective blockade of the axillary nerve eliminates the risks associated with a brachial plexus block, while providing more specific anesthesia for the deltoid region. Our initial experience suggests that the axillary nerve block (ANB) is a technically simple, safe, and effective way to manage the pain of deltoid abscesses and the necessary incision and drainage (I&D). The block involves using ultrasound guidance to inject a 20mL bolus of local anesthetic into the quadrangular space surrounding the axillary nerve (inferior to the posterolateral aspect of the acromion, near the overlap of the long head of triceps brachii and teres minor). Once injected the local will anesthetize the axillary nerve resulting in analgesia of the cutaneous area of the lateral shoulder and the deeper tissues including the deltoid muscle. Further research will clarify questions about the volume and concentration of local anesthetic, the role of injected adjuncts, and expected duration of analgesia and anesthesia. Herein we present a description of an axillary nerve block successfully used for deltoid abscess I&D in the ED. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Controls on sediment cover in bedrock-alluvial channels of the Henry Mountains, Utah

    Science.gov (United States)

    Hodge, R. A.; Yager, E.; Johnson, J. P.; Tranmer, A.

    2017-12-01

    The location and extent of sediment cover in bedrock-alluvial channels influences sediment transport rates, channel incision and instream ecology. However, factors affecting sediment cover and how it responds to changes in relative sediment supply have rarely been quantitatively evaluated in field settings. Using field surveys and SFM analysis of channel reach topography, we quantified sediment cover and channel properties including slope, width, grain size distributions, and bedrock and alluvial roughness in North Wash and Chelada Creek in the Henry Mountains, Utah. Along reaches where upstream sediment supply does not appear to be restricted, we find that the fraction of local bedrock exposure increases as a function of local relative transport capacity . In a downstream section of Chelada Creek, decadal-scale sediment supply has been restricted by an upstream culvert that has caused a backwater effect and corresponding upstream deposition. In this section, alluvial cover is uncorrelated with local stream power. To test the impact of relative sediment supply on sediment cover, a 1D sediment transport model was used to predict the equilibrium sediment cover in Chelada Creek under varying flow and sediment supply conditions. Sediment transport in each model section was predicted using the partial cover model of Johnson (2015), which accounts for differences in bedrock and alluvial roughness on critical shear stress and flow resistance. Model runs in which sediment supply was approximately equal to mean transport capacity produced a pattern of sediment cover which best matched the field observations upstream of the culvert. However, runs where sediment supply was under-capacity produced the pattern most similar to field observations downstream of the culvert, consistent with our field-based interpretations. Model results were insensitive to initial sediment cover, and equilibrium was relatively quickly reached, suggesting that the channel is responsive to changes in

  4. The clinical research of off-pump coronary artery bypass grafting by small incision at the left chest.

    Science.gov (United States)

    Xiao, L-B; Zhang, Y-H; Zhou, J-W; Yang, M; Ling, Y-P; Gao, Z-S; Wang, Y-S

    2016-01-01

    To explore the clinical value of off-pump coronary artery bypass grafting by small incision at the left chest, and develop a better surgical regimen for coronary heart disease patients. 201 coronary heart disease patients who need coronary artery bypass grafting were required and randomly divided into 2 groups including a control group and an observation group. There were 107 cases in the control group who received coronary bypass grafting by extracorporeal circulation; there were 103 cases in the observation group who received off-pump coronary bypass grafting by small incision at the left chest. The duration of the mechanism ventilation, length of stay in ICU, hospitalization time, postoperative drainage volume, and the occurrence rate of complications were recorded and compared. The duration of mechanism ventilation, length of stay in ICU, hospitalization time and postoperative drainage volume in the control group were (19.21 ± 1.33) hours, (5.08 ± 0.57) days, (21.20 ± 2.34) days and (997.68 ± 96.35) mL, which were (7.73 ± 0.74) hours, (2.83 ± 0.16) days, (15.67 ± 1.18) days and (901.53 ± 89.32) mL in the observation group respectively, with statistical difference between the two groups (pdisease, pulmonary infection, perioperative cardiac infarction and mortality did not display a significant difference between the two groups (p > 0.05). Off-pump coronary artery bypass grafting by small incision at the left chest is a surgical method with less injury and fast recovery, which can be used as the preferred therapeutical method for the coronary heart disease patients who need coronary artery bypass grafting.

  5. Single-incision, laparoscopic-assisted jejunal resection and anastomosis following a gunshot wound.

    Science.gov (United States)

    Rubin, Jacob A; Shigemoto, Reynsen; Reese, David J; Case, J Brad

    2015-01-01

    A 2 yr old castrated male Pomeranian was evaluated for a 6 wk history of chronic vomiting, intermittent anorexia, and lethargy. Physical examination revealed a palpable, nonpainful, soft-tissue mass in the midabdominal area. Abdominal radiographs and ultrasound revealed a focal, eccentric thickening of the jejunal wall with associated jejunal mural foreign body and partial mechanical obstruction. Following diagnosis of a partial intestinal obstruction as the cause of chronic vomiting, the patient underwent general anesthesia for a laparoscopic-assisted, midjejunal resection and anastomosis using a single-incision laparoscopic surgery port. The patient was discharged the day after surgery, and clinical signs abated according to information obtained during a telephone interview conducted 2 and 8 wk postoperatively. The dog described in this report is a unique case of partial intestinal obstruction treated by laparoscopic-assisted resection and anastomosis using a single-incision laparoscopic surgery port.

  6. Histological Study of Induced Incisions on Rabbits’ Tongues with Three Diode Lasers with Different Wavelengths in Continuous Mode

    Directory of Open Access Journals (Sweden)

    Salwa Yammine

    2018-01-01

    Full Text Available Objective. Diode lasers have multiple indications in everyday dental practice. They allow carrying out incisions, coagulation of soft tissue, and Low-Level Laser Therapy. The goal of this study is to compare histologically the tissue interaction zones and edges of an induced laser incision on rabbits’ tongues with three different wavelengths of 810, 940, and 980 nm in continuous mode. Methods. Fourteen male rabbits were divided into six groups. Each animal underwent three incisions of 10 mm length on the right ventral face of the tongue, carried out in continuous mode with three diode lasers with different wavelengths of 810, 940, and 980 nm. Rabbits were sacrificed at 0, 1, 2, 6, and 15 hours and 14 days. Five rabbits were sacrificed at 0 hours and 2 hours and one rabbit was sacrificed at 1, 6, and 15 hours and at 14 days. The appearance of neutrophils marked the onset time of the inflammatory reaction. Histological study of the incisions was chosen to evaluate the edges and to measure the depth and width of carbonization and necrotic and inflammatory zones. Healing was evaluated at 14 days. Friedman test was used to assess statistical differences between groups. Results. In the experimental adopted conditions, the carbonization zone was marked by degradation of vacuoles and an elongation of nuclei and was observed on the edges of incisions. Carbonization and necrotic and inflammatory zones were measured for rabbits sacrificed at 0, 1, 2, 6, and 15 hours but the onset of inflammation zone marked by the infiltration of neutrophils did not appear before 6 hours. The neutrophils infiltration was higher at 15 hours than at 6 hours. Complete healing was shown at 14 days. According to the time for the regularity of the edges, the interpretation was qualitative without a statistical test. The statistical analysis of the three different diode lasers in this study showed nonsignificant difference between the different groups for the depth (p=0

  7. Quaternary tectonic control on channel morphology over sedimentary low land: A case study in the Ajay-Damodar interfluve of Eastern India

    Directory of Open Access Journals (Sweden)

    Suvendu Roy

    2015-11-01

    Full Text Available The style of active tectonic on the deformation and characterization of fluvial landscape has been investigated on three typical skrike-slip fault zones of the Ajay-Damodar Interfluve (ADI in Eastern India through field mapping, structural analysis and examination of digital topography (ASTER-30 m, multi-spectral imageries, and Google Earth images. Channel morphology in Quaternary sediment is more deformed than Cenozoic lateritic tract and igneous rock system by the neotectonic activities. The structural and lithological controls on the river system in ADI region are reflected by distinct drainage patterns, abrupt change in flow direction, offset river channels, straight river lines, ponded river channel, marshy lands, sag ponds, palaeo-channels, alluvial fans, meander cutoffs, multi-terrace river valley, incised compressed meander, convexity of channel bed slope and knick points in longitudinal profile. Seven morphotectonic indices have been used to infer the role of neotectonic on the modification of channel morphology. A tectonic index map for the ADI region has been prepared by the integration of used morphotectonic indices, which is also calibrated by Bouguer gravity anomaly data and field investigation.

  8. A combination of subcuticular sutures and a drain for skin closure reduces wound complications in obese women undergoing surgery using vertical incisions.

    Science.gov (United States)

    Inotsume-Kojima, Y; Uchida, T; Abe, M; Doi, T; Kanayama, N

    2011-02-01

    Obesity is a risk factor for surgical site or wound complications in women undergoing surgery involving vertical incisions. Several investigators have reported the efficacy of subcutaneous drains in minimising the complication rate but there is no consensus on using these for surgery in obese patients. In 2006, the Scottish Surveillance of Healthcare Associated Infection Programme showed that using subcuticular sutures rather than staples to close incisions significantly reduced the risk of surgical site infection. Before January 2008 (group 1; N = 40), wound complications occurred in some obese patients in our hospital after obstetric and gynaecological surgery when only staples were used for skin closure. In January 2008 (group 2; N = 31), we changed the method of skin closure for obese patients [body mass index (BMI) > 28 kg/m(2)] and we now use a subcutaneous drain with four channels along the running tube and subcuticular sutures with interrupted, buried 4-0 polydioxanone sutures. The aim of this study was to assess the effects of these interventions for skin closure in obese women. The general characteristics (age, weight and BMI) were similar between the two groups. There were no wound complications in group 2. In group 1, wound disruptions and a seroma occurred in five (12.5%) and one (2.5%) patients, respectively. The wound complication rate in group 2 was significantly lower than that in group 1 (P = 0.0319). Thus, new materials and techniques for skin closure can reduce the wound complication rate in obese women. Copyright © 2010 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved.

  9. Fluvial incision by the Qingyijiang River on the northern fringe of Mt. Huangshan, eastern China: Responses to weakening of the East Asian summer monsoon

    Science.gov (United States)

    Hu, Chunsheng; Liu, Shaochen; Hu, Chenqi; Xu, Guanglai; Zhou, Yingqiu

    2017-12-01

    This paper focuses on climatic and tectonic controls to determine their relative importance to the Quaternary fluvial incision by the Qingyijiang River, eastern China. The Qingyijiang, which is one of longest tributaries of the lower Yangtze River, drains the northern piedmont of Mt. Huangshan. A field survey focused on three natural sections of the Qingyijiang in the Jingxian basin, where a well-preserved sequence of one alluvial platform (P) and three fluvial terraces (T3, T2, and T1) is presented. The heights of the platform and the terraces above river level are 65, 40, 20, and 7 m respectively. In this study, electron spin resonance (ESR), optical stimulated luminescence (OSL), and palaeomagnetic dating were applied to reconstruct the fluvial incision history of the Qingyijiang and evaluate the possible influence of tectonic uplift and/or climate change on the fluvial incision. The main results show that (1) the ages of P, T3, T2, and T1 were determined to be ∼ 1300, ∼ 900, ∼ 600, and ∼ 1.5 ka respectively, corresponding to four incision events in the Qingyijiang; (2) the East Asian summer monsoon (EASM) experienced four significant weakening events at 1300, 900, 600, and ∼ 1.5 ka, according to previous research. Correspondingly, we propose that four significant increased periods of regional precipitation occurred at 1300, 900, 600, and ∼ 1.5 ka in the study area because of the negative correlation between the intensity of the EASM and regional precipitation from 1960 to 2012; and (3) fluvial incision by the Qingyijiang arose as a result of the weakening of the EASM in combination with tectonic uplift, determined by matching fluvial incision history of the Qingyijiang with tectonic movement and EASM change. In addition, the weakening of the EASM climatically triggered fluvial incision by the Qingyijiang. This study supports the conclusion that major fluvial incision has been climatically triggered; however, it also suggests that the mechanism of

  10. Is there an improvement of antibiotic use in China? Evidence from the usage analysis of combination antibiotic therapy for type I incisions in 244 hospitals.

    Science.gov (United States)

    Zhou, Wen-Juan; Luo, Zhen-Ni; Tang, Chang-Min; Zou, Xiao-Xu; Zhao, Lu; Fang, Peng-Qian

    2016-10-01

    The improvement of antibiotic rational use in China was studied by usage analysis of combination antibiotic therapy for type I incisions in 244 hospitals. Five kinds of hospitals, including general hospital, maternity hospital, children's hospital, stomatological hospital and cancer hospital, from 30 provinces were surveyed. A systematic random sampling strategy was employed to select outpatient prescriptions and inpatient cases in 2011 and 2012. A total of 29 280 outpatient prescriptions and 73 200 inpatient cases from 244 hospitals in each year were analyzed. Data were collected with regards to the implementation of the national antibiotic stewardship program (NASP), the overall usage and the prophylactic use of antibiotic for type I incisions. Univariate analysis was used for microbiological diagnosis rate before antimicrobial therapy, prophylactic use of antibiotics for type I incision operation, and so on. For multivariate analysis, the use of antibiotics was dichotomized according to the guidelines, and entered as binary values into logistic regression analysis. The results were compared with the corresponding criteria given by the guidelines of this campaign. The antibiotic stewardship in China was effective in that more than 80% of each kind of hospitals achieved the criteria of recommended antibiotics varieties. Hospital type appeared to be a factor statistically associated with stewardship outcome. The prophylactic use of antibiotics on type I incision operations decreased by 16.22% (Pbench marking. More efforts addressing the root cause of antibiotics abuse would continue to improve the rational use of antibiotics in China.

  11. Application on small incision extracapsular cataract extraction in large-scale vision recovery action in Shaanxi Province

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    Juan Zhang

    2014-09-01

    Full Text Available AIM: To investigate the characteristics of scale cataract operations and the effects and experiences of small incision extracapsular cataract extraction with intraocular lens(IOLimplantation in large-scale vision recovery action. METHODS: Four thousand eight hundred ninety-two cases(4 892 eyesof cataract were treated by small incision non-phacoemulcification cataract extraction from March 2010 to November 2011 in our hospital(Fuming No.1 surgery car of Shaanxi Provincewhich were retrospectively analyzed. Visual acuity, intraoperative and postoperative complications, the recovery of postoperative inflammation were observed. RESULTS: Visual acuity reached 0.3 or more in 4 521 eyes(92.42%at 1d after the operation, at 3d after the operation in 4 571 eyes(93.44%, there were 4 887 eyes with IOL implantation, implantation rate was 99.90%. All the cases had lesser intraoperative and postoperative complications, and the postoperative inflammation recovered quickly. CONCLUSION: Small incision extracapsular cataract extraction with IOL implantation is simple, effective, economical, safe and adapting for large-scale vision recovery action.

  12. Changes in the channel-bed level of the western Carpathian rivers over the last 40years

    Science.gov (United States)

    Kijowska-Strugała, Małgorzata; Bucała-Hrabia, Anna

    2017-04-01

    Channel-bed level is constantly changing in time and space, and the process is dependent on both natural and anthropogenic factors. In mountain areas this is one of the more visible morphological processes. The main aim of the research was to analyze the dynamics of the position of river channel beds. Three rivers located within the western part of Polish Carpathians were chosen for the analysis: the Ropa river, the Kamienica Nawojowska river and the Ochotnica river. They are typical rivers for the Beskidy Mountains, medium Flysch mountains. To assess changes in the position of channel bed long-term series of data of minimum water stages in the river were used. The Ropa river is the biggest left tributary of the Wisłoka river (basin a of the upper Vistula River). The total length of the river amounts to 80 km, its gradient equals 58.9‰ and the water basin area amounts to 974 km2. The Kamienica Nawojowska river, with a length of 32.2 km is a right tributary of Dunajec river. The average decrease for the entire watercourse is 18.1‰. The catchment area is 238 km2. The Ochotnica river is 22.7 km long and it is a left tributary of the Dunajec river. The average slope for the entire watercourse is 36.1‰. The Ochotnica river characterized by deep valleys (catchment area 107.6 km2). Analysis of trends in minimum annual water stages in the alluvial Ropa river channel throughout the multi-year period of 1995-2014 shows an increasing trend amounting to 0.8 cm/year. In the Kamienica Nawojowska river the tendency of incision was observed starting from the 1960 to 2014. Average annual rate of increase of the minimum stages was between 0.4 to 1.2 cm/year. On the basis of the analysis of the minimum water levels in the years 1972-2011 two periods can be seen with different tendencies to change the position of the Ochotnica channel bottom. The first covers the years 1972-1996, where aggradation (3.9 cm/year) was the predominant process while in the period 1997-2011 incision

  13. Single-incision video-assisted anatomical segmentectomy with handsewn bronchial closure for endobronchial lipoma.

    Science.gov (United States)

    Galvez, Carlos; Sesma, Julio; Bolufer, Sergio; Lirio, Francisco; Navarro-Martinez, Jose; Galiana, Maria; Baschwitz, Benno; Rivera, Maria Jesus

    2016-08-01

    Endobronchial lipomas are rare benign tumors whose symptoms are usually confused with recurrent infections or even asthma diagnosis, and mostly caused by endobronquial obstructive component which also conditions severity. We report a case of a 60-year-old man with a right-lower lobe upper-segment endobronchial myxoid tumor with uncertain diagnosis. We performed a single incision video-assisted anatomical segmentectomy and wedge bronchoplasty with handsewn closure to achieve complete resection and definitive diagnosis. During the postoperative air leak was not observed and there was no complication, with low pain scores and complete recovery. Final pathological exam showed endobronchial lipoma. Single-incision (SI) anatomical segmentectomies are lung-sparing resections for benign or low-grade malignancies with diagnostic and therapeutic value, and the need for a wedge bronchoplasty is not a necessary indication for conversion to multiport or open thoracotomy.

  14. Early response of local steroid injection versus mini incision technique in treatment of carpal tunnel syndrome

    International Nuclear Information System (INIS)

    Awan, A.S.; Khan, A.; Afridi, S.A.; Khan, R.S.

    2015-01-01

    Carpal tunnel syndrome Carpal tunnel syndrome (CTS) is one of the commonest peripheral neuropathies which effects mainly middle aged women. Different techniques are being tried to decrease the post-operative pain in patients operated for CTS. The objective of this study was to compare effectiveness of local injection of steroid and mini incision technique in the treatment of carpal tunnel syndrome. Methods: This randomized control trial was conducted at department of Orthopedics and department of Neurosurgery, Ayub Teaching Hospital, Abbottabad from Aug 2011 to Feb 2013. A total of 116 patients of CTS were randomly allocated to either of the two groups. Fifty-eight Patient in Group A were subjected to local steroid injection and the same number of patient in Group B underwent mini incision technique. All patients of were advised to report to the OPD after one month to determine intervention effectiveness in terms of improvement in at least one grade of pain. Results: In this study mean age of the patients was 32.8 ± 5.1 years. Female gender was in dominance with 99 (86.3%) cases. In this study we compared the effectiveness of local steroid injection and mini incision technique in the treatment of carpel tunnel syndrome. We found out that the steroid injection was effective in 69.0% cases while mini incision technique was effective in 56.9% cases. The difference being statistically insignificant with a p-value of 0.17. Conclusion: The difference in pain after 1 month of the intervention was not statistically significant. (author)

  15. Local analgesic effect of tramadol is mediated by opioid receptors in late postoperative pain after plantar incision in rats.

    Science.gov (United States)

    de Oliveira Junior, José Oswaldo; de Freitas, Milena Fernandes; Bullara de Andrade, Carolina; Chacur, Marucia; Ashmawi, Hazem Adel

    2016-01-01

    Tramadol is a drug used to treat moderate to severe pain. It is known to present a peripheral effect, but the local mechanisms underlying its actions remain unclear. The role of peripheral opioid receptors in postoperative pain is not well understood. In the present study, we examined the peripheral opioid receptors to determine the local effect of tramadol in a plantar incision pain model. Rats were subjected to plantar incision and divided into four groups on postoperative day (POD) 1: SF_SF, 0.9% NaCl injected into the right hindpaw; SF_TraI, 0.9% NaCl and tramadol injected into the right hindpaw; SF_TraC, 0.9% NaCl and tramadol injected into the contralateral hindpaw; and Nal_Tra, naloxone and tramadol injected into the ipsilateral hindpaw. To determine the animals' nociceptive threshold, mechanical hyperalgesia was measured before incision, on POD1 before treatment and at 15, 30, 45, and 60 minutes after the incision. The same procedure was repeated on the POD2. The expression levels of μ-opioid receptor (MOR) and δ-opioid receptor (DOR) were obtained through immunoblotting assays in the lumbar dorsal root ganglia (L3-L6) in naïve rats and 1, 2, 3, and 7 days after the incision. Our results showed that the plantar incision was able to cause an increase in mechanical hyperalgesia and that tramadol reversed this hyperalgesia on POD1 and POD2. Tramadol injections in the contralateral paw did not affect the animals' nociceptive threshold. Naloxone was able to antagonize the tramadol effect partially on POD1 and completely on POD2. The DOR expression increased on POD2, POD3, and POD7, whereas the MOR expression did not change. Together, our results show that tramadol promoted a local analgesic effect in the postoperative pain model that was antagonized by naloxone in POD2, alongside the increase of DOR expression.

  16. Plantar Fascia Release Through a Single Lateral Incision in the Operative Management of a Cavovarus Foot: A Cadaver Model Analysis of the Operative Technique.

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    Kiskaddon, Eric M; Meeks, Brett D; Roberts, Joseph G; Laughlin, Richard T

    2018-04-04

    Plantar fascia release and calcaneal slide osteotomy are often components of the surgical management for cavovarus deformities of the foot. In this setting, plantar fascia release has traditionally been performed through an incision over the medial calcaneal tuberosity, and the calcaneal osteotomy through a lateral incision. Two separate incisions can potentially increase the operative time and morbidity. The purpose of the present study was threefold: to describe the operative technique, use cadaveric dissection to analyze whether a full release of the plantar fascia was possible through the lateral incision, and examine the proximity of the medial neurovascular structures to both the plantar fascia release and calcaneal slide osteotomy when performed together. In our cadaveric dissections, we found that full release of the plantar fascia is possible through the lateral incision with no obvious damage to the medial neurovascular structures. We also found that the calcaneal branch of the tibial nerve reliably crossed the osteotomy in all specimens. We have concluded that both the plantar fascia release and the calcaneal osteotomy can be safely performed through a lateral incision, if care is taken when completing the calcaneal osteotomy to ensure that the medial neurovascular structures remain uninjured. Copyright © 2017 The American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  17. Magnetic resonance imaging evaluation of incision healing after cesarean sections

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    Dicle, O. [Department of Radiodiagnosis, Dokuz Eyluel University, Izmir (Turkey); Kuecuekler, C. [Department of Radiodiagnosis, Dokuz Eyluel University, Izmir (Turkey); Pirnar, T. [Department of Radiodiagnosis, Dokuz Eyluel University, Izmir (Turkey); Erata, Y. [Department of Gynecology and Obstetrics, Dokuz Eyluel University, Izmir (Turkey); Posaci, C. [Department of Gynecology and Obstetrics, Dokuz Eyluel University, Izmir (Turkey)

    1997-02-01

    The purpose of this study was to examine the healing period of incision scar in myometrial wall and the normal pelvis after cesarean sections by means of MRI. In this study 17 voluntary women were examined after their first delivery with cesarean section in the early postpartum period (first 5 days), and following this, three more times in 3-month intervals. The MRI examinations were performed on a 1.0-T system (Magnetom, Siemens, Erlangen, Germany), and sagittal T1-weighted (550/17 TR/TE) and T2-weighted (2000/80 TR/TE) spin-echo (SE) images of the pelvis were obtained. During follow-up examinations incision scar tissues lost their signals within the first 3 months on both SE sequences, and little alteration was observed in the subsequent tests. Zonal anatomy of the uterus reappeared completely 6 months after cesarean sections. The time for the involution of the uterus was independent of the zonal anatomy recovery, and the maximum involution was inspected within the first 3 months. In conclusion, the maturation time of myometrial scar tissue in uncomplicated cesarean sections, which can be evaluated by the signal alterations in MRI, is approximately 3 months, whereas the complete involution and the recovery of the zonal anatomy need at least 6 months. (orig.). With 6 figs.

  18. Magnetic resonance imaging evaluation of incision healing after cesarean sections

    International Nuclear Information System (INIS)

    Dicle, O.; Kuecuekler, C.; Pirnar, T.; Erata, Y.; Posaci, C.

    1997-01-01

    The purpose of this study was to examine the healing period of incision scar in myometrial wall and the normal pelvis after cesarean sections by means of MRI. In this study 17 voluntary women were examined after their first delivery with cesarean section in the early postpartum period (first 5 days), and following this, three more times in 3-month intervals. The MRI examinations were performed on a 1.0-T system (Magnetom, Siemens, Erlangen, Germany), and sagittal T1-weighted (550/17 TR/TE) and T2-weighted (2000/80 TR/TE) spin-echo (SE) images of the pelvis were obtained. During follow-up examinations incision scar tissues lost their signals within the first 3 months on both SE sequences, and little alteration was observed in the subsequent tests. Zonal anatomy of the uterus reappeared completely 6 months after cesarean sections. The time for the involution of the uterus was independent of the zonal anatomy recovery, and the maximum involution was inspected within the first 3 months. In conclusion, the maturation time of myometrial scar tissue in uncomplicated cesarean sections, which can be evaluated by the signal alterations in MRI, is approximately 3 months, whereas the complete involution and the recovery of the zonal anatomy need at least 6 months. (orig.). With 6 figs

  19. Optical coherence tomography of the effects of stromal hydration on clear corneal incision architecture.

    Science.gov (United States)

    Calladine, Daniel; Tanner, Vaughan

    2009-08-01

    To evaluate the effects of stromal hydration on clear corneal incision (CCI) architecture immediately after surgery using anterior segment optical coherence tomography (AS-OCT). Department of Ophthalmology, Royal Berkshire Hospital, Reading, United Kingdom. Clear corneal incisions in adult eyes were examined using a Visante AS-OCT imaging system within 1 hour of surgery. Half the CCIs had stromal hydration with a balanced salt solution and half did not. Incisions were made with a 2.75 mm steel keratome. Intraocular pressure (IOP) was measured within 90 minutes after surgery. The CCI length and corneal thickness at the CCI site were measured using software built into the AS-OCT system. Thirty CCIs were evaluated. Stromal hydration significantly increased the measured CCI length (Pthe result of a trend toward increased corneal thickness at the CCI site with hydration (PThe mean CCI length was 1.69 mm +/- 0.27 (SD) (range 1.31 to 2.32 mm) with hydration and 1.51 +/- 0.23 mm (range 1.30 to 1.95 mm) without hydration. The mean IOP was 20.9 +/- 8.18 mm Hg and 15.8 +/- 8.20 mm Hg, respectively. The IOP tended to be higher with hydration (Pthe eye with a higher early postoperative IOP, showing the importance of taking stromal hydration into account when designing similar OCT studies of CCI architecture.

  20. The transverse colon cancer with the reversed rotation of the midgut treated with single incision laparoscopic colectomy.

    Science.gov (United States)

    Hirano, Yasumitsu; Hattori, Masakazu; Fujita, Manami; Nishida, Youji; Douden, Kenji; Hashizume, Yasuo

    2013-06-01

    Reversed rotation of the midgut is a rare type of intestinal malrotation. Moreover, synchronous colon cancer has rarely been reported. Preliminary experience with single-incision laparoscopic colectomy (SILC) for colon cancer with reversed rotation of the midgut is reported. An 82-year-old woman was admitted because of a fecal occult blood. A colonoscopy revealed transverse colon cancer. An air-barium contrast enema showed the right-sided sigmoid colon and the left-sided cecum. A computed tomography revealed that the duodenum and the transverse colon were situated at the ventral side of the superior mesenteric artery, and a preoperative diagnosis of suspicion of reversed rotation of the midgut was made. First, a lap protector was inserted through a 4.0 cm transumbilical incision. Four 5 mm ports were placed in the lap protector. On the observation of laparoscopy, the cecum and the ascending colon were not fixed with the retroperitoneum and situated on the left, and the sigmoid colon was situated on the right. We successfully mobilized the transverse colon using a single-incision laparoscopic approach. Resection was achieved following extracorporealization, and the anastomosis was performed extracorporeally using staplers. The patient was discharged on the thirteenth postoperative day. Postoperative follow-up did not reveal any umbilical wound complications. SILC for colon cancer associated with malrotation of the midgut is feasible and a promising alternative method because of its less invasiveness and its adaptability to the malrotation without extending the skin incision.

  1. Ex vivo evaluation of femtosecond pulse laser incision of urinary tract tissue in a liquid environment: implications for endoscopic treatment of benign ureteral strictures.

    Science.gov (United States)

    Liang, Jun-Hao; Kang, Jian; Pan, Yu-Long; Zhang, Liang; Qi, Jun

    2011-08-01

    The femtosecond (FS) pulse laser incises soft tissues with minimal peripheral damage and is a promising cutting tool for ureteroscopic endoureterotomy of benign ureteral strictures. To evaluate the feasibility of applying the FS laser to ureteroscopic endoureterotomy. A commercial Ti:Sapphire regenerative amplifier system (Coherent, RegA 9050, USA) was used in this study. Normal saline, 5% glucose solution, 4% mannitol solution, distilled water, and a 1% (v/v) suspension of whole blood with each of these solutions were tested for their attenuation rate (AR) of the FS laser's power. Bladder specimens from Sprague-Dawley (SD) rats were used as a surrogate model. The laser incised slots of 2 mm in length at bladder samples using three power grades (5×, 10×, and 20× the threshold power) combined with five effective pulse rates (40, 20, 10, 5, and 2.5 kHz), both in air and in normal saline. After samples were processed with standard hematoxylin-eosin staining procedures, the incision depth and collateral damage range were determined microscopically. The ARs of blood suspensions with each of the three isosmotic solutions were significantly higher than the other five solutions (P laser's cutting depth and the collateral damage were increased with the laser power or power density but the collateral damages were less than 100 µm. Microbubble formation was detected in the liquid environments tested and influenced the effective laser power. Endoscopic application of the FS laser is feasible. Microbubble formation with the laser incision, however, may influence cutting effects. Proposed methods to address these issues include increasing the irrigation rate, using distilled water as irrigation or using gas insufflation instead of irrigation. It is necessary to evaluate these methods, as well as the long-term biologic response to laser incision, on living animal models in endoscopic settings before use on humans. Copyright © 2011 Wiley-Liss, Inc.

  2. Channel Extension in Deep-Water Distributive Systems

    Science.gov (United States)

    Hoyal, D. C.; Sheets, B. A.

    2007-12-01

    The cyclic nature of channel and lobe formation in submarine fans is the result of the unstable and ephemeral nature of newly formed distributary channels. Avulsion cycles are initiated as unconfined sheet flow immediately following avulsion followed by stages of channel incision and extension, deposition of channel mouth deposits, and often channel backfilling. In contrast with those in alluvial and deltaic environments, avulsion cycles in submarine fans are relatively poorly understood due to the difficulty of observing deep ocean processes, either over short timescales needed to measure the hydrodynamics of active turbidity currents, or over longer timescales needed for the morphodynamic evolution of individual distributary channels and avulsion events. Here we report the results of over 80 experiments in a 5m x 3m x1m deep tank using saline (NaCl) density flows carrying low-density plastic sediment (SG 1.5) flowing down an inclined ramp. These experiments were designed to investigate trends observed in earlier self-organized experimental submarine fans with well-developed avulsion cycles, in which distributive lobes were observed to form on relatively high slopes. In particular, we were interested in investigating the relationship between channel extension length (distance from the inlet to the point where the flow becomes de-channelized, transitioning into a mouth-bar/lobe) and slope. The results of the experiments are clear but counter-intuitive. Channels appear to extend in discrete segments and channel extension length is inversely related to slope over a wide range of slopes (5-17 degrees). In addition, channel extension seems largely independent of inlet flow density (salt concentration) over the experimental range (10-24 g/cc). Measurements of densimetric Froude number (Fr') indicate Fr' increases downstream to near critical conditions at the channel lobe transition. Our preliminary interpretation is that distributary channels become unstable due to

  3. A Modeling Framework for Predicting the Size of Sediments Produced on Hillslopes and Supplied to Channels

    Science.gov (United States)

    Sklar, L. S.; Mahmoudi, M.

    2016-12-01

    Landscape evolution models rarely represent sediment size explicitly, despite the importance of sediment size in regulating rates of bedload sediment transport, river incision into bedrock, and many other processes in channels and on hillslopes. A key limitation has been the lack of a general model for predicting the size of sediments produced on hillslopes and supplied to channels. Here we present a framework for such a model, as a first step toward building a `geomorphic transport law' that balances mechanistic realism with computational simplicity and is widely applicable across diverse landscapes. The goal is to take as inputs landscape-scale boundary conditions such as lithology, climate and tectonics, and predict the spatial variation in the size distribution of sediments supplied to channels across catchments. The model framework has two components. The first predicts the initial size distribution of particles produced by erosion of bedrock underlying hillslopes, while the second accounts for the effects of physical and chemical weathering during transport down slopes and delivery to channels. The initial size distribution can be related to the spacing and orientation of fractures within bedrock, which depend on the stresses and deformation experienced during exhumation and on rock resistance to fracture propagation. Other controls on initial size include the sizes of mineral grains in crystalline rocks, the sizes of cemented particles in clastic sedimentary rocks, and the potential for characteristic size distributions produced by tree throw, frost cracking, and other erosional processes. To model how weathering processes transform the initial size distribution we consider the effects of erosion rate and the thickness of soil and weathered bedrock on hillslope residence time. Residence time determines the extent of size reduction, for given values of model terms that represent the potential for chemical and physical weathering. Chemical weathering potential

  4. Risk factors for an additional port in single-incision laparoscopic cholecystectomy in patients with cholecystitis.

    Science.gov (United States)

    Araki, Kenichiro; Shirabe, Ken; Watanabe, Akira; Kubo, Norio; Sasaki, Shigeru; Suzuki, Hideki; Asao, Takayuki; Kuwano, Hiroyuki

    2017-01-01

    Although single-incision laparoscopic cholecystectomy is now widely performed in patients with cholecystitis, some cases require an additional port to complete the procedure. In this study, we focused on risk factor of additional port in this surgery. We performed single-incision cholecystectomy in 75 patients with acute cholecystitis or after cholecystitis between 2010 and 2014 at Gunma University Hospital. Surgical indications followed the TG13 guidelines. Our standard procedure for single-incision cholecystectomy routinely uses two needlescopic devices. We used logistic regression analysis to identify the risk factors associated with use of an additional full-size port (5 or 10 mm). Surgical outcome was acceptable without biliary injury. Nine patients (12.0%) required an additional port, and one patient (1.3%) required conversion to open cholecystectomy because of severe adhesions around the cystic duct and common bile duct. In multivariate analysis, high C-reactive protein (CRP) values (>7.0 mg/dl) during cholecystitis attacks were significantly correlated with the need for an additional port (P = 0.009), with a sensitivity of 55.6%, specificity of 98.5%, and accuracy of 93.3%. This study indicated that the severe inflammation indicated by high CRP values during cholecystitis attacks predicts the need for an additional port. J. Med. Invest. 64: 245-249, August, 2017.

  5. Impact of two telemetry transmitter implantation incision suturing methods on the physiological state and condition of perch (Perca fluviatilis

    Directory of Open Access Journals (Sweden)

    Rożyński Maciej

    2017-06-01

    Full Text Available The aim of this work was to determine the impact on European perch, Perca fluviatilis L. (mean body weight – 78.33 g of the intraperitoneal implantation of telemetry transmitters using different suturing methods. In the first experiment silk sutures were used (experiment I – group ST, while in the second tissue adhesive was used (experiment II – group GT. Following the procedure, the fish were kept for 42 days in a recirculating system. Differences in growth and condition parameters were only noted in the first week of the experiment. Specimens from group GT had lower values for DGR (daily growth rate and SGR (specific growth rate, but a higher value for FCR (feed conversion ratio values. For the hematological parameters, lower values of MCV (mean corpuscular volume and PLT (blood platelets were noted in group GT, while for the biochemical parameters, lowered ALP (alkaline phosphatase activity and Mg (magnesium concentrations were noted in group ST. In group ST, 33.3% of the specimens loss their tags, while in group GT 77.8% did so. Differences in incision healing were only noted in the second week, when specimens in group ST were observed to have fully closed incisions, while in group GT 50% of the incisions were open. Despite the high percentage of implantation incision healing in both groups, because of the high values of tag loss rate, neither method can be recommended for perch. It might be more effective to use tag with external antennae in this species. The method use for closing implantation incisions also must be improved to eliminate tag shedding.

  6. Single perineal incision placement of artificial urinary sphincter with cadaveric correlation of sub-dartos pump placement

    Directory of Open Access Journals (Sweden)

    Cooper R. Benson

    Full Text Available ABSTRACT Purpose We present a novel AUS implantation technique using a single perineal incision for single device placement or in combination with an inflatable penile prosthesis (IPP. Urinary and sexual dysfunction following the management of prostate cancer has a significant impact on the quality of life of our patients. While there are marginal changes in the prosthetic devices, we strive to reduce post-operative morbidity while maximizing efficacy. Materials and Methods We retrospectively reviewed the outcomes of 6 patients who underwent single perineal incision placement of a virgin AUS in 2014, 3 with simultaneous IPP placement. In all cases, the pressure regulating balloons (PRB were placed in a high sub-muscular ectopic position and the pumps were placed into a sub-dartos pouch through the perineal incision, which was also validated using a cadaveric model. Results The mean patient age was 61 (SD, 7.5 years with mean body mass index of 31 (SD, 5.9. The average pre-operative pad usage was 7.7 (SD 1.63 pads per day. The mean follow-up was 13.9 months (SD 9.45. Four out of the six patients reported utilizing ≤1 pad daily at follow-up. The one patient who was not initially dry required downsizing of his cuff to 3.5cm; the remaining patient was lost to follow-up. There were no identifiable perioperative or post-operative complications. Conclusions We present our initial report of using a single perineal incision for AUS implantation with a validated sub-dartos pump location, which is safe and effective for implantation of an AUS as a single or double implantation in well-selected patients.

  7. Channel characteristics and coordination in three-echelon dual-channel supply chain

    Science.gov (United States)

    Saha, Subrata

    2016-02-01

    We explore the impact of channel structure on the manufacturer, the distributer, the retailer and the entire supply chain by considering three different channel structures in radiance of with and without coordination. These structures include a traditional retail channel and two manufacturer direct channels with and without consistent pricing. By comparing the performance of the manufacturer, the distributer and the retailer, and the entire supply chain in three different supply chain structures, it is established analytically that, under some conditions, a dual channel can outperform a single retail channel; as a consequence, a coordination mechanism is developed that not only coordinates the dual channel but also outperforms the non-cooperative single retail channel. All the analytical results are further analysed through numerical examples.

  8. The extended minimal incision approach to midface rejuvenation.

    Science.gov (United States)

    Pontius, Allison T; Williams, Edwin F

    2005-08-01

    Recent major advancements in comprehensive facial rejuvenation have focused on management of midfacial aging. Multiple techniques have been described to treat the aging midface; the mere nature of so many approaches is evidence that no one technique has prevailed. Although the nasolabial region remains a challenge to correct, the approach described herein provides comprehensive rejuvenation of the midface, lateral brow, and jawline. The technique is performed via a minimal incision brow-lift approach and has been performed (with minor modifications) by the senior author in more than 650 patients over the past 9 years. The technique has proven to be safe, reliable, and effective.

  9. Changes in Channel Geometry through the Holocene in the Le Sueur River, South-Central Minnesota, USA

    Science.gov (United States)

    Targos, Courtney Ann

    Paleochannels preserved on terraces via meander cutoffs during an incisional period record the channel geometry and thus discharge at distinct points in time throughout a river's history. We measured paleochannel geometry on terraces throughout the Le Sueur River in south-central Minnesota, to track how channel geometry has changed over the last 13,400 years. A rapid drop in base level 13,400 yr B.P. triggered knickpoint migration and valley incision that is ongoing today. Since the 1800's, the area has developed rapidly with an increase in agriculture and associated drainage, directly impacting river discharge by increasing water input to the river. Five paleochannels were identified on terraces along the Le Sueur River from 1m-resolution lidar data. Ground Penetrating Radar (GPR) was used to obtain a subsurface image across paleomeanders to estimate the geometry of paleochannels. Paleochannel geometry and estimated discharge were then compared to modern conditions to assess how much change has occurred. Three lines were run across each paleochannel perpendicular to the historic water flow. Each of the 15 lines were processed using the EKKO Project 2 software supplied by Sensors and Software to sharpen the images, making it easier to identify the paleochannel geometry. Paleodischarge was determined using the Law of the Wall and Manning's Equation, using modern slope and roughness conditions. OSL samples were collected from overbank deposits on terraces to determine the time of channel abandonment, and supplemented with terrace ages obtained from a numerical model of valley incision. Paleodischarge coupled with depositional ages provide a history of flow conditions on the Le Sueur River. Results show an increase in channel widths from the time paleochannels were occupied to modern channel dimensions from an average of 20 meters to 35 meters. The change was not constant through time, as all paleochannels analyzed on terraces had similar-sized channels. The best way

  10. The longitudinal epineural incision and complete nerve transection method for modeling sciatic nerve injury

    Directory of Open Access Journals (Sweden)

    Xing-long Cheng

    2015-01-01

    Full Text Available Injury severity, operative technique and nerve regeneration are important factors to consider when constructing a model of peripheral nerve injury. Here, we present a novel peripheral nerve injury model and compare it with the complete sciatic nerve transection method. In the experimental group, under a microscope, a 3-mm longitudinal incision was made in the epineurium of the sciatic nerve to reveal the nerve fibers, which were then transected. The small, longitudinal incision in the epineurium was then sutured closed, requiring no stump anastomosis. In the control group, the sciatic nerve was completely transected, and the epineurium was repaired by anastomosis. At 2 and 4 weeks after surgery, Wallerian degeneration was observed in both groups. In the experimental group, at 8 and 12 weeks after surgery, distinct medullary nerve fibers and axons were observed in the injured sciatic nerve. Regular, dense myelin sheaths were visible, as well as some scarring. By 12 weeks, the myelin sheaths were normal and intact, and a tight lamellar structure was observed. Functionally, limb movement and nerve conduction recovered in the injured region between 4 and 12 weeks. The present results demonstrate that longitudinal epineural incision with nerve transection can stably replicate a model of Sunderland grade IV peripheral nerve injury. Compared with the complete sciatic nerve transection model, our method reduced the difficulties of micromanipulation and surgery time, and resulted in good stump restoration, nerve regeneration, and functional recovery.

  11. Comparison between Tubularised Incised Plate Urethroplasty and Onlay Island Flap Repair in Mid and Proximal Penile Hypospadias

    Energy Technology Data Exchange (ETDEWEB)

    Javid, L.; Pansota, M. S.; Ahmad, I.; Tariq, M.; Tabassum, S. A. [Bahawal Victoria Hospital Quaid-e-Azam Medical College, Bahawalpur (Pakistan). Dept. of Urology

    2014-04-15

    Objectives: To evaluate the surgical outcome of tubularised incised plate urethroplasty and onlay island flap repair for mid and proximal penile hypospadias. Methods: The prospective study was conducted at the Bahawal Victoria Hospital, Bahawalpur from June 2011 to May 2013. A total of 60 patients with mid and proximal penile hypospadias in the age range of 02 to 06 years were included. Patients with hypospadias other than mid and proximal penile, with chordee and history of previous hypospadias repair were excluded. Patients were divided into two equal groups. Urethroplasty was done for group I and flap repair for group II. The follow-up period was 12-24 months. SPSS 16 was used for statistical analysis. Results: The mean duration of surgery was 62+-8.72 minutes for group I and 90+-11.25 minutes for group II (p<0.0001). In group I, only 03 (10.0%) patients had complications, while in group II, 09 (30.0%) patients developed complications (p=0.02). Cosmetic results were also excellent in group I compared to group II. Conclusion: Tubularised incised plate urethroplasty was better and superior than onlay island flap repair in terms of less operative time, complication rate and satisfactory cosmetic results for mid and proximal penile hypospadias. (author)

  12. Comparison between tubularised incised plate urethroplasty and onlay island flap repair in mid and proximal penile hypospadias.

    Science.gov (United States)

    Javid, Latif; Pansota, Mudassar Saeed; Ahmad, Iftikhar; Tariq, Muhammad; Tabassum, Shafqat Ali

    2014-04-01

    To evaluate the surgical outcome of tubularised incised plate urethroplasty and onlay island flap repair for mid and proximal penile hypospadias. The prospective study was conducted at the Bahawal Victoria Hospital, Bahawalpur from June 2011 to May 2013. A total of 60 patients with mid and proximal penile hypospadias in the age range of 02 to 06 years were included. Patients with hypospadias other than mid and proximal penile, with chordee and history of previous hypospadias repair were excluded. Patients were divided into two equal groups. Urethroplasty was done for group I and flap repair for group II. The follow-up period was 12-24 months. SPSS 16 was used for statistical analysis. The mean duration of surgery was 62 +/- 8.72 minutes for group I and 90 +/- 11.25 minutes for group II (p < 0.0001). In group I, only 03 (10.0%) patients had complications, while in group II, 09 (30.0%) patients developed complications (p = 0.02). Cosmetic results were also excellent in group I compared to group II. Tubularised incised plate urethroplasty was better and superior than onlay island flap repair in terms of less operative time, complication rate and satisfactory cosmetic results for mid and proximal penile hypospadias.

  13. Comparison between Tubularised Incised Plate Urethroplasty and Onlay Island Flap Repair in Mid and Proximal Penile Hypospadias

    International Nuclear Information System (INIS)

    Javid, L.; Pansota, M.S.; Ahmad, I.; Tariq, M.; Tabassum, S.A.

    2014-01-01

    Objectives: To evaluate the surgical outcome of tubularised incised plate urethroplasty and onlay island flap repair for mid and proximal penile hypospadias. Methods: The prospective study was conducted at the Bahawal Victoria Hospital, Bahawalpur from June 2011 to May 2013. A total of 60 patients with mid and proximal penile hypospadias in the age range of 02 to 06 years were included. Patients with hypospadias other than mid and proximal penile, with chordee and history of previous hypospadias repair were excluded. Patients were divided into two equal groups. Urethroplasty was done for group I and flap repair for group II. The follow-up period was 12-24 months. SPSS 16 was used for statistical analysis. Results: The mean duration of surgery was 62+-8.72 minutes for group I and 90+-11.25 minutes for group II (p<0.0001). In group I, only 03 (10.0%) patients had complications, while in group II, 09 (30.0%) patients developed complications (p=0.02). Cosmetic results were also excellent in group I compared to group II. Conclusion: Tubularised incised plate urethroplasty was better and superior than onlay island flap repair in terms of less operative time, complication rate and satisfactory cosmetic results for mid and proximal penile hypospadias. (author)

  14. Repair of a submucous cleft palate by W-pushback and levator repositioning without incision to the nasal mucosa.

    Science.gov (United States)

    Hwang, Kun

    2012-03-01

    The author created an innovative method of W-pushback and levator repositioning without having to make an incision to the nasal mucosa for submucous cleft palate repair.The W-shaped mucoperiosteal flap is outlined where the 2 peaks of W are the alveolar processes of both canine teeth and the midpoint of W is the anterior limit of the cleft notch of the hard palate. A short incision, medial to and behind the maxillary tuberosity and curved forward onto the palate and extended forward just medial to the alveolar process, is joined by a second incision from the apex of the cleft to the region of the canine tooth. The W-shaped mucoperiosteal flap is raised until the midline notch of the hard palate is exposed. The nasal mucosa and abnormally inserted levator veli palatini muscle to the posterior border of the hard palate bone are detached. By leaving the nasal mucosa intact, the detached levator veli palatini muscle is approximated at the midline and so the zona pellucida is obliterated. The cleft uvulas are cut in half and closed. The approximated W-flap is joined to the small anterior flap by 1 or more sutures (the W-pushback).Three patients were operated on with this technique without serious complications.The author believes that this method can make the levator sling and increase the length of the soft palate without making an incision to the nasal mucosa.

  15. Removable thermoplastic appliances modified by incisal cuts show altered biomechanical properties during tipping of a maxillary central incisor.

    Science.gov (United States)

    Brockmeyer, Phillipp; Kramer, Katharina; Böhrnsen, Florian; Gruber, Rudolf Matthias; Batschkus, Sarah; Rödig, Tina; Hahn, Wolfram

    2017-08-28

    The present study aimed to evaluate the force delivery of removable thermoplastic appliances (RTAs), modified by different sized incisal cuts, during tipping of a maxillary central incisor in palatal and vestibular direction. Forty-five RTAs from three different materials (Biolon®, Erkodur®, Ideal Clear®) of the same thickness (1 mm) were used. Analysis was performed on a separated maxillary central incisor which was part of a resin model with a complete dentition. In 15 RTAs, of different material, a cut was inserted at the incisal edge of tooth 11. In 15 other appliances, the cut was extended to teeth 12 and 21. Fifteen aligners remained uncut. The experimental tooth was tipped starting from the zero position in 0.05° steps to a maximal deflection of ± 0.42° of the incisal edge in vestibular and palatal direction, after positioning the RTA onto the model. The horizontal (Fx) and the vertical (Fz) force components were decreased by approximately half with increasing cut size. Fz values changed during palatal tipping from a weak intrusive force, for aligners without cut, to an extrusive force with increasing cut size. Compared to both other materials used (Erkodur® and Ideal Clear®), the Biolon® aligners showed significantly higher Fx and Fz values (p < 0.0001, respectively). RTAs modified by different sized incisal cuts show altered biomechanical properties and an inversion of the vertical force component, during tipping of a maxillary central incisor.

  16. Channel identification machines.

    Science.gov (United States)

    Lazar, Aurel A; Slutskiy, Yevgeniy B

    2012-01-01

    We present a formal methodology for identifying a channel in a system consisting of a communication channel in cascade with an asynchronous sampler. The channel is modeled as a multidimensional filter, while models of asynchronous samplers are taken from neuroscience and communications and include integrate-and-fire neurons, asynchronous sigma/delta modulators and general oscillators in cascade with zero-crossing detectors. We devise channel identification algorithms that recover a projection of the filter(s) onto a space of input signals loss-free for both scalar and vector-valued test signals. The test signals are modeled as elements of a reproducing kernel Hilbert space (RKHS) with a Dirichlet kernel. Under appropriate limiting conditions on the bandwidth and the order of the test signal space, the filter projection converges to the impulse response of the filter. We show that our results hold for a wide class of RKHSs, including the space of finite-energy bandlimited signals. We also extend our channel identification results to noisy circuits.

  17. Channel Identification Machines

    Directory of Open Access Journals (Sweden)

    Aurel A. Lazar

    2012-01-01

    Full Text Available We present a formal methodology for identifying a channel in a system consisting of a communication channel in cascade with an asynchronous sampler. The channel is modeled as a multidimensional filter, while models of asynchronous samplers are taken from neuroscience and communications and include integrate-and-fire neurons, asynchronous sigma/delta modulators and general oscillators in cascade with zero-crossing detectors. We devise channel identification algorithms that recover a projection of the filter(s onto a space of input signals loss-free for both scalar and vector-valued test signals. The test signals are modeled as elements of a reproducing kernel Hilbert space (RKHS with a Dirichlet kernel. Under appropriate limiting conditions on the bandwidth and the order of the test signal space, the filter projection converges to the impulse response of the filter. We show that our results hold for a wide class of RKHSs, including the space of finite-energy bandlimited signals. We also extend our channel identification results to noisy circuits.

  18. Spatial discontinuity and temporal evolution of channel morphology along a mixed bedrock-alluvial river, upper Drôme River, southeast France: Contingent responses to external and internal controls

    Science.gov (United States)

    Toone, J.; Rice, S. P.; Piégay, H.

    2014-01-01

    The rehabilitation of degraded river channels is often guided by assumptions of continuity, yet in response to spatial and temporal variations in controlling conditions rivers typically display discontinuous response in space and time. This study examines the development of a 5 km reach of the Drôme River, S.E. France, characterised by alternating alluvial and bedrock zones that are separated by abrupt downstream transitions. This reach is representative of the Drôme River as a whole, and other rivers in the European Alps where braided channel planforms have been replaced by more complex, discontinuous morphologies. The primary aims are to understand how this spatial complexity has developed on the Drôme; evaluate how temporal channel changes have been affected by local factors, particularly bedrock exposures, and by long-term, catchment-scale changes in sediment supply and the flood activity; and consider the implications of this discontinuous geomorphology for reach management. The development of geomorphological zonation is examined by documenting sequential changes in channel planform between seven periods, using aerial photography (1948-2006) and by analysing change in bed elevation from profiles surveyed in 1928, 2003 and 2005. Between 1948 and 2001 bedrock exposed in the channel bed and along the floodplain margins defined discontinuities in sediment connectivity that were largely responsible for the configuration of channel zones. The impact of floods on this system was not proportional to flood magnitude. A modest flood in 1978 was an important event that, by incision and avulsion at key locations, defined a pattern of zonation that persisted until the end of the study in 2006. During the final 5 years of the study, alluvial zones that previously responded to large floods by widening underwent narrowing, despite the occurrence of a large flood, and led to an overall reduction in width variance. This resulted from progressive incision beneath and

  19. Single incision laparoscopic surgery (SILS) inguinal hernia repair - recent clinical experiences of this novel technique.

    Science.gov (United States)

    Yussra, Y; Sutton, P A; Kosai, N R; Razman, J; Mishra, R K; Harunarashid, H; Das, S

    2013-01-01

    Inguinal hernia remains the most commonly encountered surgical problem. Various methods of repair have been described, and the most suitable one debated. Single port access (SPA) surgery is a rapidly evolving field, and has the advantage of affording 'scarless' surgery. Single incision laparoscopic surgery (SILS) for inguinal hernia repair is seen to be feasible in both total extraperitoneal (TEP) and transabdominal pre-peritoneal (TAPP) approaches. Data and peri-operative information on both of these however are limited. We aimed to review the clinical experience, feasibility and short term complications related to laparoscopic inguinal hernia repair via single port access. A literature search was performed using Google Scholar, Springerlink Library, Highwire Press, Surgical Endoscopy Journal, World Journal of Surgery and Medscape. The following search terms were used: laparoscopic hernia repair, TAPP, TEP, single incision laparoscopic surgery (SILS). Fourteen articles in English language related to SILS inguinal hernia repair were identified. Nine articles were related to TEP repair and the remaining 5 to TAPP. A total of 340 patients were reported within these studies: 294 patients having a TEP repair and 46 a TAPP. Only two cases of recurrence were reported. Various ports have been utilized, including the SILS port, Tri-Port and a custom- made port using conventional laparoscopic instruments. The duration of surgery was 40-100 minutes and the average length of hospital stay was one day. Early outcomes of this novel technique show it to be feasible, safe and with potentially better cosmetic outcome.

  20. Effects of entonox in comparison of lidocaine on pain severity during episiotomy incision in nulliparous women: A randomized control trial

    Directory of Open Access Journals (Sweden)

    Azam Honarmandpour

    2017-01-01

    Full Text Available Background & Aim: Episiotomy is one of the most common surgical procedures in obstetrics, which requires analgesia. Entonox gas is known to have analgesic and sedative properties. However, no studies have been found on the analgesic effects of Entonox on episiotomy incision. Therefore, this study aimed to compare the effects of Entonox and lidocaine on pain intensity during episiotomy incision in nulliparous women. Materials and Methods: This randomized controlled trial was conducted on 120 term nulliparous women, who met the inclusion criteria. Subjects were selected by randomized sampling and equally divided into two groups of intervention and control (n=60. In the intervention group, Entonox gas was applied two minutes before episiotomy incision until the end of the procedure. On the other hand, the control group received 5 ml of lidocaine 2% as routine care before episiotomy incision. Data were collected using visual analogue scale to compare the study groups in terms of pain intensity. In addition, patient satisfaction with pain management technique during episiotomy and side effects of Entonox were assessed. Data analysis was performed in SPSS version 22 using Mann-Whitney U and Chi-square tests, and P value of less than 0.05 was considered statistically significant. Results: In this study, no significant difference was observed between the intervention and control groups regarding pain intensity (P=0.52. Moreover, no significant difference was observed in the satisfaction level of the two groups (P=0.70. Conclusion: According to the results of this study, Entonox could be used as an effective and noninvasive alternative to lidocaine to reduce pain during episiotomy incision without significant side effects.

  1. Anatomic study on mental canal and incisive nerve canal in interforaminal region in Chinese population.

    Science.gov (United States)

    Xu, Yun; Suo, Ning; Tian, Xiufen; Li, Fei; Zhong, Guangxin; Liu, Xiaoran; Bao, Yongxing; Song, Tao; Tian, Hua

    2015-08-01

    This study was aimed to detect the positions of mental canal and incisive nerve canal as well as the prolongation of mandibular canal in interforaminal region in Chinese population to supply the reference data of the surgical safe zone in chin for clinicians. A total of 80 formalin-fixed semi-mandibles of Chinese adult cadavers were dissected, the positions and courses of mental canal and incisive nerve canal as well as the prolongation of mandibular canal in interforaminal region were measured. The mental foramina were present in all cases (100 %), and most of them were located below 2nd premolar (58.75 %). Accessory mental foramina were observed in 5 %. The anterior end of mandibular canal, extending along the course of 7.37 ± 1.10 mm above the lower border of mandible to interforaminal region about 3.54 ± 0.70 mm medial to the mental foramen, most often ended below between the two premolars (73.75 %), where it continued as the incisive nerve canal (100 %) and the mental canal (96.25 %). Mental canal, with the wall formed by compact bone, being 2.60 ± 0.60 mm in diameter and 4.01 ± 1.20 mm in length, opened into mental foramen. Incisive nerve canal, with the wall formed by thin compact bone and/or partly or completely by spongy bone, being 1.76 ± 0.27 mm in diameter and 24.87 ± 2.23 mm in length, extended to the incisor region along the course of 9.53 ± 1.43 mm above the lower border of mandible, and most often ended below the lateral incisor (70.00 %). This research recommended for chin operations in Chinese population: the surgical safe zone could be set in the region about over 4 mm anterior to the mental foramen, and over 12 mm above inferior border of mandible for anterior alveolar surgery, or within 9 mm above inferior border of mandible for genioplasty.

  2. Incisiones verticales en SARPE Vertical incisions in SARPE

    Directory of Open Access Journals (Sweden)

    J. Gonzalez Lagunas

    2005-06-01

    Full Text Available La expansión rápida de paladar asistida quirúrgicamente (SARPE es una de las opciones terapeuticas de los transtornos transversales del maxilar superior. Presentamos nuestra experiencia inicial con una variante técnica consistente en una corticotomía de la pared lateral del maxilar combinada con una osteotomía palatina media transincisal, y efectuadas a través de tres pequeñas incisiones verticales.Surgically assisted rapid palatal expansion (SARPE is one of the therapeutic options for the correction of transverse maxillary collapse. We present our initial experience with a technique consisting in a lateral corticotomy of the maxilla plus a transincisal midpalatal osteotomy, both performed through minimal vertical incisions.

  3. Comparing the outcomes of incisions made by colorado microdissection needle, electrosurgery tip, and surgical blade during periodontal surgery: A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Rampalli Viswa Chandra

    2016-01-01

    Full Text Available Context: Electrosurgery offers many unique advantages such as hemostasis and precise tissue cutting; however, there are a number of disadvantages including thermal injury and delayed wound healing. Aims: The aim of the present study was to compare the outcomes of incisions made by Colorado® microdissection needle, electrosurgery tip, and surgical blade during periodontal surgery. Settings and Design: Twenty-two individuals participated in this study. Three quadrants in each individual were randomly assigned into each of the following experimental groups: Colorado® microdissection needle (CMD, electrosurgery tip (EC and surgical blade (BP, in which, incisions were given with Colorado® microdissection needle, straight electrocautery tip, and a scalpel blade, respectively. Materials and Methods: Blood loss (BL was measured immediately after surgery, and changes in interdental papilla dimensions were recorded at baseline, 7, 30, 120, and 180 days after surgery. Measures of periodontal disease were recorded at baseline, 120, and 180 days after surgery. Postoperative pain and wound healing were recorded at 1, 7, and 15 days after surgery. Results: The use of CMD for periodontal surgery showed better results over EC in all parameters. CMD resulted in lesser bleeding and less postoperative pain and attained similar results to that of BP in clinical parameters of periodontal disease. Conclusions: Colorado® microdissection needle may be a better choice for incisions as it seems to show less tissue damage than cautery and offers tissue healing comparable to scalpel blade.

  4. Sparse Channel Estimation Including the Impact of the Transceiver Filters with Application to OFDM

    DEFF Research Database (Denmark)

    Barbu, Oana-Elena; Pedersen, Niels Lovmand; Manchón, Carles Navarro

    2014-01-01

    Traditionally, the dictionary matrices used in sparse wireless channel estimation have been based on the discrete Fourier transform, following the assumption that the channel frequency response (CFR) can be approximated as a linear combination of a small number of multipath components, each one......) and receive (demodulation) filters. Hence, the assumption of the CFR being sparse in the canonical Fourier dictionary may no longer hold. In this work, we derive a signal model and subsequently a novel dictionary matrix for sparse estimation that account for the impact of transceiver filters. Numerical...... results obtained in an OFDM transmission scenario demonstrate the superior accuracy of a sparse estimator that uses our proposed dictionary rather than the classical Fourier dictionary, and its robustness against a mismatch in the assumed transmit filter characteristics....

  5. Calcium channel blocker poisoning

    Directory of Open Access Journals (Sweden)

    Miran Brvar

    2005-04-01

    Full Text Available Background: Calcium channel blockers act at L-type calcium channels in cardiac and vascular smooth muscles by preventing calcium influx into cells with resultant decrease in vascular tone and cardiac inotropy, chronotropy and dromotropy. Poisoning with calcium channel blockers results in reduced cardiac output, bradycardia, atrioventricular block, hypotension and shock. The findings of hypotension and bradycardia should suggest poisoning with calcium channel blockers.Conclusions: Treatment includes immediate gastric lavage and whole-bowel irrigation in case of ingestion of sustainedrelease products. All patients should receive an activated charcoal orally. Specific treatment includes calcium, glucagone and insulin, which proved especially useful in shocked patients. Supportive care including the use of catecholamines is not always effective. In the setting of failure of pharmacological therapy transvenous pacing, balloon pump and cardiopulmonary by-pass may be necessary.

  6. Performance Analysis of a Six-Port Receiver in a WCDMA Communication System including a Multipath Fading Channel

    Directory of Open Access Journals (Sweden)

    A. O. Olopade

    2014-01-01

    Full Text Available Third generation communication systems require receivers with wide bandwidth of operation to support high transmission rates and are also reconfigurable to support various communication standards with different frequency bands. An ideal software defined radio (SDR will be the absolute answer to this requirement but it is not achievable with the current level of technology. This paper proposes the use of a six-port receiver (SPR front-end (FE in a WCDMA communication system. A WCDMA end-to-end physical layer MATLAB demo which includes a multipath channel distortion block is used to determine the viability of the six-port based receiver. The WCDMA signal after passing through a multipath channel is received using a constructed SPR FE. The baseband signal is then calibrated and corrected in MATLAB. The six-port receiver performance is measured in terms of bit error rate (BER. The signal-to-noise ratio (SNR of the transmitted IQ data is varied and the BER profile of the communication system is plotted. The effect of the multipath fading on the receiver performance and the accuracy of the calibration algorithm are obtained by comparing two different measured BER curves for different calibration techniques to the simulated BER curve of an ideal receiver.

  7. Diagnosis and management of maxillary incisors affected by incisal wear: an interdisciplinary case report.

    Science.gov (United States)

    Bernardo, Jussara Karina; Maia, Elaine A Vilela; Cardoso, Antônio Carlos; de Araújo Júnior, Edson Medeiros; Monteiro Júnior, Sylvio

    2002-01-01

    In the attempt to restore anterior teeth affected by erosion and bruxism, many clinicians have been frustrated with the constant restorative failures. Frequently, these failures are attributed to the restorative materials employed, especially in cases in which composite resins are used. However, some flaws of the restorations are related to the oversight of occlusal principles. The purpose of this article is to discuss the etiology, signs, and symptoms of incisal wear, with special attention to that caused by bruxism and chemical erosion. Relatively simple management techniques (e.g., occlusal adjustment, adhesive restorations) are proposed, and the diagnosis and management of a representative clinical case is presented. In some cases of bruxism and/or dental erosion, it is possible to acquire space to recuperate the esthetics and function of maxillary incisors affected by incisal wear through a conservative treatment associated with the control of the etiologic factors.

  8. The Supraorbital Keyhole Craniotomy through an Eyebrow Incision: Its Origins and Evolution

    Directory of Open Access Journals (Sweden)

    D. Ryan Ormond

    2013-01-01

    Full Text Available In the modern era of neurosurgery, the use of the operative microscope, rigid rod-lens endoscope, and neuronavigation has helped to overcome some of the previous limitations of surgery due to poor lighting and anatomic localization available to the surgeon. Over the last thirty years, the supraorbital craniotomy and subfrontal approach through an eyebrow incision have been developed and refined to play a legitimate role in the armamentarium of the modern skull base neurosurgeon. With careful patient selection, the supraorbital “keyhole” approach offers a less invasive but still efficacious approach to a number of lesions along the subfrontal corridor. Well over 1000 cases have been reported in the literature utilizing this approach establishing its safety and efficacy. This paper discusses the nuances of this approach, including the benefits and limitations of its use described through our technique, review of the literature, and case illustration.

  9. The waterfall paradox: How knickpoints disconnect hillslope and channel processes, isolating salmonid populations in ideal habitats

    Science.gov (United States)

    May, Christine; Roering, Joshua J.; Snow, Kyle; Griswold, Kitty; Gresswell, Robert E.

    2017-01-01

    Waterfalls create barriers to fish migration, yet hundreds of isolated salmonid populations exist above barriers and have persisted for thousands of years in steep mountainous terrain. Ecological theory indicates that small isolated populations in disturbance-prone landscapes are at greatest risk of extirpation because immigration and recolonization are not possible. On the contrary, many above-barrier populations are currently thriving while their downstream counterparts are dwindling. This quandary led us to explore geomorphic knickpoints as a mechanism for disconnecting hillslope and channel processes by limiting channel incision and decreasing the pace of base-level lowering. Using LiDAR from the Oregon Coast Range, we found gentler channel gradients, wider valleys, lower gradient hillslopes, and less shallow landslide potential in an above-barrier catchment compared to a neighboring catchment devoid of persistent knickpoints. Based on this unique geomorphic template, above-barrier channel networks are less prone to debris flows and other episodic sediment fluxes. These above-barrier catchments also have greater resiliency to flooding, owing to wider valleys with greater floodplain connectivity. Habitat preference models further indicate that salmonid habitat is present in greater quantity and quality in these above-barrier networks. Therefore the paradox of the persistence of small isolated fish populations may be facilitated by a geomorphic mechanism that both limits their connectivity to larger fish populations yet dampens the effect of disturbance by decreasing connections between hillslope and channel processes above geomorphic knickpoints.

  10. Spatial variability in channel and slope morphology within the Ardennes Massif, and its link with tectonics

    Science.gov (United States)

    Sougnez, N.; Vanacker, V.

    2010-09-01

    Geomorphic processes that produce and transport sediment, and incise river valleys are complex; and often difficult to quantify over longer timescales of 103 to 105 years. Morphometric indices that describe the topography of hill slopes, valleys and river channels have commonly been used to compare morphological characteristics between catchments and to relate them to hydrological and erosion processes. This work focuses on a wide range of slope and river channel morphometric indices to study their behavior and strength in regions affected by low to moderate tectonic activity. We selected 10 catchments of about 150 to 250 km2 across the Ardennes Massif that cover various tectonic domains with uplift rates ranging from about 0.06 to 0.20 mm year-1 since mid-Pleistocene times. The morphometric analysis indicates that the slope and channel morphology of third-order catchments is not yet in topographic steady-state, and exhibits clear convexities in slope and river profiles. Our data indicate that the fluvial system is the main driver of topographic evolution and that the spatial pattern of uplift rates is reflected in the distribution of channel steepness and convexity. The spatial variation that we observe in slope and channel morphology between the 10 third-order catchments suggests that the response of the fluvial system was strongly diachronous, and that a transient signal of adjustment is migrating from the Meuse valley towards the Ardennian headwaters.

  11. Developing and exploring a theory for the lateral erosion of bedrock channels for use in landscape evolution models

    Directory of Open Access Journals (Sweden)

    A. L. Langston

    2018-01-01

    Full Text Available Understanding how a bedrock river erodes its banks laterally is a frontier in geomorphology. Theories for the vertical incision of bedrock channels are widely implemented in the current generation of landscape evolution models. However, in general existing models do not seek to implement the lateral migration of bedrock channel walls. This is problematic, as modeling geomorphic processes such as terrace formation and hillslope–channel coupling depends on the accurate simulation of valley widening. We have developed and implemented a theory for the lateral migration of bedrock channel walls in a catchment-scale landscape evolution model. Two model formulations are presented, one representing the slow process of widening a bedrock canyon and the other representing undercutting, slumping, and rapid downstream sediment transport that occurs in softer bedrock. Model experiments were run with a range of values for bedrock erodibility and tendency towards transport- or detachment-limited behavior and varying magnitudes of sediment flux and water discharge in order to determine the role that each plays in the development of wide bedrock valleys. The results show that this simple, physics-based theory for the lateral erosion of bedrock channels produces bedrock valleys that are many times wider than the grid discretization scale. This theory for the lateral erosion of bedrock channel walls and the numerical implementation of the theory in a catchment-scale landscape evolution model is a significant first step towards understanding the factors that control the rates and spatial extent of wide bedrock valleys.

  12. Developing and exploring a theory for the lateral erosion of bedrock channels for use in landscape evolution models

    Science.gov (United States)

    Langston, Abigail L.; Tucker, Gregory E.

    2018-01-01

    Understanding how a bedrock river erodes its banks laterally is a frontier in geomorphology. Theories for the vertical incision of bedrock channels are widely implemented in the current generation of landscape evolution models. However, in general existing models do not seek to implement the lateral migration of bedrock channel walls. This is problematic, as modeling geomorphic processes such as terrace formation and hillslope-channel coupling depends on the accurate simulation of valley widening. We have developed and implemented a theory for the lateral migration of bedrock channel walls in a catchment-scale landscape evolution model. Two model formulations are presented, one representing the slow process of widening a bedrock canyon and the other representing undercutting, slumping, and rapid downstream sediment transport that occurs in softer bedrock. Model experiments were run with a range of values for bedrock erodibility and tendency towards transport- or detachment-limited behavior and varying magnitudes of sediment flux and water discharge in order to determine the role that each plays in the development of wide bedrock valleys. The results show that this simple, physics-based theory for the lateral erosion of bedrock channels produces bedrock valleys that are many times wider than the grid discretization scale. This theory for the lateral erosion of bedrock channel walls and the numerical implementation of the theory in a catchment-scale landscape evolution model is a significant first step towards understanding the factors that control the rates and spatial extent of wide bedrock valleys.

  13. Circuitous to single thread: post-dam geomorphic transformation of the Colorado River in its delta

    Science.gov (United States)

    Mueller, E. R.; Schmidt, J. C.

    2017-12-01

    The Colorado River in its delta has transformed from a maze of secondary and distributary channels to an intermittent or ephemeral stream largely disconnected from formerly active channels and floodplains. Periodic post-dam floods have demonstrated that channel migration and shifting during floods increased the extent and diversity of riparian vegetation, and suggested that restoration of fluvial processes that promote re-activation of these former channels may enhance ecosystem rehabilitation. But restoration efforts in the delta are complicated by the fact that the Colorado River has the largest reservoir size in relation to its mean annual flow of any large river in North America and most of its sediment supply is completely blocked in upstream reservoirs. As a result, small controlled floods intended to inundate formerly active channels and rejuvenate riparian vegetation must consider the new relationship between stream flow and the delta's transformed geomorphology. Post-dam channel change has been dominated by the abandonment of secondary and distributary channels, with 3 to 4 meters of bed incision in the upstream part of the delta that diminishes downstream. Initial bed incision of 2 to 3 meters occurred rapidly following completion of Hoover Dam in 1936, before further upstream water development reduced delta flows to near zero by the mid-1960s. The largest post-dam floods occurred in the 1980s, which resulted in 10s to 100s of meters of lateral migration, channel switching, and the reactivation of secondary channels and floodplains rarely inundated since dam completion. Smaller flow pulses in the 1990s and 2000s further incised the thalweg to its minimum elevation, resulting in a narrow single-thread channel inset within the multi-channel surface active during the 1980s. In 2014, an experimental pulse flow was released to the river channel with a peak discharge approximately 5% of the typical pre-dam flood peak. Topographic change was confined to the main

  14. Removable thermoplastic appliances modified by incisal cuts show altered biomechanical properties during tipping of a maxillary central incisor

    Directory of Open Access Journals (Sweden)

    Phillipp Brockmeyer

    2017-08-01

    Full Text Available Abstract Background The present study aimed to evaluate the force delivery of removable thermoplastic appliances (RTAs, modified by different sized incisal cuts, during tipping of a maxillary central incisor in palatal and vestibular direction. Methods Forty-five RTAs from three different materials (Biolon®, Erkodur®, Ideal Clear® of the same thickness (1 mm were used. Analysis was performed on a separated maxillary central incisor which was part of a resin model with a complete dentition. In 15 RTAs, of different material, a cut was inserted at the incisal edge of tooth 11. In 15 other appliances, the cut was extended to teeth 12 and 21. Fifteen aligners remained uncut. The experimental tooth was tipped starting from the zero position in 0.05° steps to a maximal deflection of ± 0.42° of the incisal edge in vestibular and palatal direction, after positioning the RTA onto the model. Results The horizontal (Fx and the vertical (Fz force components were decreased by approximately half with increasing cut size. Fz values changed during palatal tipping from a weak intrusive force, for aligners without cut, to an extrusive force with increasing cut size. Compared to both other materials used (Erkodur® and Ideal Clear®, the Biolon® aligners showed significantly higher Fx and Fz values (p < 0.0001, respectively. Conclusions RTAs modified by different sized incisal cuts show altered biomechanical properties and an inversion of the vertical force component, during tipping of a maxillary central incisor.

  15. Knickpoint Propagation and Hillslope Response in the Mangataikapua Catchment, Waipaoa River, New Zealand

    Science.gov (United States)

    Cerovski-Darriau, C.; Roering, J. J.; Bilderback, E. L.

    2012-12-01

    Base level change can cause differential incision in fluvial networks, driving a transient hillslope response as slopes attempt to adjust to a new base level. Following a shift to a warmer, wetter climate after the Last Glacial Maximum (LGM) (~17.5 ka), the Waipaoa River (NZ) rapidly incised ~120 m leaving perched relict hillslopes that are still adjusting to that base level fall. While previous studies of the Waipaoa basin have only focused on sediment contribution from channel incision or a few individual large earthflows, here we analyze an entire catchment that experiences widespread adjustment due to earthflow activity. In the Mangataikapua catchment—a tributary of the Waipaoa River principally comprised of weak mélange—we see wholesale relaxation of hillslopes due to pervasive post-LGM earthflows. Less than 6% of the mélange area retains relict terrain unaltered by earthflows, exemplifying the importance of including hillslope sediment contribution. Incision has propagated ~9 km upstream along the mainstem of the Mangataikapua (~86% of the channel length) and has created 80 m of relief at the junction with the Waipaoa. Continued adjustment along Mangataikapua tributaries and slopes is evident from knickpoints in the channels and changes in gradient, curvature, and degree of earthflow-altered terrain on the hillslopes. By identifying the location of this transition in channels and on the hillslopes, we can estimate the amount of post-LGM hillslope relaxation. We analyzed 10 major sub-catchments (drainage areas >35,000 m2) in the mélange on the southeastern side of the catchment. We used slope-area plots, in conjunction with normalized steepness index values (ksn) generated with the Stream Profiler (www.geomorphtools.org), to determine the degree to which the tributary channels have adjusted to incision along the mainstem. Preliminary results show an "upper zone" of relict channel morphology with an average curvature value of θ=-0.3 (±0.1 s.d.) and a

  16. Lateral suboccipital retrosigmoid approach with tentorial incision for petroclival meningiomas: technical note.

    Science.gov (United States)

    Yamahata, Hitoshi; Tokimura, Hiroshi; Hirahara, Kazuho; Ishii, Takeshi; Mori, Masanao; Hanaya, Ryosuke; Arita, Kazunori

    2014-08-01

    Introduction The resection of petroclival meningiomas presents great neurosurgical challenges. Although multiple surgical approaches have been developed, the retrosigmoid route tends to be used to address tumors that are predominantly located in the posterior fossa. Our modification of the lateral suboccipital retrosigmoid approach with the placement of a tentorial incision yields good visualization of the supratentorial part of the tumor around the midbrain. Methods We treated four patients, one with primary and three with recurrent petroclival meningioma, by our modified approach. After lateral suboccipital craniotomy, the infratentorial part of the tumor was removed after detaching it from the tentorial surface. The cerebellar tentorium was then carefully incised from the supracerebellar angle, taking care not to damage the superior cerebellar artery and trochlear nerve. Results The operative field surrounding the midbrain was widened by this procedure, and safe dissection of the tumor from the brainstem and other neurovascular structures was performed with direct observation of the interface. Conclusions Our approach is a useful modification of the retrosigmoid approach to petroclival meningiomas. It facilitates the safe resection of the supratentorial part of the tumor in the ambient cistern behind the tentorium.

  17. Volume Regulated Channels

    DEFF Research Database (Denmark)

    Klausen, Thomas Kjær

    of volume perturbations evolution have developed system of channels and transporters to tightly control volume homeostasis. In the past decades evidence has been mounting, that the importance of these volume regulated channels and transporters are not restricted to the defense of cellular volume...... but are also essential for a number of physiological processes such as proliferation, controlled cell death, migration and endocrinology. The thesis have been focusing on two Channels, namely the swelling activated Cl- channel (ICl, swell) and the transient receptor potential Vanilloid (TRPV4) channel. I: Cl......- serves a multitude of functions in the mammalian cell, regulating the membrane potential (Em), cell volume, protein activity and the driving force for facilitated transporters giving Cl- and Cl- channels a major potential of regulating cellular function. These functions include control of the cell cycle...

  18. Femtosecond laser refractive surgery: small-incision lenticule extraction vs. femtosecond laser-assisted LASIK.

    Science.gov (United States)

    Lee, Jimmy K; Chuck, Roy S; Park, Choul Yong

    2015-07-01

    Small-incision lenticule extraction (SMILE) is a novel technique devised to correct refractive errors. SMILE circumvents excimer laser photoablation of cornea, as the stromal lenticule cut by femtosecond laser is removed manually. Smaller incisions and preservation of anterior corneal biomechanical strength have been suggested as some of the advantages of SMILE over femtosecond laser-assisted LASIK (FS-LASIK). In this review, we compared previous published results of SMILE and FS-LASIK. The advantage, efficacy and safety of SMILE are compared with FS-LASIK. SMILE achieved similar efficacy, predictability and safety as FS-LASIK. Greater preservations of corneal biomechanical strength and corneal nerves were observed in SMILE when compared with LASIK or PRK. Additionally, the incidence of postoperative dry eye syndrome was found to be less problematic in SMILE than in FS-LASIK. SMILE is a promising new surgery for refractive error correction. Prospective and retrospective studies of SMILE have shown that results of SMILE are similar to FS-LASIK. With advances in femtosecond laser technology, SMILE may gain greater acceptance in the future.

  19. Channel change and bed-material transport in the Lower Chetco River, Oregon

    Science.gov (United States)

    Wallick, J. Rose; Anderson, Scott W.; Cannon, Charles; O'Connor, Jim E.

    2010-01-01

    year. Mined volumes probably exceeded 140,000 cubic meters per year for several years in the late 1970s.Repeat surveys and map analyses indicate a reduction in bar area and sinuosity between 1939 and 2008, chiefly in the period 1965–95. Repeat topographic and bathymetric surveys show channel incision for substantial portions of the study reach, with local areas of bed lowering by as much as 2 meters. A specific gage analysis at the upstream end of the study reach indicates that incision and narrowing followed aggradation culminating in the late 1970s. These observations are all consistent with a reduction of sediment supply relative to transport capacity since channel surveys in the late 1970s, probably owing to a combination of (1) bed sediment removal and (2) transient river adjustments to large sediment volumes brought by floods such as those in 1964 and, to a lesser extent, 1996.

  20. Median sternotomy - gold standard incision for cardiac surgeons

    Directory of Open Access Journals (Sweden)

    Radu Matache

    2016-05-01

    Full Text Available Sternotomy is the gold standard incision for cardiac surgeons but it is also used in thoracic surgery especially for mediastinal, tracheal and main stem bronchus surgery. The surgical technique is well established and identification of the correct anatomic landmarks, midline tissue preparation, osteotomy and bleeding control are important steps of the procedure. Correct sternal closure is vital for avoiding short- and long-term morbidity and mortality. The two sternal halves have to be well approximated to facilitate healing of the bone and to avoid instability, which is a risk factor for wound infection. New suture materials and techniques would be expected to be developed to further improve the patients evolution, in respect to both immediate postoperative period and long-term morbidity and mortality

  1. [Treatment of gynecomastia by a combined method of liposuction and semicircular periareolar incision glandular organ partial resection].

    Science.gov (United States)

    Liu, Su; Kuang, Ruixia; Chen, Zhenyu; Li, Huichao; Zhang, Weina; Wang, Zhiguo; Miao, Yuanxin; Chen, Lu

    2008-12-01

    To evaluate the effect of the combined method of liposuction and semicircular periareolar incision glandular organ partial resection in the treatment of gynecomastia. From June 2004 to June 2006, 40 patients, aged 11-41 years old, were treated, with no-nodule (n = 10), nodule (n = 22) and female-breast-like with nodules (n = 8). Three patients were unilateral and 37 ones were bilateral. The levels of serum prolactin, luteinizing hormone, follicle stimulating hormone, estradiol, testosterone and cortisol were normal in 38 patients, while in the other 2 patients, the levels of serum prolactin, luteinizing hormone, follicle stimulating hormone and estradiol were higher than normal, and the testosterone level was lower. Liposuction alone was performed in 10 no-nodule patients (lipo-type), and combined liposuction and semicircular periareolar incision glandular organ partial resection were conducted in the other 30 patients (lipo-glandular type). RESULTS; Except for 2 cases in which hematoma and a small amount of effusion were found on the first and second day postoperatively and then obtained healing by first intention right after hematoma removal in time, all the other patients incisions obtained healing by first intention. Nipple numbness occurred in 3 cases on the first day postoperatively and no special treatment was conducted. There was still nipple hypesthesia in these 3 cases after 6-month follow-up. There were no complications such as hematoma, effusion, nipple and mammary areola necrosis, and nipple hypesthesia in other patients. All the 40 patients were followed up for 6-24 months (13 months on average). They were satisfied with their chest figures and no recurrence was observed. The combined method of liposuction and semicircular periareolar incision glandular organ partial resection in the treatment of gynecomastia has many advantages, such as safe, micro-scars, natural and beautiflhl male breast figures as well as high patients' satisfaction.

  2. The surgical anatomy of the infrapatellar branch of the saphenous nerve in relation to incisions for anteromedial knee surgery.

    Science.gov (United States)

    Kerver, A L A; Leliveld, M S; den Hartog, D; Verhofstad, M H J; Kleinrensink, G J

    2013-12-04

    Iatrogenic injury to the infrapatellar branch of the saphenous nerve is a common complication of surgical approaches to the anteromedial side of the knee. A detailed description of the relative anatomic course of the nerve is important to define clinical guidelines and minimize iatrogenic damage during anterior knee surgery. In twenty embalmed knees, the infrapatellar branch of the saphenous nerve was dissected. With use of a computer-assisted surgical anatomy mapping tool, safe and risk zones, as well as the location-dependent direction of the nerve, were calculated. The location of the infrapatellar branch of the saphenous nerve is highly variable, and no definite safe zone could be identified. The infrapatellar branch runs in neither a purely horizontal nor a vertical course. The course of the branch is location-dependent. Medially, it runs a nearly vertical course; medial to the patellar tendon, it has a -45° distal-lateral course; and on the patella and patellar tendon, it runs a close to horizontal-lateral course. Three low risk zones for iatrogenic nerve injury were identified: one is on the medial side of the knee, at the level of the tibial tuberosity, where a -45° oblique incision is least prone to damage the nerves, and two zones are located medial to the patellar apex (cranial and caudal), where close to horizontal incisions are least prone to damage the nerves. The infrapatellar branch of the saphenous nerve is at risk for iatrogenic damage in anteromedial knee surgery, especially when longitudinal incisions are made. There are three low risk zones for a safer anterior approach to the knee. The direction of the infrapatellar branch of the saphenous nerve is location-dependent. To minimize iatrogenic damage to the nerve, the direction of incisions should be parallel to the direction of the nerve when technically possible. These findings suggest that iatrogenic damage of the infrapatellar branch of the saphenous nerve can be minimized in anteromedial

  3. Balancing hydropower production and river bed incision in operating a run-of-river hydropower scheme along the River Po

    Science.gov (United States)

    Denaro, Simona; Dinh, Quang; Bizzi, Simone; Bernardi, Dario; Pavan, Sara; Castelletti, Andrea; Schippa, Leonardo; Soncini-Sessa, Rodolfo

    2013-04-01

    Water management through dams and reservoirs is worldwide necessary to support key human-related activities ranging from hydropower production to water allocation, and flood risk mitigation. Reservoir operations are commonly planned in order to maximize these objectives. However reservoirs strongly influence river geomorphic processes causing sediment deficit downstream, altering the flow regime, leading, often, to process of river bed incision: for instance the variations of river cross sections over few years can notably affect hydropower production, flood mitigation, water supply strategies and eco-hydrological processes of the freshwater ecosystem. The river Po (a major Italian river) has experienced severe bed incision in the last decades. For this reason infrastructure stability has been negatively affected, and capacity to derive water decreased, navigation, fishing and tourism are suffering economic damages, not to mention the impact on the environment. Our case study analyzes the management of Isola Serafini hydropower plant located on the main Po river course. The plant has a major impact to the geomorphic river processes downstream, affecting sediment supply, connectivity (stopping sediment upstream the dam) and transport capacity (altering the flow regime). Current operation policy aims at maximizing hydropower production neglecting the effects in term of geomorphic processes. A new improved policy should also consider controlling downstream river bed incision. The aim of this research is to find suitable modeling framework to identify an operating policy for Isola Serafini reservoir able to provide an optimal trade-off between these two conflicting objectives: hydropower production and river bed incision downstream. A multi-objective simulation-based optimization framework is adopted. The operating policy is parameterized as a piecewise linear function and the parameters optimized using an interactive response surface approach. Global and local

  4. Recent formation of arroyos in the Little Missouri Badlands of southwestern North Dakota

    Science.gov (United States)

    Gonzalez, M.A.

    2001-01-01

    In the Little Missouri Badlands of southwestern North Dakota, the channels of ephemeral streams are incised 2 to 10 m or more into mid-to-late Holocene alluvium. The objectives of this study were to determine the timing and cause(s) of the most recent episodes of fluvial incision and to develop a process-response model that illustrates the formation and evolution of arroyos in this region. The purpose was to distinguish natural from anthropogenic changes to the landscape and to discriminate allogenic from autogenic causes of incision, thereby gaining a greater sense of how steep, relatively small, ephemeral streams evolve. Dendrochronologic and dendrogeomorphic analyses of riparian cottonwoods provide an inexpensive, high-resolution dating method to constrain the time of incision, thereby permitting determination of the cause(s) of incision by evaluating environmental conditions prior to and at the onset of fluvial incision. An examination of seven small (10 to 100 km2) drainage basins indicated ephemeral streams have undergone a four-stage cycle of change within the past 200 years, comprising(i) an initial period of relative geomorphic stability with pedogenesis on the flood plain and low rates of lateral channel migration, (ii) a period of channel incision with subsequent widening of the flood plain through lateral corrasion along middle and upstream reaches, (iii) a concomitant period of aggradation along downstream reaches and, finally, (iv) a period of downstream incision. Dendrochronologic data and dendrogeomorphic relations indicate there have been three distinct periods of fluvial incision in the past 200 years. The first period of incision began in the 1860s and 1870s prior to the onset of European settlement and intensive grazing by domesticated cattle in the area. This period of incision occurred along the middle reaches of all seven of the streams examined and coincided with a severe, protracted drought, suggesting an allogenic cause. The second period

  5. Aggradation of Leveed Channels and Their Flood Plains in Arroyo Bottoms

    Science.gov (United States)

    Vincent, K. R.

    2005-12-01

    Many arroyos that formed by incision more than a century ago in the southwestern United States are currently filling with sediment. This reversal of processes is important because it causes changes in riparian ecology, erosion hazards, ground water recharge, and sediment supply to downstream. Along the Rio Puerco and Chaco Wash in New Mexico, we examined the geometry and facies of channel and floodplain stratigraphy exposed in trenches, used high-resolution dating of the sedimentary beds, and used photographs and other historical evidence to investigate the processes of aggradation in naturally leveed channels within arroyos. Prior to the onset of aggradation, the streambeds were composed of sand and had low relief, and arroyo walls retreated rapidly due to stream undermining. Aggradation began with the formation of sand levees at the margins of the streambeds, followed by formation of newer levees increasingly closer to the thalweg. These levees coincide with rows of woody shrubs (tamarisk and willow), plants that germinated in moist sand along the high-water marks of moderate flows, and survived because subsequent periods lacked flows large enough to remove them. Flow entering a row of woody shrubs decelerates, promoting deposition of suspended sand. Stream flows in this setting are always turbid but do not have the rheology of debris flows. The rows of shrubs probably are a requirement for initial formation of sand levees on low relief streambeds in this setting. As new levees formed closer to the thalweg the channel effectively narrowed, and smaller discharges overtopped the levees adjacent to the channel. Those closer levees accumulated sand most rapidly, leaving the suspended sand concentration depleted by the time water reached more distant ones. All levees aggraded vertically. As the main channel narrowed it acquired a roughly trapezoidal-shape (Top Width/Depth ~ 9 to 5) with banks inclined close to the angle of repose. In addition, sediment deposited on

  6. A randomized clinical trial of knotless barbed suture vs conventional suture for closure of the uterine incision at cesarean delivery.

    Science.gov (United States)

    Peleg, David; Ahmad, Ronan Said; Warsof, Steven L; Marcus-Braun, Naama; Sciaky-Tamir, Yael; Ben Shachar, Inbar

    2018-03-01

    Knotless barbed sutures are monofilament sutures with barbs cut into them. These sutures self-anchor, maintaining tissue approximation without the need for surgical knots. The hypothesis of this study was that knotless barbed suture could be used on the myometrium to close the hysterotomy at cesarean delivery. The objective was to compare uterine closure time, need for additional sutures, and blood loss between this and a conventional suture. This was a prospective, unblinded, randomized controlled trial conducted at the Ziv Medical Center, Zefat, Israel. The primary outcome was the length of time needed to close the uterine incision, which was measured from the start of the first suture on the uterus until obtaining uterine hemostasis. To minimize provider bias, women were randomized by sealed envelopes that were opened in the operating room just prior to uterine closure with either a bidirectional knotless barbed suture or conventional suture. Secondary outcomes included the number of additional hemostatic sutures needed and blood loss during incision closure. Patients were enrolled from August 2016 until March 2017. One hundred two women were randomized. Fifty-one had uterine closure with knotless barbed suture and 51 with conventional suture. The groups were similar for demographics as well as number of previous cesarean deliveries. Uterine closure time using the knotless barbed suture was significantly shorter than the conventional suture by a mean of 1 minute 43 seconds (P barbed sutures were associated with a lower need for hemostatic sutures (median 0 vs 1, P barbed suture is a reasonable alternative to conventional sutures because it reduced the closure time of the uterine incision. There was also less need for additional hemostatic sutures and slightly reduced estimated blood loss. Copyright © 2018 Elsevier Inc. All rights reserved.

  7. Architecture of channel-belt deposits in an aggrading shallow sandbed braided river: the lower Niobrara River, northeast Nebraska

    Science.gov (United States)

    Skelly, Raymond L.; Bristow, Charlie S.; Ethridge, Frank G.

    2003-05-01

    Architecture of recent channel-belt deposits of the Niobrara River, northeast Nebraska, USA, records the response of a sandy braided river to rapid base-level rise. Up to 3 m of aggradation has occurred within the lower 14 km of the Niobrara River since the mid-1950s as a result of base-level rise at the confluence of the Niobrara and Missouri Rivers. Aerial photographs and channel surveys indicate that the lower Niobrara has evolved from a relatively deep, stable channel with large, bank-attached braid bars to a relatively shallow, aggrading channel with braid bars and smaller secondary channels. Architecture of channel-belt deposits associated with the recent aggradation has been defined using ground-penetrating radar (GPR) and vibracores. The channel-belt deposits exhibit a series of amalgamated channel fills and braid bar complexes (i.e., macroforms). Radar facies identified in the GPR data represent architectural elements of the braid bar complexes, large and small bedforms [two-dimensional (2-D) and three-dimensional (3-D) dunes], and channels. Individual braid bars appear to consist of basal high-flow and upper low-flow components. Preservation of the complete, high-flow bar geometry is generally incomplete due to frequent migration of smaller scale, secondary channels within the channel belt (i.e., braided channel network) at low discharges. The large-scale stratification of the braid bar deposits is dominated by cross-channel and upstream accretion. Elements of downstream accretion are also recognized. These accretion geometries have not been documented previously in similar sandy braided rivers. Braid bar deposits with low-flow modification (e.g., incision by secondary channels) are recognized in the deeper portions of the deposits imaged by GPR. Preservation of braid bars, with both high- and low-flow components, is a result of the rapid base-level rise and channel-bed aggradation experienced by the Niobrara River over the past 45 years. Recent avulsion

  8. Behaviour of UV-sensitive mutants of Proteus mirabilis to repair incision breaks

    International Nuclear Information System (INIS)

    Stoerl, K.; Mund, C.

    1977-01-01

    In U.V.-sensitive mutants of P. mirabilis with the phenotype HCR, REC and EXR single-strand breaks appeared immediately after UV-irradiation. The behaviour of REC- and EXR-mutants was similar to the wildtype. The number of incision breaks observed by sedimentation analysis in these strains was very low. They could be joined during the excision repair process. From the ability of REC- and EXR-strains to rejoin most of the induced single-strand breaks it can be concluded that these strains have approximately the same capacity for excision repair as the wildtype. HCR-mutants of P. mirabilis produced single-strand breaks after UV-irradiation in contrast to HCR-mutants of E. coli. Therefore we suggest that HCR-mutants of P. mirabilis are not completely inhibited in the incision step. The single-strand breaks introduced in the DNA at the beginning of the repair process were not rejoined during further incubation. Experiments with toluenized cells led to the same results. The newly synthesized daughter DNA-strands of UV-irradiated HCR-mutants were of low molecular weight in comparison with those from unirradiated control cells during the repair period. This result is in agreement with the incapability of HCR-mutants to remove the pyrimidine dimers from the parental template strand. (author)

  9. Mandibular incisive canal in relation to periapical surgery

    Directory of Open Access Journals (Sweden)

    Kani Bilginaylar

    2016-01-01

    Full Text Available The aim of the present paper is to emphasize the importance of the mandibular interforaminal neurovascular bundle with a case and make a warning to dentists and surgeons during oral and maxillofacial surgeries, such as implant replacement, bone harvesting, genioplasty, open reduction of a mandibular fracture, and cyst enucleations at this region. In this paper, we present a 58-year-old male who referred with pain and a tingling sensation on the left lower lip. After radiographical, extraoral and intraoral examinations, findings indicated the lesion to be a cyst which was related with a periapical lesion of the canine tooth and extracted socket of first premolar tooth. After removal of a cyst, the mandibular incisive nerve was documented which was in relation to cyst cavity.

  10. Sonographic Appearance of Abdominal Wall at the Left Flank of Laparotomy Incision Site in Ettawah Grade Does

    Directory of Open Access Journals (Sweden)

    M. F. Ulum

    2014-12-01

    Full Text Available The aim of this study was to describe the sonographic appearance of abdominal wall at the left flank of laparotomy incision site in 11 mated Ettawah grade does. Brightness-mode ultrasound examination by using transducer with frequency of 5.0-6.0 MHz was conducted to grouping the does based on their pregnancy statuses. The incision site of the abdominal wall at left flank laparotomy was transcutaneous-scanned as long as 8 cm vertically. The sonographic appearance of the laparotomy wall thickness showed that in all groups of does were similar and not different statistically. The thickness of oblique external and oblique internal abdominal muscles increased in the pregnant does as compared to non-pregnant does (P<0.05.

  11. Femtosecond laser based small incision lenticule extraction for moderate and high myopia

    DEFF Research Database (Denmark)

    Hjortdal, Jesper Østergaard; Asp, Sven; Ivarsen, Anders

    Femtosecond laser based small incision lenticule extraction for moderate and high myopia. Jesper Hjortdal, Sven Asp, Anders Ivarsen, Anders Vestergaard Department of Ophthalmology, Aarhus University Hospital, Denmark Purpose: ReLEx® smile is a new keratorefractive procedure whereby a stromal lent....... Refractive predictability, safety and patient satisfaction at 3 months seems equal to ReLEx flex and FS-LASIK. Optimizing laser energy settings and surgeon experience is important to minimize initial inferior results....

  12. Review of various liver retraction techniques in single incision laparoscopic surgery for the exposure of hiatus.

    Science.gov (United States)

    Palanivelu, Praveenraj; Patil, Kedar Pratap; Parthasarathi, Ramakrishnan; Viswambharan, Jaiganesh K; Senthilnathan, Palanisami; Palanivelu, Chinnusamy

    2015-01-01

    The main aspect of concern for upper GI procedures has been the retraction of the liver especially large left lobes as commonly encountered in Bariatric surgery. Not doing so would compromise the view of the hiatus, hence theoretically reducing the quality of the surgery and increasing the possibility of complications. The aim of this study was to review the various liver retraction techniques in single incision surgery being done at our institute and analyze them. A retrospective study of the various techniques and a subsequent analysis was made based on advantages and disadvantages of each method. Objectively a quantitative measure of hiatal exposure was done using a scoring system based on the grade of exposure after reviewing the surgical videos. From January 2011 to January 2013 total 104 patients underwent single incision surgery with the various liver retraction techniques with following grades of exposure -liver suspension tube technique with naso gastric tubing (2.11) and with corrugated drain (2.09) needlescopic method (1.2), Umbilical tape sling (1.95), crural stitch method (2.5). Needeloscopic method has the best grade of exposure and is the easiest to start with. The average time to create the liver retraction was 2.8 to 8.6 min.There was no procedure related morbidity or mortality. The mentioned liver retraction techniques are cost effective and easy to learn. We recommend using these techniques to have a good exposure of hiatus, without compromising the safety of surgery in single incision surgery.

  13. Preliminary assessment of channel stability and bed-material transport along Hunter Creek, southwestern Oregon

    Science.gov (United States)

    Jones, Krista L.; Wallick, J. Rose; O'Connor, Jim E.; Keith, Mackenzie K.; Mangano, Joseph F.; Risley, John C.

    2011-01-01

    of Hunter Creek. The entire study area has been captured in aerial photographs at least once per decade since the 1940s. This temporally rich photograph dataset would support quantitative analyses of changes in channel planform as well as vegetation cover. Light Detection And Ranging (LiDAR) data collected in 2008 would facilitate hydraulic and sediment-transport modeling and characterization of bar elevations throughout most of the study area. Few studies describing channel morphology and sediment transport exist for the Hunter Creek basin. The most detailed study reported channel incision and bank instability as well as the loss of point bars and pools in the lower 3.9 km of Hunter Creek from slightly downstream of its confluence with Yorke Creek to its mouth (EA Engineering, Sci-ence, and Technology, 1998). Repeat channel cross-sections collected from 1994 to 2010 at four bridges indicate that Hunter Creek is dynamic and subject to channel shifting, aggradation, and incision. Despite this dynamism, the channel at three bridge crossings showed little net change in thalweg elevation during this period. However, the channel thalweg aggraded 0.55 m from 2004 to 2008 near the bridge at RKM 3.5. Systematic delineation of gravel bars from aerial photographs collected in 1940, 1965, 2005, and 2009 indicates a 52-percent reduction in the area of bed-material sediment throughout the study area from 1940 to 2009. Net bar loss was greatest in the Lower Study Reach from RKM 1-4 and mainly is associ-ated with the encroachment of vegetation onto upper-bar surfaces lacking apparent vegetation in 1940. Bar-surface material was approximately equal in size to bar-subsurface material at Conn Creek Bar, whereas it was distinctly coarser than the subsurface material at Menasha Bar. Armoring ratios, which indicate the coarseness of the bar surface relative to the bar subsurface, were calculated as 0.97 for Conn Creek Bar and 1.5 for Menasha Bar. These ratios tentatively show that

  14. Small-incision 4-point scleral suture fixation of a foldable hydrophilic acrylic intraocular lens in the absence of capsule support.

    Science.gov (United States)

    Terveen, Daniel C; Fram, Nicole R; Ayres, Brandon; Berdahl, John P

    2016-02-01

    To determine the visual outcomes and complications of a new small-incision technique for 4-point fixation of a hydrophilic acrylic posterior chamber intraocular lens (IOL) in the absence of capsule support. Three North American tertiary referral centers and a private practice. Retrospective case series. Secondary IOL placement was performed from 2011 to 2014. Indications for surgery, clinical results, and complications were analyzed. Primary outcomes included postoperative corrected distance visual acuity (CDVA) and surgical complications. Charts of 35 patients (37 eyes) were reviewed. The mean age at surgery was 56 years, and the mean follow-up was 6 months (range 3 to 24 months). Clinical indications included a dislocated IOL (30%), ocular trauma (19%), crystalline lens subluxation (19%), uveitis-glaucoma-hyphema syndrome (5%), post-complicated cataract (8%), congenital cataract (8%), and decompensated cornea (3%). The mean CDVA improved from 20/80 preoperatively to 20/40 postoperatively (P IOL dislocation (3%). Small-incision 4-point scleral fixation of the Akreos AO60 hydrophilic acrylic IOL in the absence of capsule support appears to be a safe and effective technique for secondary IOL placement. Drs. Berdahl and Ayres are consultants to Bausch & Lomb, Inc. Drs. Ayres and Fram have received speaker fees from Bausch & Lomb. Dr. Terveen does not have a financial or proprietary interest in any material or methods mentioned. Copyright © 2016 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  15. Analysis of interactions between channel dynamics and vegetation development following damming: example of the Old Rhine downstream of Kembs (1949-2009)

    Science.gov (United States)

    Arnaud, F.; Béraud, C.; Piégay, H.; Schmitt, L.; Rollet, A.; Johnstone, K.; Hoenen, D.; Béal, D.

    2010-12-01

    The 45 km-long reach of the Rhine River from Kembs to Breisach has been heavily impacted by engineering works during the last two centuries. The Kembs dam and the lateral “Grand Canal d’Alsace” achieved in 1959 induced significant decrease in sediment transport and diversion of most of the flow in the lateral canal so that the by-passed “Old Rhine” runs now a minimum flow (3% of the mean annual discharge during 300 days per year). Two combined approaches were performed to understand the Old Rhine morphological response to “dewatering”, peak flow reduction and sediment transport disruption in particular the vegetation expansion process and its potential feedback impacts on the channel hydraulics and the sediment transport: i) a space-time approach using series of aerial photographs and historical cross-sections and ii) 1D morphodynamic simulations. Sets of aerial photographs integrated in a GIS environment have been used to map the extent of water bodies, gravel bars, riparian vegetation (grasslands, shrubs, trees identified using differences in colour, texture and structure) and anthropogenic features every 10 years since the 1950s. Results show a strong channel narrowing and associated vegetation expansion until 1982. Tests conducted on the different dates underlined homogeneous segments and downstream progression of the processes through time, demonstrating different patterns of adjustments. Cross-sections of 1950 and 1990 were overlaid with land cover layers, demonstrating that incision and sedimentation areas are spatially linked with the planform changes. From these findings, we hypothesised that vegetation encroachment modified hydraulic conditions, enabling sediment transport, winnowing and deposition processes despite of peak flow reduction and armour layer development due to intense incision following channelization works. In order to test these causality hypothesis, the mean sediment mobility along the homogeneous segments was assessed using

  16. Integrating channel form and processes in the Gangetic plains rivers: Implications for geomorphic diversity

    Science.gov (United States)

    Roy, N. G.; Sinha, R.

    2018-02-01

    Geomorphic diversity at a variety of spatial and temporal scales has been studied in the western Ganga plains (WGP), India, to isolate the dominating factors at each scale that have the potential to cause major geomorphic change. The Ganga River and its major tributaries draining the WGP have been investigated in terms of longitudinal, cross-sectional, and planform morphology to assess the influence of potential controls such as climate, geology, topography, land use, hydrology, and sediment transport. These data were then compared with those from the rivers draining the eastern Ganga plains (EGP) to understand the geomorphic diversity across the Ganga plains and the causal factors. Our investigations suggest that in-channel geomorphic diversity over decadal scale in rivers with low width-to-depth (W/D) ratio is caused by periodic incision/aggradation, but it is driven by channel avulsion in rivers characterized by high W/D ratio. Similarly, planform (reach-scale) parameters such as sinuosity and braid-channel-ratio are influenced by intrinsic factors such as changes in hydrological conditions and morphodynamics (cutoffs, small-scale avulsion) that are in turn impacted by natural and human-induced factors. Finally, we have isolated the climatic and hydrologic effects on the longitudinal profile concavity of alluvial trunk channels in tectonically stable and unstable landscapes. We demonstrate that the rivers flowing through a tectonically stable landscape are graded in nature where higher discharge tends to create more concave longitudinal profiles compared to those in tectonically unstable landscape at 103-year scale.

  17. David J. Triggle: Medicinal chemistry, to pharmacology, calcium channels, and beyond.

    Science.gov (United States)

    Walker, Michael J A

    2015-11-15

    David Triggle's scientific career began as a chemist, went through medicinal chemistry into pharmacology, and finally on to somewhat more philosophical interests in later years. It was a career marked by many contributions to all of those aspects of science. Chief amongst his many contributions, in addition to those in medicinal chemistry, was his work on the drugs known as calcium ion channel blockers or (calcium antagonists). In the calcium ion channel field he was a particularly instrumental figure in sorting out the mechanisms, actions and roles of the class of calcium channel blockers, known chemical and pharmacologically as the dihydropyridines (DHPs) in particular, as well as other calcium blockers of diverse structures. During the course of a long career, and extensive journeys into medicinal chemistry and pharmacology, he published voluminously in terms of papers, reviews, conference proceedings and books. Notably, many of his papers often had limited authorship where, as senior author it reflected his deep involvement in all aspects of the reported work. His work always helped clarify the field while his incisive reviews, together with his role in coordinating and running scientific meetings, were a great help in clarifying and organizing various fields of study. He has had a long and illustrious career, and is wellknown in the world of biomedical science; his contributions are appreciated, and well recognized everywhere. The following article attempts to chart a path through his work and contributions to medicinal chemistry, pharmacology, science, academia and students. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Comparison of CO(2) laser and 4.0 MHz radiosurgery for making incisions in the skin and muscles of green iguanas (Iguana iguana).

    Science.gov (United States)

    Hernández-Divers, S J; Stahl, S J; Rakich, P M; Blas-Machado, U

    2009-01-03

    Four green iguanas scheduled for euthanasia were used to compare the extent of collateral tissue damage associated with CO(2) laser and 4.0 MHz radiosurgery. The iguanas were anaesthetised and a series of three skin and three muscle incisions was made by 4.0 MHz radiosurgery (0.18 mm wire electrode, 25 W, cut mode) and CO(2) laser (0.3 mm ceramic tip, 15 W focused beam super-pulse mode), and three incisions were made with a scalpel blade as controls. Following euthanasia, a total of 60 skin and 36 muscle sections were evaluated histologically. Radiosurgery and the laser both produced bloodless incisions, but radiosurgery caused significantly less collateral tissue damage in the skin (307 [97] v 386 [108] microm) and the muscle (18 [7] v 91 [15] microm).

  19. Adjustments in channel morphology due to land-use changes and check dam installation in mountain torrents of Calabria (Southern Italy)

    Science.gov (United States)

    Fortugno, Diego; Zema, Demetrio Antonio; Bombino, Giuseppe; Tamburino, Vincenzo; Quinonero Rubio, Juan Manuel; Boix-Fayos, Carolina

    2016-04-01

    In Mediterranean semi-arid conditions the geomorphic effects of land-use changes and check dam installation on active channel headwater morphology are not completely understood. In such environments, the availability of specific studies, which monitor channel adjustments as a response to reforestation and check dams over representative observation periods, could help develop new management strategies and erosion control measures. This investigation is an integrated approach assessing the adjustments of channel morphology in a typical torrent (Sant'Agata, Calabria, Southern Italy) after land-use changes (e.g. fire, reforestation, land abandonment) and check dam construction across a period of about 60 years (1955-2012). A statistical analysis of historical rainfall records, an analysis of land-use change in the catchment area and a geomorphological mapping of channel adjustments were carried out and combined with field surveys of bed surface grain-size over a 5-km reach including 14 check dams. The analysis of the historical rainfall records showed a slight decrease in the amount and erosivity of precipitation. Mapping of land-use changes highlighted a general increase of vegetal coverage on the slopes adjacent to the monitored reaches. Together with the check dam network installation, this increase could have induced a reduction in water and sediment supply. The different erosional and depositional forms and adjustments showed a general narrowing between consecutive check dams together with local modifications detected upstream (bed aggradation and cross section expansion together with low-flow realignments) and downstream (local incision) of the installed check dams. Changes in the torrent bends were also detected as a response to erosional and depositional processes with different intensities. The study highlighted: (i) the efficiency of check dams against the disrupting power of the most intense floods by stabilising the active channel; and (ii) the influence of

  20. Hydraulic conditions of flood flows in a Polish Carpathian river subjected to variable human impacts

    Science.gov (United States)

    Radecki-Pawlik, Artur; Czech, Wiktoria; Wyżga, Bartłomiej; Mikuś, Paweł; Zawiejska, Joanna; Ruiz-Villanueva, Virginia

    2016-04-01

    Channel morphology of the Czarny Dunajec River, Polish Carpathians, has been considerably modified as a result of channelization and gravel-mining induced channel incision, and now it varies from a single-thread, incised or regulated channel to an unmanaged, multi-thread channel. We investigated effects of these distinct channel morphologies on the conditions for flood flows in a study of 25 cross-sections from the middle river course where the Czarny Dunajec receives no significant tributaries and flood discharges increase little in the downstream direction. Cross-sectional morphology, channel slope and roughness of particular cross-section parts were used as input data for the hydraulic modelling performed with the 1D steady-flow HEC-RAS model for discharges with recurrence interval from 1.5 to 50 years. The model for each cross-section was calibrated with the water level of a 20-year flood from May 2014, determined shortly after the flood on the basis of high-water marks. Results indicated that incised and channelized river reaches are typified by similar flow widths and cross-sectional flow areas, which are substantially smaller than those in the multi-thread reach. However, because of steeper channel slope in the incised reach than in the channelized reach, the three river reaches differ in unit stream power and bed shear stress, which attain the highest values in the incised reach, intermediate values in the channelized reach, and the lowest ones in the multi-thread reach. These patterns of flow power and hydraulic forces are reflected in significant differences in river competence between the three river reaches. Since the introduction of the channelization scheme 30 years ago, sedimentation has reduced its initial flow conveyance by more than half and elevated water stages at given flood discharges by about 0.5-0.7 m. This partly reflects a progressive growth of natural levees along artificially stabilized channel banks. By contrast, sediments of natural

  1. Aesthetic assessment in periciliary "v-incision" versus conventional external dacryocystorhinostomy in Asians.

    Science.gov (United States)

    Ng, Danny Siu-Chun; Chan, Edwin; Yu, Derek Kim-Hun; Ko, Simon Tak-Chuen

    2015-10-01

    To determine the functional and aesthetic outcomes of periciliary "v-incision" external dacryocystorhinostomy (DCR) and to compare with conventional approach. Charts review of consecutive cases of "v-incision" (VDCR) or conventional DCR performed in a single institute, between January 2007 and March 2014. All procedures were performed or supervised by a single surgeon. Two periciliary incisions were made near the skin-mucosal junction at the upper and lower eyelid margins medial to the punctum joining at the medial canthal angle to form a "v" shape. Subcutaneous dissection was carried out inferomedially to reach the anterior lacrimal crest. DCR was then performed in the usual manner. Functional success was defined as no persistent or recurrent epiphora and patency on irrigation of the lacrimal drainage system at least 6 months post-surgery. A cross-sectional aesthetic survey was conducted by asking the patients to rate their scar appearance satisfaction on a visual analogue scale (VAS). External photographs were graded by two independent, masked physicians using VAS as well as the Stony Brook scar evaluation scale (SBSES). Sixty-one patients with median age of 64 years met the inclusion criteria, with median follow-up duration of 28 months. Thirty-eight eyes underwent VDCR, and 23 had conventional DCR. The functional success rate for VDCR was 83.3, 95 % confidence intervals (95%CI) [lower 0.68, upper 0.92] and for conventional DCR was 73.9 %, 95%CI [lower 0.54, upper 0.87]; without statistically significant difference (p = 0.38). VDCR patients rated higher aesthetic outcome on VAS (mean scores 95.5 ± 16.8 vs 82.9 ± 25.1, p = 0.03). On the SBSES, both observers gave higher aesthetic scores to the VDCR group (observer #1 4.6 ± 1.1 and #2 4.7 ± 1.2, p aesthetic outcomes as reported by surgeons and patients. However, a higher proportion of trainees under supervision performed conventional DCR, and it is uncertain whether the outcomes were

  2. Laparoscopic resection of lower rectal cancer with telescopic anastomosis without abdominal incisions.

    Science.gov (United States)

    Li, Shi-Yong; Chen, Gang; Du, Jun-Feng; Chen, Guang; Wei, Xiao-Jun; Cui, Wei; Zuo, Fu-Yi; Yu, Bo; Dong, Xing; Ji, Xi-Qing; Yuan, Qiang

    2015-04-28

    To assess laparoscopic radical resection of lower rectal cancer with telescopic anastomosis through transanal resection without abdominal incisions. From March 2010 to June 2014, 30 patients (14 men and 16 women, aged 36-78 years, mean age 59.8 years) underwent laparoscopic radical resection of lower rectal cancer with telescopic anastomosis through anus-preserving transanal resection. The tumors were 5-7 cm away from the anal margin in 24 cases, and 4 cm in six cases. In preoperative assessment, there were 21 cases of T1N0M0 and nine of T2N0M0. Through the middle approach, the sigmoid mesentery was freed at the root with an ultrasonic scalpel and the roots of the inferior mesenteric artery and vein were dissected, clamped and cut. Following the total mesorectal excision principle, the rectum was separated until the anorectal ring reached 3-5 cm from the distal end of the tumor. For perineal surgery, a ring incision was made 2 cm above the dentate line, and sharp dissection was performed submucosally towards the superior direction, until the plane of the levator ani muscle, to transect the rectum. The rectum and distal sigmoid colon were removed together from the anus, followed by a telescopic anastomosis between the full thickness of the proximal colon and the mucosa and submucosal tissue of the rectum. For the present cohort of 30 cases, the mean operative time was 178 min, with an average of 13 positive lymph nodes detected. One case of postoperative anastomotic leak was observed, requiring temporary colostomy, which was closed and recovered 3 mo later. The postoperative pathology showed T1-T2N0M0 in 19 cases and T2N1M0 in 11 cases. Twelve months after surgery, 94.4% patients achieved anal function Kirwan grade 1, indicating that their anal function returned to normal. The patients were followed up for 1-36 mo, with an average of 23 mo. There was no local recurrence, and 17 patients survived for > 3 years (with a survival rate of 100%). Laparoscopic radical

  3. Short-term outcomes of small-incision lenticule extraction (SMILE) for low, medium, and high myopia.

    Science.gov (United States)

    Fernández, Joaquín; Valero, Almudena; Martínez, Javier; Piñero, David P; Rodríguez-Vallejo, Manuel

    2017-03-10

    To determine the safety, efficacy, and predictability of small-incision lenticule extraction at 6-month follow-up, depending on the level of the myopic refractive error. The surgeries were performed by a surgeon new to this technique. Seventy-one subjects with a mean age of 31.86 ± 5.57 years were included in this retrospective observational study. Subjects were divided into 3 groups depending on the preoperative spherical equivalent (SE): low group from -1.00 D to -3.00 D, medium from -3.25 D to -5.00 D, and high from -5.25 D to -7.00 D. Manifest refraction, corrected distance visual acuity (CDVA), and uncorrected distance visual acuity (UDVA) were measured before surgery and at 6 months after the treatment. In total, 1.4% of the eyes lost 1 line of CDVA after the procedure, whereas 95.8% remained unchanged and 2.8% gained 1 line. A significant undercorrection (p = 0.031) was found in the high myopia group (median -0.50 D), whereas the low and medium groups remained near to emmetropia. In terms of efficacy, no statistically significant intergroup differences for postoperative UDVA (p = 0.282) were found. The vector analysis also showed undercorrection of the preoperative cylinder, even though the standard deviations decreased from 0.9 D in the x axis and 0.7 D in the y axis to 0.24 D and 0.27 D, respectively. Small-incision lenticule extraction might be a safe, effective, and predictable procedure even for inexperienced surgeons. No differences in efficacy were found among myopia levels even though undercorrections were found for SE and cylinder in high myopia.

  4. Indoor MIMO Channel Measurement and Modeling

    DEFF Research Database (Denmark)

    Nielsen, Jesper Ødum; Andersen, Jørgen Bach

    2005-01-01

    Forming accurate models of the multiple input multiple output (MIMO) channel is essential both for simulation as well as understanding of the basic properties of the channel. This paper investigates different known models using measurements obtained with a 16x32 MIMO channel sounder for the 5.8GHz...... band. The measurements were carried out in various indoor scenarios including both temporal and spatial aspects of channel changes. The models considered include the so-called Kronecker model, a model proposed by Weichselberger et. al., and a model involving the full covariance matrix, the most...

  5. Effect of electroacupuncture on the cervicospinal P2X7 receptor/fractalkine/CX3CR1 signaling pathway in a rat neck-incision pain model.

    Science.gov (United States)

    Gao, Y H; Li, C W; Wang, J Y; Tan, L H; Duanmu, C L; Jing, X H; Chang, X R; Liu, J L

    2017-06-01

    Increasing evidence supports that acupuncture intervention is an effective approach for intraoperative and postoperative pain. Neuron-microglia crosstalk, mediated by the purinergic P2X7 receptor (R)/fractalkine/CX3CR1 cascade in the spinal cord dorsal horn, plays a pivotal role in pain processing. However, its involvement in the analgesic effect of electroacupuncture (EA) remains unclear. In this study, a rat neck-incision pain model was established by making a longitudinal incision along the midline of the neck and subsequent repeated mechanical stimulation. EA stimulation was applied to bilateral LI18, LI4-PC6, or ST36-GB34. The thermal pain threshold, cervicospinal ATP concentration, expression levels of purinergic P2XR and P2YR subunits mRNAs, and fractalkine, CX3CR1 and p38 MAPK proteins, were detected separately. The neck incision induced strong thermal hyperalgesia and upregulation of spinal ATP within 48 h. No significant change was found in thermal hyperalgesia after a single session of EA intervention. However, a single session of EA dramatically enhanced the neck incision-induced upregulation of ATP and upregulated the expression of P2X7R, which was reversed by two sessions of EA. Two sessions of EA at bilateral LI18 or LI4-PC6 attenuated hyperalgesia significantly, accompanied with downregulation of P2X7R/fractalkine/ CX3CR1 signaling after three sessions of EA. EA stimulation of LI18 or LI4-PC6 alleviates thermal hyperalgesia in neck-incision pain rats, which may be associated with its effects in regulating the neck incision-induced increase of ATP and P2X7R and subsequently suppressing fractalkine/CX3CR1 signaling in the cervical spinal cord.

  6. Channel electron multipliers

    International Nuclear Information System (INIS)

    Seidman, A.; Avrahami, Z.; Sheinfux, B.; Grinberg, J.

    1976-01-01

    A channel electron multiplier is described having a tubular wall coated with a secondary-electron emitting material and including an electric field for accelerating the electrons, the electric field comprising a plurality of low-resistive conductive rings each alternating with a high-resistive insulating ring. The thickness of the low-resistive rings is many times larger than that of the high-resistive rings, being in the order of tens of microns for the low-resistive rings and at least one order of magnitude lower for the high-resistive rings; and the diameter of the channel tubular walls is also many times larger than the thickness of the high-resistive rings. Both single-channel and multiple-channel electron multipliers are described. A very important advantage, particularly in making multiple-channel multipliers, is the simplicity of the procedure that may be used in constructing such multipliers. Other operational advantages are described

  7. The evaluation of tissue mass loss in the incision line of prostate with benign hyperplasia performed using holmium laser and cutting electrode.

    Science.gov (United States)

    Szewczyk, Mariusz; Jesionek-Kupnicka, Dorota; Lipiński, Marek Ireneusz; Lipinski, Piotr; Różański, Waldemar

    2014-01-01

    The aim of this study is to compare the changes in the incision line of prostatic adenoma using a monopolar cutting electrode and holmium laser, as well as the assessment of associated tissue mass and volume loss of benign prostatic hyperplasia (BPH). The material used in this study consisted of 74 preparations of prostatic adenoma obtained via open retropubic adenomectomy, with an average volume of 120.7 ml. The material obtained cut in vitro before fixation in formaldehyde. One lobe was cut using holmium laser, the other using a monopolar cutting electrode. After the incision was made, tissue mass and volume loss were evaluated. Thermocoagulation changes in the incision line were examinedunder light microscope. In the case of the holmium laser incision, the average tissue mass loss was 1.73 g, tissue volume loss 3.57 ml and the depth of thermocoagulation was 1.17 mm. When the monopolar cutting electrode was used average tissue mass loss was 0.807 g, tissue volume loss 2.48 ml and the depth of thermocoagulation was 0.19 mm. Where holmium laser was used, it was observed that the layer of tissue with thermocoagulation changes was deeper than in the case of the monopolar cutting electrode. Moreover, it was noticed that holmium laser caused bigger tissue mass and volume loss than the cutting electrode.

  8. A comparison of single-suture and double-suture incision closures in seaward-migrating juvenile Chinook salmon implanted with acoustic transmitters: implications for research in river basins containing hydropower structures

    Energy Technology Data Exchange (ETDEWEB)

    Brown, Richard S.; Deters, Katherine A.; Cook, Katrina V.; Eppard, M. B.

    2013-07-15

    Reductions in the size of acoustic transmitters implanted in migrating juvenile salmonids have resulted in the ability to make shorter incisions that may warrant using only a single suture for closure. However, it is not known if one suture will sufficiently hold the incision closed, particularly when outward pressure is placed on the surgical site such as when migrating fish experience pressure changes associated with passage at hydroelectric dams. The objective of this research was to evaluate the effectiveness of single-suture incision closures on juvenile Chinook salmon (Oncorhynchus tshawytscha). Juvenile Chinook salmon were surgically implanted with a 2012 Juvenile Salmon Acoustic Telemetry System (JSATS) transmitter (0.30 g) and a passive integrated transponder tag (0.10 g) and incisions were closed with either one suture or two sutures. Mortality and tag retention were monitored and fish were examined after 7 and 14 days to evaluate tissue responses. In a separate experiment, surgically implanted fish were exposed to simulated turbine passage and then examined for expulsion of transmitters, expulsion of viscera through the incision, and mortal injury. With incisions closed using a single suture, there was no mortality or tag loss and similar or reduced tissue reaction compared to incisions closed with two sutures. Further, surgery time was significantly reduced when one suture was used, which leads to less handling and reduced stress. No tags were expelled during pressure scenarios and expulsion of viscera only occurred in two non-mortally injured fish (5%) with single sutures that were also exposed to very high pressure changes. No viscera expulsion was present in fish exposed to pressure scenarios likely representative of hydroturbine passage at many Columbia River dams (e.g. <2.7 ratio of pressure change; an acclimation pressure of 146.2 absolute kpa and a lowest exposure pressure of ~ 53.3 absolute kpa). Based on these results, we recommend the use of a

  9. Intra-parotid dermoid cyst: excision through a face lift incision.

    Science.gov (United States)

    Shakeel, M; Keh, S M; Chapman, A; Hussain, A

    2014-11-01

    Intra-parotid dermoid cysts are extremely rare. Clinically, they present like any other parotid lump and pre-operative diagnosis is rarely possible. A 62 years old Caucasian man presented with a painless lump in his right parotid region. The Magnetic Resonance Imaging (MRI) scan revealed a 3 x 3 cm mass in the parotid tail. Cytological examination was unhelpful. The patient underwent successful excision of the cyst through a small face lift incision. No drain was inserted and the patient was discharged home the same day. The patient made an uneventful recovery and was highly satisfied with the aesthetic outcome. The definite histopathological diagnosis was an intra-parotid dermoid cyst.

  10. A case of bifocal endometriosis involving a pfannenstiel incision.

    Science.gov (United States)

    Evsen, Mehmet Sidik; Sak, Muhammet Erdal; Yalinkaya, Ahmet; Firat, Ugur; Caca, Fatma Nur

    2011-01-01

    A 25-year-old woman was referred to our clinic for atypical cyclic pain and masses at both ends of a Pfannenstiel incision scar. Ultrasound of the anterior abdominal wall showed two masses. Both masses were hypoechoic, heterogeneous lesions located at opposite ends of the scar. The lesions were surgically excised with. Microscopic examination revealed endometrial gland structures with endometrial stroma in fibroadipose tissue in sections of both specimens indicative of endometriosis. Incisional endometriosis (IE) is a form of extrapelvic endometriosis especially in scars of obstetric or gynecologic surgery IE may be multifocal at surgical scars. We report the a case of bifocal incisional endometriosis in Pfannesteil scar. Whole scar evaluation should be done for incisional endometriosis and surgical excision should be performed for treatment.

  11. Review of various liver retraction techniques in single incision laparoscopic surgery for the exposure of hiatus

    Directory of Open Access Journals (Sweden)

    Praveenraj Palanivelu

    2015-01-01

    Full Text Available Background: The main aspect of concern for upper GI procedures has been the retraction of the liver especially large left lobes as commonly encountered in Bariatric surgery. Not doing so would compromise the view of the hiatus, hence theoretically reducing the quality of the surgery and increasing the possibility of complications. The aim of this study was to review the various liver retraction techniques in single incision surgery being done at our institute and analyze them. Material and Methods: A retrospective study of the various techniques and a subsequent analysis was made based on advantages and disadvantages of each method. Objectively a quantitative measure of hiatal exposure was done using a scoring system based on the grade of exposure after reviewing the surgical videos. From January 2011 to January 2013 total 104 patients underwent single incision surgery with the various liver retraction techniques with following grades of exposure -liver suspension tube technique with naso gastric tubing (2.11 and with corrugated drain (2.09 needlescopic method (1.2, Umbilical tape sling (1.95, crural stitch method (2.5. Needeloscopic method has the best grade of exposure and is the easiest to start with. The average time to create the liver retraction was 2.8 to 8.6 min.There was no procedure related morbidity or mortality. Conclusions: The mentioned liver retraction techniques are cost effective and easy to learn. We recommend using these techniques to have a good exposure of hiatus, without compromising the safety of surgery in single incision surgery.

  12. Negative Suction Drain Through a Mini Periareolar Incision for the Treatment of Lactational Breast Abscess Shortens Hospital Stay and Increases Breastfeeding Rates.

    Science.gov (United States)

    Wei, Jinli; Zhang, Jiaxin; Fu, Deyuan

    2016-06-01

    Although breast abscess is a serious uncommon complication of mastitis with high morbidity rate, there is a lack of high-quality randomized trial to demonstrate the best treatments. We reported a novel way of applying negative suction drain through a mini periareolar incision. We retrospectively analyzed and compared the clinical characteristics of 62 patients with lactational breast abscess in our department from August 2012 to April 2015. Thirty-two patients went through traditional incision and drainage (Group A) and 30 patients were placed on negative suction drain through mini periareolar incision (Group B). There is no significant difference between the two groups in terms of age, white blood cell (WBC) count, size of the abscess cavity, and positive rate of Staphylococcus aureus (SA) or methicillin-resistant Staphylococcus aureus (MRSA). Patients in Group B had a shorter hospitalized stay (p = 0.003) and had a higher rate of continuation of breastfeeding (p breast abscess and maintaining breastfeeding.

  13. Clinical observation of small-incision extracapsular cataract extraction with intraocular lens implantation for the treatment of cataract in the sight restoration project

    Directory of Open Access Journals (Sweden)

    Xiao-Jian Cheng

    2014-04-01

    Full Text Available AIM: To analyze the clinical effects of small-incision extracapsular cataract extraction with intraocular lens implantation for the treatment of cataract.METHODS:Totally 642 cases 676 eyes of cataract were treated by small-incision extracapsular cataract extraction with intraocular lens implantation. Complication during and after operations and postoperative visual acuity was observed.RESULTS:Visual acuity of 670 eyes was ≥0.05 and off-blindness rate was 99.11%, and there was 627 eyes ≥0.3 and the off-disability rate was 92.75% after 1mo. Rupture of posterior capsule during surgery occurred in 24 eyes. Fifty-four eyes were corneal edema, and anterior chamber exudation were 26 eyes, and 23 eyes were hypertension after operation. CONCLUSION: There are a little complications during and after operation for cataract treated by small-incision extracapsular cataract extraction with intraocular lens implantation. Patients have good recovery after operation. This operation does not need high-standard equipments and is suitable in the sight restoration project.

  14. Surgical peripheral iridectomy via a clear-cornea phacoemulsification incision for pupillary block following cataract surgery in acute angle closure.

    Science.gov (United States)

    Fang, Aiwu; Wang, Peijuan; He, Rui; Qu, Jia

    2018-05-18

    To describe a technique of surgical peripheral iridectomy via a clear-cornea tunnel incision to prevent or treat pupillary block following phacoemulsification. Description of technique and retrospective description results in 20 eyes of 20 patients with acute angle closure with coexisting visually significant cataract undergoing phacoemulsification considered at risk of postoperative papillary block as well as two pseudo-phakic eyes with acute postoperative pupillary-block. Following phacoemulsification and insertion of an intraocular lens, a needle with a bent tip was inserted behind the iris through the corneal tunnel incision. A blunt iris repositor was introduced through the paracentesis and placed above the iris to exert posterior pressure and create a puncture. The size of the puncture was enlarged using scissors. For postoperative pupillary block the same technique was carried out through the existing incisions created for phacoemulsification. Peripheral iridectomy was successfully created in all 22 eyes. At a mean follow-up of 18.77 ± 9.72 months, none of the iridectomies closed or required enlargement. Two eyes had mild intraoperative bleeding and one eye a small Descemet's detachment that did not require intervention. No clinically significant complications were observed. Visual acuity and IOP improved or was maintained in all patients. The incidence of pupillary block in our hospital was 0.09% overall, 0.6% in diabetics and 3.5% in those with diabetic retinopathy. This technique of peripheral iridectomy via the cornea tunnel incision can be safely used during phacoemulsification in eyes at high risk of pupillary block or in the treatment of acute postoperative pupillary-block after cataract surgery. The technique is likely to be especially useful in brown iris, or if a laser is not available.

  15. Valley-scale morphology drives differences in fluvial sediment budgets and incision rates during contrasting flow regimes

    Science.gov (United States)

    Weber, M. D.; Pasternack, G. B.

    2017-07-01

    High-resolution topographic surveys using LiDAR and multibeam sonar can be used to characterize and quantify fluvial change. This study used repeat surveys to explore how topographic change, fluvial processes, sediment budgets, and aggradation and incision rates vary across spatial scales and across two contrasting decadal flow regimes in a regulated gravel/cobble river. A novel method for quantifying digital elevation model uncertainty was developed and applied to a topographic change detection analysis from 2006/2008 to 2014. During this period, which had four modest 3-5 year floods, most sediment was laterally redistributed through bank erosion and channel migration. Erosion primarily occurred in the floodplain (97,000 m3), terraces (80,000 m3), and lateral bars (58,000 m3); while deposition occurred in the adjacent pools (73,000 m3), fast glides (48,000 m3), and runs (36,000 m3). In contrast, significantly higher magnitude and longer duration floods from 1999 to 2006/2008 caused sediment to be displaced longitudinally, with the upstream reaches exporting sediment and the downstream reaches aggrading. The river maintained floodplain connectivity during both periods, despite different processes dominating the type of connectivity. Larger floods promoted overbank scour and avulsion, while smaller floods promoted bank erosion and lateral migration. This study explores and illustrates how the geomorphic response to contrasting flood regimes in a nonuniform river is highly dependent on which landforms are controlling hydraulics.

  16. Short-term pre- and post-operative stress prolongs incision-induced pain hypersensitivity without changing basal pain perception.

    Science.gov (United States)

    Cao, Jing; Wang, Po-Kai; Tiwari, Vinod; Liang, Lingli; Lutz, Brianna Marie; Shieh, Kun-Ruey; Zang, Wei-Dong; Kaufman, Andrew G; Bekker, Alex; Gao, Xiao-Qun; Tao, Yuan-Xiang

    2015-12-02

    Chronic stress has been reported to increase basal pain sensitivity and/or exacerbate existing persistent pain. However, most surgical patients have normal physiological and psychological health status such as normal pain perception before surgery although they do experience short-term stress during pre- and post-operative periods. Whether or not this short-term stress affects persistent postsurgical pain is unclear. In this study, we showed that pre- or post-surgical exposure to immobilization 6 h daily for three consecutive days did not change basal responses to mechanical, thermal, or cold stimuli or peak levels of incision-induced hypersensitivity to these stimuli; however, immobilization did prolong the duration of incision-induced hypersensitivity in both male and female rats. These phenomena were also observed in post-surgical exposure to forced swimming 25 min daily for 3 consecutive days. Short-term stress induced by immobilization was demonstrated by an elevation in the level of serum corticosterone, an increase in swim immobility, and a decrease in sucrose consumption. Blocking this short-term stress via intrathecal administration of a selective glucocorticoid receptor antagonist, RU38486, or bilateral adrenalectomy significantly attenuated the prolongation of incision-induced hypersensitivity to mechanical, thermal, and cold stimuli. Our results indicate that short-term stress during the pre- or post-operative period delays postoperative pain recovery although it does not affect basal pain perception. Prevention of short-term stress may facilitate patients' recovery from postoperative pain.

  17. Treatment of stress fracture of the olecranon in throwing athletes with internal fixation through a small incision

    Directory of Open Access Journals (Sweden)

    Fujioka Hiroyuki

    2012-12-01

    Full Text Available Abstract The present study is a report of retrospective case series of stress fracture of the olecranon. Six patients presented posterior elbow pain in throwing in baseball and softball, but fracture was not diagnosed in radiographs. We detected stress fracture of the olecranon using computed tomographic (CT scan and treated the patient with internal fixation with a headless cannulated double threaded screw through a small skin incision. All patients returned to competitive level without elbow complaints after the operation. When throwing athletes present with unusual posterior elbow pain and no significant findings on radiographs, a CT scan examination should be performed. We recommend surgical treatment of internal fixation with a screw through a small skin incision, as a good option for stress fracture of the olecranon in order to allow early return to sports activity in competitive athletes.

  18. Isotachophoresis system having larger-diameter channels flowing into channels with reduced diameter and with selectable counter-flow

    Energy Technology Data Exchange (ETDEWEB)

    Mariella, Jr., Raymond P.

    2018-03-06

    An isotachophoresis system for separating a sample containing particles into discrete packets including a flow channel, the flow channel having a large diameter section and a small diameter section; a negative electrode operably connected to the flow channel; a positive electrode operably connected to the flow channel; a leading carrier fluid in the flow channel; a trailing carrier fluid in the flow channel; and a control for separating the particles in the sample into discrete packets using the leading carrier fluid, the trailing carrier fluid, the large diameter section, and the small diameter section.

  19. Consolidation equipment for irradiated nuclear fuel channels

    International Nuclear Information System (INIS)

    Taguchi, M.; Komatsu, Y.; Ose, T.

    1989-01-01

    The authors have developed and put into use a new type of mechanical consolidation equipment for irradiated nuclear fuel channels. This includes round-slice cutting of the top 100mm of the fuel channel with a guillotine cutter, and press cutting of the two corners of the remaining length of the fuel channel. Four guillotine blades work in combination with receiving blades arranged inside the fuel channel to cut the top 100mm, including the clips and spacers, of the fuel channel into a round slice. A press assembled in the consolidation equipment then presses the slice to achieve volume reduction. The press cutting operation uses two press cutting blades arranged inside the fuel channel and the receiving blades outside the fuel channel. The remaining length of fuel channel is cut off into L-shaped pieces by press cutting. This consolidation equipment is highly efficient because the round-slice cutting, pressing, and press cutting are all achieved by one unit

  20. VKCDB: Voltage-gated potassium channel database

    Directory of Open Access Journals (Sweden)

    Gallin Warren J

    2004-01-01

    Full Text Available Abstract Background The family of voltage-gated potassium channels comprises a functionally diverse group of membrane proteins. They help maintain and regulate the potassium ion-based component of the membrane potential and are thus central to many critical physiological processes. VKCDB (Voltage-gated potassium [K] Channel DataBase is a database of structural and functional data on these channels. It is designed as a resource for research on the molecular basis of voltage-gated potassium channel function. Description Voltage-gated potassium channel sequences were identified by using BLASTP to search GENBANK and SWISSPROT. Annotations for all voltage-gated potassium channels were selectively parsed and integrated into VKCDB. Electrophysiological and pharmacological data for the channels were collected from published journal articles. Transmembrane domain predictions by TMHMM and PHD are included for each VKCDB entry. Multiple sequence alignments of conserved domains of channels of the four Kv families and the KCNQ family are also included. Currently VKCDB contains 346 channel entries. It can be browsed and searched using a set of functionally relevant categories. Protein sequences can also be searched using a local BLAST engine. Conclusions VKCDB is a resource for comparative studies of voltage-gated potassium channels. The methods used to construct VKCDB are general; they can be used to create specialized databases for other protein families. VKCDB is accessible at http://vkcdb.biology.ualberta.ca.

  1. A preliminary randomized clinical trial comparing diode laser and scalpel periosteal incision during implant surgery: impact on postoperative morbidity and implant survival.

    Science.gov (United States)

    Shahnaz, Aysan; Jamali, Raika; Mohammadi, Farnush; Khorsand, Afshin; Moslemi, Neda; Fekrazad, Reza

    2018-01-01

    The aim of this preliminary randomized clinical trial was to compare: (1) post-operative morbidity after application of laser or scalpel incision for flap advancement during implant surgery and bone grafting and (2) implant survival rate following flap advancement with laser or scalpel incision after 6 months of loading. Eighteen patients who were scheduled for dental implant placement and simultaneous bone grafting were randomly assigned to test or control groups. Diode laser (810 nm, 2 W, pulse interval 200 μs; pulse length 100 μs, 400-μm initiated fiber tip), or scalpel (control) was used to sever the periosteum to create a tension-free flap. Visual analogue scale (VAS) pain score, rate of nonsteroid anti-inflammatory drug (NSAID) consumption, intensity of swelling, and ecchymosis were measured for the six postsurgical days. Six months after loading, implant survival was assessed. VAS pain score (during the first four postoperative days), rate of NSAID consumption (during the first three postoperative days), and intensity of swelling (during the first five postoperative days) were significantly lower in the test group compared to the control group (All P values laser for performing periosteal releasing incision reduced the incidence and severity of postoperative morbidity of the patients undergone implant surgery in conjunction with bone augmentation procedure. We did not find any detrimental effect of laser incision on the implant survival within 6 months of loading.

  2. Preliminary assessment of channel stability and bed-material transport in the Rogue River basin, southwestern Oregon

    Science.gov (United States)

    Jones, Krista L.; O'Connor, Jim E.; Keith, Mackenzie K.; Mangano, Joseph F.; Wallick, J. Rose

    2012-01-01

    This report summarizes a preliminary assessment of bed-material transport, vertical and lateral channel changes, and existing datasets for the Rogue River basin, which encompasses 13,390 square kilometers (km2) along the southwestern Oregon coast. This study, conducted to inform permitting decisions regarding instream gravel mining, revealed that: * The Rogue River in its lowermost 178.5 kilometers (km) alternates between confined and unconfined segments, and is predominately alluvial along its lowermost 44 km. The study area on the mainstem Rogue River can be divided into five reaches based on topography, hydrology, and tidal influence. The largely confined, active channel flows over bedrock and coarse bed material composed chiefly of boulders and cobbles in the Grants Pass (river kilometers [RKM] 178.5-152.8), Merlin (RKM 152.8-132.7), and Galice Reaches (RKM 132.7-43.9). Within these confined reaches, the channel contains few bars and has stable planforms except for locally wider segments such as the Brushy Chutes area in the Merlin Reach. Conversely, the active channel flows over predominately alluvial material and contains nearly continuous gravel bars in the Lobster Creek Reach (RKM 43.9-6.7). The channel in the Tidal Reach (RKM 6.7-0) is also alluvial, but tidally affected and unconfined until RKM 2. The Lobster Creek and Tidal Reaches contain some of the most extensive bar deposits within the Rogue River study area. * For the 56.6-km-long segment of the Applegate River included in this study, the river was divided into two reaches based on topography. In the Upper Applegate River Reach (RKM 56.6-41.6), the confined, active channel flows over alluvium and bedrock and has few bars. In the Lower Applegate River Reach (RKM 41.6-0), the active channel alternates between confined and unconfined segments, flows predominantly over alluvium, shifts laterally in unconfined sections, and contains more numerous and larger bars. * The 6.5-km segment of the lower

  3. Preputial reconstruction and tubularized incised plate urethroplasty in proximal hypospadias with ventral penile curvature

    OpenAIRE

    Bhat, Amilal; Gandhi, Ajay; Saxena, Gajendra; Choudhary, Gautam Ram

    2010-01-01

    Aims : Objective of this study was to assess the feasibility and results of preputial reconstruction and tubularized incised plate urethroplasty (TIP) in patients of proximal hypospadias with ventral penile curvature. Materials and Methods : Twenty-seven patients of proximal hypospadias who underwent preputioplasty with TIP were evaluated retrospectively. Ventral curvature was corrected by mobilization of the urethral plate with the corpus spongiosum and the proximal urethra; dorsal plica...

  4. ASIC3 channels in multimodal sensory perception.

    Science.gov (United States)

    Li, Wei-Guang; Xu, Tian-Le

    2011-01-19

    Acid-sensing ion channels (ASICs), which are members of the sodium-selective cation channels belonging to the epithelial sodium channel/degenerin (ENaC/DEG) family, act as membrane-bound receptors for extracellular protons as well as nonproton ligands. At least five ASIC subunits have been identified in mammalian neurons, which form both homotrimeric and heterotrimeric channels. The highly proton sensitive ASIC3 channels are predominantly distributed in peripheral sensory neurons, correlating with their roles in multimodal sensory perception, including nociception, mechanosensation, and chemosensation. Different from other ASIC subunit composing ion channels, ASIC3 channels can mediate a sustained window current in response to mild extracellular acidosis (pH 7.3-6.7), which often occurs accompanied by many sensory stimuli. Furthermore, recent evidence indicates that the sustained component of ASIC3 currents can be enhanced by nonproton ligands including the endogenous metabolite agmatine. In this review, we first summarize the growing body of evidence for the involvement of ASIC3 channels in multimodal sensory perception and then discuss the potential mechanisms underlying ASIC3 activation and mediation of sensory perception, with a special emphasis on its role in nociception. We conclude that ASIC3 activation and modulation by diverse sensory stimuli represent a new avenue for understanding the role of ASIC3 channels in sensory perception. Furthermore, the emerging implications of ASIC3 channels in multiple sensory dysfunctions including nociception allow the development of new pharmacotherapy.

  5. Demystifying Mechanosensitive Piezo Ion Channels.

    Science.gov (United States)

    Xu, X Z Shawn

    2016-06-01

    Mechanosensitive channels mediate touch, hearing, proprioception, and blood pressure regulation. Piezo proteins, including Piezo1 and Piezo2, represent a new class of mechanosensitive channels that have been reported to play key roles in most, if not all, of these modalities. The structural architecture and molecular mechanisms by which Piezos act as mechanosensitive channels, however, remain mysterious. Two new studies have now provided critical insights into the atomic structure and molecular basis of the ion permeation and mechano-gating properties of the Piezo1 channel.

  6. Geomorphological evolution of a fluvial channel after primary lahar deposition: Huiloac Gorge, Popocatépetl volcano (Mexico)

    Science.gov (United States)

    Tanarro, L. M.; Andrés, N.; Zamorano, J. J.; Palacios, D.; Renschler, C. S.

    2010-10-01

    Popocatépetl volcano (19°02' N, 98°62' W, 5424 m) began its most recent period of volcanic activity in December 1994. The interaction of volcanic and glacier activity triggered the formation of lahars through the Huiloac Gorge, located on the northern flank of the volcano, causing significant morphological changes in the channel. The most powerful lahars occurred in April 1995, July 1997 and January 2001, and were followed by secondary lahars that formed during the post-eruptive period. This study interprets the geomorphological evolution of the Huiloac Gorge after the January 2001 lahar. Variations in channel morphology at a 520 m-long research site located mid-way down the gorge were recorded over a 4 year period from February 2002 to March 2005, and depicted in five geomorphological maps (scale 1:200) for 14 February and 15 October 2002, 27 September 2003, 9 February 2004, and 16 March 2006. A GIS was used to calculate the surface area for the landforms identified for each map and detected changes and erosion-deposition processes of the landforms using the overlay function for different dates. Findings reveal that secondary lahars and others types of flows, like sediment-laden or muddy streamflows caused by precipitation, rapidly modified the gorge channel following the January 2001 non-eruptive lahar, a period associated with volcanic inactivity and the disappearance of the glacier once located at the headwall of the gorge. Field observations also confirmed that secondary flows altered the dynamics and geomorphological development of the channel. These flows incised and destroyed the formations generated by the primary lahars (1997 and 2001), causing a widening of the channel that continues today. After February 2004, a rain-triggered lahar and other flows infilled the channel with materials transported by these flows. The deposits on the lateral edges of the channel form terraces. A recent lull in lahar activity contrasts with the increasing instability of

  7. Channel Power in Multi-Channel Environments

    NARCIS (Netherlands)

    M.G. Dekimpe (Marnik); B. Skiera (Bernd)

    2004-01-01

    textabstractIn the literature, little attention has been paid to instances where companies add an Internet channel to their direct channel portfolio. However, actively managing multiple sales channels requires knowing the customers’ channel preferences and the resulting channel power. Two key

  8. Coupling of the nucleotide incision and 3' {yields} 5' exonuclease activities in Escherichia coli endonuclease IV: Structural and genetic evidences

    Energy Technology Data Exchange (ETDEWEB)

    Golan, Gali [Hebrew University of Jerusalem, Jerusalem 91904 (Israel); Ishchenko, Alexander A. [Groupe Reparation de l' ADN, CNRS UMR 8126, Univ. Paris-Sud, Institut de Cancerologie Gustave Roussy, 39, rue Camille Desmoulins, F-94805 Villejuif Cedex (France); Khassenov, Bekbolat [National Center for Biotechnology, Astana (Kazakhstan); Shoham, Gil, E-mail: gil2@vms.huji.ac.il [Hebrew University of Jerusalem, Jerusalem 91904 (Israel); Saparbaev, Murat K., E-mail: smurat@igr.fr [Groupe Reparation de l' ADN, CNRS UMR 8126, Univ. Paris-Sud, Institut de Cancerologie Gustave Roussy, 39, rue Camille Desmoulins, F-94805 Villejuif Cedex (France)

    2010-03-01

    Aerobic respiration generates reactive oxygen species (ROS) as a by-product of cellular metabolism which can damage DNA. The complex nature of oxidative DNA damage requires actions of several repair pathways. Oxidized DNA bases are substrates for two overlapping pathways: base excision repair (BER) and nucleotide incision repair (NIR). In the BER pathway a DNA glycosylase cleaves the N-glycosylic bond between the abnormal base and deoxyribose, leaving either an abasic site or single-stranded DNA break. Alternatively, in the NIR pathway, an apurinic/apyrimidinic (AP) endonuclease incises duplex DNA 5' next to oxidatively damaged nucleotide. The multifunctional Escherichia coli endonuclease IV (Nfo) is involved in both BER and NIR pathways. Nfo incises duplex DNA 5' of a damaged residue but also possesses an intrinsic 3' {yields} 5' exonuclease activity. Herein, we demonstrate that Nfo-catalyzed NIR and exonuclease activities can generate a single-strand gap at the 5' side of 5,6-dihydrouracil residue. Furthermore, we show that Nfo mutants carrying amino acid substitutions H69A and G149D are deficient in both NIR and exonuclease activities, suggesting that these two functions are genetically linked and governed by the same amino acid residues. The crystal structure of Nfo-H69A mutant reveals the loss of one of the active site zinc atoms (Zn1) and rearrangements of the catalytic site, but no gross changes in the overall enzyme conformation. We hypothesize that these minor changes strongly affect the DNA binding of Nfo. Decreased affinity may lead to a different kinking angle of the DNA helix and this in turn thwart nucleotide incision and exonuclease activities of Nfo mutants but to lesser extent of their AP endonuclease function. Based on the biochemical and genetic data we propose a model where nucleotide incision coupled to 3' {yields} 5' exonuclease activity prevents formation of lethal double-strand breaks when repairing bi

  9. Two kinds of manual chopping methods applied in small incision extracapsular cataract extraction

    Directory of Open Access Journals (Sweden)

    Xia Jiang

    2016-02-01

    Full Text Available AIM:To research clinical effect of two manual chopping methods for small incision extracapsular cataract extraction. METHODS: We observed 143 cases(184 eyeswith grade Ⅳ or higher taken the small incision cataract extraction and intraocular lens implantation. Patients were given randomly knifed chopping with closed hook(92 eyesor double knifed chopping(92 eyes. The intra-operative posterior capsule rupture was observed and compared. At 1d, 1wk and 1mo postoperatively, visual acuity, corneal edema and corneal astigmatism were observed and analyzed. RESULTS:There were 10 eyes in patients accepting knifed chopping with closed hook with intra-operative posterior capsule rupture and 1 eye in patients accepting double knifed chopping. The difference between the two groups was statistically significant. The visual acuity of patients accepting knifed chopping with closed hook(92 eyesat 1d postoperatively was 0.380±0.105, and that of patients accepting double knifed chopping(92 eyeswas 0.420±0.095; the difference between the two groups was statistically significant. The visual acuity of patients accepting knifed chopping with closed hook(84 eyesat 1wk postoperatively was 0.480±0.123, and that of patients accepting double knifed chopping(86 eyeswas 0.520±0.085; the difference between the two groups was statistically significant. The visual acuity of patients accepting knifed chopping with closed hook(60 eyesat 1mo postoperatively was 0.610±0.083, and that of patients accepting double knifed chopping(52 eyeswas 0.643±0.072; the difference between the two groups was not statistically significant. The differences on corneal edema and corneal astigmatism between the two methods at 1d, 1wk and 1mo postoperatively were not statistically significant. CONCLUSION:The application of knifed chopping with closed hook and double knifed chopping in small incision extracapsular cataract extraction and intraocular lens implantation can effectively treat with

  10. Objective and subjective outcome in 42 patients after treatment of sialolithiasis by transoral incision of Warthon's duct

    DEFF Research Database (Denmark)

    Juul, Marie Louise; Wagner, Niels

    2014-01-01

    In this retrospective follow-up study, we present the middle-term results of transoral removal of submandibular calculi by incision in the floor of the mouth together with a patient satisfaction survey. These results will be compared with those of international studies. This is an individual...... retrospective cohort follow-up study. Forty-two patients had salivary calculi removed by incision in the mouth in the period from August 2009 to July 2012 at the Ear-nose-throat department of the North Zealand Hospital, Hillerød, Denmark. A retrospective study was carried out, focusing on the effects...... of the surgery and on patient satisfaction. The patients completed a questionnaire and underwent an objective physical exam. We found a high success rate (93 %), high patient satisfaction (94 %) and a high number of patients with no symptoms (92 %). In 94 % of the patients the gland was preserved, and there were...

  11. Quantum channels with a finite memory

    International Nuclear Information System (INIS)

    Bowen, Garry; Mancini, Stefano

    2004-01-01

    In this paper we study quantum communication channels with correlated noise effects, i.e., quantum channels with memory. We derive a model for correlated noise channels that includes a channel memory state. We examine the case where the memory is finite, and derive bounds on the classical and quantum capacities. For the entanglement-assisted and unassisted classical capacities it is shown that these bounds are attainable for certain classes of channel. Also, we show that the structure of any finite-memory state is unimportant in the asymptotic limit, and specifically, for a perfect finite-memory channel where no information is lost to the environment, achieving the upper bound implies that the channel is asymptotically noiseless

  12. Middel Pleistocene to Holocene fluvial terrace development and uplift-driven valley incision in the SE Carpathians, Romania

    NARCIS (Netherlands)

    Necea, D.; Fielitz, W.; Andriessen, P.A.M.; Dinu, C.

    2013-01-01

    This study reveals that in the SE Carpathians terrace development and fluvial incision during the Middle Pleistocene-Holocene are predominantly controlled by tectonic uplift as shown by terrace distributions and uplift amounts and rates. The work focuses on a transect from the internal nappes and

  13. Interior point decoding for linear vector channels

    International Nuclear Information System (INIS)

    Wadayama, T

    2008-01-01

    In this paper, a novel decoding algorithm for low-density parity-check (LDPC) codes based on convex optimization is presented. The decoding algorithm, called interior point decoding, is designed for linear vector channels. The linear vector channels include many practically important channels such as inter-symbol interference channels and partial response channels. It is shown that the maximum likelihood decoding (MLD) rule for a linear vector channel can be relaxed to a convex optimization problem, which is called a relaxed MLD problem

  14. Interior point decoding for linear vector channels

    Energy Technology Data Exchange (ETDEWEB)

    Wadayama, T [Nagoya Institute of Technology, Gokiso, Showa-ku, Nagoya, Aichi, 466-8555 (Japan)], E-mail: wadayama@nitech.ac.jp

    2008-01-15

    In this paper, a novel decoding algorithm for low-density parity-check (LDPC) codes based on convex optimization is presented. The decoding algorithm, called interior point decoding, is designed for linear vector channels. The linear vector channels include many practically important channels such as inter-symbol interference channels and partial response channels. It is shown that the maximum likelihood decoding (MLD) rule for a linear vector channel can be relaxed to a convex optimization problem, which is called a relaxed MLD problem.

  15. The activity of pomegranate extract standardized 40% ellagic acid during the healing process of incision wounds in albino rats (Rattus norvegicus

    Directory of Open Access Journals (Sweden)

    Wiwik Misaco Yuniarti

    2018-03-01

    Full Text Available Aim: This research aimed to evaluate the effects of pomegranate extract standardized to 40% ellagic acid on the incised wound in albino rats. Materials and Methods: Fifty albino rats were divided into 10 treatment groups. The five groups were sacrificed on the 8th day, while the others were sacrificed on the 15th day. Two groups of albino rats with incised wound were not treated at all (P0, the other two groups of albino rats with incised wound were treated with Betadine® (P1 ointment, and the rest of the groups were treated with pomegranate extract standardized to 40% ellagic acid with a concentration of 2.5% (P2, 5% (P3, and 7.5% (P4. The treatments were carried out twice a day with an interval of 12 h for 7 and 14 days. At the end of the research, the skin tissue of those albino rats had been taken for histopathologic preparations before H and E staining was performed. Results: Collagen deposition, polymorphonuclear neutrophils (PMN infiltration, angiogenesis, and fibrosis degree in Group P4 treated with 7.5% pomegranate extract standardized to 40% ellagic acid for 14 days were significantly different from those in Groups P0, P1, P2, and P3, especially in the case of PMN inflammation (p<0.05. Conclusion: The administration of 7.5% pomegranate extract standardized to 40% ellagic acid for 14 days on incised wounds of those albino rats can accelerate the wound healing process characterized by collagen deposition improvement, PMN infiltration in the wound area, angiogenesis, and fibrosis degree.

  16. D2-like receptors in the descending dopaminergic pathway are not involved in the decreased postoperative nociceptive threshold induced by plantar incision in adult rats.

    Science.gov (United States)

    Ohtani, Norimasa; Masaki, Eiji

    2016-01-01

    Approximately half of all patients who undergo surgery develop postoperative pain, the mechanisms of which are not well understood by anesthesiologists. D2-like receptors in the descending dopaminergic pathway play an important role in regulation of pain transmission in the spinal cord. Impairment of inhibitory neurons in the spinal cord is suggested as part of the mechanism for neuropathic pain, which is one component of postoperative pain. The purpose of this study was to investigate whether impairment of D2-like receptors in the descending dopaminergic pathway in the spinal cord is involved in the decreased postoperative nociceptive threshold in rats. Male Sprague-Dawley rats (250-300 g) were anesthetized with sevoflurane and an intrathecal (IT) catheter was implanted. Six days later, a plantar incision was made. On the following day, saline, a D2-like receptor agonist (quinpirole), or a D2-like receptor antagonist (sulpiride) was administered intrathecally. Thermal and mechanical nociceptive responses were assessed by exposure to infrared radiant heat and the von Frey filament test before and after plantar incision. Plantar incision decreased both thermal latency and the mechanical nociceptive threshold. IT administration of quinpirole inhibited the nociceptive responses induced by plantar incision, but sulpiride had no effect. A D2-like receptor agonist had antinociceptive effects on the hypersensitivity response triggered by a surgical incision, but a D2-like receptor antagonist had no effect on this response. These results suggest that impairment and/or modification of D2-like receptors in the descending dopaminergic pathway in the spinal cord is not involved in the postoperative decrease in nociceptive threshold.

  17. Meta-analysis of negative-pressure wound therapy for closed surgical incisions

    DEFF Research Database (Denmark)

    Hyldig, N; Birke-Sorensen, H; Kruse, M

    2016-01-01

    . RESULTS: Ten studies met the inclusion criteria, reporting on 1311 incisions in 1089 patients. NPWT was associated with a significant reduction in wound infection (relative risk (RR) 0·54, 95 per cent c.i. 0·33 to 0·89) and seroma formation (RR 0·48, 0·27 to 0·84) compared with standard care....... The reduction in wound dehiscence was not significant. The numbers needed to treat were three (seroma), 17 (dehiscence) and 25 (infection). Methodological heterogeneity across studies led to downgrading of the quality of evidence to moderate for infection and seroma, and low for dehiscence. CONCLUSION: Compared...

  18. Caesium-137 in sandy sediments of the River Loire (FR): Assessment of an alluvial island evolving over the last 50 years

    Energy Technology Data Exchange (ETDEWEB)

    Detriche, Sebastien; Rodrigues, Stephane; Macaire, Jean-Jacques; Breheret, Jean-Gabriel; Bakyono, Jean-Paul [Universite Francois-Rabelais de Tours, CNRS/INSU UMR 6113 ISTO, Universite d' Orleans Faculte des Sciences et Techniques, Laboratoire de Geologie des Environnements Aquatiques Continentaux, Parc de Grandmont, 37200 Tours (France); Bonte, Philippe [UMR CNRS-CEA 1572, Laboratoire des Sciences du Climat et de l' Environnement - LSCE, CNRS, Domaine du CNRS, Bat. 12, 91198 Gif-sur-Yvette (France); Juge, Philippe [CETU-Elmis ingenieries, Antenne Universitaire en Val de Vienne, 11 quai Danton, 37500 Chinon (France)

    2010-07-01

    Recent sedimentological and morphological evolution of an island in the River Loire (FR) was investigated using the {sup 137}Cs method. This study describes the morphological adjustment of the island in the last 50 years, which corresponds to the increased bed incision of this sandy, multiple-channel environment because of, among other things, the increase in sediment extraction up to 1995. The results show that some {sup 137}Cs can be retained by sandy particles, potentially in clay minerals forming weathering features included in detrital sand grains. From a morphological perspective, significant lateral erosion can be observed in the upstream part of the island, while a weak lateral accretion occurs in its downstream section. Data about {sup 137}Cs and aerial photographs show that the morphology of the island margins has undergone significant changes leading to a lateral migration, while the centre of the island has remained relatively stable or is slowly eroding. The migration of the island depends on: (1) the withdrawal of inherited pre-incision morphological units, such as levees, or the development of new units, such as a channel shelf; (2) water and sediment supply from surrounding channels during flood events; (3) preferential sediment trapping (20 mm year{sup -1}) from the presence of riparian vegetation on the bank of the secondary channel that is subject to narrowing. The sedimentological and morphological response of the island in the context of incision of the Loire river bed is expressed mainly by lateral migration and secondarily by a low vertical adjustment. (authors)

  19. Caesium-137 in sandy sediments of the River Loire (FR): Assessment of an alluvial island evolving over the last 50 years

    International Nuclear Information System (INIS)

    Detriche, Sebastien; Rodrigues, Stephane; Macaire, Jean-Jacques; Breheret, Jean-Gabriel; Bakyono, Jean-Paul; Bonte, Philippe; Juge, Philippe

    2010-01-01

    Recent sedimentological and morphological evolution of an island in the River Loire (FR) was investigated using the 137 Cs method. This study describes the morphological adjustment of the island in the last 50 years, which corresponds to the increased bed incision of this sandy, multiple-channel environment because of, among other things, the increase in sediment extraction up to 1995. The results show that some 137 Cs can be retained by sandy particles, potentially in clay minerals forming weathering features included in detrital sand grains. From a morphological perspective, significant lateral erosion can be observed in the upstream part of the island, while a weak lateral accretion occurs in its downstream section. Data about 137 Cs and aerial photographs show that the morphology of the island margins has undergone significant changes leading to a lateral migration, while the centre of the island has remained relatively stable or is slowly eroding. The migration of the island depends on: (1) the withdrawal of inherited pre-incision morphological units, such as levees, or the development of new units, such as a channel shelf; (2) water and sediment supply from surrounding channels during flood events; (3) preferential sediment trapping (20 mm year -1 ) from the presence of riparian vegetation on the bank of the secondary channel that is subject to narrowing. The sedimentological and morphological response of the island in the context of incision of the Loire river bed is expressed mainly by lateral migration and secondarily by a low vertical adjustment. (authors)

  20. Patient-specific surgical simulator for the pre-operative planning of single-incision laparoscopic surgery with bimanual robots.

    Science.gov (United States)

    Turini, Giuseppe; Moglia, Andrea; Ferrari, Vincenzo; Ferrari, Mauro; Mosca, Franco

    2012-01-01

    The trend of surgical robotics is to follow the evolution of laparoscopy, which is now moving towards single-incision laparoscopic surgery. The main drawback of this approach is the limited maneuverability of the surgical tools. Promising solutions to improve the surgeon's dexterity are based on bimanual robots. However, since both robot arms are completely inserted into the patient's body, issues related to possible unwanted collisions with structures adjacent to the target organ may arise. This paper presents a simulator based on patient-specific data for the positioning and workspace evaluation of bimanual surgical robots in the pre-operative planning of single-incision laparoscopic surgery. The simulator, designed for the pre-operative planning of robotic laparoscopic interventions, was tested by five expert surgeons who evaluated its main functionalities and provided an overall rating for the system. The proposed system demonstrated good performance and usability, and was designed to integrate both present and future bimanual surgical robots.

  1. Coherifying quantum channels

    Science.gov (United States)

    Korzekwa, Kamil; Czachórski, Stanisław; Puchała, Zbigniew; Życzkowski, Karol

    2018-04-01

    Is it always possible to explain random stochastic transitions between states of a finite-dimensional system as arising from the deterministic quantum evolution of the system? If not, then what is the minimal amount of randomness required by quantum theory to explain a given stochastic process? Here, we address this problem by studying possible coherifications of a quantum channel Φ, i.e., we look for channels {{{Φ }}}{ \\mathcal C } that induce the same classical transitions T, but are ‘more coherent’. To quantify the coherence of a channel Φ we measure the coherence of the corresponding Jamiołkowski state J Φ. We show that the classical transition matrix T can be coherified to reversible unitary dynamics if and only if T is unistochastic. Otherwise the Jamiołkowski state {J}{{Φ }}{ \\mathcal C } of the optimally coherified channel is mixed, and the dynamics must necessarily be irreversible. To assess the extent to which an optimal process {{{Φ }}}{ \\mathcal C } is indeterministic we find explicit bounds on the entropy and purity of {J}{{Φ }}{ \\mathcal C }, and relate the latter to the unitarity of {{{Φ }}}{ \\mathcal C }. We also find optimal coherifications for several classes of channels, including all one-qubit channels. Finally, we provide a non-optimal coherification procedure that works for an arbitrary channel Φ and reduces its rank (the minimal number of required Kraus operators) from {d}2 to d.

  2. A randomized, nonblinded extension study of single-incision versus transobturator midurethral sling in women with stress urinary incontinence

    NARCIS (Netherlands)

    Schellart, René P.; Zwolsman, Sandra E.; Lucot, Jean-Philippe; de Ridder, Dirk J. M. K.; Dijkgraaf, Marcel G. W.; Roovers, Jan-Paul W. R.

    2018-01-01

    Midurethral sling procedures are the first surgical option in women undergoing surgery for stress urinary incontinence (SUI). Single-incision midurethral-slings (SIMS) were designed to provide similar efficacy to traditional midurethral slings but with reduced morbidity. In this international trial

  3. Curative effects of small incision cataract surgery versus phacoemulsification: a Meta-analysis

    Directory of Open Access Journals (Sweden)

    Chang-Jian Yang

    2013-08-01

    Full Text Available AIM: To evaluate the curative efficacy of small incision cataract surgery(SICSversus phacoemulsification(Phaco.METHODS: A computerized literature search was carried out in Chinese Biomedical Database(CBM, Wanfang Data, VIP and Chinese National Knowledge Infrastructure(CNKIto collect articles published between 1989-2013 concerning the curative efficacy of SICS versus Phaco. The studies were assessed in terms of clinical case-control criteria. Meta-analysis were performed to assess the visual acuity, the complications rates between SICS and Phaco 90 days after surgery. Treatment effects were measured as risk difference(RDbetween SICS and Phaco. Fixed and random effect models were employed to combine results after a heterogeneity test. RESULTS:A total of 8 studies were included in our Meta-analysis. At 90 days postoperative time, there were no significant differences between the two groups at the visual acuity >0.5(P=0.14; and no significant differences on the complications rates of corneal astigmatism, corneal edema, posterior capsular rupture and anterior iris reaction(P>0.05.CONCLUSION: These results suggest that there is no different on the curative effects of SICS and Phaco for cataract.

  4. MARKETING CHANNELS

    Directory of Open Access Journals (Sweden)

    Ljiljana Stošić Mihajlović

    2014-07-01

    Full Text Available Marketing channel is a set of entities and institutions, completion of distribution and marketing activities, attend the efficient and effective networking of producers and consumers. Marketing channels include the total flows of goods, money and information taking place between the institutions in the system of marketing, establishing a connection between them. The functions of the exchange, the physical supply and service activities, inherent in the system of marketing and trade. They represent paths which products and services are moving after the production, which will ultimately end up buying and eating by the user.

  5. Co-evolution of Riparian Vegetation and Channel Dynamics in an Aggrading Braided River System, Mount Pinatubo, Philippines

    Science.gov (United States)

    Gran, K. B.; Michal, T.

    2014-12-01

    Increased bank stability by riparian vegetation in braided rivers can decrease bed reworking rates and focus the flow. The magnitude of influence and resulting channel morphology are functions of vegetation strength vs. channel dynamics, a concept encapsulated in a dimensionless ratio between timescales for vegetation growth and channel reworking known as T*. We investigate this relationship in an aggrading braided river at Mount Pinatubo, Philippines, and compare results to numerical and physical models. Gradual reductions in post-eruption sediment loads have reduced bed reworking rates, allowing vegetation to persist year-round and impact channel dynamics on the Pasig-Potrero and Sacobia Rivers. From 2009-2011, we collected data detailing vegetation extent, type, density, and root strength. Incorporating these data into RipRoot and BSTEM models shows cohesion due to roots increased from zero in unvegetated conditions to >10.2 kPa in densely-growing grasses. Field-based parameters were incorporated into a cellular model comparing vegetation growth and sediment mobility effects on braided channel dynamics. The model shows that both low sediment mobility and high vegetation strength lead to less active systems, reflecting trends observed in the field. An estimated T* between 0.8 - 2.3 for the Pasig-Potrero River suggests channels were mobile enough to maintain the braidplain width clear of vegetation and even experience slight gains in area through annual removal of existing vegetation. However, persistent vegetation focused flow and thus aggradation over the unvegetated fraction of braidplain, leading to an aggradational imbalance and transition to a more avulsive state. While physical models predict continued narrowing of the active braidplain as T* declines, the future trajectory of channel-vegetation interactions at Pinatubo as sedimentation rates decline appears more complicated due to strong seasonal variability in precipitation and sediment loads. By 2011

  6. Functional modifications of acid-sensing ion channels by ligand-gated chloride channels.

    Directory of Open Access Journals (Sweden)

    Xuanmao Chen

    Full Text Available Together, acid-sensing ion channels (ASICs and epithelial sodium channels (ENaC constitute the majority of voltage-independent sodium channels in mammals. ENaC is regulated by a chloride channel, the cystic fibrosis transmembrane conductance regulator (CFTR. Here we show that ASICs were reversibly inhibited by activation of GABA(A receptors in murine hippocampal neurons. This inhibition of ASICs required opening of the chloride channels but occurred with both outward and inward GABA(A receptor-mediated currents. Moreover, activation of the GABA(A receptors modified the pharmacological features and kinetic properties of the ASIC currents, including the time course of activation, desensitization and deactivation. Modification of ASICs by open GABA(A receptors was also observed in both nucleated patches and outside-out patches excised from hippocampal neurons. Interestingly, ASICs and GABA(A receptors interacted to regulate synaptic plasticity in CA1 hippocampal slices. The activation of glycine receptors, which are similar to GABA(A receptors, also modified ASICs in spinal neurons. We conclude that GABA(A receptors and glycine receptors modify ASICs in neurons through mechanisms that require the opening of chloride channels.

  7. [Expression of cannabinoid receptor I during mice skin incised wound healing course].

    Science.gov (United States)

    Zhao, Zhen-bin; Guan, Da-wei; Liu, Wei-wei; Wang, Tao; Fan, Yan-yan; Cheng, Zi-hui; Zheng, Ji-long; Hu, Geng-yi

    2010-08-01

    To investigate the expression of cannabinoid receptor I (CB1R) during mice skin incised wound healing course and time-dependent changes of CB1R in wound age determination. The changes of CBIR expression in skin incised wound were detected by immunohistochemistry and Western blotting. The control group showed a low expression of CB1R detected mainly in epidermis, hair follicles, sebaceous gland and dermomuscular layer. CB1R expression was undetectable in neutrophils in the wound specimens from 6h to 12h post-injury. CB1R positive cells were mostly mononuclear cells (MNCs) and fibroblastic cells (FBCs) from 1 d to 5 d post-injury. CB1R positive cells were mostly FBCs from 7 d to 14d post-injury. The ratio of the CB1R positive cells increased gradually in the wound specimens from 6 h to 3 d post-injury, reached peak level at 5 d, and then decreased gradually from 7d to 14 d post-injury. The positive bands of CB1R were observed in all time points of the wound healing course by Western blotting. The expression peak showed at 5 d post-injury. CB1R is activated during the wound healing course. The expression of CB1R is found in mononuclear cells, which could be involved in inflammation reaction. CBIR is observed in fibroblastic cells, which could participate in the wound healing. CB1R may be a potentially useful marker for determination of wound healing age.

  8. Recovery of prairie fish assemblages at the transition from channelized to nonchannelized: Implications for conservation of natural channels

    Science.gov (United States)

    Vokoun, Jason C.; Rabeni, Charles F.

    2003-01-01

    Fish assemblages were systematically sampled along the transition from channelized to unchannelized reaches in seven streams in northern Missouri, USA. Streams ranged in size from 4th to 8th order and were located in the Central Dissected Till Plains including the Grand, Chariton, Salt, and Fabius watersheds. Maximum species richness was reached 3-5 km downstream from the end of channelization. A limited core group of 10 species was present at most of the sites (channelized and unchannelized locations), and a diverse group of 45 species was present at relatively few sites (rarely channelized locations). The core group consisted largely of tolerant, omnivorous species and contained no top carnivores. The 45-species diverse group included a greater proportion of intolerant, benthic invertivorous, lithophilous, and carnivorous species. The effect of channelization extended well into unchannelized reaches and should be considered by conservation planners.

  9. Radio propagation measurement and channel modelling

    CERN Document Server

    Salous, Sana

    2013-01-01

    While there are numerous books describing modern wireless communication systems that contain overviews of radio propagation and radio channel modelling, there are none that contain detailed information on the design, implementation and calibration of radio channel measurement equipment, the planning of experiments and the in depth analysis of measured data. The book would begin with an explanation of the fundamentals of radio wave propagation and progress through a series of topics, including the measurement of radio channel characteristics, radio channel sounders, measurement strategies

  10. Channel follower leakage restrictor

    International Nuclear Information System (INIS)

    Williamson, H.E.; Smith, B.A.

    1977-01-01

    An improved means is provided to control coolant leakage between the flow channel and the lower tie plate of a nuclear fuel assembly. The means includes an opening in the lower tie plate and a movable element adjacent thereto. The coolant pressure within the tie plate biases the movable means toward the inner surface of the surrounding flow channel to compensate for any movement of the flow channel away from the lower tie plate to thereby control the leakage of coolant flow from the fuel assemblies to the spaces among the fuel assemblies of the core. 9 figures

  11. D2-like receptors in the descending dopaminergic pathway are not involved in the decreased postoperative nociceptive threshold induced by plantar incision in adult rats

    Directory of Open Access Journals (Sweden)

    Ohtani N

    2016-10-01

    Full Text Available Norimasa Ohtani, Eiji Masaki Division of Dento-oral Anesthesiology, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan Background: Approximately half of all patients who undergo surgery develop postoperative pain, the mechanisms of which are not well understood by anesthesiologists. D2-like receptors in the descending dopaminergic pathway play an important role in regulation of pain transmission in the spinal cord. Impairment of inhibitory neurons in the spinal cord is suggested as part of the mechanism for neuropathic pain, which is one component of postoperative pain. The purpose of this study was to investigate whether impairment of D2-like receptors in the descending dopaminergic pathway in the spinal cord is involved in the decreased postoperative nociceptive threshold in rats.Methods: Male Sprague-Dawley rats (250–300 g were anesthetized with sevoflurane and an intrathecal (IT catheter was implanted. Six days later, a plantar incision was made. On the following day, saline, a D2-like receptor agonist (quinpirole, or a D2-like receptor antagonist (sulpiride was administered intrathecally. Thermal and mechanical nociceptive responses were assessed by exposure to infrared radiant heat and the von Frey filament test before and after plantar incision.Results: Plantar incision decreased both thermal latency and the mechanical nociceptive threshold. IT administration of quinpirole inhibited the nociceptive responses induced by plantar incision, but sulpiride had no effect.Conclusion: A D2-like receptor agonist had antinociceptive effects on the hypersensitivity response triggered by a surgical incision, but a D2-like receptor antagonist had no effect on this response. These results suggest that impairment and/or modification of D2-like receptors in the descending dopaminergic pathway in the spinal cord is not involved in the postoperative decrease in nociceptive threshold. Keywords: postoperative pain, descending pathway

  12. A new surface-process model for landscape evolution at a mountain belt scale

    Science.gov (United States)

    Willett, Sean D.; Braun, Jean; Herman, Frederic

    2010-05-01

    We present a new surface process model designed for modeling surface erosion and mass transport at an orogenic scale. Modeling surface processes at a large-scale is difficult because surface geomorphic processes are frequently described at the scale of a few meters, and such resolution cannot be represented in orogen-scale models operating over hundreds of square kilometers. We circumvent this problem by implementing a hybrid numerical -- analytical model. Like many previous models, the model is based on a numerical fluvial network represented by a series of nodes linked by model rivers in a descending network, with fluvial incision and sediment transport defined by laws operating on this network. However we only represent the largest rivers in the landscape by nodes in this model. Low-order rivers and water divides between large rivers are determined from analytical solutions assuming steady-state conditions with respect to the local river channel. The analytical solution includes the same fluvial incision law as the large rivers and a channel head with a specified size and mean slope. This permits a precise representation of the position of water divides between river basins. This is a key characteristic in landscape evolution as divide migration provides a positive feedback between river incision and a consequent increase in drainage area. The analytical solution also provides an explicit criterion for river capture, which occurs once a water divide migrates to its neighboring channel. This algorithm avoids the artificial network organization that often results from meshing and remeshing algorithms in numerical models. We demonstrate the use of this model with several simple examples including uniform uplift of a block, simultaneous uplift and shortening of a block, and a model involving strike slip faulting. We find a strong dependence on initial condition, but also a surprisingly strong dependence on channel head height parameters. Low channel heads, as

  13. A Model of Beaver Meadow Complex Evolution in the Silvies River Basin, Oregon.

    Science.gov (United States)

    Nash, C.; Grant, G.; Campbell, S. D.

    2014-12-01

    There is increasing evidence to suggest that the pervasive incision seen in the American West is due, in part, to the removal of beaver (Castor canadensis) in the first half of the 19th century. New restoration strategies for these systems focus on the reintroduction of beaver and construction of beaver dam analogs. Such dams locally raise streams beds and water tables, reconnect incised channels to their former floodplains, trap sediment, increase hydraulic diversity, and promote riparian vegetation. However, the geomorphic and hydrologic impacts of both the original beaver dams and their analogs are poorly understood. Observations in the Silvies River basin in Oregon, USA - an upland, semi-arid catchment with extremely high historic beaver populations and a presently recovering population, inform a conceptual model for valley floor evolution with beaver dams. The evolution of the beaver dam complex is characterized by eight stages of morphologic adjustment: water impoundment, sediment deposition, pond filling, multi-thread meadow creation, dam breaching, channel incision, channel widening, and floodplain development. Well-constructed beaver dams, given sufficient time and sediment flux, will evolve from a series of ponds to a multi-threaded channel flowing through a wet meadow complex. If a dam in the system fails, due to overtopping, undercutting, lack of maintenance, or abandonment, the upstream channel will concentrate into a single channel and incise, followed over time by widening once critical bank heights are exceeded. From stratigraphic, dendrochronologic, and geomorphic measurements, we are constraining average timescales associated with each stage's duration and transitional period. Measured sedimentation rates behind modern beaver dam analogs on five stream systems permit calculation of sediment flux over recent time periods, and aid in developing regional rates of sediment deposition over a range of drainage areas and gradients. Stratigraphic and

  14. Comparison of Radiofrequency and Electrocautery With Conventional Scalpel Incisions.

    Science.gov (United States)

    Hasar, Zafer Burak; Ozmeric, Nurdan; Ozdemir, Burcu; Gökmenoğlu, Ceren; Baris, Emre; Altan, Gökçen; Kahraman, Sevil

    2016-11-01

    The disadvantages of conventional scalpels, including insufficient control of bleeding, prompted us to search for new alternative methods such as electrosurgery and radiosurgery. In this study, the conventional scalpel was compared with radiosurgery and electrosurgery for wound healing with assessment of lateral heat production, inflammation, and instrument performance. Incisions were made in the palatal mucosa of 42 Wistar rats using a scalpel, electrocautery instrument, or radiofrequency instrument. Postoperative hemostasis, tissue coagulation, and tissue sticking were measured, and pain evaluation through weight loss was recorded. Gingival biopsy specimens from the surgical area were obtained at the time of surgery and 2, 4, 7, and 14 days postoperatively and were evaluated immunohistochemically for inducible nitric oxide synthase and heat shock protein 70. Kruskal-Wallis, 1-way analysis of variance, and Mann-Whitney U tests were used for statistical evaluation. The rats in the electrosurgery and radiosurgery groups had aggressively greater weight loss when compared with the scalpel group in the first 7 days. Hemostasis was better in the electrocautery group, tissue coagulation was greater in the radiofrequency group (P < .001), and tissue sticking was lesser in the scalpel group (P < .001) compared with the other groups. Inducible nitric oxide synthase expression and heat shock protein 70 expression were similar in all 3 groups. Electrosurgery performed better regarding hemostasis, whereas a scalpel was superior in terms of tissue sticking and tissue coagulation. Radiosurgery was superior regarding hemostasis when compared with a conventional scalpel, but it was not as successful as electrosurgery. Copyright © 2016. Published by Elsevier Inc.

  15. Single-incision laparoscopic appendectomy using homemade glove port at low cost

    Directory of Open Access Journals (Sweden)

    Sang Myoung Lee

    2016-01-01

    Full Text Available Purpose: The aim of this study was to report homemade glove port technique for single-incision laparoscopic appendectomy (SILA. Materials and Methods: Our homemade glove port was composed of a size 6 latex sterile surgical glove, a sterilized plastic bangle, and three pieces of silicon tube (5 cm in length that were used as the suction tube. Clinical data were retrospectively collected from those patients who underwent SILA at Bucheon St. Mary's Hospital, Bucheon, Gyeonggi-do, South Korea between February 2014 and June 2014, including patient demographics, and operative and postoperative outcomes. To compare the outcomes, a retrospective review was performed for those patients who underwent conventional laparoscopic appendectomy (CLA between October 2013 and January 2014. Both SILA and CLA were performed by the same surgical team. Results: The SILA and CLA groups included 37 and 57 patients, respectively. The mean age, weight, body mass index (BMI, operation time, and pathologic diagnosis of gangrenous appendicitis were not significantly different between the two groups. However, the mean hospital stay in the CLA group was significantly (P = 0.018 longer than that in the SILA group (4.2 days vs 3.5 days. There was no conversion to open surgery in both the groups. Of the cases who underwent SILA, 10 (27.0% needed insertion of additional port and drain. There was one (3.2% complication of umbilical surgical site infection. Conclusion: In this study, SILA, with homemade glove port, was technically feasible and safe at low cost.

  16. Parallel pocket incision: Less invasive surgical intervention for the treatment of intractable pressure ulcer with wound edge undermining.

    Science.gov (United States)

    Yamamoto, Takumi; Yoshimatsu, Hidehiko; Hayashi, Akitatsu; Koshima, Isao

    2015-10-01

    The treatment of deep pressure ulcer with a wide wound edge undermining (pocket) is challenging, especially when conservative treatments are ineffective. As most patients with a pressure ulcer suffer from systemic comorbidities, invasive surgery cannot be performed on all patients, and less invasive treatment is required. Less invasive surgical intervention to a deep pressure ulcer, parallel pocket incision (PPI), was performed on 10 patients with intractable pressure ulcers with a pocket formation. In PPI procedures, two parallel skin incisions were made to open up the deepest fold of the pocket and to preserve the skin overlying the pocket lesion; through the created incisions, the necrotic tissues around the deepest fold of the undermining could be easily removed, which facilitated spontaneous wound healing. Postoperative results and complications were evaluated. All PPI procedures were safely performed under local infiltration anesthesia without major postoperative complication; minor bleeding was seen intraoperatively in three patients, which could be easily controlled with electric cautery coagulation. Nine of 10 ulcers were cured after PPI, and one could not be followed up due to the patient's death non-related to the pressure ulcer. For the nine cured patients, the average time for cure was 14.9 weeks, and no recurrence was observed at postoperative 6 months. PPI is a simple, technically easy, and less invasive surgical intervention to an intractable pressure ulcer with a pocket, which can be safely performed under local infiltration anesthesia even on a patient with severe systemic comorbidities. Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  17. Dysfunctional HCN ion channels in neurological diseases

    Directory of Open Access Journals (Sweden)

    Jacopo C. DiFrancesco

    2015-03-01

    Full Text Available Hyperpolarization-activated cyclic nucleotide-gated (HCN channels are expressed as four different isoforms (HCN1-4 in the heart and in the central and peripheral nervous systems. HCN channels are activated by membrane hyperpolarization at voltages close to resting membrane potentials and carry the hyperpolarization-activated current, dubbed If (funny current in heart and Ih in neurons. HCN channels contribute in several ways to neuronal activity and are responsible for many important cellular functions, including cellular excitability, generation and modulation of rhythmic activity, dendritic integration, transmission of synaptic potentials and plasticity phenomena. Because of their role, defective HCN channels are natural candidates in the search for potential causes of neurological disorders in humans. Several data, including growing evidence that some forms of epilepsy are associated with HCN mutations, support the notion of an involvement of dysfunctional HCN channels in different experimental models of the disease. Additionally, some anti-epileptic drugs are known to modify the activity of the Ih current. HCN channels are widely expressed in the peripheral nervous system and recent evidence has highlighted the importance of the HCN2 isoform in the transmission of pain. HCN channels are also present in the midbrain system, where they finely regulate the activity of dopaminergic neurons, and a potential role of these channels in the pathogenesis of Parkinson’s disease has recently emerged. The function of HCN channels is regulated by specific accessory proteins, which control the correct expression and modulation of the neuronal Ih current. Alteration of these proteins can severely interfere with the physiological channel function, potentially predisposing to pathological conditions. In this review we address the present knowledge of the association between HCN dysfunctions and neurological diseases, including clinical, genetic and

  18. Inhibition by local bupivacaine-releasing microspheres of acute postoperative pain from hairy skin incision.

    Science.gov (United States)

    Ohri, Rachit; Wang, Jeffrey Chi-Fei; Blaskovich, Phillip D; Pham, Lan N; Costa, Daniel S; Nichols, Gary A; Hildebrand, William P; Scarborough, Nelson L; Herman, Clifford J; Strichartz, Gary R

    2013-09-01

    Acute postoperative pain causes physiological deficits and slows recovery. Reduction of such pain by local anesthetics that are delivered for several days postoperatively is a desirable clinical objective, which is approached by a new formulation and applied in animal studies reported here. We subcutaneously injected a new formulation of poly-lactic-co-glycolic acid polymer microspheres, which provides steady drug release for 96+ hours into rats at the dorsal region 2 hours before surgery. A single 1.2-cm-long skin incision was followed by blunt dissection of skin away from the underlying fascia, and closed by 2 sutures, followed by 14 days of testing. Microspheres containing 5, 10, 20, and 40 mg bupivacaine were injected locally 2 hours before surgery; bupivacaine-free microspheres were the vehicle control, and bupivacaine HCl solution (0.5%), the positive control. Mechanical sensitivity was determined by the frequency of local muscle contractions to repeated pokes with nylon monofilaments (von Frey hairs) exerting 4 and 15 g forces, testing, respectively, allodynia and hyperalgesia, and by pinprick. Injection of bupivacaine microspheres (40 mg drug) into intact skin reduced responses to 15 g von Frey hairs for 6 hours and to pinprick for 36 hours. Respective reductions from bupivacaine HCl lasted for 3 and 2 hours. Skin incision and dissection alone caused mechanical allodynia and hyperalgesia for 14 days. Microspheres containing 20 or 40 mg bupivacaine suppressed postoperative hypersensitivity for up to 3 days, reduced integrated allodynia (area under curve of response versus time) over postoperative days 1 to 5 by 51% ± 20% (mean ± SE) and 78% ± 12%, and reduced integrated hyperalgesia by 55% ± 13% and 64% ± 11%, for the respective doses. Five and ten milligrams bupivacaine in microspheres and the 0.5% bupivacaine solution were ineffective in reducing postoperative hypersensitivity, as were 40 mg bupivacaine microspheres injected contralateral to the

  19. Single incision laparoscopic-assisted intestinal surgery (SILAIS) in 7 dogs and 1 cat.

    Science.gov (United States)

    Case, J Brad; Ellison, Gary

    2013-06-01

    To describe the clinical findings and short-term outcome in 7 dogs and 1 cat undergoing single-incision laparoscopic-assisted intestinal surgery (SILAIS) using an SILS™ or EndoCone™ port. Prospective case series. Dogs (n = 7) and cat (n = 1). An SILS™ port using three 5-mm instrument cannulas or EndoCone™ port was used to perform an initial limited laparoscopic abdominal exploration. The stomach and descending duodenum were explored intracorporeally and the jejunum through orad descending colon was explored extracorporeally. All intestinal procedures (enterotomy, biopsy, resection, and anastomosis) were performed extracorporeally. Omentalization of affected bowel was accomplished either intracorporeally or extracorporeally. Short-term outcome was determined. SILAIS was completed successfully in all but 1 dog and all animals had a good short-term outcome. Most (n = 5) animals were discharged the day after surgery. SILAIS was performed in a median of 120 minutes (interquartile range; 82-148 minutes) and was associated with a moderate level of difficulty. No major complications occurred but conversion to celiotomy (n = 1) and enlargement of the incision (n = 3) was required because of inability to exteriorize the affected bowel. SILAIS using an SILS™ or EndoCone™ port in dogs and cats is feasible and appears effective in selected cases. Single portal laparoscopic-assisted intestinal surgery might be an effective method of minimizing morbidity in dogs and cats with uncomplicated intestinal disease. © Copyright 2013 by The American College of Veterinary Surgeons.

  20. Geomorphic and hydraulic controls on large-scale riverbank failure on a mixed bedrock-alluvial river system, the River Murray, South Australia: a bathymetric analysis.

    Science.gov (United States)

    De Carli, E.; Hubble, T.

    2014-12-01

    During the peak of the Millennium Drought (1997-2010) pool-levels in the lower River Murray in South Australia dropped 1.5 metres below sea level, resulting in large-scale mass failure of the alluvial banks. The largest of these failures occurred without signs of prior instability at Long Island Marina whereby a 270 metre length of populated and vegetated riverbank collapsed in a series of rotational failures. Analysis of long-reach bathymetric surveys of the river channel revealed a strong relationship between geomorphic and hydraulic controls on channel width and downstream alluvial failure. As the entrenched channel planform meanders within and encroaches upon its bedrock valley confines the channel width is 'pinched' and decreases by up to half, resulting in a deepening thalweg and channel bed incision. The authors posit that flow and shear velocities increase at these geomorphically controlled 'pinch-points' resulting in complex and variable hydraulic patterns such as erosional scour eddies, which act to scour the toe of the slope over-steepening and destabilising the alluvial margins. Analysis of bathymetric datasets between 2009 and 2014 revealed signs of active incision and erosional scour of the channel bed. This is counter to conceptual models which deem the backwater zone of a river to be one of decelerating flow and thus sediment deposition. Complex and variable flow patterns have been observed in other mixed alluvial-bedrock river systems, and signs of active incision observed in the backwater zone of the Mississippi River, United States. The incision and widening of the lower Murray River suggests the channel is in an erosional phase of channel readjustment which has implications for riverbank collapse on the alluvial margins. The prevention of seawater ingress due to barrage construction at the Murray mouth and Southern Ocean confluence, allowed pool-levels to drop significantly during the Millennium Drought reducing lateral confining support to the

  1. Turbine component having surface cooling channels and method of forming same

    Science.gov (United States)

    Miranda, Carlos Miguel; Trimmer, Andrew Lee; Kottilingam, Srikanth Chandrudu

    2017-09-05

    A component for a turbine engine includes a substrate that includes a first surface, and an insert coupled to the substrate proximate the substrate first surface. The component also includes a channel. The channel is defined by a first channel wall formed in the substrate and a second channel wall formed by at least one coating disposed on the substrate first surface. The component further includes an inlet opening defined in flow communication with the channel. The inlet opening is defined by a first inlet wall formed in the substrate and a second inlet wall defined by the insert.

  2. Channel and hillslope processes revisited in the Arroyo de los Frijoles watershed near Santa Fe, New Mexico

    Science.gov (United States)

    Gellis, Allen C.; Emmett, William W.; Leopold, Luna Bergere

    2005-01-01

    Frijoles, 1.53 meters, and the greatest aggradation, 0.38 meter, occur downstream and upstream, respectively, from a culvert in a dirt road. Periods of high average annual rainfall intensity reported for Santa Fe for 1853–80 immediately preceded late 19th century arroyo incision, and another period of high-intensity rainfall began in 1967. This may indicate that climatic factors are again favorable for arroyo incision in this part of New Mexico; data from this resurvey, however, do not provide evidence of a renewed cycle of erosion.At a 1930’s Civilian Conservation Corps-constructed dam on Coyote C. Arroyo, the measured sediment yield from 1966 to 1993 was 139 metric tonnes per square kilometer per year. Sediment yields have decreased through time because of either a decrease in the trap efficiency of the reservoir over time or a decrease in sediment delivery to the reservoir because of upstream channel storage. The effects of base-level rise on the channel profile were documented in 1993 through resurveys of sediment deposits behind two small dams, Big Sweat Dam and Little Sweat Dam. Both dams, built in 1960, showed sediment deposition that extends 20 and 9.3 meters upstream, respectively, and the 1993 sediment gradient was nearly the same as the unaffected channel upstream. Big Sweat Dam showed fluctuations in channel gradient within 5.3 meters of the dam, which may be a result of local scour following complete filling of the dam, scour from increased sinuosity, or differences in the location of surveying stations over time. The sinuosity of the channel has increased over time, presumably from a reduction in slope. Channel gradients 0 to 11.0 meters upstream from Little Sweat Dam have remained constant at about 0.028 from 1964 to 1993.Measurement of erosion or hillslope-erosion plots show that average values of surface erosion range from 0.019 to 0.096 centimeters per year and are within values reported for regional erosion and denudation studies. Sediment yield from

  3. TRP channels: an overview

    DEFF Research Database (Denmark)

    Pedersen, Stine Falsig; Owsianik, Grzegorz; Nilius, Bernd

    2005-01-01

    The TRP ("transient receptor potential") family of ion channels now comprises more than 30 cation channels, most of which are permeable for Ca2+, and some also for Mg2+. On the basis of sequence homology, the TRP family can be divided in seven main subfamilies: the TRPC ('Canonical') family......, the TRPV ('Vanilloid') family, the TRPM ('Melastatin') family, the TRPP ('Polycystin') family, the TRPML ('Mucolipin') family, the TRPA ('Ankyrin') family, and the TRPN ('NOMPC') family. The cloning and characterization of members of this cation channel family has exploded during recent years, leading...... to a plethora of data on the roles of TRPs in a variety of tissues and species, including mammals, insects, and yeast. The present review summarizes the most pertinent recent evidence regarding the structural and functional properties of TRP channels, focusing on the regulation and physiology of mammalian TRPs....

  4. [Drainage of amoebic liver abscess by single incision laparoscopic surgery. Report of a case].

    Science.gov (United States)

    Telich-Tarriba, José Eduardo; Parrao-Alcántara, Iris Jocelyn; Montes-Hernández, Jesús Manuel; Vega-Pérez, Jesús

    2015-01-01

    Single incision laparoscopic surgery has increased recently due to successful results, achieved in several procedures. The aim of the present work is to present the first case in which single incision laparoscopy is used for the drainage of an amoebic liver abscess. A 44-year-old man presented with intense right upper quadrant pain, generalised jaundice, tachycardia, fever, hepatomegaly and a positive Murphy's sign. Laboratory results revealed an increased plasma bilirubin, elevated alkaline phosphatase and transaminases, leucocytosis, negative viral panel for hepatitis, and positive antibodies against Entamoeba histolytica. On an abdominal computed tomography a 15 × 12.1 cm hypodense lesion was observed in the patient's liver, identified as an amoebic liver abscess. Analgesics and antibiotics were started and subsequently the patient was submitted to laparoscopic drainage of the abscess using a single port approach. Drainage and irrigation of the abscess was performed. Four days later the patient was discharged without complications. Management of amoebic liver abscess is focused on the elimination of the infectious agent and obliteration of the abscess cavity in order to prevent its complications, especially rupture. Laparoscopic surgery has proved to be a safe and effective way to manage this entity. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  5. [Relationship between FoxO1 Expression and Wound Age during Skin Incised Wound Healing].

    Science.gov (United States)

    Chen, Y; Ji, X Y; Fan, Y Y; Yu, L S

    2018-02-01

    To investigate FoxO1 expression and its time-dependent changes during the skin incised wound healing. After the establishment of the skin incised wound model in mice, the FoxO1 expression of skin in different time periods was detected by immunohistochemistry and Western blotting. Immunohistochemistry staining showed that FoxO1 was weakly expressed in a few fibroblasts of epidermis, hair follicles, sebaceous glands, vessel endothelium and dermis in the control group. The FoxO1 expression was enhanced in the epidermis and skin appendages around the wound during 6-12 h after injury, which could be detected in the infiltrating neutrophils and a small number of monocytes. FoxO1 was mainly expressed in monocytes during 1-3 d after injury, and in neovascular endothelial cells and fibroblasts during 5-10 d. On the 14th day after injury, the FoxO1 expression still could be detected in a few fibroblasts. The Western blotting results showed that the FoxO1 expression quantity of the tissue samples in injury group was higher than in control group. The FoxO1 expression peaked at 12 h and 7 d after injury. FoxO1 is time-dependently expressed in skin wound healing, which can be a useful marker for wound age determination. Copyright© by the Editorial Department of Journal of Forensic Medicine.

  6. [Management of moderate to severe pediatric concealed penis in children by Devine's technique via incision between the penis and scrotum].

    Science.gov (United States)

    Zhang, Xin-Sheng; Liu, Shi-Xiong; Xiang, Xue-Yan; Zhang, Wen-Gang; Tang, Da-Xing

    2014-04-01

    To search for a simple and effective surgical approach to the management of moderate to severe pediatric concealed penis in children. We used Devine's technique via incision between the penis and scrotum in the treatment of 68 cases of moderate to severe pediatric concealed penis. The patients were aged 3 -13 (mean 6.5) years, 30 with moderate and 38 with severe pediatric concealed penis. This strategy achieved good near- and long-term effects and satisfactory appearance of the penis, which was similar to that of circumcision. At 3 months after surgery, the penile length was 3 - 5.2 cm, averaging (2.35 +/- 0.35) cm. Devine's technique via incision between the penis and scrotum is a simple and effective surgical option for moderate to severe pediatric concealed penis in children.

  7. Post-Translational Modifications of TRP Channels

    Directory of Open Access Journals (Sweden)

    Olaf Voolstra

    2014-04-01

    Full Text Available Transient receptor potential (TRP channels constitute an ancient family of cation channels that have been found in many eukaryotic organisms from yeast to human. TRP channels exert a multitude of physiological functions ranging from Ca2+ homeostasis in the kidney to pain reception and vision. These channels are activated by a wide range of stimuli and undergo covalent post-translational modifications that affect and modulate their subcellular targeting, their biophysical properties, or channel gating. These modifications include N-linked glycosylation, protein phosphorylation, and covalent attachment of chemicals that reversibly bind to specific cysteine residues. The latter modification represents an unusual activation mechanism of ligand-gated ion channels that is in contrast to the lock-and-key paradigm of receptor activation by its agonists. In this review, we summarize the post-translational modifications identified on TRP channels and, when available, explain their physiological role.

  8. Vascular mapping of the retroauricular skin - proposal for a posterior superior surgical incision for transcutaneous bone-conduction hearing implants.

    Science.gov (United States)

    Perenyi, Adam; Bere, Zsofia; Jarabin, Janos; Sztano, Balazs; Kukla, Edit; Bikhazi, Ziad; Tiszlavicz, Laszlo; Toth, Ferenc; Kiss, Jozsef Geza; Rovo, Laszlo

    2017-01-17

    Passive transcutaneous osseointegrated hearing implant systems have become increasingly popular more recently. The area over the implant is vulnerable due to vibration and pressure from the externally worn sound processor. Good perfusion and neural integrity has the potential to reduce complications. The authors' objective was to determine the ideal surgical exposure to maintain perfusion and neural integrity and decrease surgical time as a result of reduced bleeding. The vascular anatomy of the temporal-parietal soft tissue was examined in a total of 50 subjects. Imaging diagnostics included magnetic resonance angiography in 12 and Doppler ultrasound in 25 healthy subjects to reveal the arterial network. Cadaver dissection of 13 subjects formed the control group. The prevalence of the arteries were statistically analyzed with sector analysis in the surgically relevant area. The main arterial branches of this region could be well identified with each method. Statistical analysis showed that the arterial pattern was similar in all subjects. The prevalence of major arteries is low in the upper posterior area though large in proximity to the auricle region. Diverse methods indicate the advantages of a posterior superior incision because the major arteries and nerves are at less risk of damage and best preserved. Although injury to these structures is rare, when it occurs, the distal flow is compromised and the peri-implant area is left intact. Hand-held Doppler is efficient and cost-effective in finding the best position for incision, if necessary, in subjects with a history of surgical stress to the retroauricular skin. This was a non-interventional study.

  9. Ca2+-dependent K+ Channels in Exocrine Salivary Glands

    Science.gov (United States)

    Catalán, Marcelo A.; Peña-Munzenmayer, Gaspar; Melvin, James E.

    2014-01-01

    In the last 15 years, remarkable progress has been realized in identifying the genes that encode the ion-transporting proteins involved in exocrine gland function, including salivary glands. Among these proteins, Ca2+-dependent K+ channels take part in key functions including membrane potential regulation, fluid movement and K+ secretion in exocrine glands. Two K+ channels have been identified in exocrine salivary glands: 1) a Ca2+-activated K+ channel of intermediate single channel conductance encoded by the KCNN4 gene; and, 2) a voltage- and Ca2+-dependent K+ channel of large single channel conductance encoded by the KCNMA1 gene. This review focuses on the physiological roles of Ca2+-dependent K+ channels in exocrine salivary glands. We also discuss interesting recent findings on the regulation of Ca2+-dependent K+ channels by protein-protein interactions that may significantly impact exocrine gland physiology. PMID:24559652

  10. Plio-Quaternary river incision rates inferred from burial dating (Al-26/Be-10) of in cave-deposited alluvium in the Meuse catchment (E Belgium): new insights into the uplift history of the Ardennes massif

    Science.gov (United States)

    Rixhon, Gilles; Bourlès, Didier; Braucher, Régis; Peeters, Alexandre; Demoulin, Alain

    2017-04-01

    Although the Late Cenozoic uplift of the intraplate Variscan Ardennes/Rhenish massif (N Europe) has been long studied, its causes, shape and timing are still under debate (Demoulin & Hallot, 2009). This is mainly due to the scarcity of reliable ages for uplift markers, such as Quaternary terrace staircases along the deeply-incised valleys or Late Tertiary planation surfaces. In parallel, multi-level cave systems in limestone rocks, wherein abandoned phreatic passages filled with alluvium represent former phases of fluvial base-level stability, record the history of regional river incision (Anthony & Granger, 2007). Here, we present new burial ages (Al-26/Be-10) from fluvial gravels washed in a multi-level cave system developed in Devonian limestones of the lower Ourthe valley (main Ardennian tributary of the Meuse). Our results highlight a significant increase of incision rates from the Middle Pleistocene on, and allow reconstructing the incision history in the northern part of the Ardennes over the last 3.4 Ma. These long-term incision rates derived from burial ages are then discussed in relation to the existing studies dealing with river incision and/or tectonic uplift of the Ardennes/Rhenish massif (e.g. Demoulin & Hallot, 2009; Rixhon et al., 2011). Our cosmogenic nuclide ages thus enlarge the data pool required to explore the spatio-temporal characteristics of the drainage system's incision response to combined tectonic and climatic signals. References Anthony, D., Granger, D.E., 2007. A new chronology for the age of Appalachian erosional surfaces determined by cosmogenic nuclides in cave sediments. Earth Surf. Process. Landforms 32, 874-887 Demoulin, A., Hallot, E., 2009. Shape and amount of the Quaternary uplift of the western Rhenish shield and the Ardennes (western Europe). Tectonophysics 474, 696-708. Rixhon, G., et al., 2011. Quaternary river incision in NE Ardennes (Belgium): Insights from Be-10/Al-26 dating of rive terraces. Quaternary Geochronology 6

  11. Postoperative ocular higher-order aberrations and contrast sensitivity: femtosecond lenticule extraction versus pseudo small-incision lenticule extraction.

    Science.gov (United States)

    Tan, Deborah K L; Tay, Wan Ting; Chan, Cordelia; Tan, Donald T H; Mehta, Jodhbir S

    2015-03-01

    To evaluate and compare changes in contrast sensitivity and ocular higher-order aberrations (HOAs) after femtosecond lenticule extraction (FLEx) and pseudo small-incision lenticule extraction (SMILE). Singapore National Eye Centre, Singapore. Retrospective case series. Patients had femtosecond lenticule extraction (Group 1) or pseudo small-incision lenticule extraction (Group 2) between March 2010 and December 2011. The main outcome measures were manifest refraction, HOAs, and contrast sensitivity 1, 3, 6, and 12 months postoperatively. Fifty-two consecutive patients (102 eyes) were recruited, 21 patients (42 eyes) in Group 1 and the 31 patients (60 eyes) in Group 2. The uncorrected and corrected distance visual acuities were significantly better in Group 2 than in Group 1 at 12 months (P = .032). There was no significant increase in 3rd- or 4th-order aberrations at 1 year and no significant difference between the 2 groups preoperatively or postoperatively. At 1 year, there was a significant increase in mesopic contrast sensitivity in Group 2 at 1.5 cycles per degree (cpd) (P = .008) that was not found in Group 1, and photopic contrast sensitivity at 6.0 cpd was higher in Group 2 (P = .027). These results indicate that refractive lenticule extraction is safe and effective with no significant induction of HOAs or deterioration in contrast sensitivity at 1 year. Induction of HOAs was not significantly different between both variants of refractive lenticule extraction. However, there was significant improvement in photopic contrast sensitivity after pseudo small-incision lenticule extraction, which persisted through 1 year. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  12. Delamination technique together with longitudinal incisions for treatment of Chiari I/syringomyelia complex: a prospective clinical study

    Directory of Open Access Journals (Sweden)

    Savas Yildiray

    2009-06-01

    Full Text Available Abstract Background Treatment modalities in Chiari malformation type 1(CMI accompanied by syringomyelia have not yet been standardized. Pathologies such as a small posterior fossa and thickened dura mater have been discussed previously. Various techniques have been explored to enlarge the foramen magnum and to expand the dura. The aim of this clinical study was to explore a new technique of excision of the external dura accompanied by widening the cisterna magna and making longitudinal incisions in the internal dura, without disturbing the arachnoid. Methods Ten patients with CMI and syringomyelia, operated between 2004 and 2006, formed this prospective series. All cases underwent foramen magnum decompression of 3 × 3 cm area with C1–C2 (partial laminectomy, resection of foramen magnum fibrous band, excision of external dura, delamination and widening of internal dura with longitudinal incisions. Results Patients were aged between 25 and 58 years and occipital headache was the most common complaint. The mean duration of preoperative symptoms was 4 years and the follow-up time was 25 months. Clinical progression was halted for all patients; eight patients completely recovered and two reported no change. In one patient, there was a transient cerebrospinal fluid (CSF fistula that was treated with tissue adhesive. While syringomyelia persisted radiologically with radiological stability in five patients; for three patients the syringomyelic cavity decreased in size, and for the remaining two it regressed completely. Conclusion Removal of the fibrous band and the outer dural layer, at level of foramen magnum, together with the incision of inner dural layer appears to be good technique in adult CMI patients. The advantages are short operation time, no need for duraplasty, sufficient posterior fossa decompression, absence of CSF fistulas as a result of extra arachnoidal surgery, and short duration of hospitalization. Hence this surgical technique has

  13. Calcium homeostasis modulator (CALHM) ion channels.

    Science.gov (United States)

    Ma, Zhongming; Tanis, Jessica E; Taruno, Akiyuki; Foskett, J Kevin

    2016-03-01

    Calcium homeostasis modulator 1 (CALHM1), formerly known as FAM26C, was recently identified as a physiologically important plasma membrane ion channel. CALHM1 and its Caenorhabditis elegans homolog, CLHM-1, are regulated by membrane voltage and extracellular Ca(2+) concentration ([Ca(2+)]o). In the presence of physiological [Ca(2+)]o (∼1.5 mM), CALHM1 and CLHM-1 are closed at resting membrane potentials but can be opened by strong depolarizations. Reducing [Ca(2+)]o increases channel open probability, enabling channel activation at negative membrane potentials. Together, voltage and Ca(2+) o allosterically regulate CALHM channel gating. Through convergent evolution, CALHM has structural features that are reminiscent of connexins and pannexins/innexins/LRRC8 (volume-regulated anion channel (VRAC)) gene families, including four transmembrane helices with cytoplasmic amino and carboxyl termini. A CALHM1 channel is a hexamer of CALHM1 monomers with a functional pore diameter of ∼14 Å. CALHM channels discriminate poorly among cations and anions, with signaling molecules including Ca(2+) and ATP able to permeate through its pore. CALHM1 is expressed in the brain where it plays an important role in cortical neuron excitability induced by low [Ca(2+)]o and in type II taste bud cells in the tongue that sense sweet, bitter, and umami tastes where it functions as an essential ATP release channel to mediate nonsynaptic neurotransmitter release. CLHM-1 is expressed in C. elegans sensory neurons and body wall muscles, and its genetic deletion causes locomotion defects. Thus, CALHM is a voltage- and Ca(2+) o-gated ion channel, permeable to large cations and anions, that plays important roles in physiology.

  14. Excision of thymine dimers from specifically incised DNA by extracts of xeroderma pigmentosum cells

    Energy Technology Data Exchange (ETDEWEB)

    Cook, K; Friedberg, E C; Slor, H; Cleaver, J E

    1975-07-17

    DNA repair defects as exhibited in fibroblasts from patients with xeroderma pigmentosa were studied. Five complementation groups for excision-repair defects were examined to test the hypothesis that a defective endonuclease or exonuclease may be the cause. No evidence was found to indicate that the enzyme activity functions in dimer excision. Since ultraviolet irradiated E. coli DNA incised with an endonuclease purified from phage-infected cells were used, it is possible that other factors may be involved in human UV endonuclease action. (JWP)

  15. Channel Planform Dynamics Monitoring and Channel Stability Assessment in Two Sediment-Rich Rivers in Taiwan

    Directory of Open Access Journals (Sweden)

    Cheng-Wei Kuo

    2017-01-01

    Full Text Available Recurrent flood events induced by typhoons are powerful agents to modify channel morphology in Taiwan’s rivers. Frequent channel migrations reflect highly sensitive valley floors and increase the risk to infrastructure and residents along rivers. Therefore, monitoring channel planforms is essential for analyzing channel stability as well as improving river management. This study analyzed annual channel changes along two sediment-rich rivers, the Zhuoshui River and the Gaoping River, from 2008 to 2015 based on satellite images of FORMOSAT-2. Channel areas were digitized from mid-catchment to river mouth (~90 km. Channel stability for reaches was assessed through analyzing the changes of river indices including braid index, active channel width, and channel activity. In general, the valley width plays a key role in braided degree, active channel width, and channel activity. These indices increase as the valley width expands whereas the braid index decreases slightly close to the river mouth due to the change of river types. This downstream pattern in the Zhuoshui River was interrupted by hydraulic construction which resulted in limited changes downstream from the weir, due to the lack of water and sediment supply. A 200-year flood, Typhoon Morakot in 2009, induced significant changes in the two rivers. The highly active landscape in Taiwan results in very sensitive channels compared to other regions. An integrated Sensitivity Index was proposed for identifying unstable reaches, which could be a useful reference for river authorities when making priorities in river regulation strategy. This study shows that satellite image monitoring coupled with river indices analysis could be an effective tool to evaluate spatial and temporal changes in channel stability in highly dynamic river systems.

  16. Fuel channel refilling

    International Nuclear Information System (INIS)

    Shoukri, M.; Abdul-Razzak, A.

    1990-04-01

    Analysis of existing data on fuel channel refilling is presented. The analysis focuses on the data obtained using the Stern Laboratories Cold Water Injection Test (CWIT) Facility. The two-fluid model thermal-hydraulics computer code CATHENA is also used to simulate experimental results on fuel channel refilling from both the CWIT and RD-14 facilities. Conclusions related to single and double break tests, including the effect of non-condensible gases, are presented. A set of recommendations is given for further analysis and separate effect experiments. (67 figs., 5 tabs., 24 refs.)

  17. G-Channel Restoration for RWB CFA with Double-Exposed W Channel.

    Science.gov (United States)

    Park, Chulhee; Song, Ki Sun; Kang, Moon Gi

    2017-02-05

    In this paper, we propose a green (G)-channel restoration for a red-white-blue (RWB) color filter array (CFA) image sensor using the dual sampling technique. By using white (W) pixels instead of G pixels, the RWB CFA provides high-sensitivity imaging and an improved signal-to-noise ratio compared to the Bayer CFA. However, owing to this high sensitivity, the W pixel values become rapidly over-saturated before the red-blue (RB) pixel values reach the appropriate levels. Because the missing G color information included in the W channel cannot be restored with a saturated W, multiple captures with dual sampling are necessary to solve this early W-pixel saturation problem. Each W pixel has a different exposure time when compared to those of the R and B pixels, because the W pixels are double-exposed. Therefore, a RWB-to-RGB color conversion method is required in order to restore the G color information, using a double-exposed W channel. The proposed G-channel restoration algorithm restores G color information from the W channel by considering the energy difference caused by the different exposure times. Using the proposed method, the RGB full-color image can be obtained while maintaining the high-sensitivity characteristic of the W pixels.

  18. Surgical treatment of synovial osteochondromatosis of the hip using a modified-Hardinge approach with a Z-shaped capsular incision

    Directory of Open Access Journals (Sweden)

    Yu Takeda

    2015-12-01

    Full Text Available Synovial osteochondromatosis of the hip is a rare condition, and the surgical treatment approach for this condition requires complete removal of loose bodies combined with synovectomy. While these, procedures are generally accepted as the optimal treatment method, this is still controversial topic. Recent studies have reported that open surgical procedures remain acceptable for synovial osteochondromatosis of the hip. These procedures include the dislocation of the femoral head, and complications such as femoral head necrosis and bursitis or great trochanter non-union due to trochanteric osteotomy have been reported. The present study reports a modified technique for surgical dislocation through a Z-shaped capsular incision without trochanteric flip osteotomy for the treatment of synovial osteochondromatosis of the hip.

  19. Dynamics of laser-induced channel formation in water and influence of pulse duration on the ablation of biotissue under water with pulsed erbium-laser radiation

    Science.gov (United States)

    Ith, M.; Pratisto, H.; Altermatt, H. J.; Frenz, M.; Weber, H. P.

    1994-12-01

    The ability to use fiber-delivered erbium-laser radiation for non-contact arthroscopic meniscectomy in a liquid environment was studied. The laser radiation is transmitted through a water-vapor channel created by the leading part of the laser pulse. The dynamics of the channel formation around a submerged fiber tip was investigated with time-resolved flash photography. Strong pressure transients with amplitudes up to a few hundreds of bars measured with a needle hydrophone were found to accompany the channel formation process. Additional pressure transients in the range of kbars were observed after the laser pulse associated with the collapse of the vapor channel. Transmission measurements revealed that the duration the laser-induced channel stays open, and therefore the energy transmittable through it, is substantially determined by the laser pulse duration. The optimum pulse duration was found to be in the range between 250 and 350 µS. This was confirmed by histological evaluations of the laser incisions in meniscus: Increasing the pulse duration from 300 to 800 µs leads to a decrease in the crater depth from 1600 to 300 µm. A comparison of the histological examination after laser treatment through air and through water gave information on the influence of the vapor channel on the ablation efficiency, the cutting quality and the induced thermal damage in the adjacent tissue. The study shows that the erbium laser combined with an adequate fiber delivery system represents an effective surgical instrument liable to become increasingly accepted in orthopedic surgery.

  20. From membrane tension to channel gating: A principal energy transfer mechanism for mechanosensitive channels.

    Science.gov (United States)

    Zhang, Xuejun C; Liu, Zhenfeng; Li, Jie

    2016-11-01

    Mechanosensitive (MS) channels are evolutionarily conserved membrane proteins that play essential roles in multiple cellular processes, including sensing mechanical forces and regulating osmotic pressure. Bacterial MscL and MscS are two prototypes of MS channels. Numerous structural studies, in combination with biochemical and cellular data, provide valuable insights into the mechanism of energy transfer from membrane tension to gating of the channel. We discuss these data in a unified two-state model of thermodynamics. In addition, we propose a lipid diffusion-mediated mechanism to explain the adaptation phenomenon of MscS. © 2016 The Protein Society.

  1. Energy conversion device with support member having pore channels

    Science.gov (United States)

    Routkevitch, Dmitri [Longmont, CO; Wind, Rikard A [Johnstown, CO

    2014-01-07

    Energy devices such as energy conversion devices and energy storage devices and methods for the manufacture of such devices. The devices include a support member having an array of pore channels having a small average pore channel diameter and having a pore channel length. Material layers that may include energy conversion materials and conductive materials are coaxially disposed within the pore channels to form material rods having a relatively small cross-section and a relatively long length. By varying the structure of the materials in the pore channels, various energy devices can be fabricated, such as photovoltaic (PV) devices, radiation detectors, capacitors, batteries and the like.

  2. Separation of Particles in Channels Rotary Engine

    Directory of Open Access Journals (Sweden)

    Zyatikov Pavel

    2015-01-01

    Full Text Available The article considers the separation of particles in channels with different relative length. It is shown that the intensity of turbulence at the inlet section of the channel varies considerably in its length. The dependence of the turbulence damping along the channel expressing by fraction of the distance is shown. The ratio of the particle separation efficiency out the gas flow in the rotor channel is defined. The values of particle separation efficiency in the channel for the angle α=π/4 in turbulent aerosol flow is shows, including without mixing the particles.

  3. Treatment of mandibular condyle fractures using a modified transparotid approach via the parotid mini-incision: experience with 31 cases.

    Directory of Open Access Journals (Sweden)

    Jun Shi

    Full Text Available Surgery for mandibular condyle fractures must allow direct vision of the fracture, reduce surgical trauma and achieve reduction and fixation while avoiding facial nerve injury. This prospective study was conducted to introduce a new surgical approach for open reduction and internal fixation of mandibular condyle fractures using a modified transparotid approach via the parotid mini-incision, and surgical outcomes were evaluated. The modified transparotid approach via the parotid mini-incision was applied and rigid internal fixation using a small titanium plate was carried out for 36 mandibular condyle fractures in 31 cases. Postoperative follow-up of patients ranged from 3 to 26 months; in the first 3 months after surgery, outcomes for all patients were analyzed by evaluating the degree of mouth opening, occlusal relationship, facial nerve function and results of imaging studies. The occlusal relationships were excellent in all patients and none had symptoms of intraoperative ipsilateral facial nerve injury. The mean degree of mouth opening was 4.0 (maximum 4.8 cm, minimum 3.0 cm. No mandibular deviations were noted in any patient during mouth opening. CT showed complete anatomical reduction of the mandibular condyle fracture in all patients. The modified transparotid approach via the smaller, easily concealed parotid mini-incision is minimally invasive and achieves anatomical reduction and rigid internal fixation with a simplified procedure that directly exposes the fracture site. Study results showed that this procedure is safe and feasible for treating mandibular condyle fracture, and offers a short operative path, protection of the facial nerve and satisfactory aesthetic outcomes.

  4. 10Be and 26Al dating of river terraces and quaternary incision rates in the Ardenne massif (eastern Belgium)

    Science.gov (United States)

    Rixhon, G.; Braucher, R.; Siame, L.; Bourlès, D.; Demoulin, A.

    2009-04-01

    Because of the lack of reliable chronological data, the Quaternary evolution of the hydrographic network of the Ardennes (western continuation of the Rhenish shield, western Europe) remains still poorly known. Therefore, we measured the cosmogenic nuclides content (10Be and 26Al) of terrace sediments of Ardennian rivers (Meuse, Ourthe & Amblève) in order to date several terrace levels and to better constrain the Quaternary incision of the network. Though these dating methods are successfully used to determine ages of superficial (e.g., glacial) deposits, dating of fluvial terraces remains difficult. Possible predepositional exposures of the sampled material (inherited 10Be and 26Al) may indeed bias the measurements towards higher nuclide concentrations while several postdepositional processes (burial, erosion) may cause a lowering of the 10Be and 26Al concentrations. In an attempt to overcome these difficulties, the selected fluvial deposits (six locations) were sampled using a profiling technique on as thick as possible sections (more than 3 m). While previous studies assigned an early middle Pleistocene age (around 800 ka) to the main terrace level in the Rhine-Meuse system, our 10Be dates for the same terrace level (according to geometrical correlation) in the Amblève River, a Meuse subtributary, are much younger (upper Pleistocene). To explain this age discrepancy, we suggest that the incision was strongly diachronous from the Meuse valley towards its Ardennian headwaters, as a result of a delayed upstream propagation of the incision wave when it passes tributary junctions.

  5. A novel nomogram for the treatment of astigmatism with femtosecond-laser arcuate incisions at the time of cataract surgery

    Directory of Open Access Journals (Sweden)

    Baharozian CJ

    2017-10-01

    Full Text Available Connor J Baharozian,1 Christian Song,2,3 Kathryn M Hatch,2,3 Jonathan H Talamo2,3 1Boston University School of Medicine, 2Massachusetts Eye and Ear Infirmary, 3Department of Ophthalmology, Harvard Medical School, Boston, MA, USA Purpose: The purpose of this study was to determine an arcuate incision (AI nomogram to treat astigmatism during femtosecond laser-assisted cataract surgery. Methods: This is a retrospective, cohort study. Femtosecond laser (FSL-assisted transepithelial AIs were created at a 9.0 mm optical zone, 80% depth, centered on the limbus. We modified the manual Donnenfeld limbal relaxing incision nomogram to 70% for with-the-rule (WTR, 80% for oblique (OBL, and 100% for against-the-rule (ATR astigmatism. The correction index (CI equaled AI-induced astigmatism/target-induced astigmatism. Measures included preoperative keratometric corneal cylinder (Pre Kcyl, postoperative Kcyl (Post Kcyl, and postoperative residual refractive astigmatism (Post RRA. Results: Mean Pre Kcyl and 1–2 months Post RRA in 161 eyes of 116 patients were 0.626±0.417 diopters (D (range 0.5–2 D, and 0.495±0.400 D (range 0–1.5 D, respectively. Mean absolute astigmatic changes (Pre Kcyl–Post Kcyl without accounting for axis change in the WTR, ATR, and OBL groups were 0.165±0.383 D (P<0.001, 0.374±0.536 D (P<0.001, and 0.253±0.416 D (P=0.02, respectively. Mean absolute astigmatic changes using RRA as the postoperative measurement (Pre Kcyl–Post RRA without accounting for axis change were 0.440±0.461 D (P<0.001, 0.238±0.571 D (P<0.05, 0.154±0.450 (P=0.111 in WTR, ATR, and OBL groups, respectively. CIs for WTR, ATR, and OBL were 0.53, 1.01, and 0.95, respectively. There were no intraoperative or postoperative complications related to the AIs.Conclusion: Transepithelial FSL-AIs using the modified Donnenfeld nomogram show potential for management of mild to moderate corneal astigmatism. An increase in the magnitude or reduction of the optical zone

  6. Five years' experience of transverse groin incision for femoral artery access in arterial reconstructive surgery: parallel observational longitudinal group comparison study.

    LENUS (Irish Health Repository)

    Beirne, Christopher

    2008-07-01

    Vertical groin incisions (VGIs) have been used to access femoral vessels, but reports allude to wound complications. Our aim was to compare VGI with transverse groin incision (TGI) for femoral artery exposure. Over a 5-year interval, 196 patients with 284 femoral artery exposures for supra- and infrainguinal procedures were studied. Primary endpoints were surgical skin site wound infection, seroma, haematoma formation, and major lower limb amputation. Secondary endpoints were graft patency, wound paresthesias, and length of hospital stay. There were 160 TGIs and 124 VGIs. The demographics and risk factor profile were not statistically different between groups. Seroma developed in 4.4% of TGIs and 13.7% of VGIs (p= .005). The complicated skin and soft tissue infection rate was five times greater with VGI (p= .001). The VGI group had a significantly higher rate of major amputation (p= .0005). Significantly higher graft failure rates were observed in the VGI group (p= .011). No paresthesia was reported in any TGI wound. The mean hospital stay was also significantly shorter in the TGI group (p= .006). The study data support and expound on the theory that an alternative incision to VGI offers lower short- and long-term morbidity. Our findings sustain the selection of the TGI in femoral artery surgery for both supra- and infrainguinal procedures without compromise of vessel exposure.

  7. Pannexin-1 channels in epilepsy.

    Science.gov (United States)

    Aquilino, Mark S; Whyte-Fagundes, Paige; Zoidl, Georg; Carlen, Peter L

    2017-09-05

    Pannexin-1 (Panx1) expression is raised in several animal seizure models and in resected human epileptic brain tissue, suggesting relevance to epilepsy. Multiple factors that are characteristic of seizures are thought to regulate Panx1 channel opening, including elevated levels of extracellular K + . Panx1, when open, 1) releases ATP, glutamate, and other metabolites into the extracellular medium, and 2) may depolarize the membrane due to a channel reversal potential around 0mV. Resultant ATP release from stimulated Panx1 can activate purinergic receptors, including P2X7 receptors. Glutamate and other signaling molecules released by Panx1 opening may have both excitatory and inhibitory actions on seizure generation. This review examines the critical and complex roles of Panx1 channels in epilepsy, which could provide a basis for future therapeutics. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Water channel reactor fuels and fuel channels: Design, performance, research and development. Proceedings of a technical committee meeting

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-01-01

    The International Working Group on Water Reactor Fuel Performance and Technology (IWGFPT) recommended holding a Technical Committee Meeting on Water Channel Reactor Fuel including into this category fuels and pressure tubes/fuel channels for Atucha-I and II, BWR, CANDU, FUGEN and RBMK reactors. The IWGFPT considered that even if the characteristics of Atucha, CANDUs, BWRs, FUGEN and RBMKs differ considerably, there are also common features. These features include materials aspects, as well as core, fuel assembly and fuel rod design, and some safety issues. There is also some similarity in fuel power history and operating conditions (Atucha-I and II, FUGEN and RBMK). Experts from 11 countries participated at the meeting and presented papers on technology, performance, safety and design, and materials aspects of fuels and pressure tubes/fuel channels for the above types of water channel reactors. Refs, figs, tabs.

  9. Water channel reactor fuels and fuel channels: Design, performance, research and development. Proceedings of a technical committee meeting

    International Nuclear Information System (INIS)

    1998-01-01

    The International Working Group on Water Reactor Fuel Performance and Technology (IWGFPT) recommended holding a Technical Committee Meeting on Water Channel Reactor Fuel including into this category fuels and pressure tubes/fuel channels for Atucha-I and II, BWR, CANDU, FUGEN and RBMK reactors. The IWGFPT considered that even if the characteristics of Atucha, CANDUs, BWRs, FUGEN and RBMKs differ considerably, there are also common features. These features include materials aspects, as well as core, fuel assembly and fuel rod design, and some safety issues. There is also some similarity in fuel power history and operating conditions (Atucha-I and II, FUGEN and RBMK). Experts from 11 countries participated at the meeting and presented papers on technology, performance, safety and design, and materials aspects of fuels and pressure tubes/fuel channels for the above types of water channel reactors

  10. Propagation channel characterization, parameter estimation, and modeling for wireless communications

    CERN Document Server

    Yin, Xuefeng

    2016-01-01

    Thoroughly covering channel characteristics and parameters, this book provides the knowledge needed to design various wireless systems, such as cellular communication systems, RFID and ad hoc wireless communication systems. It gives a detailed introduction to aspects of channels before presenting the novel estimation and modelling techniques which can be used to achieve accurate models. To systematically guide readers through the topic, the book is organised in three distinct parts. The first part covers the fundamentals of the characterization of propagation channels, including the conventional single-input single-output (SISO) propagation channel characterization as well as its extension to multiple-input multiple-output (MIMO) cases. Part two focuses on channel measurements and channel data post-processing. Wideband channel measurements are introduced, including the equipment, technology and advantages and disadvantages of different data acquisition schemes. The channel parameter estimation methods are ...

  11. Dry eye evaluation and correlation analysis between tear film stability and corneal surface regularity after small incision lenticule extraction.

    Science.gov (United States)

    Zhang, Hui; Wang, Yan

    2017-09-22

    To investigate the dry eye after small incision lenticule extraction (SMILE) and explore the correlations between changes in the tear film stability, the tear secretion and the corneal surface regularity. Sixty-two eyes of 22 men and 13 women who underwent SMILE were included in this study. Corneal topography was measured to assess the index of surface variance (ISV) and the index of vertical asymmetry (IVA). Dry eye tests including subjective symptom questionnaire, tear breakup time (TBUT), corneal fluorescein staining and Schirmer's test (ST) were evaluated before and at 1 and 6 months postoperatively. TBUT was found to be significantly decreased from 9.8 ± 3.4 s preoperatively to 7.4 ± 3.8 s at 1 month and 6.5 ± 3.6 s at 6 months (both P short-TBUT type of dry eye. Corneal surface regularity indices might be helpful in the assessment of tear film stability following SMILE procedure.

  12. The 'French Fry' VAC technique: hybridisation of traditional open wound NPWT with closed incision NPWT.

    Science.gov (United States)

    Chopra, Karan; Tadisina, Kashyap K; Singh, Devinder P

    2016-04-01

    Surgical site occurrences (SSO), specifically surgical site infections represent a significant burden in the US health care system. It has been hypothesised that postoperative dressing can help drive down SSO. We describe the successful use of a novel technique combining both closed incision and open negative pressure wound therapy in the management of a high-risk wound associated with lymphoedema of obesity. © 2014 The Authors. International Wound Journal © 2014 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

  13. Sedimentary architecture and chronostratigraphy of a late Quaternary incised-valley fill: A case study of the late Middle and Late Pleistocene Rhine system in the Netherlands

    Science.gov (United States)

    Peeters, J.; Busschers, F. S.; Stouthamer, E.; Bosch, J. H. A.; Van den Berg, M. W.; Wallinga, J.; Versendaal, A. J.; Bunnik, F. P. M.; Middelkoop, H.

    2016-01-01

    This paper describes the sedimentary architecture, chronostratigraphy and palaeogeography of the late Middle and Late Pleistocene (Marine Isotope Stage/MIS 6-2) incised Rhine-valley fill in the central Netherlands based on six geological transects, luminescence dating, biostratigraphical data and a 3D geological model. The incised-valley fill consists of a ca. 50 m thick and 10-20 km wide sand-dominated succession and includes a well-developed sequence dating from the Last Interglacial: known as the Eemian in northwest Europe. The lower part of the valley fill contains coarse-grained fluvio-glacial and fluvial Rhine sediments that were deposited under Late Saalian (MIS 6) cold-climatic periglacial conditions and during the transition into the warm Eemian interglacial (MIS 5e-d). This unit is overlain by fine-grained fresh-water flood-basin deposits, which are transgressed by a fine-grained estuarine unit that formed during marine high-stand. This ca. 10 m thick sequence reflects gradual drowning of the Eemian interglacial fluvial Rhine system and transformation into an estuary due to relative sea-level rise. The chronological data suggests a delay in timing of regional Eemian interglacial transgression and sea-level high-stand of several thousand years, when compared to eustatic sea-level. As a result of this glacio-isostatic controlled delay, formation of the interglacial lower deltaic system took only place for a relative short period of time: progradation was therefore limited. During the cooler Weichselian Early Glacial period (MIS 5d-a) deposition of deltaic sediments continued and extensive westward progradation of the Rhine system occurred. Major parts of the Eemian and Weichselian Early Glacial deposits were eroded and buried as a result of sea-level lowering and climate cooling during the early Middle Weichselian (MIS 4-3). Near complete sedimentary preservation occurred along the margins of the incised valley allowing the detailed reconstruction presented

  14. HYDROGEOMORPHIC SETTING, CHARACTERISTICS, AND RESPONSE TO STREAM INCISION OF MONTANA RIPARIAN MEADOWS IN THE CENTRAL GREAT BASIN--IMPLICATIONS FOR RESTORATION

    Science.gov (United States)

    Riparian wet meadow complexes in the mountains of the central Great Basin are scarce, ecologically important systems that are threatened by stream incision. An interdisciplinary group has investigated 1) the origin, characteristics, and controls on the evolution of these riparian...

  15. Cnidarian Toxins Acting on Voltage-Gated Ion Channels

    Directory of Open Access Journals (Sweden)

    Robert M. Greenberg

    2006-04-01

    Full Text Available Abstract: Voltage-gated ion channels generate electrical activity in excitable cells. As such, they are essential components of neuromuscular and neuronal systems, and are targeted by toxins from a wide variety of phyla, including the cnidarians. Here, we review cnidarian toxins known to target voltage-gated ion channels, the specific channel types targeted, and, where known, the sites of action of cnidarian toxins on different channels.

  16. Open fenestration of the distal landing zone via a subxyphoid incision for subsequent endovascular repair of a dissecting thoracic aneurysm.

    Science.gov (United States)

    Konings, Renske; de Bruin, Jorg L; Wisselink, Willem

    2013-02-01

    To describe a novel hybrid technique to address two challenges in endovascular repair of chronic dissecting thoracic aortic aneurysm (dTAA): obtaining an adequate seal of the stent-graft in a half-moon-shaped fibrotic aortic lumen and preserving flow into the distal true and false lumens. The technique is demonstrated in a 52-year-old man who presented with progressive asymptomatic dilatation of the thoracic aorta 9 years after undergoing a Bentall procedure for a Stanford type A dissection followed by arch replacement and elephant trunk construction. Imaging at this admission showed a 6.8-cm dissecting aneurysm extending distally to ∼4 cm above the celiac trunk; the dissection included both common iliac arteries. The patient refused a thoracotomy, so a hybrid procedure was devised to resect the intimal flap via a median subxyphoid incision and transperitoneal approach through the lesser sac. Two overlapping Zenith TX-2 stent-grafts were deployed into the elephant trunk, terminating just above the surgically created "flow divider" at the level of the celiac trunk. Imaging showed adequate sealing at both ends of the stent-graft and a type II endoleak that persisted into follow-up, but the aneurysm diameter decreased to 6.4 cm, and there was unobstructed flow into the visceral, renal, and iliac arteries. In this case of chronic dTAA, open surgical removal of a segment of the dissection flap via a subxyphoid incision provided a distal landing zone for subsequent endoluminal repair, with exclusion of the aneurysm and preservation of antegrade flow in both true and false lumens.

  17. Accessory Axillary Breast Excision with Liposuction Using Minimal Incision: A Preliminary Report.

    Science.gov (United States)

    Hwang, Seong Bae; Choi, Byung Seo; Byun, Geon Young; Koo, Bum Hwan; Lee, Sung Ryul

    2017-02-01

    Accessory breasts have received little attention in the surgical fields, although the condition is quite common in the female population, with 2-6% of women suffering from it. Its convexity and cyclic pain make women feel embarrassed and uncomfortable, so patients often desire surgical excision to improve their appearances and to remove the pain. A total of 967 patients who had been treated by an excision of accessory breast tissue with liposuction using minimal incision from September 2013 to Dec 2015 at the Damsoyu Hospital were analyzed for clinical factors retrospectively. All 967 patients were female. There were 514 (53.2%) unmarried patients and 453 (46.8%) married patients. The major clinical manifestation was the problem in the appearance with cyclic pain in both unmarried and married groups (82.7 vs. 87.9%). Three types of accessory breasts were observed: 779 (80.6%) breast tissue only in axillae, 182 (18.8%) breast tissue with accessory nipple, and 6 (0.6%) breast tissue with accessory nipple-areolar complex. The mean operation time was 58 min. All cyclic axillar pain in our cases was resolved after the operation. Postoperative complications developed in 160 patients (16.55%). Among them, seroma after operation was the most common (11.27%). In our study, 95.65% of the patients were satisfied with the cosmetic outcomes. The surgical excision of accessory breasts with liposuction through the minimal incision is a safe and effective method to make women feel comfortable in clinical manifestations and be satisfied with their cosmetic axillar line. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

  18. Channelling and electromagnetic radiation of channelling particles

    International Nuclear Information System (INIS)

    Kalashnikov, N.

    1983-01-01

    A brief description is presented of the channelling of charged particles between atoms in the crystal lattice. The specificities are discussed of the transverse motion of channelling particles as are the origin and properties of quasi-characteristic radiation of channelling particles which accompany transfers from one band of permissible energies of the transverse motion of channelling particles to the other. (B.S.)

  19. Grafting voltage and pharmacological sensitivity in potassium channels.

    Science.gov (United States)

    Lan, Xi; Fan, Chunyan; Ji, Wei; Tian, Fuyun; Xu, Tao; Gao, Zhaobing

    2016-08-01

    A classical voltage-gated ion channel consists of four voltage-sensing domains (VSDs). However, the roles of each VSD in the channels remain elusive. We developed a GVTDT (Graft VSD To Dimeric TASK3 channels that lack endogenous VSDs) strategy to produce voltage-gated channels with a reduced number of VSDs. TASK3 channels exhibit a high host tolerance to VSDs of various voltage-gated ion channels without interfering with the intrinsic properties of the TASK3 selectivity filter. The constructed channels, exemplified by the channels grafted with one or two VSDs from Kv7.1 channels, exhibit classical voltage sensitivity, including voltage-dependent opening and closing. Furthermore, the grafted Kv7.1 VSD transfers the potentiation activity of benzbromarone, an activator that acts on the VSDs of the donor channels, to the constructed channels. Our study indicates that one VSD is sufficient to voltage-dependently gate the pore and provides new insight into the roles of VSDs.

  20. On the capacity of Rician fading channels with full channel state information at low SNR

    KAUST Repository

    Rezki, Zouheir

    2012-06-01

    The capacity of flat Rayleigh fading channels with full channel state information (CSI) at the transmitter and at the receiver at asymptotically low SNR has been recently shown to scale essentially as SNR log (1/SNR). In this paper, we investigate the Rician fading channel capacity with full CSI, and show that the capacity of this channel scales essentially as 1/1+K SNR log (1 /SNR), where K is the Rician factor. This characterization includes perfect CSI at both the transmitter and the receiver or noisy CSI at the transmitter and perfect CSI at the receiver. We also show that one-bit CSI at the transmitter is enough to achieve this asymptotic capacity using an On-Off power control scheme. Our framework may be seen as a generalization of previous works as it captures the Rayleigh fading channel as a special case by letting K goes to zero. © 2012 IEEE.

  1. Quantum Correlations Evolution Asymmetry in Quantum Channels

    International Nuclear Information System (INIS)

    Li Meng; Huang Yun-Feng; Guo Guang-Can

    2017-01-01

    It was demonstrated that the entanglement evolution of a specially designed quantum state in the bistochastic channel is asymmetric. In this work, we generalize the study of the quantum correlations, including entanglement and quantum discord, evolution asymmetry to various quantum channels. We found that the asymmetry of entanglement and quantum discord only occurs in some special quantum channels, and the behavior of the entanglement evolution may be quite different from the behavior of the quantum discord evolution. To quantum entanglement, in some channels it decreases monotonously with the increase of the quantum channel intensity. In some other channels, when we increase the intensity of the quantum channel, it decreases at first, then keeps zero for some time, and then rises up. To quantum discord, the evolution becomes more complex and you may find that it evolutes unsmoothly at some points. These results illustrate the strong dependence of the quantum correlations evolution on the property of the quantum channels. (paper)

  2. Role of TRP channels in the cardiovascular system.

    Science.gov (United States)

    Yue, Zhichao; Xie, Jia; Yu, Albert S; Stock, Jonathan; Du, Jianyang; Yue, Lixia

    2015-02-01

    The transient receptor potential (TRP) superfamily consists of a large number of nonselective cation channels with variable degree of Ca(2+)-permeability. The 28 mammalian TRP channel proteins can be grouped into six subfamilies: canonical, vanilloid, melastatin, ankyrin, polycystic, and mucolipin TRPs. The majority of these TRP channels are expressed in different cell types including both excitable and nonexcitable cells of the cardiovascular system. Unlike voltage-gated ion channels, TRP channels do not have a typical voltage sensor, but instead can sense a variety of other stimuli including pressure, shear stress, mechanical stretch, oxidative stress, lipid environment alterations, hypertrophic signals, and inflammation products. By integrating multiple stimuli and transducing their activity to downstream cellular signal pathways via Ca(2+) entry and/or membrane depolarization, TRP channels play an essential role in regulating fundamental cell functions such as contraction, relaxation, proliferation, differentiation, and cell death. With the use of targeted deletion and transgenic mouse models, recent studies have revealed that TRP channels are involved in numerous cellular functions and play an important role in the pathophysiology of many diseases in the cardiovascular system. Moreover, several TRP channels are involved in inherited diseases of the cardiovascular system. This review presents an overview of current knowledge concerning the physiological functions of TRP channels in the cardiovascular system and their contributions to cardiovascular diseases. Ultimately, TRP channels may become potential therapeutic targets for cardiovascular diseases. Copyright © 2015 the American Physiological Society.

  3. Analysis of Relative Parallelism Between Hamular-Incisive-Papilla Plane and Campers Plane in Edentulous Subjects: A Comparative Study.

    Science.gov (United States)

    Tambake, Deepti; Shetty, Shilpa; Satish Babu, C L; Fulari, Sangamesh G

    2014-12-01

    The study was undertaken to evaluate the parallelism between hamular-incisive-papilla plane (HIP) and the Campers plane. And to determine which part of the posterior reference of the tragus i.e., the superior, middle or the inferior of the Camper's plane is parallel to HIP using digital lateral cephalograms. Fifty edentulous subjects with well formed ridges were selected for the study. The master casts were obtained using the standard selective pressure impression procedure. On the deepest point of the hamular notches and the centre of the incisive papilla stainless steel spherical bearings were glued to the cast at the marked points. The study templates were fabricated with autopolymerizing acrylic resin. The subjects were prepared for the lateral cephalograms. Stainless steel spherical bearings were adhered to the superior, middle, inferior points of the tragus of the ear and inferior border of the ala of the nose using surgical adhesive tape. The subjects with study templates were subjected to lateral cephalograms. Cephalometric tracings were done using Autocad 2010 software. Lines were drawn connecting the incisive papilla and hamular notch and the stainless steel spherical bearings placed on the superior, middle and inferior points on the tragus and the ala of the nose i.e., the Campers line S, Campers line M, Campers line I. The angles between the three Camper's line and the HIP were measured and recorded. Higher mean angulation was recorded in Campers line S -HIP (8.03) followed by Campers line M-HIP (4.60). Campers line I-HIP recorded the least angulation (3.80). The HIP is parallel to the Camper's plane. The Camper's plane formed with the posterior reference point as inferior point of the tragus is relatively parallel to the HIP.

  4. Corneal tissue welding with infrared laser irradiation after clear corneal incision.

    Science.gov (United States)

    Rasier, Rfat; Ozeren, Mediha; Artunay, Ozgür; Bahçecioğlu, Halil; Seçkin, Ismail; Kalaycoğlu, Hamit; Kurt, Adnan; Sennaroğlu, Alphan; Gülsoy, Murat

    2010-09-01

    The aim of this study was to investigate the potential of infrared lasers for corneal welding to seal corneal cuts done in an experimental animal model. Full-thickness corneal cuts on freshly enucleated bovine eyes were irradiated with infrared (809-nm diode, 980-nm diode, 1070-nm YLF, and 1980-nm Tm:YAP) lasers to get immediate laser welding. An 809-nm laser was used with the topical application of indocyanine green to enhance the photothermal interaction at the weld site. In total, 60 bovine eyes were used in this study; 40 eyes were used in the first part of the study for the determination of optimal welding parameters (15 eyes were excluded because of macroscopic carbonization, opacification, or corneal shrinkage; 2 eyes were used for control), and 20 eyes were used for further investigation of more promising lasers (YLF and Tm:YAP). Laser wavelength, irradiating power, exposure time, and spot size were the dose parameters, and optimal dose for immediate closure with minimal thermal damage was estimated through histological examination of welded samples. In the first part of the study, results showed that none of the applications was satisfactory. Full-thickness success rates were 28% (2 of 7) for 809-nm and for 980-nm diode lasers and 67% (2 of 3) for 1070-nm YLF and (4 of 6) for 1980-nm Tm:YAP lasers. In the second part of the study, YLF and Tm:YAP lasers were investigated with bigger sample size. Results were not conclusive but promising again. Five corneal incisions were full-thickness welded out of 10 corneas with 1070-nm laser, and 4 corneal incisions were partially welded out of 10 corneas with 1980-nm laser in the second part of the study. Results showed that noteworthy corneal welding could be obtained with 1070-nm YLF laser and 1980-nm Tm:YAP laser wavelengths. Furthermore, in vitro and in vivo studies will shed light on the potential usage of corneal laser welding technique.

  5. Ectasia following small-incision lenticule extraction (SMILE: a review of the literature

    Directory of Open Access Journals (Sweden)

    Moshirfar M

    2017-09-01

    Full Text Available Majid Moshirfar,1,2 Julio C Albarracin,3 Jordan D Desautels,1,4 Orry C Birdsong,1 Steven H Linn,1 Phillip C Hoopes Sr1 1HDR Research Center, Hoopes Vision, Draper, 2John A Moran Eye Center, Department of Ophthalmology and Visual Sciences, University of Utah School of Medicine, Salt Lake City, UT, 3Department of Ophthalmology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, 4Department of Ophthalmology, Warren Alpert Medical School of Brown University, Providence, RI, USA Purpose: Four cases of corneal ectasia after small-incision lenticule extraction (SMILE have been reported. In this review, we provide an overview of the published literature on corneal ectasia after SMILE and risk factors associated with this complication.Methods: Case reports were identified by a search of seven electronic databases for pertinent heading terms between 2011 and July 2017. We identified patient characteristics and surgical details including preoperative topography, central corneal thickness, and anterior keratometry (Km. Residual stromal bed (RSB values not reported were computed using VisuMax ReLEx SMILE software Version 2.10.10. Preoperative ectasia risk was measured using the Randleman Ectasia Risk Score System (ERSS. Percent tissue alteration was calculated for each patient as described by Santhiago et al.Results: Seven eyes of four patients developed corneal ectasia post SMILE. Two patients had abnormal topography in both eyes. One patient had abnormal topography in one eye. Only one patient was noted to have normal topography in both eyes and later developed ectasia in one eye in the absence of any known risk factors. The mean Randleman ectasia risk score was 4±3 (range: 1–8. The mean calculated percent tissue altered (PTA was 38%±6% (range: 30%–47%.Conclusion: A majority of reported ectasia cases occurred in patients with subclinical keratoconus. These conditions may be exacerbated by SMILE and should be

  6. Modified skin incision for avoiding the lesser occipital nerve and occipital artery during retrosigmoid craniotomy: potential applications for enhancing operative working distance and angles while minimizing the risk of postoperative neuralgias and intraoperative hemorrhage.

    Science.gov (United States)

    Tubbs, R Shane; Fries, Fabian N; Kulwin, Charles; Mortazavi, Martin M; Loukas, Marios; Cohen-Gadol, Aaron A

    2016-10-01

    Chronic postoperative neuralgias and headache following retrosigmoid craniotomy can be uncomfortable for the patient. We aimed to better elucidate the regional nerve anatomy in an effort to minimize this postoperative complication. Ten adult cadaveric heads (20 sides) were dissected to observe the relationship between the lesser occipital nerve and a traditional linear versus modified U incision during retrosigmoid craniotomy. Additionally, the relationship between these incisions and the occipital artery were observed. The lesser occipital nerve was found to have two types of course. Type I nerves (60%) remained close to the posterior border of the sternocleidomastoid muscle and some crossed anteriorly over the sternocleidomastoid muscle near the mastoid process. Type II nerves (40%) left the posterior border of the sternocleidomastoid muscle and swung medially (up to 4.5cm posterior to the posterior border of the sternocleidomastoid muscle) as they ascended over the occiput. The lesser occipital nerve was near a midpoint of a line between the external occipital protuberance and mastoid process in all specimens with the type II nerve configuration. Based on our findings, the inverted U incision would be less likely to injure the type II nerves but would necessarily cross over type I nerves, especially more cranially on the nerve at the apex of the incision. As the more traditional linear incision would most likely transect the type I nerves and more so near their trunk, the U incision may be the overall better choice in avoiding neural and occipital artery injury during retrosigmoid approaches. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Laparoscopic completion cholecystectomy and common bile duct exploration for retained gallbladder after single-incision cholecystectomy.

    Science.gov (United States)

    Kroh, Matthew; Chalikonda, Sricharan; Chand, Bipan; Walsh, R Matthew

    2013-01-01

    Recent enthusiasm in the surgical community for less invasive surgical approaches has resulted in widespread application of single-incision techniques. This has been most commonly applied in laparoscopic cholecystectomy in general surgery. Cosmesis appears to be improved, but other advantages remain to be seen. Feasibility has been demonstrated, but there is little description in the current literature regarding complications. We report the case of a patient who previously underwent single-incision laparoscopic cholecystectomy for symptomatic gallstone disease. After a brief symptom-free interval, she developed acute pancreatitis. At evaluation, imaging results of ultrasonography and magnetic resonance cholangiopancreatography demonstrated a retained gallbladder with cholelithiasis. The patient was subsequently referred to our hospital, where she underwent further evaluation and surgical intervention. Our patient underwent 4-port laparoscopic remnant cholecystectomy with transcystic common bile duct exploration. Operative exploration demonstrated a large remnant gallbladder and a partially obstructed cystic duct with many stones. Transcystic exploration with balloon extraction resulted in duct clearance. The procedure took 75 minutes, with minimal blood loss. The patient's postoperative course was uneventful. Final pathology results demonstrated a remnant gallbladder with cholelithiasis and cholecystitis. This report is the first in the literature to describe successful laparoscopic remnant cholecystectomy and transcystic common bile duct exploration after previous single-port cholecystectomy. Although inadvertent partial cholecystectomy is not unique to this technique, single-port laparoscopic procedures may result in different and significant complications.

  8. Correlation between the distance of maxillary central incisors and incisive papilla in different arch form

    Directory of Open Access Journals (Sweden)

    Nur Ateyya Natasha Mohd Zali

    2018-01-01

    Full Text Available In edentulous treatment, relocation of anterior teeth in the preexisting natural position is the utmost importance. It is necessary to refer to the significant anatomical landmarks, one of them is incisive papilla. To make it more efficient both functionally and biologically, the teeth were arranged in particular geometric manner known as a dental arch. The author has chosen to conducted the research among the Malay race represented by the Malay undergraduate students. The purpose of this study was to evaluate the correlation between the distance of maxillary central incisors and incisive papilla (CI-IP in different arch form and gender. Maxillary impressions of 34 dentate individuals were taken, and the measurements were performed using a digital caliper. The results showed the CI-IP distance was ranging between 7.65 to 9.90 mm, with the average of 8.77 mm. There was no significant difference of the CI-IP distance between male and female regardless of their arch forms (p>0.05. Individuals with ovoid and tapered arch form, however, showed a significant difference of the CI-IP distance between male and female (p0.05. It can be concluded that gender factor was irrelevant towards the CI-IP distance regardless of the individual arch form. However, there was a correlation between the CI-IP distance in different arch forms in both male and female sample.

  9. Transverse uterine fundal incision for placenta praevia with accreta, involving the entire anterior uterine wall: a case series.

    Science.gov (United States)

    Kotsuji, F; Nishijima, K; Kurokawa, T; Yoshida, Y; Sekiya, T; Banzai, M; Minakami, H; Udagawa, Y

    2013-08-01

    To determine the feasibility and safety of transverse fundal incision with manual placental removal in women with placenta praevia and possible placenta accreta. Case series. Four level-three Japanese obstetric centres. Thirty-four women with prior caesarean section and placenta praevia that widely covers the anterior uterine wall, in whom placenta accreta cannot be ruled out. A transverse fundal incision was performed at the time of caesarean section and manual placental removal was attempted under direct observation. Operative fluid loss. The total volume of fluid lost during our operative procedure compares favourably with the volume lost during our routine transverse lower-segment caesarean sections performed in patients without placenta praevia or accreta. The average fluid loss was 1370 g. No patients required transfer to intensive care, and there were no cases of fetal anaemia. This procedure has the potential to reduce the heavy bleeding that arises from caesarean deliveries in women with placenta praevia and placenta accreta. © 2013 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2013 RCOG.

  10. Enhancing dissemination of Beauveria bassiana with host plant base incision trapfor the management of the banana weevil Cosmopolites sordidus

    NARCIS (Netherlands)

    Tinzaara, W.; Emudong, P.; Nankinga, C.; Tushemereirwe, W.; Kagezi, G.H.; Gold, C.S.; Dicke, M.; Huis, van A.; Karamura, E.

    2015-01-01

    The banana weevil, Cosmopolites sordidus (Germar) (Coleoptera: Curculionidae) is an important pest of highland banana in East and central Africa. It causes yield loss of up to 100% in heavily infested fields. Studies were carried out in Uganda to evaluate the efficacy of the the plant base incision

  11. Applying alpha-channeling to mirror machines

    Energy Technology Data Exchange (ETDEWEB)

    Zhmoginov, A. I.; Fisch, N. J. [Department of Astrophysical Sciences, Princeton University, Princeton, New Jersey 08544 (United States)

    2012-05-15

    The {alpha}-channeling effect entails the use of radio-frequency waves to expel and cool high-energetic {alpha} particles born in a fusion reactor; the device reactivity can then be increased even further by redirecting the extracted energy to fuel ions. Originally proposed for tokamaks, this technique has also been shown to benefit open-ended fusion devices. Here, the fundamental theory and practical aspects of {alpha} channeling in mirror machines are reviewed, including the influence of magnetic field inhomogeneity and the effect of a finite wave region on the {alpha}-channeling mechanism. For practical implementation of the {alpha}-channeling effect in mirror geometry, suitable contained weakly damped modes are identified. In addition, the parameter space of candidate waves for implementing the {alpha}-channeling effect can be significantly extended through the introduction of a suitable minority ion species that has the catalytic effect of moderating the transfer of power from the {alpha}-channeling wave to the fuel ions.

  12. Plasma channels for electron beam transport

    International Nuclear Information System (INIS)

    Schneider, R.F.; Smith, J.R.; Moffatt, M.E.; Nguyen, K.T.; Uhm, H.S.

    1988-01-01

    In recent years, there has been much interest in transport of intense relativistic electron beams using plasma channels. These channels are formed by either: ionization of an organic gas by UV photoionization or electron impact ionization of a low pressure gas utilizing a low energy (typically several hundred volts) electron gun. The second method is discussed here. As their electron gun, the authors used a 12 volt lightbulb filament which is biased to -400 volts with respect to the grounded 15 cm diameter drift tube. The electrons emitted from the filament are confined by an axial magnetic field of --100 Gauss to create a plasma channel which is less than 1 cm in radius. The channel density has been determined with Langmuir probes and the resulting line densities were found to be 10 11 to 10 12 per cm. When a multi-kiloamp electron beam is injected onto this channel, the beam space charge will eject the plasma electrons leaving the ions behind to charge neutralize the electron beam, hence allowing the beam to propagate. In this work, the authors performed experimental studies on the dynamics of the plasma channel. These include Langmuir probe measurements of a steady state (DC) channel, as well as time-resolved Langmuir probe studies of pulsed channels. In addition they performed experimental studies of beam propagation in these plasma channels. Specifically, they observed the behavior of current transport in these channels. Detailed results of beam transport and channel studies are presented

  13. Study of modified two incisions silicone oil removal with a 23G transconjunctival sutureless vitrectomy system

    Directory of Open Access Journals (Sweden)

    Hai-Jun Yang

    2015-01-01

    Full Text Available AIM:To evaluate the efficacy and safety of silicone oil removal with a 23G transconjunctival sutureless vitrectomy system linked disposable transfusion tube and self-made suction tip. METHODS: The suction tip was made with a 23G infusion tube be cut from the end of the 5mm. It was used to connect the disposable transfusion tube and 23G puncture cannula. The disposable transfusion tube which was cut from the end of the MaiFei's pipe was connected with the effusion box of the vitreous cutter. Intraocular silicone oil was proactive suction and removed through two incisions on pars plana ciliaris with the vitreous cutter suction system. RESULTS: Only 13 cases(9.8%need suture puncture ports in 132 cases in the operation. Operation time was 7-28min. The average operation time was 15.1± 6.2min. In early postoperative, there were 107 cases(81.1%appeared lower intraocular pressure(CONCLUSION: The surgery that silicone oil is removed through two incisions with a 23G transconjunctival sutureless vitrectomy system linked disposable transfusion tube and self-made suction tip has the advantages of safe, effective, fast, economic, and it is worthy of popularization and application in clinical.

  14. Analysis on incidence and management of complications after femtosecond laser-assisted small incision lenticule extraction

    Directory of Open Access Journals (Sweden)

    Cai-Hong Li

    2018-04-01

    Full Text Available AIM: To evaluate the safety and postoperative complications of femtosecond laser-assisted small incision lenticule extraction(SMILE. METHODS: Retrospective case series. A total of 1127 patients(2 236 eyeswho were treated with SMILE for myopia or myopia astigmatism between June 2016 and May 2017 were enrolled in this study. Eyes that developed postoperative complications were noted and identified. The incidence, risk factors, management and prognosis were analyzed. The follow-up was 6mo.RESULTS: The rate of postoperative complications was 8.05%, included diffuse lamellar keratitis(3.31%, delayed visual acuity(2.59%, minor interface residue(0.63%, and ghost images(1.52%. These complications had an impact on best corrected visual acuity(BCVAat 3mo in only 1 eye with decentered ablation and was re-treated with topography-guided laser-assisted subepithelial keratomileusis(LASEK. Good visual outcomes were achieved in all eyes finally. CONCLUSION: Although few eyes suffered postoperative complications, SMILE is an acceptable safe surgery. Careful surgical skill, appropriate surgical parameter, and rational postoperative medication can decrease the risk of complication.

  15. Transobturator Midurethral Slings versus Single-Incision Slings for Stress Incontinence in Overweight Patients

    Directory of Open Access Journals (Sweden)

    Omer Bayrak

    2015-08-01

    Full Text Available ABSTRACTPurpose:To compare transobturator midurethral sling (TOS and single-incision sling procedures in terms of their effects on urinary incontinence and the quality of life in overweight (BMI ≥25-29.9 kg/m2 female patients using the International Consultation on Incontinence Questionnaire scoring form (ICIQ-SF and Quality of Life of Persons with Urinary Incontinence scoring form (I-QOL.Materials and Methods:In this prospective trial, the patients were divided into two groups consecutively; first 20 overweight female patients underwent the TOS (Unitape T®,Promedon, Cordoba, Argentina procedure and the subsequent 20 consecutive overweight female patients underwent the single-incision sling [TVT-secur (Ethicon Inc., Sommerville, USA] procedure. Age, urinary incontinence period, parity and daily pads usage were recorded. No usage of pads was defined as subjective cure rate postoperatively. Before the operation and 6. month after the surgery, the patients completed the ICIQ-SF and I-QOL.Results:There was no significant difference between the two groups in terms of mean age, duration of incontinence, parity, and BMI (p>0.05. ICIQ-SF and I-QOL revealed that the patients in the TOS group showed significantly better improvement (76.20% versus 64.10%, p=0.001, 81.31% versus 69.28%, p=0.001, respectively. In addition, subjective cure rates were found higher in TOS group (75% versus 55%, p=0.190.Conclusions:The existing data is showed that incontinence symptoms and the quality of life have higher improvement in overweight female patients who underwent the TOS procedure. It is likely that the TOS procedure may provide stronger urethral support and better contributes to continence in this group of patients.

  16. FMCG companies specific distribution channels

    Directory of Open Access Journals (Sweden)

    Ioana Barin

    2009-12-01

    Full Text Available Distribution includes all activities undertaken by the producer, alone or in cooperation, since the end of the final finished products or services until they are in possession of consumers. The distribution consists of the following major components: distribution channels or marketing channels, which together form a distribution network; logistics o rphysical distribution. In order to effective achieve, distribution of goods requires an amount of activities and operational processes related to transit of goods from producer to consumer, the best conditions, using existing distribution channels and logistics system. One of the essential functions of a distribution is performing acts of sale, through which, with the actual movement of goods, their change of ownership takes place, that the successive transfer of ownership from producer to consumer. This is an itinerary in the economic cycle of goods, called the distribution channel.

  17. Monitoring fluvial erosion of the Oso landslide, Washington, using repeat Structure-from-Motion photogrammetry

    Science.gov (United States)

    Anderson, S. W.; Magirl, C. S.; Keith, M. K.

    2015-12-01

    On March 22, 2014, the Oso landslide, located in northwestern Washington State, catastrophically mobilized about 8 million m3 of mixed glacial sediment, creating a valley-wide blockage that impounded the North Fork Stillaguamish River to a height of 8 m. The river overtopped the landslide blockage within several days and incised a new channel through predominately fine-grained, cohesive glaciolacustrine sediment in the center of the deposit. Our research focuses on the evolution of this new channel. Using a consumer-grade digital camera mounted on a fixed wing-aircraft, we used structure-from-motion (SfM) photogrammetry to produce 25 cm digital elevation models (DEMs) of the channel at one-month intervals between November 2014 and July 2015. A large RTK GPS validation dataset and inter-survey comparisons documents sub-decimeter vertical and horizontal accuracies. In combination with aerial lidar surveys acquired in March and April 2014, this dataset provides a uniquely resolved look at the erosion of a landslide dam. The newly-formed channel incised rapidly, lowering to within a meter of its pre-slide elevation by May 2014 despite modest flows. During high flows of the 2014-2015 winter flood season, erosion was dominated by channel widening of tens of meters with an overall stable planform. Incision fully returned the channel to pre-slide elevations by December 2014. A total of 510,000 +/- 50,000 m3 of material was eroded between March 2014 and July 2015, split evenly between the initial period of incision and the later period of widening. Sediment yield and channel morphology showed asymptotic trends towards stability. Measurements of deposit bulk density and grain size allowed conversion of volumetric sediment yields to mass yields by size classes. Over the 16 months after the slide, the river eroded about 0.82 +/- 0.1 Mt of sediment, of which 0.78 Mt was finer than 2mm. This yield agrees within 15% of an independent estimate based on concurrent sediment gaging

  18. Anthropocene streams and base-level controls from historic dams in the unglaciated mid-Atlantic region, USA

    Science.gov (United States)

    Merritts, Dorothy; Walter, Robert; Rahnis, Michael; Hartranft, Jeff; Cox, Scott; Gellis, Allen; Potter, Noel; Hilgartner, William; Langland, Michael; Manion, Lauren; Lippincott, Caitlin; Siddiqui, Sauleh; Rehman, Zain; Scheid, Chris; Kratz, Laura; Shilling, Andrea; Jenschke, Matthew; Datin, Katherine; Cranmer, Elizabeth; Reed, Austin; Matuszewski, Derek; Voli, Mark; Ohlson, Erik; Neugebauer, Ali; Ahamed, Aakash; Neal, Conor; Winter, Allison; Becker, Steven

    2011-01-01

    Recently, widespread valley-bottom damming for water power was identified as a primary control on valley sedimentation in the mid-Atlantic US during the late seventeenth to early twentieth century. The timing of damming coincided with that of accelerated upland erosion during post-European settlement land-use change. In this paper, we examine the impact of local drops in base level on incision into historic reservoir sediment as thousands of ageing dams breach. Analysis of lidar and field data indicates that historic milldam building led to local base-level rises of 2-5 m (typical milldam height) and reduced valley slopes by half. Subsequent base-level fall with dam breaching led to an approximate doubling in slope, a significant base-level forcing. Case studies in forested, rural as well as agricultural and urban areas demonstrate that a breached dam can lead to stream incision, bank erosion and increased loads of suspended sediment, even with no change in land use. After dam breaching, key predictors of stream bank erosion include number of years since dam breach, proximity to a dam and dam height. One implication of this work is that conceptual models linking channel condition and sediment yield exclusively with modern upland land use are incomplete for valleys impacted by milldams. With no equivalent in the Holocene or late Pleistocene sedimentary record, modern incised stream-channel forms in the mid-Atlantic region represent a transient response to both base-level forcing and major changes in land use beginning centuries ago. Similar channel forms might also exist in other locales where historic milling was prevalent.

  19. Quantum capacity under adversarial quantum noise: arbitrarily varying quantum channels

    OpenAIRE

    Ahlswede, Rudolf; Bjelakovic, Igor; Boche, Holger; Noetzel, Janis

    2010-01-01

    We investigate entanglement transmission over an unknown channel in the presence of a third party (called the adversary), which is enabled to choose the channel from a given set of memoryless but non-stationary channels without informing the legitimate sender and receiver about the particular choice that he made. This channel model is called arbitrarily varying quantum channel (AVQC). We derive a quantum version of Ahlswede's dichotomy for classical arbitrarily varying channels. This includes...

  20. 5,6-EET potently inhibits T-type calcium channels

    DEFF Research Database (Denmark)

    Cazade, M.; Bidaud, I.; Hansen, Pernille B. Lærkegaard

    2014-01-01

    T-type calcium channels (T-channels) are important actors in neuronal pacemaking, in heart rhythm, and in the control of the vascular tone. T-channels are regulated by several endogenous lipids including the primary eicosanoid arachidonic acid (AA), which display an important role in vasodilation...