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Sample records for intraoperative frozen section

  1. Intraoperative visualization, frozen section, and permanent pathology in endometrial cancer

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    Soheila Aminimoghaddam

    2014-12-01

    Conclusion: Although the sample size of the studied population was small but our study results support the previous data and suggest that in early stages and low grade tumors, gross examination and frozen section diagnosis are conveniently predictive of lymph node metastasis. These data might be useful for prediction of tumor invasion using frozen section and gross examination in low grade tumors and early stages and for doing complete surgical staging and lymph node sampling. However the im-portance of surgical staging always must be considered in patients who need systemat-ic lymphadenectomy. In overall these data might help to come up with new guidelines for surgical risk assessment in endometrial cancer.

  2. Intraoperative frozen section analysis of the proximal bile ducts in hilar cholangiocarcinoma is of limited value.

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    Mantel, Hendrik T J; Westerkamp, Andrie C; Sieders, Egbert; Peeters, Paul M J G; de Jong, Koert P; Boer, Marieke T; de Kleine, Ruben H; Gouw, Annette S H; Porte, Robert J

    2016-07-01

    Frozen section analysis (FS) during cancer surgery is widely used to assess resection margins. However, in hilar cholangiocarcinoma (HCCA), FS may be less reliable because of the specific growth characteristics of the tumor. The aim of this study was to determine the accuracy and consequences of intraoperative FS of the proximal bile duct margins in HCCA. Between 1990 and 2014, 67 patients underwent combined extrahepatic bile duct resection and partial liver resection for HCCA with the use of FS. Sensitivity and specificity of FS was 68% and 97%, respectively. Seventeen of 67 patients (25%) displayed a positive bile duct margin at FS. The false-negative rate was 16% (eight patients). Ten patients (15%) with a positive bile duct margin underwent an additional resection in an attempt to achieve negative margins, which succeeded in three patients (4%). However, only one of these three patients did not have concomitant lymph node metastases, which are associated with a poor prognosis by itself. The use of FS of the proximal bile duct is of limited clinical value because of the relatively low sensitivity, high risk of false-negative results, and the low rate of secondary obtained tumor-free resection margins. Supported by the literature, a new approach to the use of FS in HCCA should be adopted, reserving the technique only for cases in which a substantial additional resection is possible.

  3. Intra-operative frozen section diagnosis of breast lesions: a retrospective analysis of 13 243 Chinese patients

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    NIU Yun; FU Xi-lin; YU Yong; Peizhong Peter Wang; CAO Xu-chen

    2007-01-01

    Background Although cytological methods for breast oncology have been used in recent decades, intra-operative frozen section has been playing a vital role in making therapeutic decisions. We analyzed a large series of frozen section diagnoses for Chinese cases of breast lesion within the last 15 years. The experience was expected to increase the diagnostic accuracy of cases with breast lesions.Methods The data from consecutive 13243 cases of breast lesions diagnosed with intra-operative frozen sections between 1988 to 2002 were compared with paraffin sections in a case by case manner. The causes of false negative and positive diagnoses as well as delayed diagnoses were analyzed.Results One hundred and seventeen cases (0.9%) were falsely diagnosed, with one false positive case and 116 false negative cases. The diagnosis of 47 cases (0.4%) was delayed. The proportion of several lesions had the features of the patients'ages. Six types (false invasion, peri-papilloma, adenoma of nipple duct, florid adenosis, sclerosing adenosis,and granulose cell tumor) of lesions may lead to false positive, and four types (morphological changes responding chemotherapy, well differentiated papillary carcinoma, invasive lobular carcinoma, and tubular carcinoma) to a false negative. Gross and microscopic findings may be inconsistent in two types of lesions (radial scar and florid adenosis)microscopic and clinical findings in three types (ganulomatous mastitis mammary, duct ectasia, and fat necrosis), and three types (abundant fat or sclerous tissues; borderline lesions and changes of post-chemotherapy) were likely wrongly classified.Conclusions Intra-operative frozen section can accurately identify breast lesions in many instances, leading to fewer errors on account of more diagnostic experience and understanding of diagnostic limitations.

  4. Comparison of the cytology technique and the frozen section results in intraoperative consultation of the breast lesions

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    "Haeri H

    2002-07-01

    Full Text Available The cytology study is effective and reliable technique in intraoperative consultation. This study was performed to evaluate the accuracy of the cytology study in intraoperative consultation of the breast lesions. 125 specimens of the breast lesions were examined and studied in Imam Khomeini Hospital during the years 1998-99. The sensitivity, specificity and accuracy for cytological method were 87.5% , 95%, 90.5% and for the frozen section 92.4%, 100% and 95.4% respectively. The false positive reports were 2% in the cytology technique and the most important source of error and false postivie reports was fibroadenoma in this method. By reviewing the results. It could be concluded that combination of these two techniques is beneficial and more reliable in intraoperative consultation resports of the breast lesions

  5. Intraoperative frozen section analysis of the proximal bile ducts in hilar cholangiocarcinoma is of limited value

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    Mantel, Hendrik T J; Westerkamp, Andrie C; Sieders, Egbert; Peeters, Paul M J G; de Jong, Koert P; Boer, de Marieke; de Kleine, Ruben H; Gouw, Annette S H; Porte, Robert J

    2016-01-01

    Frozen section analysis (FS) during cancer surgery is widely used to assess resection margins. However, in hilar cholangiocarcinoma (HCCA), FS may be less reliable because of the specific growth characteristics of the tumor. The aim of this study was to determine the accuracy and consequences of int

  6. Intraoperative frozen section assessment of sentinel lymph nodes in the operative management of women with symptomatic breast cancer

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    Landers Rob

    2008-06-01

    Full Text Available Abstract Background Maximisation of the potential of sentinel lymph node biopsy as a minimally invasive method of axillary staging requires sensitive intraoperative pathological analysis so that rates of re-operation for lymphatic metastases are minimised. The aim of this study was to describe the test parameters of the frozen section evaluation of sentinel node biopsy for breast cancer compared to the gold standard of standard permanent pathological evaluation at our institution. Methods The accuracy of intraoperative frozen section (FS of sentinel nodes was determined in 94 consecutive women undergoing surgery for clinically node negative, invasive breast cancer (37:T1 disease; 43:T2; 14:T3. Definitive evidence of lymphatic spread on FS indicated immediate level II axillary clearance while sentinel node "negativity" on intraoperative testing led to the operation being curtailed to allow formal H&E analysis of the remaining sentinel nodal tissue. Results Intraoperative FS correctly predicted axillary involvement in 23/30 patients with lymphatic metastases (76% sensitivity rate permitting definitive surgery to be completed at the index operation in 87 women (93% overall. All SN found involved on FS were confirmed as harbouring tumour cells on subsequent formal specimen examination (100% specificity and positive predictive value with 16 patients having additional non-sentinel nodes found also to contain tumour. Negative Predictive Values were highest in women with T1 tumours (97% and lessened with more local advancement of disease (T2 rates: 86%; T3: 75%. Of those with falsely negative FS, three had only micrometastatic disease. Conclusion Intraoperative FS reliably evaluates the status of the sentinel node allowing most women complete their surgery in a single stage. Thus SN can be offered with increased confidence to those less likely to have negative axillae hence expanding the population of potential beneficiaries.

  7. Frozen section is superior to imprint cytology for the intra-operative assessment of sentinel lymph node metastasis in Stage I Breast cancer patients

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    Makita Masujiro

    2006-05-01

    Full Text Available Abstract Background A standard intra-operative procedure for assessing sentinel lymph node metastasis in breast cancer patients has not yet been established. Patients and methods One hundred and thirty-eight patients with stage I breast cancer who underwent sentinel node biopsy using both imprint cytology and frozen section were analyzed. Results Seventeen of the 138 patients had sentinel node involvement. Results of imprint cytology included nine false negative cases (sensitivity, 47.1%. In contrast, only two cases of false negatives were found on frozen section (sensitivity, 88.2%. There were two false positive cases identified by imprint cytology (specificity, 98.3%. On the other hand, frozen section had 100% specificity. Conclusion These findings suggest that frozen section is superior to imprint cytology for the intra-operative determination of sentinel lymph node metastasis in stage I breast cancer patients.

  8. Frozen section is superior to imprint cytology for the intra-operative assessment of sentinel lymph node metastasis in Stage I Breast cancer patients

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    Mori, Miki; Tada, Keiichiro; Ikenaga, Motoko; Miyagi, Yumi; Nishimura, Seiichiro; Takahashi, Kaoru; Makita, Masujiro; Iwase, Takuji; Kasumi, Fujio; Koizumi, Mituru

    2006-01-01

    Background A standard intra-operative procedure for assessing sentinel lymph node metastasis in breast cancer patients has not yet been established. Patients and methods One hundred and thirty-eight patients with stage I breast cancer who underwent sentinel node biopsy using both imprint cytology and frozen section were analyzed. Results Seventeen of the 138 patients had sentinel node involvement. Results of imprint cytology included nine false negative cases (sensitivity, 47.1%). In contrast, only two cases of false negatives were found on frozen section (sensitivity, 88.2%). There were two false positive cases identified by imprint cytology (specificity, 98.3%). On the other hand, frozen section had 100% specificity. Conclusion These findings suggest that frozen section is superior to imprint cytology for the intra-operative determination of sentinel lymph node metastasis in stage I breast cancer patients. PMID:16707007

  9. The Value of Intraoperative Frozen Section Analysis for Margin Status in Breast Conservation Surgery in a Nontertiary Institution

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    Mona P. Tan

    2014-01-01

    Full Text Available Introduction. Breast conservation treatment (BCT for early-stage breast malignancies requires negative margins and good cosmesis. Reoperations may be needed to achieve negative margins, which can have an adverse impact on outcomes. This study was performed to evaluate the efficacy of intraoperative frozen section analysis (IFSA for margin assessment to reduce excision rates. Methods. All patients treated at the authors’ private healthcare facility between 2009 and 2011 for breast cancer were included in the study. Those for whom BCT was intended underwent wide excision with IFSA. Six margins of the excised tissue, and the sentinel lymph node (SLN, where appropriate, were submitted for IFSA. Patient demographics, tumour characteristics, number of operations performed, and outcomes were analysed. Results. Of the 161 patients analysed, 138 (85.7% had successful breast conservation. Four patients required a reoperation for incomplete surgical extirpation. One had a false negative SLN assessment on IFSA, and was returned to the operating room for an axillary dissection. Three patients required reoperations for inadvertently missed multicentric disease. None had false negative margin evaluation with IFSA necessitating reexcision. Conclusion. The use of IFSA allows low rates of reoperation with BCT. Further research is needed to establish consistency in low reexcision rates for cost-effectiveness and optimum resource allocation.

  10. Hyalinizing trabecular tumor of the thyroid: Diagnosed of a rare tumor using ultrasonography, cytology, and intraoperative frozen sections

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    Jang, Hyun Sik; Kim, Eun Kyung; Kwak, Jin Young; Moon, Hee Jung; Yoon, Jung Hyun [Dept. of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University, College of Medicine, Seoul (Korea, Republic of); Park, Cheol Keun; Son, Eun Ju [Gangnam Severance Hospital, Yonsei University, College of Medicine, Seoul (Korea, Republic of)

    2016-03-15

    The goal of this study was to evaluate the clinicopathological and imaging features of thyroid nodules surgically diagnosed as hyaline trabecular tumor (HTT), and to assess the role of cytology and frozen sections (FS) in the diagnosis of HTT. This study included 21 thyroid nodules in 21 patients treated from August 2005 to March 2015 (mean age, 53.3 years) who were either diagnosed as HTT or had HTT suggested as a possible diagnosis based on cytology, FS, or the final pathology report. Patients' medical records were retrospectively reviewed for cytopathologic results and outcomes during the course of follow-up. Sonograms were reviewed and categorized. Twelve nodules from 12 patients were surgically confirmed as HTT. Ultrasonography (US)-guided fine needle aspiration (FNA) was performed on 11 nodules, of which six (54.5%) were papillary thyroid carcinoma (PTC) or suspicious for PTC and three (27.3%) were HTT or suspicious for HTT. Intraoperative FS suggested the possibility of HTT in seven nodules, of which four (57.1%) were confirmed as HTT. US-FNA suggested the diagnosis of HTT in 10 nodules, of which three (30.0%) were confirmed as HTT. Common US features of the 12 pathologically confirmed cases of HTT were hypoechogenicity or marked hypoechogenicity (83.4%), absence of calcifications (91.7%), parallel shape (100.0%), presence of vascularity (75.0%), and probable benignity (58.3%). HTT should be included in the differential diagnosis of solid tumors with hypoechogenicity or marked hypoechogenicity and otherwise benign US features that have been diagnosed as PTC through cytology.

  11. Hyalinizing trabecular tumor of the thyroid: diagnosis of a rare tumor using ultrasonography, cytology, and intraoperative frozen sections

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    Hyunsik Jang

    2016-04-01

    Full Text Available Purpose: The goal of this study was to evaluate the clinicopathological and imaging features of thyroid nodules surgically diagnosed as hyaline trabecular tumor (HTT, and to assess the role of cytology and frozen sections (FS in the diagnosis of HTT. Methods: This study included 21 thyroid nodules in 21 patients treated from August 2005 to March 2015 (mean age, 53.3 years who were either diagnosed as HTT or had HTT suggested as a possible diagnosis based on cytology, FS, or the final pathology report. Patients’ medical records were retrospectively reviewed for cytopathologic results and outcomes during the course of follow-up. Sonograms were reviewed and categorized. Results: Twelve nodules from 12 patients were surgically confirmed as HTT. Ultrasonography (US-guided fine needle aspiration (FNA was performed on 11 nodules, of which six (54.5% were papillary thyroid carcinoma (PTC or suspicious for PTC and three (27.3% were HTT or suspicious for HTT. Intraoperative FS suggested the possibility of HTT in seven nodules, of which four (57.1% were confirmed as HTT. US-FNA suggested the diagnosis of HTT in 10 nodules, of which three (30.0% were confirmed as HTT. Common US features of the 12 pathologically confirmed cases of HTT were hypoechogenicity or marked hypoechogenicity (83.4%, absence of calcifications (91.7%, parallel shape (100.0%, presence of vascularity (75.0%, and probable benignity (58.3%. Conclusion: HTT should be included in the differential diagnosis of solid tumors with hypoechogenicity or marked hypoechogenicity and otherwise benign US features that have been diagnosed as PTC through cytology.

  12. Comparison of contact endoscopy and frozen section histopathology in the intra-operative diagnosis of laryngeal pathology.

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    Cikojević, D; Gluncić, I; Pesutić-Pisac, V

    2008-08-01

    Andrea et al. were the first to use contact endoscopy in the diagnosis of laryngeal disease, in 1995. This method enables in vivo microscopy of laryngeal mucosa. In the present study, comparison of contact endoscopy with frozen section histopathology was performed in 142 patients with various diseases of the larynx. Paraffin section histopathology diagnosed 70 benign lesions, 23 precancerous lesions and 49 malignant lesions. Frozen section histopathology showed a sensitivity of 89.8 per cent, a specificity of 98.9 per cent and an accuracy of 95.7 per cent (chi2 = 1.5; p = 0.18). Frozen histopathology diagnosed 45 malignant lesions, including one false positive and five false negative results. Contact endoscopy yielded a sensitivity of 79.59 per cent, a specificity of 100 per cent and an accuracy of 92.95 per cent (chi2 = 8.1; p = 0.002). All malignant lesions diagnosed by contact endoscopy were confirmed by histopathology; contact endoscopy failed to recognise malignant lesions in 10 patients. Contact endoscopy is preferable to frozen section histopathology as it is noninvasive, provides information on microscopic diagnosis and laryngeal lesion margins, and enables visualisation of the laryngeal mucosa microvasculature. The use of contact endoscopy along with frozen section histopathology improves diagnostic accuracy and allows for operative (or other) therapy to continue according to the results obtained.

  13. Multiple Myeloma Presenting as Massive Amyloid Deposition in a Parathyroid Gland Associated with Amyloid Goiter: A Medullary Thyroid Carcinoma Mimic on Intra-operative Frozen Section.

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    Hill, Kirk; Diaz, Jason; Hagemann, Ian S; Chernock, Rebecca D

    2017-09-06

    Clinical examples of amyloid deposition in parathyroid glands are exceedingly rare and usually present as an incidental finding in a patient with amyloid goiter. Here, we present the first histologically documented case of parathyroid amyloid deposition that presented as a mass. The patient did not have hyperparathyroidism. The parathyroid gland was submitted for intra-operative frozen section and concern for medullary thyroid carcinoma was raised. An important histologic clue arguing against medullary thyroid carcinoma was the evenly dispersed nature of the amyloid. Histologic perinuclear clearing and parathyroid hormone immunohistochemistry confirmed parathyroid origin on permanent sections. The patient was also found to have associated amyloid goiter. Mass spectrometry of the amyloid showed it to be composed of kappa light chains. On further work-up, the patient was diagnosed with multiple myeloma. Awareness of parathyroid amyloid deposition is important as it is a histologic mimic of medullary thyroid carcinoma, especially on frozen section. Amyloid typing with evaluation for multiple myeloma in any patient with kappa or lambda light chain restriction is also important.

  14. Clinical Analysis of Parotid Tumor Intraoperative Frozen Section Examination%腮腺肿瘤术中冰冻切片检查的临床分析

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    王亦飞; 王辉

    2014-01-01

    目的:探讨腮腺肿瘤术中…冰冻切片检查的临床效果。方法选取我院2012年1月~2014年3月72例腮腺肿瘤手术治疗患者,手术过程中…实施冰冻切片检查,分析其临床效果。结果快速冰冻检查恶性肿瘤敏感度为87.9%,特异性96.4%。结论快速冰冻切片在腮腺手术中…能够快速准确的诊断良、恶性肿瘤,且可对临床判定腮腺恶性肿瘤恶性程度予以一定参考。%Objective To study the clinical effect of intraoperative frozen section examination of parotid tumors. Methods From January 2012 to March 2014, 72 cases of patients with parotid gland tumor surgery, surgery in the process of implementation of frozen section examination, to analyze its clinical effect. Results Malignant tumor sensitivity was 87.9%, specificity of 96.4%. Conclusion Rapid frozen section in the parotid gland surgery can fast accurate diagnosis of benign and malignant tumor, and can judge parotid gland malignant tumor malignant degree of clinical give certain reference, higher clinical value.

  15. [Diagnostic validity of the intraoperative analysis in frozen section of the sentinel lymph node in the surgical management of breast cancer].

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    Bañuelos-Andrío, Luis; Rodríguez-Caravaca, Gil; Argüelles-Pintos, Miguel; Mitjavilla-Casanovas, Mercedes

    2014-01-01

    The method for intraoperative sentinel lymph node (SLN) evaluation has still not been established in breast cancer staging. This study has evaluated the diagnostic validity and impact of intraoperative analysis using the frozen section (FS) of SLN. We performed a descriptive study of the diagnostic validity of the FS of the SLN in patients with breast cancer and selective sentinel node biopsy (SSNB) from October-2006 to October-2012. The diagnostic validity indexes were evaluated using sensitivity, specificity, positive and negative predictive values and global value. Gold standard was considered as the final histopathological results of the biopsies. A total of 370 patients were studied. Sensitivity and specificity for detection of metastasis by FS in the SLN were 67% and 100%, respectively. Global diagnostic validity was 95%. There was a correlation between detection of metastasis and tumor size (pcancer. FS reduces the need for second interventions, at least for most patients who have breast cancer with identifiable positive SLN and unequivocal evidence of positive lymph node disease. Copyright © 2013 Elsevier España, S.L. and SEMNIM. All rights reserved.

  16. Use of frozen section in genitourinary pathology.

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    Shen, Steven S; Truong, Luan D; Ro, Jae Y; Ayala, Alberto G

    2012-08-01

    Frozen section diagnosis provides critical information for immediate surgical management decision making. Over the last several years, there have been some significant advances in treatment of genitourinary cancer, particularly with regard to surgical techniques. These changes in turn impact the type and frequency of intraoperative frozen section requests. In this review, we describe the main indications and diagnostic challenges of frozen section diagnosis during surgeries of each genitourinary organ system including prostate, kidney, bladder, testis, and penis. The pitfalls and approaches to different diagnostic situations are discussed. It is also stressed that pathologists must not only be familiar with the histological diagnosis, but also understand the limitations of frozen section diagnosis and communicate with urologists during the intraoperative treatment decision making process.

  17. Comparison of intraoperative frozen section analysis of sentinel node with preoperative positron emission tomography in the diagnosis of axillary lymph node status in breast cancer patients

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    Yang, Jung-Hyun; Nam, Seok-Jin; Lee, Hae-Kyung; Kim, Byung-Tae [Sungkyunkwan Univ., Seoul (Korea, Republic of); Lee, Tae-Seung; Jung, Sung-Hoo

    2001-01-01

    Although axillary lymph node status is an important prognostic factor and axillary dissection is regarded as the gold standard for staging, it requires radical surgery which is accompanied by considerable postoperative problems such as lymphedema. This study was carried out to evaluate the diagnostic accuracy of preoperative positron emission tomography (PET) and intraoperative frozen biopsy of sentinel lymphadenectomy (SLND) in detecting axillary lymph node metastasis. We studied 18 patients who had preoperative PET and SLND for breast cancer in the Department of Surgery at Samsung Medical Center. They all had preoperative PET with a radiolabeled glucose analogue ([{sup 18}F]FDG) to visualize primary tumors and metastatic nodes. Isosulphan blue dye was used for intraoperative SLND. Frozen and permanent biopsies were then compared after full axillary dissection. In 18 cases, six had positive metastatic nodes in the permanent biopsy of full axillary dissection but were negative in three cases by preoperative PET. There was one false negative result by frozen biopsy of SLND which was later shown to be positive by permanent biopsy. The sensitivity and specificity of SLND and PET for detecting axillary node metastasis were 83, 100% and 50, 100%, respectively. Although both methods are good for axillary nodal status, the intraoperative frozen biopsy result of SLND was superior to preoperative PET in our preliminary study. (author)

  18. Intraoperative frozen section analysis of margins in breast conserving surgery significantly decreases reoperative rates: one-year experience at an ambulatory surgical center.

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    Jorns, Julie M; Visscher, Daniel; Sabel, Michael; Breslin, Tara; Healy, Patrick; Daignaut, Stephanie; Myers, Jeffrey L; Wu, Angela J

    2012-11-01

    Intraoperative frozen section (FS) margin evaluation is not common practice for patients undergoing breast conservation therapy (BCT), but offers a significant reduction in reoperation. In this study, a technique to allow for more effective freezing of breast tissue was developed to perform FS evaluation of lumpectomy margins (FSM) for all patients undergoing BCT at an ambulatory surgery center. FS evaluation of sentinel lymph node biopsy specimens was performed concurrently. One hundred eighty-one study and 188 control patients, with and without FS evaluation, were compared. Reexcision was reduced 34% (from 48.9% to 14.9%) and reoperation was reduced 36% (from 55.3% to 19.3%) with FS evaluation. Most of the decrease in reoperative rate was because of a decrease in the need for margin reexcision. The number of patients requiring 1, 2, or 3 operations to complete therapy was 84, 92, and 12, respectively, in the control group, and 146, 33, and 2, respectively, in the study group. Lobular subtype, multifocal disease, and larger tumor size (≥2 cm) were significantly associated with failure of FSM to prevent reoperation, but reoperation rates were still significantly decreased in this subgroup of patients (from 75.5% to 43.8%) with FSM. This study highlights an innovative yet simple and adaptable FS approach that resulted in a nearly 3-fold reduction in reoperation for patients undergoing BCT.

  19. ULTRATHIN FROZEN SECTIONS

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    Bernhard, W.; Leduc, Elizabeth H.

    1967-01-01

    A relatively simple method for obtaining ultrathin, frozen sections for electron microscopy has been developed. Tissues, cultured cells, and bacteria may be employed. They are fixed in 1.25–4% glutaraldehyde for 1–4 hr, are washed overnight in buffer at 3°C, and are embedded in 20% thiolated gelatin or pure gelatin. Before sectioning they are partially dehydrated in 50% glycerol, frozen in liquid nitrogen on a modified tissue holder, and subsequently maintained at -70°C with dry ice. Finally, they are sectioned very rapidly with glass knives on a slightly modified Porter-Blum MT-1 microtome in a commercial deep-freeze maintained at -35°C and are floated in the trough of the knife on a 40% solution of dimethylsulfoxide (DMSO). The sections are picked up in plastic loops and transferred to distilled water at room temperature for thawing and removal of the DMSO, placed on grids coated with Formvar and carbon, air-dried, and stained with phosphotungstic acid, sodium silicotungstate, or a triple stain of osmium tetroxide, uranyl acetate, and lead. Large flat sections are obtained in which ultrastructural preservation is good. They are particularly useful for cytochemical studies. PMID:4167504

  20. Establishing an accurate diagnosis of a parotid lump: evaluation of the current biopsy methods - fine needle aspiration cytology, ultrasound-guided core biopsy, and intraoperative frozen section.

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    Howlett, D C; Skelton, E; Moody, A B

    2015-09-01

    The optimum technique for histological confirmation of the nature of a parotid mass remains controversial. Fine needle aspiration cytology (FNAC), which has traditionally been used, is associated with high non-diagnostic and false negative rates, and ultrasound (US)-guided core biopsy and frozen section have been explored as alternatives. US-guided core biopsy is more invasive than FNAC, but is safe, well-tolerated, and associated with improved diagnostic performance. Although frozen section offers better specificity than FNAC, it has a number of important drawbacks and cannot be considered as a primary diagnostic tool. US-guided core biopsy should be considered as the initial diagnostic technique of choice, and in units where the accuracy of FNAC is good it can be used when FNAC is equivocal or non-diagnostic. Copyright © 2015 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  1. Role of frozen section in surgery of benign thyroid

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    Tomaž Štupnik

    2007-04-01

    Full Text Available Background: Fine-needle aspiration biopsy can very reliably discriminate between benign and malignant thyroid tumors. The role of additional intraoperative frozen section to guide intraoperative management was questioned.Methods: A retrospective analysis of all thyroid resections at our department between 2000 and 2004 was performed.Results: 420 patients with benign thyroid lesions underwent surgical resections. 169 lobectomies and 251 total thyroidectomies were performed and 57 (13.5 % thyroid cancers discovered (mostly papillary carcinomas. 54 frozen sections were performed and sensitivity rate of 11.1 % and specificity rate of 97.8 % was estimated.Conclusions: Our data supports the fact that intraoperative frozen section is not sensitive enough to substantially add to preoperative fine-needle aspiration biopsy, even with more selective use. We conclude that routine use of frozen section is not cost-effective in surgery of the benign thyroid and can therefore be abandoned.

  2. Use of the virtual slide and the dynamic real-time telepathology systems for a consultation and the frozen section intra-operative diagnosis in thoracic/pulmonary pathology.

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    Lech Chyczewski

    2010-05-01

    Full Text Available We report the results of a study designed for assessment of the diagnostic accuracy and usability of internet-based digital microscopy: the dynamic real-time telepathology system (Coolscope and the Virtual microscopy (Aperio Scan Scope system, in the context of pulmonary pathology. The systems were implemented to the routine pulmonary pathology workflows and used for the intra-operative frozen-section primary diagnosis as well as for the secondary (consultative diagnosis. The histological material presented for the teleconsultations included the samples of lung parenchyma, bronchial biopsy and resected lung/bronchi tumours. For the primary diagnosis 4 categories of material can be distinguished (304 samples: 1 the frozen sections of lung tumours, resected bronchial margins and lymph nodes; 2 fine needle aspiration [FNA] biopsies (TBNA; EBUS-TBNA, EUS-FNA; 3 oligobiopsies of bronchus, oesophagus, skin; and 4 exfoliative cytology. The telepathology diagnoses compared with conventional light microscopy diagnoses showed very high concordance for the Coolscope and Aperio Virtual Slide modality: 87.5% and 100%, respectively - within the group of teleconsultations. For the frozen sections, the primary telediagnoses were concordant with the light microscopy paraffin sections diagnoses in 100% for Aperio; and in 97.5% for Coolscope. An excellent agreement (100% was seen in the telediagnoses and conventional slides diagnoses for FNA, oligobiopsies and cytology - for both telepathology systems. These results provide some encouragement for the implementation of Coolscope and virtual slide-based telepathology (Aperio system to the routine histopathological diagnostics.

  3. Cytokeratin on frozen sections of sentinel node may spare breast cancer patients secondary axillary surgery

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    Stovgaard, Elisabeth Specht; Tvedskov, Tove Filtenborg; Lænkholm, Anne Vibeke

    2012-01-01

    this method with focus on intraoperative diagnostic values. Material and Methods. Results from 336 patients from the centre using IHC intraoperatively were compared with 343 patients from the center not using IHC on frozen section. Final evaluation on paraffin sections with haematoxylin-eosin (HE) staining...

  4. Frozen section investigation of the sentinel node in malignant melanoma and breast cancer

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    Tanis, PJ; Boom, RPA; Faneyte, IF; Peterse, JL; Nieweg, OE; Rutgers, EJT; Tiebosch, ATMG; Kroon, BBR; Schraffordt Koops, H.

    2001-01-01

    Background: Intraoperative frozen section investigation allows immediate regional lymph node dissection when the sentinel node contains tumor. The purpose of this study was to determine the sensitivity of frozen section diagnosis of the sentinel node in melanoma and breast cancer patients. Methods:

  5. Frozen section diagnosis in ophthalmic pathology

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    Biswas Jyotirmay

    1993-01-01

    Full Text Available Frozen section diagnosis is extensively used in various branches of pathology, but its application in ophthalmic pathology was recognised only in the 1970s. We studied 10 sections of ocular and adenexal lesions by frozen section diagnosis, which included orbital lesions (4 cases, lid lesions (3 cases, and intraocular tissue (1 case. The time taken for processing ranged between 10 to 15 minutes. Diagnoses based on frozen section evaluation included lymphoma, mesenchymal chondrosarcoma, solar keratosis, compound naevus, silicone oil globules in cataractous lens, neurofibromatosis, pseudotumour, retinoblastoma, and chronic blepharitis. Although further histopathologic examination correlated well with the frozen section (100% observations, the diagnosis was deferred in the case of naevus and reactive lymphoid hyperplasia. Our study shows that frozen section diagnosis in ophthalmic surgery is quite reliable and is particularly useful in ocular adenexal lesions

  6. Xanthogranuloma of the sellar region diagnosed by frozen section

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    Ji, Kun; Zhang, Liyan; Wang, Liwei

    2016-01-01

    Abstract Xanthogranuloma (XG) of the sellar region is uncommon and is difficult to diagnose based on intraoperative frozen sections. This study is a case presentation and review of the literature, highlighting the need to explore underlying diseases in order to guarantee an accurate patient diagnosis. Herein, we presented the case of a 43-year-old woman who was afflicted with xanthogranuloma of the sellar region; the patient had a history of headache and lengthened menstrual cycles over the 6 months prior to presentation. Endocrinology tests revealed that the patient’s levels of prolactin were high and the MRI of the patient showed a clearly defined sellar mass. As a result, the patient was considered to have prolactinoma prior to undergoing surgery. The tumor was completely removed using a transsphenoidal approach, and intraoperative frozen section revealed histology similar to xanthogranuloma. When the tumor was removed by surgical operation, the patient’s visual field defects and headache were relieved. Although intraoperative frozen section should provide some guidance with regard to the diagnosis, a pathological study is conducted to confirm the actual diagnosis. PMID:28352831

  7. Xanthogranuloma of the sellar region diagnosed by frozen section

    Directory of Open Access Journals (Sweden)

    Ji Kun

    2016-01-01

    Full Text Available Xanthogranuloma (XG of the sellar region is uncommon and is difficult to diagnose based on intraoperative frozen sections. This study is a case presentation and review of the literature, highlighting the need to explore underlying diseases in order to guarantee an accurate patient diagnosis. Herein, we presented the case of a 43-year-old woman who was afflicted with xanthogranuloma of the sellar region; the patient had a history of headache and lengthened menstrual cycles over the 6 months prior to presentation. Endocrinology tests revealed that the patient’s levels of prolactin were high and the MRI of the patient showed a clearly defined sellar mass. As a result, the patient was considered to have prolactinoma prior to undergoing surgery. The tumor was completely removed using a transsphenoidal approach, and intraoperative frozen section revealed histology similar to xanthogranuloma. When the tumor was removed by surgical operation, the patient’s visual field defects and headache were relieved. Although intraoperative frozen section should provide some guidance with regard to the diagnosis, a pathological study is conducted to confirm the actual diagnosis.

  8. Use of virtual slide system for quick frozen intra-operative telepathology diagnosis in Kyoto, Japan

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    Nakano Kooji

    2008-07-01

    Full Text Available Abstract We started to use virtual slide (VS and virtual microscopy (VM systems for quick frozen intra-operative telepathology diagnosis in Kyoto, Japan. In the system we used a digital slide scanner, VASSALO by CLARO Inc., and a broadband optic fibre provided by NTT West Japan Inc. with the best effort capacity of 100 Mbps. The client is the pathology laboratory of Yamashiro Public hospital, one of the local centre hospitals located in the south of Kyoto Prefecture, where a fulltime pathologist is not present. The client is connected by VPN to the telepathology centre of our institute located in central Kyoto. As a result of the recent 15 test cases of VS telepathology diagnosis, including cases judging negative or positive surgical margins, we could estimate the usefulness of VS in intra-operative remote diagnosis. The time required for the frozen section VS file making was found to be around 10 min when we use ×10 objective and if the maximal dimension of the frozen sample is less than 20 mm. Good correct focus of VS images was attained in all cases and all the fields of each tissue specimen. Up to now the capacity of best effort B-band appears to be sufficient to attain diagnosis on time in intra-operation. Telepathology diagnosis was achieved within 5 minutes in most cases using VS viewer provided by CLARO Inc. The VS telepathology system was found to be superior to the conventional still image telepathology system using a robotic microscope since in the former we can observe much greater image information than in the latter in a certain limited time of intra-operation and in the much more efficient ways. In the near future VS telepathology will replace conventional still image telepathology with a robotic microscope even in quick frozen intra-operative diagnosis.

  9. Frozen Section Evaluation of Margin Status in Primary Squamous Cell Carcinomas of the Head and Neck: A Correlation Study of Frozen Section and Final Diagnoses.

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    Layfield, Eleanor M; Schmidt, Robert L; Esebua, Magda; Layfield, Lester J

    2017-08-23

    Frozen section is routinely used for intraoperative margin evaluation in carcinomas of the head and neck. We studied a series of frozen sections performed for margin status of head and neck tumors to determine diagnostic accuracy. All frozen sections for margin control of squamous carcinomas of the head and neck were studied from a 66 month period. Frozen and permanent section diagnoses were classified as negative or malignant. Correlation of diagnoses was performed to determine accuracy. One thousand seven hundred and ninety-six pairs of frozen section and corresponding permanent section diagnoses were obtained. Discordances were found in 55 (3.1%) pairs. In 35 pairs (1.9%), frozen section was reported as benign, but permanent sections disclosed carcinoma. In 21 cases, the discrepancy was due to sampling and in the remaining cases it was an interpretive error. In 20 cases (1.1%), frozen section was malignant, but the permanent section was interpreted as negative. Frozen section is an accurate method for evaluation of operative margins for head and neck carcinomas with concordance between frozen and permanent results of 97%. Most errors are false negative results with the majority of these being due to sampling issues.

  10. Accuracy of frozen section diagnosis: a retrospective analysis of 4785 cases

    DEFF Research Database (Denmark)

    Winther, Charlotte; Graem, Niels

    2011-01-01

    During a 1-year period 4785 intraoperative consultations were performed. The pathology reports were retrospectively reviewed to determine the accuracy of frozen section diagnosis in various tissue types. Skin for evaluation of section margins and axillary sentinel lymph nodes for evaluation...... of metastatic disease were most frequently sent for frozen section diagnosis. The number of discordant cases were 182, 178 were false negative and four were false positive. When frozen section diagnoses were compared with permanent section diagnoses, the overall diagnostic concordance was 95.1%. The number...... of deferred specimens was 57. The accuracy of frozen section diagnosis varied between tissue types, and axillary sentinel lymph nodes accounted for the greatest number of discordances. In conclusion, the frozen section diagnosis is a reliable method with varying concordance and deferral rates between tissue...

  11. Borderline Ovarian Tumors and Diagnostic Dilemma of Intraoperative Diagnosis: Could Preoperative He4 Assay and ROMA Score Assessment Increase the Frozen Section Accuracy? A Multicenter Case-Control Study

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    Salvatore Gizzo

    2014-01-01

    Full Text Available The aim of our study was to assess the value of a preoperative He4-serum-assay and ROMA-score assessment in improving the accuracy of frozen section histology in the diagnosis of borderline ovarian tumors (BOT. 113 women presenting with a unilateral ovarian mass diagnosed as serous/mucinous BOT at frozen-section-histology (FS and/or confirmed on final pathology were recruited. Pathologists were informed of the results of preoperative clinical/instrumental assessment of all patients. For Group_A patients, additional information regarding He4, CA125, and ROMA score was available (in Group_B only CA125 was known. The comparison between Group A and Group B in terms of FS accuracy, demonstrated a consensual diagnosis in 62.8% versus 58.6% (P: n.s., underdiagnosis in 25.6% versus 41.4% (P<0.05, and overdiagnosis in 11.6% versus 0% (P<0.01. Low FS diagnostic accuracy was associated with menopausal status (OR: 2.13, laparoscopic approach (OR: 2.18, mucinous histotype (OR: 2.23, low grading (OR: 1.30, and FIGO stage I (OR: 2.53. Ultrasound detection of papillae (OR: 0.29, septa (OR: 0.39, atypical vascularization (OR: 0.34, serum He4 assay (OR: 0.39, and ROMA score assessment (OR: 0.44 decreased the probability of underdiagnosis. A combined preoperative assessment through serum markers and ultrasonographic features may potentially reduce the risk of underdiagnosis of BOTs on FS while likely increasing the concomitant incidence of false-positive events.

  12. The accuracy of frozen section analysis in ultrasound- guided core needle biopsy of breast lesions

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    Riss Paul

    2009-09-01

    Full Text Available Abstract Background Limited data are available to evaluate the accuracy of frozen section analysis and ultrasound- guided core needle biopsy of the breast. Methods In a retrospective analysis data of 120 consecutive handheldultrasound- guided 14- gauge automated core needle biopsies (CNB in 109 consecutive patients with breast lesions between 2006 and 2007 were evaluated. Results In our outpatient clinic120 CNB were performed. In 59/120 (49.2% cases we compared histological diagnosis on frozen sections with those on paraffin sections of CNB and finally with the result of open biopsy. Of the cases 42/59 (71.2% were proved to be malignant and 17/59 (28.8% to be benign in the definitive histology. 2/59 (3.3% biopsies had a false negative frozen section result. No false positive results of the intraoperative frozen section analysis were obtained, resulting in a sensitivity, specificity and positive predicting value (PPV and negative predicting value (NPV of 95%, 100%, 100% and 90%, respectively. Histological and morphobiological parameters did not show up relevance for correct frozen section analysis. In cases of malignancy time between diagnosis and definitive treatment could not be reduced due to frozen section analysis. Conclusion The frozen section analysis of suspect breast lesions performed by CNB displays good sensitivity/specificity characteristics. Immediate investigations of CNB is an accurate diagnostic tool and an important step in reducing psychological strain by minimizing the period of uncertainty in patients with breast tumor.

  13. Coccidioides, cryptococcus, or blastomyces? A diagnostic dilemma encountered during frozen section evaluation.

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    McClain, Colt M; Van Horn, Gerald T; Chappell, James D; Stratton, Charles W

    2012-01-01

    Intraoperative consultation via frozen section is an important part of modern day surgical pathology. Recognizing fungi in tissues on frozen and permanent sections is not always a simple task, and correctly identifying the agent can be a significant challenge, even for experienced microscopists. We present a case of a 17-year-old boy with chronic osteomyelitis involving the right proximal ulna. During an irrigation and debridement operation, a frozen section was sent to surgical pathology for evaluation. A limited patient history coupled with sparse organisms present in the frozen section led to the diagnosis of fungal osteomyelitis, favor Coccidioides . Follow-up permanent sections with special staining and successful fungal culture clarified the causal agent to be Blastomyces dermatitidis . The role of frozen sections is not to perfectly speciate the fungal pathogen but to describe the morphology and infectious process and provide a differential diagnosis of the candidate fungi. The importance of intraoperative culture in infectious cases cannot be understated, and it is the responsibility of pathologists to inform surgeons that tissue is needed for culture. A brief overview of Blastomyces , including histopathologic features and key microscopic differences from Coccidioides and Cryptococcus , is discussed.

  14. Utility of frozen section analysis for fungal organisms in soft tissue wound debridement margin determination.

    Science.gov (United States)

    Zimmermann, Nives; Hagen, Matthew C; Schrager, Jason J; Hebbeler-Clark, Renee S; Masineni, Sreeharsha

    2015-10-15

    Zygomycetes cause different patterns of infection in immunosuppressed individuals, including sino-orbito-cerebral, pulmonary, skin/soft tissue infection and disseminated disease. Infections with Zygomycetes have a high mortality rate, even with prompt treatment, which includes anti-fungal agents and surgical debridement. In some centers, clear margins are monitored by serial frozen sections, but there are no specific guidelines for the use of frozen sections during surgical debridement. Studies in fungal rhinosinusitis found 62.5-85 % sensitivity of frozen section analysis in margin assessment. However, the utility of frozen section analysis for margin evaluation in debridement of skin/soft tissue infection has not been published. We present a case of zygomycosis of decubitus ulcers in which we assessed statistical measures of performance of frozen section analysis for presence of fungal organisms on the margin, compared with formalin-fixed paraffin embedded (FFPE) sections as gold standard. A total of 33 specimens (94 blocks) were sectioned, stained with H&E and evaluated by both frozen and FFPE analysis. Negative interpretations were confirmed by Gomori methenamine silver stain on FFPE sections. H&E staining of frozen sections had 68.4 % sensitivity and 100 % specificity for assessing margins clear of fungal organisms. The negative and positive predictive values were 70.0 % and 100 %, respectively. Using presence of acute inflammation and necrosis as markers of fungal infection improved sensitivity (100 %) at the expense of specificity (42.9 %). Use of intraoperative assessment of skin and soft tissue margins for fungal infection is a valuable tool in the management of skin and soft tissue fungal infection treatment.

  15. Preparation of slides for microscopy from frozen tissue sections.

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    Bachman, Julia

    2013-01-01

    Freezing tissue is a convenient method for long-term storage. In addition, sectioning tissue under frozen conditions or embedded within a frozen matrix allows for stabilization of tissue during the sectioning process. This is advantageous for small and/or delicate tissue (e.g., rodent brains younger than postnatal day 7) and tissue that will be sectioned very thin (usually <150 μm).

  16. Biopsy of uterine leiomyomata and frozen sections before laparoscopic morcellation.

    Science.gov (United States)

    Tulandi, Togas; Ferenczy, Alex

    2014-01-01

    Uterine sarcoma is rare. However, its morcellation can be associated with spread of disease. The definitive diagnosis of uterine sarcomas is made via histology. To date, the only reliable preoperative test for determination of the types of myometrial tumors is analysis of either frozen sections or permanent formalin-fixed tissue sections of surgical specimens. We report 2 cases in which the feasibility of obtaining multiple biopsy specimens of uterine leiomyomas and frozen sections before laparoscopic morcellation is demonstrated. This procedure might reduce the risk of laparoscopic morcellation of unsuspected leiomyosarcomas while still offering the advantages of a minimally invasive technique.

  17. Diagnostic accuracy of frozen section in Central nervous system lesions, a 10-year study.

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    Maliheh KHODDAMI*

    2015-01-01

    Full Text Available How to Cite This Article: Khoddami M, Akbarzadeh A, Mordai A, Bidari Zerehpoush F, Alipour H, Samadzadeh S, Alipour B.Diagnostic Accuracy of Frozen Section of Central Nervous System Lesions: A 10-Year Study. Iran J Child Neurol. 2015 Winter;9(1:25-30. AbstractObjectiveDefinitive diagnosis of the central nervous system (CNS lesions is unknown prior to histopathological examination. To determine the method and the endpoint for surgery, intraoperative evaluation of the lesion helps the surgeon.In this study, the diagnostic accuracy and pitfalls of using frozen section (FS ofCNS lesions is determined.Materials & MethodsIn this retrospective study, we analyzed the results of FS and permanent diagnoses of all CNS lesions by reviewing reports from 3 general hospitals between March 2001 and March 2011.Results273 cases were reviewed and patients with an age range from 3 to 77 years of age were considered. 166 (60.4% had complete concordance between FS and permanent section diagnosis, 83 (30.2% had partial concordance, and 24 cases (9.5% were discordant. Considering the concordant and partially concordant cases, the accuracy rate was 99.5%, sensitivity was 91.4%, specificity was 99.7%, and positive and negative predictive values were 88.4% and 99.8%, respectively.ConclusionOur results show high sensitivity and specificity of FS diagnosis in the evaluation of CNS lesions. A Kappa agreement score of 0.88 shows high concordance for FS results with permanent section. Pathologist’s misinterpretation, small biopsy samples (not representative of the entire tumor, suboptimal slides, and inadequate information about tumor location and radiologic findings appear to be the major causes for these discrepancies indicated from our study. ReferencesTaxy JB, Anthony G. Biopsy interpretation: the frozen section. 1st ed. China: Lippincott Williams & Wilkins; 2010. P.301-3.Somerset HL, Kleinschmidt-DeMasters BK. Approach to the intraoperative consultation for

  18. Frozen section diagnosis for non-melanoma skin cancers: correlation with permanent section diagnosis.

    Science.gov (United States)

    Onajin, Oluwakemi; Wetter, David A; Roenigk, Randall K; Gibson, Lawrence E; Weaver, Amy L; Comfere, Nneka I

    2015-07-01

    Frozen section pathology is routinely used for margin assessment of non-melanoma skin cancer (NMSC). Frozen section can also be used for the primary diagnosis of several skin lesions. Limited data exist on the accuracy of frozen section in the diagnosis of NMSC. We performed a retrospective chart review of 300 cases in which frozen section diagnoses were compared with permanent section diagnoses of NMSC. Frozen section and permanent section pathology were concordant 83.3% of the time, with the highest concordance rates noted for basal cell carcinoma (145/153, 95%). Our results show a high level of concordance between frozen section and corresponding permanent section pathology diagnosis for NMSC. The rapidity of frozen section tissue processing and pathology reporting makes this technique useful in dermatologic practice for immediate diagnosis and management of NMSC. Further studies should explore strategies to decrease or eliminate discrepancies between frozen and permanent section diagnosis. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Hematoxylin and safranin O staining of frozen sections.

    Science.gov (United States)

    Tran, D; Golick, M; Rabinovitz, H; Rivlin, D; Elgart, G; Nordlow, B

    2000-03-01

    Currently the hematoxylin and eosin staining procedure is the most popular among Mohs surgeons for histology. However, safranin O, a cheaper and relatively safer stain which is predominantly used for plant histology, should be considered as it offers similar or improved accuracy in the diagnosis of frozen sections of basal and squamous cell carcinomas.

  20. Comparison of Different Telepathology Solutions for Primary Frozen Section Diagnostic

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    P. Hufnagl

    2000-01-01

    Full Text Available In a retrospective study on a set of 125 cases we compared the following three telepathology solutions for primary frozen section diagnosis: ATM‐TP (connection via ATM, TPS 1.0 (connection via LAN and TELEMIC (connection via Internet, which represent different concepts of telepathological procedures.

  1. Reassessment of the usefulness of frozen section analysis for hip and knee joint revisions.

    Science.gov (United States)

    Kanner, William A; Saleh, Khaled J; Frierson, Henry F

    2008-09-01

    Intraoperative frozen section (FS) consultation is used in evaluating possible infection in cases of hip and knee revision arthroplasty, serving as an adjunct to preoperative and intraoperative studies. We examined our experience for more than 11 years to determine if FS examination had value when sections were sent nonselectively. We reviewed 244 cases, 132 with available culture results. The criterion for the presence of acute inflammation was more than 5 polymorphonuclear leukocytes per high-power field (hpf) in at least 5 separate hpfs, excluding surface inflammatory exudate and fibrin. Only 27 cases (11.1%) demonstrated positive FS or paraffin section results. In comparison with intraoperative culture, the sensitivity, specificity, positive predictive value, and negative predictive value for FS analysis alone (on review) were 29%, 95%, 40%, and 92%. As currently used, FS analysis has excellent specificity and negative predictive value but poor sensitivity and positive predictive value. We suggest that FS examination be used more selectively in conjunction with other studies, namely erythrocyte sedimentation rate and C-reactive protein.

  2. Pulsed field gel electrophoresis on frozen tumour tissue sections.

    OpenAIRE

    Boultwood, J; Kaklamanis, L.; Gatter, K C; Wainscoat, J S

    1992-01-01

    The application of pulsed field gel electrophoresis (PFGE) to the molecular genetic analysis of solid tumours has been restricted by the requirement for whole single cells as a DNA source. A simple technique which allows for the direct analysis of histologically characterised solid tumour material by pulsed field gel electrophoresis was developed. Single frozen tissue sections obtained from colonic carcinoma specimens were embedded without further manipulation in molten, low melting temperatu...

  3. Correlation of Routine Histo-Pathology, Frozen Section and Squash Preparation in The Diagnosis of Space Occupying Lesions of Central Nervous System

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    Aritra Ash

    2016-06-01

    Full Text Available Intra-operative consultation is an important part of the management of patients with space occupying lesions (SOL of central nervous system. The correlation between intra-operative frozen section diagnosis with final histopathological diagnosis is an integral part of quality assurance in surgical pathology. Aim of study-1To study the correlation of routine histopathology, frozen section (FS and squash preparation in the diagnosis of SOL of central nervous system (CNS.2 To find out incidence of various types of lesions of CNS.3 To study sensitivity of frozen section, squash cytology and routine histopathology for diagnosis of SOLs of CNS. Materials and Methods-Total 100 cases of SOLs of CNS were studied retrospectively which were diagnosed and reported with frozen section followed by routine histopathology. The diagnoses on frozen sections and squash cytology were compared with the final diagnosis on paraffin sections to assess the concordance and discordance rates between both as well as to find out the incidence of various lesions of CNS. Results- In present study, the overall concordance rate was 88%, discordance rate was 12% in our institution. In cases where the FS and the routine histopathology diagnosis were discordant the final diagnosis was derived from the findings of routine histopathological examination. Astrocytoma (38% was the most common diagnosis with highest incidence rate in frozen section as well as routine histology in the present study.

  4. Frozen section can 'sharpen' or 'sand off' the surgeon's knife: Two case Illustrations with skull base meningioma mimics.

    Science.gov (United States)

    Karthigeyan, Madhivanan; Salunke, Pravin; Gupta, Kirti; Singh, Apinderpreet; Rajasekhar, Rekhapalli

    2017-08-22

    Lesions at skull base merit careful evaluation of imaging and meticulous preoperative planning. Their needless radical resection could add to surgical morbidity. Occasionally, dura-based inflammatory/ infectious lesions at this site radiologically mimic meningiomas, which are the commonly encountered entity at this site. Not all require excision; rather it could be harmful in few. We describe two patients with skull base lesions that apparently resembled a meningioma on imaging, while the frozen section in both cases was contrary to the pre-operative diagnosis with inflammatory lesion in the first and invasive aspergillosis in the second case. Formalin-fixed paraffin embedded sections confirmed the frozen section diagnosis. Safe resection was performed in the former while surgery was abandoned and the patient started on antifungal therapy in the latter. Both had good outcome. The present report thus underscores the usefulness of intraoperative frozen section to decide on further course of treatment when faced with such unexpected situations. Frozen sections/ crush smears hold a great potential to avoid unwarranted surgical morbidity, particularly for skull base lesions. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. A Comparison between the Diagnostic Accuracy of Frozen Section and Permanent Section Analyses in Central Nervous System

    Science.gov (United States)

    Amraei, Razie; Moradi, Afshin; Zham, Hanieh; Ahadi, Mahsa; Baikpour, Maryam; Rakhshan, Azadeh

    2017-01-01

    Objective: Using diagnostic pathological methods during surgery is a valuable means of determining the appropriate management for patients. Application of Frozen Section in CNS surgeries might face challenges due to friability of brain tissue and its relative inaccessibility. Various studies have evaluated the diagnostic acuity of frozen section compared to gold standard but results have been quite inconsistent. We conducted the present study to evaluate the accuracy of cryostat in diagnosing central nervous system tumors compared to the Gold Standard method. Methods: In this descriptive retrospective study, patients with definite diagnosis of central nervous system tumors made through histopathological evaluations were identified by reviewing the archives of pathology reports during 1996-2013. Demographic data, clinical history, radiologic findings and results of pathologic evaluations were extracted from the medical records and entered into SPSS statistical software v.22 for analysis. Results: A total of 405 patients diagnosed with CNS tumors were identified, of which 16 patients were not eligible and eventually 389 patients were included in the study. Regarding tumor category, subtype and grade, the results of the two methods were totally compatible in 303 patients (77.9%) and discrepant in 22.1% of cases. The tumors located in the middle fossa (p=0.031; OR=2.27; 95% CI: 1.08-4.79) and the posterior fossa (p=0.021; OR=2.46; 95% CI: 1.15-5.26) and the tumors biopsied using the stereotactic method (p=0.050; OR=2.42; 95% CI: 1.001-5.83) were associated with an increased chance of discrepant results between the two methods. Conclusion: Frozen section can correctly diagnose and affect the management of CNS lesions in 77.9% of cases. Finding ways to increase the sensitivity and specificity of this method and providing surgeons with more definite and exact intra-operative diagnosis can improve management of central nervous system lesions to a considerable degree. PMID

  6. Strategies of Individual Surgical Treatment for Early Stage Non-small Cell Lung Cancer and the Guidance of Intraoperative Frozen Pathology

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    Bin HU

    2016-06-01

    Full Text Available Early stage non-small cell lung cancer patients, especially those who presented small GGO on image, are increasing in Asia population. Retrospective clinical data indicated that the efficacy of sub-lobectomy for these patients may be non-inferior to that of lobectomy. Meanwhile, sub-lobectomy could preserve more pulmonary function for the patients. Researches have demonstrated that careful evaluation for the image manifestation is essential before sub-lobectomy and those who diagnosed as adenocarcinoma in situ or minimally invasive adenocarcinoma may be more appropriate for this procedure. Precise diagnosis of Intraoperative frozen section is an effective method toward personalization of surgical care for early-stage non-smallcell lung cancer.

  7. Evaluation of panoramic digital images using Panoptiq for frozen section diagnosis

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    Dinesh Pradhan

    2016-01-01

    Full Text Available Introduction: Whole slide imaging (WSI permits intraoperative consultations (frozen sections to be performed remotely. However, WSI files are large and can be problematic if there are tissue artifacts (e.g., tissue folds or when slides are scanned without multiplanes (Z-stacks to permit focusing. The Panoptiq dynamic imaging system allows users to create their own digital files that combine low power panoramic digital images with regions of interest that can be imaged using high power Z-stacks. The aim of this study was to determine the utility of the Panoptiq dynamic imaging system for frozen section telepathology. Materials and Methods: Twenty archival randomly selected genitourinary surgical pathology frozen sectional cases were evaluated using conventional light microscopy (glass slides, panoramic images, and whole slide images. To create panoramic images glass slides were digitized using a Prosilica GT camera (model GT1920C, Allied Vision Technologies attached to an Olympus B × 45 microscope and Dell Precision Tower 810 computer (Dell. Panoptiq 3 version 3.1.2 software was used for image acquisition and Panoptiq View version 3.1.2 to view images (ViewsIQ, Richmond, BC, Canada. Image acquisition using Panoptiq software involved a pathology resident, who manually created digital maps (×4 objective and then selected representative regions of interest to generate Z-stacks at higher magnification (×40 objective. Whole slide images were generated using an Aperio XT Scanscope (Leica and viewed using ImageScope Software (Aperio ePathology, Leica. Three pathologists were asked to render diagnoses and rate image quality (1-10 and their diagnostic confidence (1-10 for each modality. Results: The diagnostic concordance with glass slides was 98.3% for panoramic images and 100% for WSI. Panoptiq images were comparable to the glass slide viewing experience in terms of image quality and diagnostic confidence. Complaints regarding WSI included poor focus

  8. The Use of Frozen Section in the Early Diagnosis of Acute Invasive Fungal Sinusitis.

    Science.gov (United States)

    Melancon, C Claire; Clinger, John D

    2017-08-01

    Objectives Acute invasive fungal sinusitis (AIFS) remains a significant cause of morbidity and mortality in the immunocompromised patient population. Early diagnosis is key to improving patient outcomes. Frozen section biopsies have been shown to decrease time to diagnosis when compared with permanent pathology. However, its accuracy has not been adequately described in the literature, specifically in regard to AIFS. The aim of this study is to evaluate the statistical diagnostic accuracy of frozen sections and to review the etiology, clinical presentation, and current diagnostic protocols in management of AIFS. Study Design Case series with chart review. Setting Tertiary referral center. Subjects and Methods Retrospective review included 67 pathologic records in Co-Path, with search criteria including invasive fungal, clinical history, frozen section, and final diagnosis between the dates of 2006 and 2015. Results Sixty-seven cases were reviewed per the search criteria in Co-Path. Of these, 31 met further criteria of having had frozen section analysis. Variables such as sensitivity, specificity, positive predictive value, and negative predictive value were assessed. All 21 positive frozen sections correlated with positive permanent pathology, giving a positive predictive value of 100%. Frozen section biopsies were 87.5% sensitive and 100% specific. Conclusion Early diagnosis of AIFS has been shown to decrease morbidity and mortality. Frozen section biopsies remain key in obtaining an early diagnosis among patients with a high clinical suspicion for invasive fungal sinusitis. Frozen section biopsies positive for invasive fungal pathology were universally consistent with definitive diagnosis.

  9. Evaluation of the value of frozen tissue section used as "gold standard" for immunohistochemistry.

    Science.gov (United States)

    Shi, Shan-Rong; Liu, Cheng; Pootrakul, Llana; Tang, Laurie; Young, Andrew; Chen, Ryan; Cote, Richard J; Taylor, Clive R

    2008-03-01

    To examine the use of acetone- or ethanol-fixed frozen tissue sections as the "gold standard" for immunohistochemical analysis, we evaluated frozen sections with various conditions of fixation and antigen retrieval (AR). Fresh human tissues were frozen in OCT. An adjacent tissue block was fixed in 10% neutral buffered formalin (NBF) and paraffin embedded (FFPE). Frozen sections were fixed by 6 protocols: acetone, ethanol, NBF (2 durations), and NBF + calcium chloride (2 durations). AR was used for all NBF-fixed sections. More than half of the antibodies (16/26 [62%]) showed immunohistochemical results indistinguishable between acetone- and NBF-fixed sections; 8 (31%) showed better immunohistochemical signals following NBF and AR; 2 gave better immunohistochemical results for acetone-fixed sections. Most cytoplasmic proteins (10/13) showed comparable immunohistochemical signals between acetone- and NBF-fixed sections. For nuclear proteins, NBF-fixed sections gave better immunohistochemical signals than did acetone-fixed sections. In most cases, NBF yielded stronger signals with less background and better morphology. The data do not support the use of acetone-fixed frozen tissue sections as the gold standard for immunohistochemical analysis. In evaluating new antibodies, a combination of acetone- and NBF-fixed frozen sections should be used, although in practice, FFPE tissue sections may serve as the standard for most antigens for immunohistochemical analysis.

  10. Relation between Birth Weight and Intraoperative Hemorrhage during Cesarean Section in Pregnancy with Placenta Previa.

    Science.gov (United States)

    Soyama, Hiroaki; Miyamoto, Morikazu; Ishibashi, Hiroki; Takano, Masashi; Sasa, Hidenori; Furuya, Kenichi

    2016-01-01

    Placenta previa, one of the most severe obstetric complications, carries an increased risk of intraoperative massive hemorrhage. Several risk factors for intraoperative hemorrhage have been identified to date. However, the correlation between birth weight and intraoperative hemorrhage has not been investigated. Here we estimate the correlation between birth weight and the occurrence of intraoperative massive hemorrhage in placenta previa. We included all 256 singleton pregnancies delivered via cesarean section at our hospital because of placenta previa between 2003 and 2015. We calculated not only measured birth weights but also standard deviation values according to the Japanese standard growth curve to adjust for differences in gestational age. We assessed the correlation between birth weight and the occurrence of intraoperative massive hemorrhage (>1500 mL blood loss). Receiver operating characteristic curves were constructed to determine the cutoff value of intraoperative massive hemorrhage. Of 256 pregnant women with placenta previa, 96 (38%) developed intraoperative massive hemorrhage. Receiver-operating characteristic curves revealed that the area under the curve of the combination variables between the standard deviation of birth weight and intraoperative massive hemorrhage was 0.71. The cutoff value with a sensitivity of 81.3% and specificity of 55.6% was -0.33 standard deviation. The multivariate analysis revealed that a standard deviation of >-0.33 (odds ratio, 5.88; 95% confidence interval, 3.04-12.00), need for hemostatic procedures (odds ratio, 3.31; 95% confidence interval, 1.79-6.25), and placental adhesion (odds ratio, 12.68; 95% confidence interval, 2.85-92.13) were independent risk of intraoperative massive hemorrhage. In patients with placenta previa, a birth weight >-0.33 standard deviation was a significant risk indicator of massive hemorrhage during cesarean section. Based on this result, further studies are required to investigate whether

  11. Utility of telepathology as a consultation tool between an off-site surgical pathology suite and affiliated hospitals in the frozen section diagnosis of lung neoplasms

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    Taisia Vitkovski

    2015-01-01

    Full Text Available Background: Increasingly, as in our institution, operating rooms are located in hospitals and the pathology suite is located at a distant location because of off-site consolidation of pathology services. Telepathology is a technology which bridges the gap between pathologists and offers a means to obtain a consultation remotely. We aimed to evaluate the utility of telepathology as a means to assist the pathologist at the time of intraoperative consultation of lung nodules when a subspecialty pathologist is not available to directly review the slide. Methods: Cases of lung nodules suspicious for a neoplasm were included. Frozen sections were prepared in the usual manner. The pathologists on the intraoperative consultation service at two of our system hospitals notified the thoracic pathologist of each case after rendering a preliminary diagnosis. The consultation was performed utilizing a Nikon™ Digital Sight camera and web-based Remote Medical Technologies™ software with live video streaming directed by the host pathologist. The thoracic pathologist rendered a diagnosis without knowledge of the preliminary interpretation then discussed the interpretation with the frozen section pathologist. The interpretations were compared with the final diagnosis rendered after sign-out. Results: One hundred and three consecutive cases were included. The frozen section pathologist and a thoracic pathologist had concordant diagnoses in 93 cases (90.2%, discordant diagnoses in nine cases (8.7%, and one case in which both deferred. There was an agreement between the thoracic pathologist′s diagnosis and the final diagnosis in 98% of total cases including 8/9 (88.9% of the total discordant cases. In two cases, if the thoracic pathologist had not been consulted, the patient would have been undertreated. Conclusions: We have shown that telepathology is an excellent consultation tool in the frozen section diagnosis of lung nodules.

  12. Excision of periocular basal cell carcinoma guided by en face frozen section.

    Science.gov (United States)

    Tullett, Mark; Sagili, Suresh; Barrett, Andrew; Malhotra, Raman

    2013-09-01

    We describe a technique for monitoring excision margins in periocular basal cell carcinoma (BCC) using en face frozen sections and report outcomes. We excised periocular BCC with 3mm margins. An outer 1mm sliver of the perimeter of the specimen was mapped and sent for evaluation by en face frozen section. The central tumour mass was processed using routine paraffin sections. A further 3mm level was excised at the site of any affected margin and the outer 1mm sliver was again evaluated by frozen section. We identified 78 patients from November 2003 to July 2009; 67 had primary tumours and 11 (14%) had recurrent BCC of which 52 (66%) were located on the lower eyelid. Growth patterns were nodular (n=34, 43%), infiltrative (n=25, 32%), micronodular (n=12, 16%), and superficial (n=7, 9%). A third of BCC with a clinically nodular appearance showed additional histological patterns including infiltrative and micronodular growth patterns. Of 30 clinically nodular carcinomas, 29 were excised completely with one level, and one required 2 levels of excision for clearance after evaluation by frozen section. Mean follow-up was 23 months (range 2-60). There was one recurrence (1%). Excision of margins guided by en face frozen section is justified by the low rates of recurrence, and it can easily be taught or imported into hospital practice. Clinically nodular BCC have subclinical extensions that can be missed on bread loaf sectioning, which makes the sampling of margins a standard for periocular BCC. Copyright © 2012 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  13. Fluorescence in situ hybridization for detection of small RNAs on frozen tissue sections

    DEFF Research Database (Denmark)

    Silahtaroglu, Asli

    2014-01-01

    processes and diseases, the function of each single microRNA is still yet to be explored in all tissues and cells they are present. Therefore, an efficient in situ hybridization method, combining locked nucleic acid technology and tyramide signal amplification system, has been developed and presented...... for detection of microRNAs in frozen section at a cellular resolution and with high sensitivity....

  14. Diagnostic Value of Frozen Section in Patients with Non-Palpable Breast Lesions.

    Science.gov (United States)

    Abuoglu, Hacı Hasan; Günay, Emre; Sunamak, Oğuzhan; Yiğitbaşı, M Rafet

    2016-01-01

    We analyzed wire-marking, frozen section (FS) and surgical approach in malignancy-suspicious non-palpable lesions detected on mammography (MG) and ultrasonography (US) as breast mass, microcalcifications and distorsions. Material and Methods: A hundred patients in whom wiremarking and frozen section analysis was performed because of non-palpable, malignancy-suspected breast lesions at General Surgery Department, Goztepe Training and Research Hospital, Istanbul were analyzed retrospectively. Results: Seventy-six % of the cases was in BIRADS 4, 21% in BIRADS 3 and 3% BIRADS 5, according to Breast Imaging Reporting and Data System (BIRADS) classification. There was a statistically significant correlation between paraffin block (PB) and frozen section analyses (kappa statistics: 0.872; p 0.01). In BIRADS 4 group of the patients, there was a significant correlation between PB and FS results (Correlation ratio was 85.3% and kappa statistics: 0.853; p 0.01). In early stage breast cancer wire-marking and resection method is an important diagnostic tool. In BIRADS 4 patients with non-palpable breast lesions, wire marking, resection under general anesthesia and FS can be used trustfully. In patients with early breast cancer, breast-conserving surgery and sentinel lymphnode biopsy may avoid unnecessary axillary lymph node dissection. Celsius.

  15. Experience with a Dynamic Inexpensive Video-Conferencing System for Frozen Section Telepathology

    Directory of Open Access Journals (Sweden)

    J. P. A. Baak

    2000-01-01

    Full Text Available Aim: To evaluate the feasibility of an inexpensive, generally applicable video‐conferencing system for frozen section telepathology (TP. Methods: A commercially widely available PC‐based dynamic video‐conferencing system (PictureTel LIVE, model PCS 100 has been evaluated, using two, four and six ISDN channels (128–384 kilobits per second (kbs bandwidths. 129 frozen sections have been analyzed which were classified by TP as benign, uncertain (the remark probably benign, or probably malignant was allowed, malignant, or not acceptable image quality. The TP results were compared with the original frozen section diagnosis and final paraffin diagnosis. Results: Only 384 kbs (3 ISDN‐2 lines resulted in acceptable speed and quality of microscope images, and synchronous image/speech transfer. In one of the frozen section cases (0.7%, TP image quality was classified as not acceptable, leaving 128 frozen sections for the analysis. Five of these cases were uncertain by TP, and also deferred by frozen section procedure (FS. One more benign and three malignant FS cases were classified as uncertain by TP. Three additional cases were uncertain by FS, but benign according to TP (in agreement with the final diagnosis. In one case, FS diagnosis was uncertain but TP was malignant (in agreement with the final diagnosis. Thus, test efficiency (i.e., cases with complete agreement was 120/128 (93.8%, Kappa = 0.88 between FS and TP. Sensitivity was 93.5%, specificity 98.6%, positive and negative predictive values were 97.7% and 96.0%. Between TP and final diagnosis agreement was even higher. More importantly, there was not a single discrepancy as to benign‐malignant. Moreover, there was a clear learning effect: 5 of the 8 FS/TP discrepancies occurred in the first 42 cases (5/42=11.9%, the remaining 3 in the following 86 cases (3/86=3.5%. Discussion: The results are encouraging. However, TP evaluation is time‐consuming (5–15 min for one case instead of 2

  16. LNA-FISH for detection of microRNAs in frozen sections

    DEFF Research Database (Denmark)

    Silahtaroglu, Asli N

    2010-01-01

    MicroRNAs (miRNAs) are small ( approximately 22 nt) noncoding RNA molecules that regulate the expression of protein coding genes either by cleavage or translational repression. miRNAs comprise one of the most abundant classes of gene regulatory molecules in multicellular organisms. Yet......, the function of miRNAs at the tissue, cell, and subcellular levels is still to be explored. Especially, determining spatial and temporal expression of miRNAs has been a challenge due to their short size and low expression. This protocol describes a fast and effective method for detection of miRNAs in frozen...... tissue sections using fluorescence in situ hybridization. The method employs the unique recognition power of locked nucleic acids as probes together with enhanced detection power of the tyramide signal amplification system for detection of miRNAs in frozen tissues of human and animal origin within...

  17. Frozen section evaluation of margins in radical prostatectomy specimens: a contemporary study and literature review.

    Science.gov (United States)

    Nunez, Amberly L; Giannico, Giovanna A; Mukhtar, Faisal; Dailey, Virginia; El-Galley, Rizk; Hameed, Omar

    2016-10-01

    The utility of routine frozen section (FS) analysis for margin evaluation during radical prostatectomy (RP) remains controversial. A retrospective search was conducted to identify RPs evaluated by FS over a 5-year period. The potential of FS to discriminate between benign and malignant tissue and to predict final margins was evaluated. During the study period, 71 (12.3%) of 575 cases underwent FS evaluation of margins, generating 192 individual FSs. There were 8 FSs diagnosed as atypical/indeterminate because of significant freezing, crushing, and/or thermal artifacts; 11 as positive for carcinoma; and 173 as benign. Two FSs classified as benign were diagnosed as positive for carcinoma on subsequent permanent section. Frozen sections' sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for diagnosis of prostatic adenocarcinoma were 85%, 100%, 100%, 99%, and 99%, respectively. Overall RP final margin predictive accuracy was 81%. Positive FS was significantly associated with perineural invasion on biopsy and extraprostatic extension and higher stage disease on RP, but not with the overall final margin status. The high FS accuracy supports its use to guide the extent of surgery. However, FS cannot be used to predict the overall final margin status. Recognition of the histological artifacts inherent to the FS procedure is important to ensure appropriate utilization.

  18. [CONTROVERSIES REGARDING THE ACCURACY AND LIMITATIONS OF FROZEN SECTION IN THYROID PATHOLOGY: AN EVIDENCE-BASED ASSESSMENT].

    Science.gov (United States)

    Stanciu-Pop, C; Pop, F C; Thiry, A; Scagnol, I; Maweja, S; Hamoir, E; Beckers, A; Meurisse, M; Grosu, F; Delvenne, Ph

    2015-12-01

    Palpable thyroid nodules are present clinically in 4-7% of the population and their prevalence increases to 50%-67% when using high-resolution neck ultrasonography. By contrast, thyroid carcinoma (TC) represents only 5-20% of these nodules, which underlines the need for an appropriate approach to avoid unnecessary surgery. Frozen section (PS) has been used for more than 40 years in thyroid surgery to establish the diagnosis of malignancy. However, a controversy persists regarding the accuracy of FS and its place in thyroid pathology has changed with the emergence of fine-needle aspiration (FNA). A PubMed Medline and SpringerLink search was made covering the period from January 2000 to June 2012 to assess the accuracy of ES, its limitations and indications for the diagnosis of thyroid nodules. Twenty publications encompassing 8.567 subjects were included in our study. The average value of TC among thyroid nodules in analyzed studies was 15.5 %. ES ability to detect cancer expressed by its sensitivity (Ss) was 67.5 %. More than two thirds of the authors considered PS useful exclusively in the presence of doubtful ENA and for guiding the surgical extension in cases confirmed as malignant by FNA; however, only 33% accepted FS as a routine examination for the management of thyroid nodules. The influence of FS on surgical reintervention rate in nodular thyroid pathology was considered to be negligible by most studies, whereas 31 % of the authors thought that FS has a favorable benefit by decreasing the number of surgical re-interventions. In conclusion, the role of FS in thyroid pathology evolved from a mandatory component for thyroid surgery to an optional examination after a pre-operative FNA cytology. The accuracy of FS seems to provide no sufficient additional benefit and most experts support its use only in the presence of equivocal or suspicious cytological features, for guiding the surgical extension in cases confirmed as malignant by FNA and for the

  19. Role of scrape cytology in the intraoperative diagnosis of tumor

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    Kolte Sachin

    2010-01-01

    Full Text Available Background : Rapid diagnosis of surgically removed specimens has created many controversies and a single completely reliable method has not yet been developed. Histopathology of a paraffin section remains the ultimate gold standard in tissue diagnosis. Frozen section is routinely used by the surgical pathology laboratories for intraoperative diagnosis. The use of either frozen section or cytological examination alone has an acceptable rate (93-97% of correct diagnosis, with regard to interpretation of benign versus malignant. Aim : To evaluate the utility of scrape cytology for the rapid diagnosis of surgically removed tumors and its utilisation for learning cytopathology. Materials and Methods : 75 surgically removed specimens from various organs and systems were studied. Scrapings were taken from each specimen before formalin fixation and stained by modified rapid Papanicolaou staining. Results : Of the 75 cases studied, 73 could be correctly differentiated into benign and malignant tumors, with an accuracy rate of 97.3%. Conclusions : Intraoperative scrape cytology is useful for intraoperative diagnosis of tumor, where facilities for frozen section are not available. The skill and expertise developed by routinely practicing intraoperative cytology can be applied to the interpretation of fine needle aspirate smears. Thus, apart from its diagnostic role, intraoperative cytology can become a very useful learning tool in the field of cytopathology.

  20. Visualizing Oxazine 4 nerve-specific fluorescence ex vivo in frozen tissue sections

    Science.gov (United States)

    Barth, Connor W.; Gibbs, Summer L.

    2016-03-01

    Nerve damage plagues surgical outcomes and remains a major burden for patients, surgeons, and the healthcare system. Fluorescence image-guided surgery using nerve specific small molecule fluorophores offers a solution to diminish surgical nerve damage through improved intraoperative nerve identification and visualization. Oxazine 4 has shown superior nerve specificity in initial testing in vivo, while exhibiting a red shifted excitation and emission spectra compared to other nerve-specific fluorophores. However, Oxazine 4 does not exhibit near-infrared (NIR) excitation and emission, which would be ideal to improve penetration depth and nerve signal to background ratios for in vivo imaging. Successful development of a NIR nerve-specific fluorophore will require understanding of the molecular target of fluorophore nerve specificity. While previous small molecule nerve-specific fluorophores have demonstrated excellent ex vivo nerve specificity, Oxazine 4 ex vivo nerve specific fluorescence has been difficult to visualize. In the present study, we examined each step of the ex vivo fluorescence microscopy sample preparation procedure to discover how in vivo nerve-specific fluorescence is changed during ex vivo tissue sample preparation. Through step-by-step examination we found that Oxazine 4 fluorescence was significantly diminished by washing and mounting tissue sections for microscopy. A method to preserve Oxazine 4 nerve specific fluorescence ex vivo was determined, which can be utilized for visualization by fluorescence microscopy.

  1. Intraoperative parathyroid hormone assay-cutting the Gordian knot

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    Chandralekha Tampi

    2014-01-01

    Full Text Available Background: Hyperparathyroidism is treated by surgical excision of the hyperfunctioning parathyroid gland. In case of adenoma the single abnormal gland is removed, while in hyperplasias, a subtotal excision, that is, three-and-a-half of the four glands are removed. This therapeutic decision is made intraoperatively through frozen section evaluation and is sometimes problematic, due to a histological overlap between hyperplasia and the adenoma. The intraoperative parathyroid hormone (IOPTH assay, propogated in recent years, offers an elegant solution, with a high success rate, due to its ability to identify the removal of all hyperfunctioning parathyroid tissue. Aim: To study the feasibility of using IOPTH in our setting. Materials and Methods: Seven patients undergoing surgery for primary hyperparathyroidism had their IOPTH levels evaluated, along with the routine frozen and paraffin sections. Results: All seven patients showed more than a 50% intraoperative fall in serum PTH after excision of the abnormal gland. This was indicative of an adenoma and was confirmed by histopathological examination and normalization of serum calcium postoperatively. Conclusion: The intraoperative parathyroid hormone is a sensitive and specific guide to a complete removal of the abnormal parathyroid tissue. It can be incorporated without difficulty as an intraoperative guide and is superior to frozen section diagnosis in parathyroid surgery.

  2. Intelligent framework for diagnosis of frozen shoulder using cross sectional survey and case studies.

    Science.gov (United States)

    Batool, Humaira; Usman Akram, M; Batool, Fouzia; Butt, Wasi Haider

    2016-01-01

    Frozen shoulder is a disease in which shoulder becomes stiff. Accurate diagnosis of frozen shoulder is helpful in providing economical and effective treatment for patients. This research provides the classification of unstructured data using data mining techniques. Prediction results are validated by K-fold cross-validation method. It also provides accurate diagnosis of frozen shoulder using Naïve Bayesian and Random Forest models. At the end results are presented by performance measure techniques. In this research, 145 respondents (patients) with a severe finding of frozen shoulder are included. They are selected on premise of (clinical) assessment confirmed after by MRI. This data is taken from the department of Orthopedics (Pakistan Institute of Medical Sciences Islamabad and Railway Hospital Rawalpindi) between September 2014 to November 2015. Frozen shoulder is categorized on the basis of MRI result. The predictor variables are taken from patient survey and patient reports, which consisted of 35+ variables. The outcome variable is coded into numeric system of "intact" and "no-intact". The outcome variable is assigned into numeric code, 1 for "intact" and 0 for "no-intact". "Intact" group is used as an indication that tissue is damaged badly and "no-intact" is classified as normal. Distribution of result is 110 patients for "Intact" group and 35 patients for "No-Intact" group (false positive rate was 24 %). In this research we have utilized two methods i.e. Naive Bayes and Random Forest. A statistics regression model (Logistic regression) to categorize frozen shoulder finding into "intact" and "no-intact" classes. In the end, we validated our results by Bayesian theorem. This gives a rough estimate about the probability of frozen shoulder. In this research, our anticipated and predictive procedures gave better outcome as compared to statistical techniques. The specificity and sensitivity ratio of predicting a frozen shoulder are better in the Naïve Bayes as

  3. Value of frozen section examination in diagnosis and treatment of high-grade cervical intraepithelial neoplasia

    Institute of Scientific and Technical Information of China (English)

    REN Fang; FENG Wei; SHI Hui-rong; WU Qing-hua; CHEN Zhi-min

    2012-01-01

    Background Invasive cancer of the cervix is considered a preventable disease because it has a long pre-invasive state,cervical cytology screening programs are currently available,and treatment of pre-invasive lesions is effective.We tested the accuracy of frozen section examination (FSE) of cone specimens to identify the endocervical margin and rule out invasion in patients with high-grade cervical intraepithelial neoplasia (CIN).Methods For 320 consecutive patients with a preoperative biopsy result of CIN stage 2/3,cold-knife conization (CKC)was performed followed by FSE.The results from analyses of permanent paraffin sections (PS) were compared with the FSE findings.Results The accuracy of FSE was 87% (278/320).For all of the seven patients with an invasive squamous cell carcinoma of the cervix identified by FSE,the diagnosis was confirmed by PS analysis.For one patient,the FSE result was cervicitis,whereas PS ananlysis showed microinvasive carcinoma.Appropriate surgery was performed for all patients based on the FSE and biopsy results.The FSE and PS results were not significantly different (P=0.000).Definitive examination of margin status using PS was concordant with FSE findings in all cases.Conclusions FSE is a rapid and reliable method for evaluating CKC specimens.It can identify frank invasion,permit adequate treatment in a one-stage procedure,and reliably detect clear resection margins.Since discrepancies do exist and may result in inappropriate treatment,further research is required to decrease these discrepancies and avoid missing even one case.

  4. Validation of whole slide imaging for frozen section diagnosis in surgical pathology

    Directory of Open Access Journals (Sweden)

    Thomas W Bauer

    2015-01-01

    Full Text Available Background: Whole slide imaging (WSI using high-resolution scanners is gaining acceptance as a platform for consultation as well as for frozen section (FS evaluation in surgical pathology. We report results of an intra-observer concordance study comparing evaluation of WSI of scanned FS microscope slides with the original interpretation of the same microscope slides after an average lag time of approximately 1-year. Methods: A total of 70 FS cases (148 microscope slides originally interpreted by 2 pathologists were scanned at ×20 using Aperio CS2 scanner (Leica Biosystems, San Diego, CA, USA. Reports were redacted such that the study pathologists reviewed images using eSlide Manager Healthcare Network application (Leica Biosystems accompanied by the same clinical information available at the time of original FS evaluation. Discrepancies between the original FS diagnosis and WSI diagnosis were categorized as major (impacted patient care or minor (no impact on patient care. Results: Lymph nodes, margins for head and neck cancer resections, and arthroplasty specimens to exclude infection, were the most common FS specimens. The average wash-out interval was 380 days (range: 303–466 days. There was one major discrepancy (1.4% of 70 cases where the original FS was interpreted as severe squamous dysplasia, and the WSI FS diagnosis was mild dysplasia. There were two minor discrepancies; one where the original FS was called focal moderate squamous dysplasia and WSI FS diagnosis was negative for dysplasia. The second case was an endometrial adenocarcinoma that was originally interpreted as Federation of Gynecology and Obstetrics (FIGO Grade I, while the WSI FS diagnosis was FIGO Grade II. Conclusions: These findings validate and support the use of WSI to provide interpretation of FS in our network of affiliated hospitals and ambulatory surgery centers.

  5. The diagnostic properties of frozen sections in suspected intracranial tumors: A study of 578 consecutive cases

    Directory of Open Access Journals (Sweden)

    Kathrine Tofte

    2014-01-01

    Conclusions: Intraoperative FS diagnoses demonstrate high diagnostic accuracy. However, agreement varies among histopathological entities and is lower in low-grade tumors than in high-grade tumors. Sensitivity for diagnosing CNS lymphomas is low. A variable degree of reservation is always necessary when interpreting and communicating FS diagnoses.

  6. The influence of immunohistochemistry on mRNA recovery from microdissected frozen and formalin-fixed, paraffin-embedded sections.

    Science.gov (United States)

    Gjerdrum, Lise Mette; Abrahamsen, Helene N; Villegas, Berta; Sorensen, Boe S; Schmidt, Henrik; Hamilton-Dutoit, Stephen J

    2004-12-01

    Laser-assisted microdissection (LAM) is now widely used to obtain specific cell populations from heterogeneous tissues. A major disadvantage of LAM is poor tissue morphology during microscopy, in part because coverslips are not used. Immunohistochemical labeling can improve identification of target cells but may affect the subsequent analysis of the microdissected tissue. We studied the effect of immunohistochemistry (IHC) on mRNA recovery from labeled cells after microdissection from both frozen and formalin-fixed, paraffin-embedded (FFPE) sections, using Melan-A and Ki-67 staining in lymph nodes with metastatic melanoma as a model. We developed rapid protocols for immunostaining in an attempt to limit loss of mRNA during procedures. A sensitive real-time quantitative reverse transcription-PCR was used to measure mRNA. We found a marked decrease in the mRNA yield from 500 microdissected cells from frozen and paraffin sections after immunostaining for both markers. Recovery of mRNA decreased by up to 89%, comparing the immunostained with the routinely stained sections. Interestingly, the ratio between mRNA for the two markers was similar in all stains, indicating that immunostained sections may be used for mRNA analysis. We also investigated the effect of storing membrane-mounted sections for microdissection under different conditions. Slides mounted with paraffin sections could be stored at room temperature for up to 90 days with no significant decrease in mRNA recovery.

  7. Development of a Whole Slide Imaging System on Smartphones and Evaluation With Frozen Section Samples.

    Science.gov (United States)

    Yu, Hong; Gao, Feng; Jiang, Liren; Ma, Shuoxin

    2017-09-15

    The aim was to develop scalable Whole Slide Imaging (sWSI), a WSI system based on mainstream smartphones coupled with regular optical microscopes. This ultra-low-cost solution should offer diagnostic-ready imaging quality on par with standalone scanners, supporting both oil and dry objective lenses of different magnifications, and reasonably high throughput. These performance metrics should be evaluated by expert pathologists and match those of high-end scanners. The aim was to develop scalable Whole Slide Imaging (sWSI), a whole slide imaging system based on smartphones coupled with optical microscopes. This ultra-low-cost solution should offer diagnostic-ready imaging quality on par with standalone scanners, supporting both oil and dry object lens of different magnification. All performance metrics should be evaluated by expert pathologists and match those of high-end scanners. In the sWSI design, the digitization process is split asynchronously between light-weight clients on smartphones and powerful cloud servers. The client apps automatically capture FoVs at up to 12-megapixel resolution and process them in real-time to track the operation of users, then give instant feedback of guidance. The servers first restitch each pair of FoVs, then automatically correct the unknown nonlinear distortion introduced by the lens of the smartphone on the fly, based on pair-wise stitching, before finally combining all FoVs into one gigapixel VS for each scan. These VSs can be viewed using Internet browsers anywhere. In the evaluation experiment, 100 frozen section slides from patients randomly selected among in-patients of the participating hospital were scanned by both a high-end Leica scanner and sWSI. All VSs were examined by senior pathologists whose diagnoses were compared against those made using optical microscopy as ground truth to evaluate the image quality. The sWSI system is developed for both Android and iPhone smartphones and is currently being offered to the

  8. Localization of telomerase hTERT protein in frozen sections of basal cell carcinomas (BCC) and tumor margin tissues.

    Science.gov (United States)

    Fabricius, Eva-Maria; Kruse-Boitschenko, Ute; Khoury, Reem; Wildner, Gustav-Paul; Raguse, Jan-Dirk; Klein, Martin; Hoffmeister, Bodo

    2009-12-01

    In previous studies we demonstrated telomerase activity in frozen tissues from BCC and their tumor-free margins by the PCR ELISA. In this study we examined in the same frozen sections immunohistochemical presence of hTERT in the nucleus. After fixation in acetone and methanol followed by steaming we used for visualization the antigen-antibody reactions by APAAP. This was the best method of preparation of the frozen sections in our preliminary hTERT-study with squamous cell carcinomas. This study was supplemented with antibodies against Ki-67, nucleolin, common leucocyte antigen CD45 and mutated p53. The immunoreactive scores were determined and included the comparison with telomerase activity. The investigation of hTERT expression was performed in the tissues of 41 patients with BCC and control tissues of 14 patients without tumor. Eleven commercial antibodies were used for a nuclear staining of hTERT expression. With the anti-hTERT antibodies we looked for both satisfactory distribution and intensity of immunohistochemical labeling in the carcinomas and in the squamous epithelia of the tumor centers, of the tumor-free margins and of the control tissues. The hTERT expression in the BCC was distributed heterogeneously. The score values established by the anti-hTERT antibodies used were variably or significantly increased. In the stroma they tended to be negative, so we disregarded stroma hTERT. Proof of hTERT did not differ uniformly from telomerase activity. We compared the high with the lower median hTERT values in the Kaplan-Meier curve. Patients with lower hTERT scores in the center or tumor margin as shown by some of the antibodies suffered relapse earlier. Finally, we compared the hTERT expression in BCC tissues with the hTERT scores in HNSCC tissues from our previous study. Only one anti-hTERT antibody (our Ab 7) yielded significantly higher scores in BCC than in HNSCC.

  9. Diagnostic value of frozen section study for thyroid nodules in patients referred to Shariati Hospital 1997-2000

    Directory of Open Access Journals (Sweden)

    "Shirzad M

    2001-11-01

    Full Text Available Frozen section is a useful method in the diagnosis of different malignancies including those of thyroid origin. However, there are still controversies about its application, sensitivity and specificity for thyroid neoplasm. In this study, diagnostic value of frozen section (FS was compared with permanent histopathologic and Fine Needle Aspiration (FNA. In this study, which was conducted in process research method, permanent sample, FNA, and frozen section results in 214 patients was compared. All of these 214 patients had been seeking medical evaluation for thyroid nodules between years 1997 and 1999 in Shariati hospital. All pathologic evaluations were performed by pathology staff of this hospital. Permanent pathology was considered as the gold standard; so the specificity, sensitivity and diagnostic precision of FNA and FS were evaluated on the basis of its results. We use Macnemar test for this purpose. The number of patients during this period were 214 (160 women and 54 men. Mean age of our patients was 42.3±5.4 and their age ranged between 12 to 84 years. Pathologic results revealed that 163 of the patients (76 percent had benign lesions, and 51 of them (24 percent had malignant lesions. Thyroid malignancies comparised papillary carcinoma (70 percent, follicular carcinoma (13.5 percent, papilofollicular carcinoma (6 percent, medulary carcinoma (6 percent, Hurtle cell carcinoma (4 percent and anaplastic carcinoma (5 percent. FNA was done in all of the patients before surgery and was able to determine the status of nodules in 150 patients. Sensitivity, specificity and precision of FNA in these 150 patients were 72, 96 and 90 percents respectively. When FNA was unable to determine the status of a nodule (64 remaining patients, FS was applied to do the job. A sensitivity of 36 percent, specificity of 85 percent and precision of 73 percent was found in this group of patients. Macnemar test showed that there is no significant difference between

  10. Effective melanin depigmentation of human and murine ocular tissues: an improved method for paraffin and frozen sections.

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    Caroline Manicam

    Full Text Available PURPOSE: The removal of excessive melanin pigments that obscure ocular tissue morphology is important to address scientific questions and for differential diagnosis of ocular tumours based on histology. Thus, the goal of the present study was to establish an effective and fast melanin bleaching method for paraffin and frozen mouse and human ocular tissues. METHODS: Paraffin-embedded and frozen ocular specimens from mice and human donors were subjected to bleaching employing two methods. The first employed potassium permanganate (KMnO4 with oxalic acid, and the second 10% hydrogen peroxide (H2O2. To determine optimal bleaching conditions, depigmentation was carried out at various incubation times. The effect of diluents used for 10% H2O2 was assessed using phosphate-buffered saline (PBS, and deionized water. Three different slide types and two fixatives, which were ice-cold acetone with 80% methanol, and 4% paraformaldehyde (PFA were used to determine the optimal conditions for better tissue adherence during bleaching. All tissues were stained in hematoxylin and eosin for histological evaluation. RESULTS: Optimal bleaching was achieved using warm 10% H2O2 diluted in PBS at 65°C for 120 minutes. Chromium-gelatin-coated slides prevented tissue detachment. Adherence of cryosections was also improved with post-fixation using 4% PFA and overnight air-drying at RT after cryosectioning. Tissue morphology was preserved under these conditions. Conversely, tissues bleached in KMnO4/oxalic acid demonstrated poor depigmentation with extensive tissue damage. CONCLUSIONS: Warm dilute H2O2 at 65°C for 120 minutes rapidly and effectively bleached both cryo- and paraffin sections of murine and human ocular tissues.

  11. Fine structures and ion images on fresh frozen dried ultrathin sections by transmission electron and scanning ion microscopy

    Energy Technology Data Exchange (ETDEWEB)

    Takaya, K.; Okabe, M.; Sawataishi, M.; Takashima, H.; Yoshida, T

    2003-01-15

    Ion microscopy (IM) of air-dried or freeze-dried cryostat and semi-thin cryosections has provided ion images of elements and organic substances in wide areas of the tissue. For reproducible ion images by a shorter time of exposure to the primary ion beam, fresh frozen dried ultrathin sections were prepared by freezing the tissue in propane chilled with liquid nitrogen, cryocut at 60 nm, mounted on grids and silicon wafer pieces, and freeze-dried. Rat Cowper gland and sciatic nerve, bone marrow of the rat administered of lithium carbonate, tree frog and African toad spleen and buffy coat of atopic dermatitis patients were examined. Fine structures and ion images of the corresponding areas in the same or neighboring sections were observed by transmission electron microscopy (TEM) followed by sector type and time-of-flight type IM. Cells in the buffy coat contained larger amounts of potassium and magnesium while plasma had larger amounts of sodium and calcium. However, in the tissues, lithium, sodium, magnesium, calcium and potassium were distributed in the cell and calcium showed a granular appearance. A granular cell of the tree frog spleen contained sodium and potassium over the cell and magnesium and calcium were confined to granules.

  12. Frozen section analysis of sentinel lymph nodes in patients with breast cancer does not impair the probability to detect lymph node metastases

    NARCIS (Netherlands)

    E.V.E. Madsen (Eva V. E.); J. van Dalen (Jan); P.J. van Gorp (Patrick); P.M.P. Van Oort (Poultje M. P.)

    2012-01-01

    textabstractIntra-operative frozen section analysis (FS analysis) of sentinel lymph nodes (SLNs) in patients with breast cancer can prevent a second operation for axillary lymph node dissection. In contrast, loss of tissue during FS analysis may impair the probability to detect lymph node metastases

  13. [Intraoperative awareness].

    Science.gov (United States)

    Schneider, G

    2003-02-01

    The first cases of general anesthesia were already cases with awareness. Until today, case reports of patients with awareness are published. These published cases are likely to be the top of the iceberg, as most patients with postoperative recall do not inform their anesthesiologist. Incidence of awareness with recall is between 0.1 and 0.2 %. In a large multicenter-study, incidence of recall was 0.1 % without, and 0.18 % with the use of muscle relaxants. The risk is increased with decreased doses of anesthetics, e.g. in patients with hemodynamic instability (trauma cases), patients undergoing cesarean section or cardiac surgery. Intraoperative awareness does not necessarily cause explicit (conscious) memory. Even in the absence of explicit memory, implicit (unconscious) memory can still have consequences for the patient. In the worst case, it can cause post-traumatic stress disorder. There is doubt whether patients may profit from positive suggestions given during intraoperative awareness. Recommendations to administer benzodiazepines to prevent explicit memory must be reconsidered. Complete neuromuscular block should be avoided whenever possible. If a patient is thought to be aware, he should be contacted, his situation should be explained and affirming comments should be given until consciousness is lost again. Postoperative visit should include questions about awareness and recall. The anesthetist should not disbelieve reported recall. Explanation of what had happened and referral to an experienced psychologist must be offered. Thus, the incidence of severe sequelae should decrease.

  14. 21 CFR 160.110 - Frozen eggs.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Frozen eggs. 160.110 Section 160.110 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN... Frozen eggs. (a) Frozen eggs, frozen whole eggs, frozen mixed eggs is the food prepared by...

  15. Frozen section hematoxylin-eosin rapid dyeing%冰冻切片苏木紫-伊红快速染色法探讨

    Institute of Scientific and Technical Information of China (English)

    谷培云; 董莉

    2013-01-01

    To study frozen section hematoxylin-eosin rapid dyeing and provide diagnostic message for clinic. Frozen section hematoxylin-eosin rapid dyeing. Rapid staining method of making specimen,there were morphology and structure of cell nucleus, clear, good quality color. The dyeing process is only 5 minutes to microscopic examination, provide timely nature of clinical specimens.%探讨冰冻切片苏木紫-伊红快速染色法,为临床及时提供诊断信息。苏木紫-伊红快速染色方法制作出的标本,细胞形态和结构清晰,细胞核、细胞质显色良好,染色过程快,仅5 min后即可镜检,可及时为临床提供送检标本性质。

  16. Frozen Frozen CO2

    Science.gov (United States)

    2005-01-01

    2 October 2005 This Mars Global Surveyor (MGS) Mars Orbiter Camera (MOC) image shows a view of frozen carbon dioxide in the south polar residual cap of Mars. Much of the south polar residual cap exhibits terrain that resembles stacks of sliced Swiss cheese, but this portion of the cap lacks the typical, circular depressions that characterize much of the region. Carbon dioxide on Mars freezes at a temperature of around 148 Kelvins, which is -125oC or about -193oF. Location near: 87.2oS, 28.4oW Image width: width: 3 km (1.9 mi) Illumination from: upper left Season: Southern Spring

  17. Hypothesis for the mechanism for heat-induced antigen retrieval occurring on fresh frozen sections without formalin-fixation in immunohistochemistry.

    Science.gov (United States)

    Kakimoto, Kochi; Takekoshi, Susumu; Miyajima, Katsuhiro; Osamura, R Yoshiyuki

    2008-08-01

    The mechanism involved in heat-induced antigen retrieval (AR) remains unproven but probably utilizes the breaking of formalin-induced cross-linkages. We investigated the effectiveness of heat-induced AR on immunohistochemistry and dot-blot analysis using rat uterus tissue sections and protein extracts without formalin-fixation. The unfixed frozen sections, which did not show immunostaining with nine antibodies, were clearly stained after heating the sections. In the dot-blot analysis, the immunoblot sensitivity of detection was greatly enhanced by heating the protein-blotted membrane. These results indicate that other mechanisms of breaking formalin-induced cross-linkages may be present. We propose that one of the other mechanisms for heat-induced AR is that accessibility to the target epitopes of antigenic proteins is limited by natural steric barriers even in the fresh state caused by the antigenic protein itself.

  18. Achieving Adequate Margins in Ameloblastoma Resection: The Role for Intra-Operative Specimen Imaging. Clinical Report and Systematic Review

    Science.gov (United States)

    Ramakrishnan, Anand; Mirkazemi, Mansoor; Baillieu, Charles; Ptasznik, Ronnie; Leong, James

    2012-01-01

    Background Ameloblastoma is a locally aggressive odontogenic neoplasm. With local recurrence rates reaching 90%, only completeness of excision can facilitate cure. Surgical clearance has widely been based on pre-operative imaging to guide operative excision margins, however use of intra-operative specimen x-ray or frozen-section has been sought to improve clearance rates, and advanced imaging technologies in this role have been proposed. This manuscript aims to quantify the evidence for evaluating intra-operative resection margins and present the current standard in this role. Method The current study comprises the first reported comparison of imaging modalities for assessing ameloblastoma margins. A case is presented in which margins are assessed with each of clinical assessment based on preoperative imaging, intra-operative specimen x-ray, intra-operative specimen computed tomography (CT) and definitive histology. Each modality is compared quantitatively. These results are compared to the literature through means of systematic review of current evidence. Results A comparative study highlights the role for CT imaging over plain radiography. With no other comparative studies and a paucity of high level evidence establishing a role for intra-operative margin assessment in ameloblastoma in the literature, only level 4 evidence supporting the use of frozen section and specimen x-ray, and only one level 4 study assesses intra-operative CT. Conclusion The current study suggests that intra-operative specimen CT offers an improvement over existing techniques in this role. While establishing a gold-standard will require higher level comparative studies, the use of intra-operative CT can facilitate accurate single-stage resection. PMID:23094099

  19. Achieving adequate margins in ameloblastoma resection: the role for intra-operative specimen imaging. Clinical report and systematic review.

    Directory of Open Access Journals (Sweden)

    Inoka De Silva

    Full Text Available BACKGROUND: Ameloblastoma is a locally aggressive odontogenic neoplasm. With local recurrence rates reaching 90%, only completeness of excision can facilitate cure. Surgical clearance has widely been based on pre-operative imaging to guide operative excision margins, however use of intra-operative specimen x-ray or frozen-section has been sought to improve clearance rates, and advanced imaging technologies in this role have been proposed. This manuscript aims to quantify the evidence for evaluating intra-operative resection margins and present the current standard in this role. METHOD: The current study comprises the first reported comparison of imaging modalities for assessing ameloblastoma margins. A case is presented in which margins are assessed with each of clinical assessment based on preoperative imaging, intra-operative specimen x-ray, intra-operative specimen computed tomography (CT and definitive histology. Each modality is compared quantitatively. These results are compared to the literature through means of systematic review of current evidence. RESULTS: A comparative study highlights the role for CT imaging over plain radiography. With no other comparative studies and a paucity of high level evidence establishing a role for intra-operative margin assessment in ameloblastoma in the literature, only level 4 evidence supporting the use of frozen section and specimen x-ray, and only one level 4 study assesses intra-operative CT. CONCLUSION: The current study suggests that intra-operative specimen CT offers an improvement over existing techniques in this role. While establishing a gold-standard will require higher level comparative studies, the use of intra-operative CT can facilitate accurate single-stage resection.

  20. Adult Wilms' tumor. Intraoperative cytology and ancillary studies performed in a case as an adjunct to the histologic diagnosis.

    Science.gov (United States)

    Berkley, C; Stanley, M W; Wolpert, J; Rainwater, L M; Smith, C

    1990-01-01

    A case of blastema-predominant Wilms' tumor in a 64-year-old woman is reported. Intraoperative cytology of a renal mass was used to rule out malignant lymphoma and neuroendocrine carcinoma. Light and electron microscopy, immunocytochemical staining and flow cytometry (FCM) were also performed. Immunoperoxidase studies of smears showed positive staining for vimentin and negative staining for cytokeratins and epithelial membrane antigen. FCM DNA analysis of paraffin-embedded tissue showed no aneuploid peak. Frozen section interpretation of such tumors as seen in this case may be difficult, requiring distinction among several small-blue-cell neoplasms, including Wilms' tumor, neuroendocrine carcinoma and malignant lymphoma; intraoperative cytology can provide a valuable adjunct to frozen section diagnosis.

  1. Detection of microRNAs in frozen tissue sections by fluorescence in situ hybridization using locked nucleicacid probes and tyramide signal amplification

    DEFF Research Database (Denmark)

    Silahtaroglu, Asli N.; Nolting, Dorrit; Andersen, Lars Dyrskjøt

    2007-01-01

    RNAs in frozen tissue sections using fluorescence in situ hybridization (FISH). The method combines the unique miRNA recognition properties of locked nucleic acid (LNA)-modified oligonucleotide probes with FISH using the tyramide signal amplification (TSA) technology. Although both approaches have previously...... been shown to increase detection sensitivity in FISH, combining these techniques into one protocol significantly decreases the time needed for miRNA detection in cryosections, while simultaneously retaining high detection sensitivity. Starting with fixation of the tissue sections, this miRNA FISH...... protocol can be completed within approximately 6 h and allows miRNA detection in a wide variety of animal tissue cryosections as well as in human tumor biopsies at high cellular resolution....

  2. Detection of microRNAs in frozen tissue sections by fluorescence in situ hybridization using locked nucleicacid probes and tyramide signal amplification

    DEFF Research Database (Denmark)

    Silahtaroglu, Asli N.; Nolting, Dorrit; Andersen, Lars Dyrskjøt;

    2007-01-01

    The ability to determine spatial and temporal microRNA (miRNA) accumulation at the tissue, cell and subcellular levels is essential for understanding the biological roles of miRNAs and miRNA-associated gene regulatory networks. This protocol describes a method for fast and effective detection of mi......RNAs in frozen tissue sections using fluorescence in situ hybridization (FISH). The method combines the unique miRNA recognition properties of locked nucleic acid (LNA)-modified oligonucleotide probes with FISH using the tyramide signal amplification (TSA) technology. Although both approaches have previously...... protocol can be completed within approximately 6 h and allows miRNA detection in a wide variety of animal tissue cryosections as well as in human tumor biopsies at high cellular resolution....

  3. Frozen Shoulder

    Science.gov (United States)

    ... Frozen shoulder occurs in about 2% of the general population. It most commonly affects people between the ages of 40 and 60, and occurs in women more o en than men. Anatomy Your shoulder is a ball-and-socket joint ...

  4. Diagnosis of Ovarian Carcinoma Histotype Based on Limited Sampling: A Prospective Study Comparing Cytology, Frozen Section, and Core Biopsies to Full Pathologic Examination.

    Science.gov (United States)

    Hoang, Lien N; Zachara, Susanna; Soma, Anita; Köbel, Martin; Lee, Cheng-Han; McAlpine, Jessica N; Huntsman, David; Thomson, Thomas; van Niekerk, Dirk; Singh, Naveena; Gilks, C Blake

    2015-11-01

    Growing insights into the biological features and molecular underpinnings of ovarian cancer has prompted a shift toward histotype-specific treatments and clinical trials. As a result, the preoperative diagnosis of ovarian carcinomas based on small tissue sampling is rapidly gaining importance. The data on the accuracy of ovarian carcinoma histotype-specific diagnosis based on small tissue samples, however, remains very limited in the literature. Herein, we describe a prospective series of 30 ovarian tumors diagnosed using cytology, frozen section, core needle biopsy, and immunohistochemistry (p53, p16, WT1, HNF-1β, ARID1A, TFF3, vimentin, and PR). The accuracy of histotype diagnosis using each of these modalities was 52%, 81%, 85%, and 84% respectively, using the final pathology report as the reference standard. The accuracy of histotype diagnosis using the Calculator for Ovarian Subtype Prediction (COSP), which evaluates immunohistochemical stains independent of histopathologic features, was 85%. Diagnostic accuracy varied across histotype and was lowest for endometrioid carcinoma across all diagnostic modalities (54%). High-grade serous carcinomas were the most overdiagnosed on core needle biopsy (accounting for 45% of misdiagnoses) and clear cell carcinomas the most overdiagnosed on frozen section (accounting for 36% of misdiagnoses). On core needle biopsy, 2/30 (7%) cases had a higher grade lesion missed due to sampling limitations. In this study, we identify several challenges in the diagnosis of ovarian tumors based on limited tissue sampling. Recognition of these scenarios can help improve diagnostic accuracy as we move forward with histotype-specific therapeutic strategies.

  5. Experience of intraoperative uterus bleeding cesarean section among 15 cases%剖宫产术中子宫出血15例防治体会

    Institute of Scientific and Technical Information of China (English)

    丁云青

    2012-01-01

    OBJECTIVE To discuss the experience of intraoperative uterus bleeding cesarean section for 15 cases. METHODS 50 patients with uterine bleeding during childbirth and cesarean section were selected from January 2008 to December 2010 in obstetrics and gynecology. 50 cases were at the age of 20-35 years old; 16 cases were puerpera, and 34 cases were included. During recent 10 years, 50 cases entered intraoperative hemorrhage uterine cesarean section, eight suture of the uterus bleeding wound and oppression of the uterus were taken. RESULTS The uterus were preserved by effectively stopping bleeding. CONCLUSION Each case with massive bleeding may happen maternal, and need to alert instance lactation. Each instance surgery should take the strict preoperative discussion and risk assessment, prepare blood, especially for severe anemia, thrombocy-topenia or blood coagulation disorders.%目的 就剖宫产术中子宫出血15例防治体会进行探讨.方法 选取2008年1月~2010年12月某院妇产科进行剖宫产分娩且子宫出血的患者50例,50例中年龄为20~35岁;经产妇为16例,初产妇为34例.该院近10年来剖宫产术中遇到子宫大出血50例,采取了8字缝合子宫出血创面及压迫缝合子宫法.结果 有效制止出血成功保留子宫.结论 每一例产妇均有发生大出血可能,需要警觉每一例产妇.每一例手术需要有严格的术前讨论和风险评估,做好配血和备血,对重度贫血、血小板减少或凝血功能障碍术前要纠正.

  6. 7 CFR 58.327 - Frozen cream.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Frozen cream. 58.327 Section 58.327 Agriculture... Material § 58.327 Frozen cream. To produce frozen cream eligible for official certification, the quality of the cream used shall meet the requirements of cream acceptable for the manufacture of U.S. Grade AA...

  7. 21 CFR 152.126 - Frozen cherry pie.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Frozen cherry pie. 152.126 Section 152.126 Food... pie. (a) Identity. (1) Frozen cherry pie (excluding baked and then frozen) is the food prepared by... ingredients as prescribed by paragraph (a)(2) of this section. The finished food is frozen. (2) The...

  8. Rapid and accurate intraoperative pathological diagnosis by artificial intelligence with deep learning technology.

    Science.gov (United States)

    Zhang, Jing; Song, Yanlin; Xia, Fan; Zhu, Chenjing; Zhang, Yingying; Song, Wenpeng; Xu, Jianguo; Ma, Xuelei

    2017-09-01

    Frozen section is widely used for intraoperative pathological diagnosis (IOPD), which is essential for intraoperative decision making. However, frozen section suffers from some drawbacks, such as time consuming and high misdiagnosis rate. Recently, artificial intelligence (AI) with deep learning technology has shown bright future in medicine. We hypothesize that AI with deep learning technology could help IOPD, with a computer trained by a dataset of intraoperative lesion images. Evidences supporting our hypothesis included the successful use of AI with deep learning technology in diagnosing skin cancer, and the developed method of deep-learning algorithm. Large size of the training dataset is critical to increase the diagnostic accuracy. The performance of the trained machine could be tested by new images before clinical use. Real-time diagnosis, easy to use and potential high accuracy were the advantages of AI for IOPD. In sum, AI with deep learning technology is a promising method to help rapid and accurate IOPD. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Detection of microRNAs in frozen tissue sections by fluorescence in situ hybridization using locked nucleic acid probes and tyramide signal amplification.

    Science.gov (United States)

    Silahtaroglu, Asli N; Nolting, Dorrit; Dyrskjøt, Lars; Berezikov, Eugene; Møller, Morten; Tommerup, Niels; Kauppinen, Sakari

    2007-01-01

    The ability to determine spatial and temporal microRNA (miRNA) accumulation at the tissue, cell and subcellular levels is essential for understanding the biological roles of miRNAs and miRNA-associated gene regulatory networks. This protocol describes a method for fast and effective detection of miRNAs in frozen tissue sections using fluorescence in situ hybridization (FISH). The method combines the unique miRNA recognition properties of locked nucleic acid (LNA)-modified oligonucleotide probes with FISH using the tyramide signal amplification (TSA) technology. Although both approaches have previously been shown to increase detection sensitivity in FISH, combining these techniques into one protocol significantly decreases the time needed for miRNA detection in cryosections, while simultaneously retaining high detection sensitivity. Starting with fixation of the tissue sections, this miRNA FISH protocol can be completed within approximately 6 h and allows miRNA detection in a wide variety of animal tissue cryosections as well as in human tumor biopsies at high cellular resolution.

  10. Immunofluorescent Staining for the Detection of the Hepatitis B Core Antigen in Frozen Liver Sections of Human Liver Chimeric Mice.

    Science.gov (United States)

    Allweiss, Lena; Lütgehetmann, Marc; Dandri, Maura

    2017-01-01

    The hepatitis B virus (HBV) is the causative agent for chronic hepatitis B infection, which affects an estimate of 240 million people worldwide and puts them at risk of developing terminal liver disease. The life cycle of the virus and its interactions with the host immune system are still incompletely understood, and currently available treatment options rarely achieve a cure. Therefore, basic research and new drug development are needed. One parameter for measuring the intrahepatic activity of the virus is monitoring the production of the HBV core antigen (HBcAg), which not only serves as the main structural protein of its nucleocapsid but is also recruited to the covalently closed circular DNA (cccDNA), the nuclear HBV genome responsible for infection persistence. Here, we report a sensitive immunofluorescence staining method to detect HBcAg in cryopreserved liver sections. The method combines conventional immunofluorescence staining procedures with the Tyramide Signal Amplification (TSA) system.

  11. Using immunoglobulin Y as an alternative antibody for the detection of hepatitis A virus in frozen liver sections

    Directory of Open Access Journals (Sweden)

    Gentil Arthur Bentes

    2015-06-01

    Full Text Available An increasing amount of research has been conducted on immunoglobulin Y (IgY because the use of IgY offers several advantages with respect to diagnostic testing, including its easy accessibility, low cost and translatability to large-scale production, in addition to the fact that it can be ethically produced. In a previous work, immunoglobulin was produced and purified from egg yolks (IgY reactive to hepatitis A virus (HAV antigens. In the present work, this anti-HAV-specific IgY was used in an indirect immunofluorescence assay to detect viral antigens in liver biopsies that were obtained from experimentally infected cynomolgus monkeys. Fields that were positive for HAV antigen were detected in liver sections using confocal microscopy. In conclusion, egg yolks from immunised hens may be a reliable source for antibody production, which can be employed for immunological studies.

  12. Using immunoglobulin Y as an alternative antibody for the detection of hepatitis A virus in frozen liver sections.

    Science.gov (United States)

    Bentes, Gentil Arthur; Lanzarini, Natália Maria; Lima, Lyana Rodrigues Pinto; Manso, Pedro Paulo de Abreu; da Silva, Alexandre Dos Santos; Mouta Junior, Sergio da Silva E; Guimarães, Juliana Rodrigues; de Moraes, Marcia Terezinha Baroni; Pelajo-Machado, Marcelo; Pinto, Marcelo Alves

    2015-06-01

    An increasing amount of research has been conducted on immunoglobulin Y (IgY) because the use of IgY offers several advantages with respect to diagnostic testing, including its easy accessibility, low cost and translatability to large-scale production, in addition to the fact that it can be ethically produced. In a previous work, immunoglobulin was produced and purified from egg yolks (IgY) reactive to hepatitis A virus (HAV) antigens. In the present work, this anti-HAV-specific IgY was used in an indirect immunofluorescence assay to detect viral antigens in liver biopsies that were obtained from experimentally infected cynomolgus monkeys. Fields that were positive for HAV antigen were detected in liver sections using confocal microscopy. In conclusion, egg yolks from immunised hens may be a reliable source for antibody production, which can be employed for immunological studies.

  13. Frozen assets

    Energy Technology Data Exchange (ETDEWEB)

    1988-12-02

    In June this year, delegates from more than 30 Antarctic Treaty nations met and agreed on a set of rules under the 'Convention on the Regulation of Antartic Mineral Resource Activities'. The convention presents a legal basis for mining which previously did not exist but it requires the two-third approval of a regulatory committee comprising countries both with and without territorial claims. However, the environment of the Antarctic is so harsh that very few in the international mining industry consider mining in the frozen continent a viable proposition.

  14. Filter paper-assisted cell transfer (FaCT) technique: A novel cell-sampling technique for intraoperative diagnosis of central nervous system tumors.

    Science.gov (United States)

    Kawamura, Jumpei; Kamoshida, Shingo; Shimakata, Takaaki; Hayashi, Yurie; Sakamaki, Kuniko; Denda, Tamami; Kawai, Kenji; Kuwao, Sadahito

    2017-04-01

    Intraoperative diagnosis of central nervous system (CNS) tumors provides critical guidance to surgeons in the determination of surgical resection margins and treatment. The techniques and preparations used for the intraoperative diagnosis of CNS tumors include frozen sectioning and cytologic methods (squash smear and touch imprint). Cytologic specimens, which do not have freezing artifacts, are important as an adjuvant tool to frozen sections. However, if the amount of submitted tissue samples is limited, then it is difficult to prepare both frozen sections and squash smears or touch imprint specimens from a single sample at the same time. Therefore, the objective of this study was to derive cells directly from filter paper on which tumor samples are placed. The authors established the filter paper-assisted cell transfer (FaCT) smear technique, in which tumor cells are transferred onto a glass slide directly from the filter paper sample spot after the biopsy is removed. Cell yields and diagnostic accuracy of the FaCT smears were assessed in 40 CNS tumors. FaCT smears had ample cell numbers and well preserved cell morphology sufficient for cytologic diagnosis, even if the submitted tissues were minimal. The overall diagnostic concordance rates between frozen sections and FaCT smears were 90% and 87.5%, respectively (no significant differences). When combining FaCT smears with frozen sections, the diagnostic concordance rate rose to 92.5%. The current results suggest that the FaCT smear technique is a simple and effective processing method that has significant value for intraoperative diagnosis of CNS tumors. Cancer Cytopathol 2017;125:277-282. © 2016 American Cancer Society. © 2017 American Cancer Society.

  15. Intraoperative Neuromonitoring

    Directory of Open Access Journals (Sweden)

    Kubilay Varlı

    2016-06-01

    Full Text Available The principal aim of “intraoperative neuromonitoring” (IN is to prevent potential neurologic deficits that may be caused by the surgical process, which is very appropriate to the principal rule of medicine “primum non nocere.” Monitoring neurologic structures, in addition to reducing the neurologic deficits, also provides very valuable knowledge about anatomy and physiology of the central nervous system. IN is almost a routine technique during surgeries concerned with central and/or peripheral neurologic structures. The monitoring technique used varies depending on the involved neurologic structure and the aim of the surgical intervention. Because of this, the staff that run the monitoring must be well trained and experienced. As it similar in the other countries, there are serious controversies in IN in our country in terms of training, price, and legal aspects. Before the problems become bigger and hard to solve, all sides of neuromonitoring must be together to regulate all aspects of the issue.

  16. 21 CFR 160.190 - Frozen egg yolks.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Frozen egg yolks. 160.190 Section 160.190 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN... Frozen egg yolks. (a) Frozen egg yolks, frozen yolks is the food prepared by freezing egg yolks...

  17. 21 CFR 160.150 - Frozen egg whites.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Frozen egg whites. 160.150 Section 160.150 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR... § 160.150 Frozen egg whites. (a) Frozen egg whites, frozen egg albumen is the food prepared by...

  18. Identification of regions of normal grey matter and white matter from pathologic glioblastoma and necrosis in frozen sections using Raman imaging.

    Science.gov (United States)

    Kast, Rachel; Auner, Gregory; Yurgelevic, Sally; Broadbent, Brandy; Raghunathan, Aditya; Poisson, Laila M; Mikkelsen, Tom; Rosenblum, Mark L; Kalkanis, Steven N

    2015-11-01

    In neurosurgical applications, a tool capable of distinguishing grey matter, white matter, and areas of tumor and/or necrosis in near-real time could greatly aid in tumor resection decision making. Raman spectroscopy is a non-destructive spectroscopic technique which provides molecular information about the tissue under examination based on the vibrational properties of the constituent molecules. With careful measurement and data processing, a spatial step and repeat acquisition of Raman spectra can be used to create Raman images. Forty frozen brain tissue sections were imaged in their entirety using a 300-µm-square measurement grid, and two or more regions of interest within each tissue were also imaged using a 25 µm-square step size. Molecular correlates for histologic features of interest were identified within the Raman spectra, and novel imaging algorithms were developed to compare molecular features across multiple tissues. In previous work, the relative concentration of individual biomolecules was imaged. Here, the relative concentrations of 1004, 1300:1344, and 1660 cm(-1), which correspond primarily to protein and lipid content, were simultaneously imaged across all tissues. This provided simple interpretation of boundaries between grey matter, white matter, and diseased tissue, and corresponded with findings from adjacent hematoxylin and eosin-stained sections. This novel, yet simple, multi-channel imaging technique allows clinically-relevant resolution with straightforward molecular interpretation of Raman images not possible by imaging any single peak. This method can be applied to either surgical or laboratory tools for rapid, non-destructive imaging of grey and white matter.

  19. Role of intraoperative squash smear cytology as a diagnostic modality in lipoma of quadrigeminal cistern

    Directory of Open Access Journals (Sweden)

    Kaushik Majumdar

    2013-01-01

    Full Text Available Quadrigeminal lipoma is a rare tumor that has been categorized as developmental malformation rather than a hamartoma or true neoplasm, due to its origin from abnormal persistence and mal-differentiation of meninx primitiva during the development of the subarachnoid cisterns. Reported admixture of adipose tissue with heterotopic elements also supports a developmental origin. Quadrigeminal lipomas are frequently asymptomatic and detected incidentally. Though a favorable clinical course is usually expected, recurrences may occur due to partial removal of lesions in close relation to vital structure. We describe the role of intraoperative squash smear cytology as a diagnostic aid in quadrigeminal cistern lipoma and an alternative to frozen sections that are technically difficult to obtain due to presence of lobules of fibro-adipose tissue. With radiological correlation, squash cytology can be an economical method for intraoperative diagnosis, pending subsequent histopathological confirmation.

  20. The Value of Neurosurgical and Intraoperative Magnetic Resonance Imaging and Diffusion Tensor Imaging Tractography in Clinically Integrated Neuroanatomy Modules: A Cross-Sectional Study

    Science.gov (United States)

    Familiari, Giuseppe; Relucenti, Michela; Heyn, Rosemarie; Baldini, Rossella; D'Andrea, Giancarlo; Familiari, Pietro; Bozzao, Alessandro; Raco, Antonino

    2013-01-01

    Neuroanatomy is considered to be one of the most difficult anatomical subjects for students. To provide motivation and improve learning outcomes in this area, clinical cases and neurosurgical images from diffusion tensor imaging (DTI) tractographies produced using an intraoperative magnetic resonance imaging apparatus (MRI/DTI) were presented and…

  1. Combined use of fine-needle aspiration biopsy, MIBI scans and frozen section biopsy offers the best diagnostic accuracy in the assessment of the hypofunctioning solitary thyroid nodule

    Energy Technology Data Exchange (ETDEWEB)

    Hurtado-Lopez, Luis Mauricio; Arellano-Montano, Sara; Torres-Acosta, Evelyn Migdalia; Zaldivar-Ramirez, Felipe Rafael; Duarte-Torres, Reyna Margarita; Alonso-de-Ruiz, Patricia; Martinez-Duncker, Ivan [Thyroid Clinic, General Hospital of Mexico, Mexico City (Mexico); Martinez-Duncker, Carlos [Thyroid Clinic, General Hospital of Mexico, Mexico City (Mexico); Molecular Nuclear Medicine, Hospital Infantil de Mexico, Mexico (Mexico)

    2004-09-01

    The probability of malignancy is increased in hypofunctioning solitary thyroid nodules (HFNs). Fine-needle aspiration biopsy (FNA), {sup 99m}Tc-methoxyisobutylisonitrile (MIBI) and frozen section biopsy (FS) have limited independent diagnostic accuracy for the differential diagnosis of HFNs. The goal of this study was to assess the accuracy of the three independent diagnostic methods in distinguishing between benign and malignant disease. A total of 130 patients with an HFN on the {sup 99m}Tc-pertechnetate scan were included in this study. FNA, MIBI scans, FS, thyroidectomy and histological analysis of surgical specimens for final diagnosis were performed in all patients. Of the 130 patients, 80 (61.54%) had benign lesions and 50 (38.46%), malignant lesions. FNA was diagnostic in 78/130 (60%) patients and non-diagnostic in 52/130 (40%) patients. None of the patients with a negative MIBI scan had a final histological diagnosis of malignancy, and MIBI scans were negative in 38.46% of patients with non-diagnostic FNA results. FS was diagnostic in 104/130 (80%) patients and non-diagnostic in 26/130 (20%) patients. Sensitivity, specificity, positive and negative predictive values and positive and negative likelihood ratios were 81.3%, 97.8%, 96%, 88%, 36.95 and 0.19 respectively for FNA; 100%, 61.3%, 61.7%, 100%, 2.58 and 0 respectively for MIBI; and 80.5%, 100%, 100%, 89%, 0 and 0.2 respectively for FS. Use of both MIBI scans and FS in patients with non-diagnostic FNA rendered a specificity and sensitivity of 100%. MIBI scans exclude malignancy in a significant proportion of patients with non-diagnostic FNAs (38% in this study). Cystic nodules with a positive MIBI scan should be further investigated even when the FNA result indicates a benign lesion. Combined use of FNA, MIBI and FS offers the best diagnostic accuracy. (orig.)

  2. The Optical Biopsy: A Novel Technique for Rapid Intraoperative Diagnosis of Primary Pulmonary Adenocarcinomas.

    Science.gov (United States)

    Kennedy, Gregory T; Okusanya, Olugbenga T; Keating, Jane J; Heitjan, Daniel F; Deshpande, Charuhas; Litzky, Leslie A; Albelda, Steven M; Drebin, Jeffrey A; Nie, Shuming; Low, Philip S; Singhal, Sunil

    2015-10-01

    With increasing use of chest computed tomography scans, indeterminate pulmonary nodules are frequently detected as an incidental finding and present a diagnostic challenge. Tissue biopsy followed by histological review and immunohistochemistry is the gold standard to obtain a diagnosis and the most common malignant finding is a primary lung adenocarcinoma. Our objective was to determine whether an intraoperative optical biopsy (molecular imaging) may provide an alternative approach for determining if a pulmonary nodule is a primary lung adenocarcinoma. Before surgery, 30 patients with an indeterminate pulmonary nodule were intravenously administered a folate receptor-targeted fluorescent contrast agent specific for primary lung adenocarcinomas. During surgery, the nodule was removed and the presence of fluorescence (optical biopsy) was assessed in the operating room to determine if the nodule was a primary pulmonary adenocarcinoma. Standard-of-care frozen section and immunohistochemical staining on permanent sections were then performed as the gold standard to validate the results of the optical biopsy. Optical biopsies identified 19 of 19 (100%) primary pulmonary adenocarcinomas. There were no false positive or false negative diagnoses. An optical biopsy required 2.4 minutes compared to 26.5 minutes for frozen section (P biopsy has excellent positive predictive value for intraoperative diagnosis of primary lung adenocarcinomas. With refinement, this technology may prove to be an important supplement to standard pathology for examining close surgical margins, identifying lymph node involvement, and determining whether suspicious nodules are malignant.

  3. Rapid intraoperative parathyroid hormone assay--more than just a comfort measure.

    LENUS (Irish Health Repository)

    Hanif, F

    2012-02-03

    BACKGROUND: Minimally invasive radio-guided parathyroidectomy (MIRP) has been embraced as an acceptable therapeutic approach to primary hyperparathyroidism. Preoperative sestamibi scanning has facilitated this technique. Here we evaluate the addition of a rapid intraoperative parathyroid hormone (iPTH) assay for patients undergoing MIRP. METHODS: A series of 51 patients underwent sestamibi localization of parathyroid glands followed by MIRP for primary hyperparathyroidism. Using peripheral venous samples, iPTH levels were measured prior to gland excision, as well as post-excision at 5, 10, and 15 minutes, taking a 50% reduction in iPTH level as indicative of complete excision. Next, changes in serum iPTH were compared with preoperative and postoperative changes in serum calcium, as well as levels of intraoperative ex-vivo radiation counts taken by hand-held gamma probe. RESULTS: In this series, a drop of greater than 50% in iPTH levels was observed in 94% of patients (n=48). Moreover, a significant drop in iPTH occurred within 10 minutes of excision in the majority (n=42) of cases (P<0.004). Changes in iPTH were comparable with the therapeutic reduction in calcium levels, as well as with the change in intraoperative ex-vivo gamma counts. CONCLUSIONS: This study demonstrates that the addition of an iPTH assay to MIRP provides a quick and reliable intraoperative diagnostic modality in confirming correct adenoma removal. Moreover, it precludes the requirement of frozen section.

  4. Cytologic features during intraoperative assessment of central neurocytoma: a report of three cases and review of the literature.

    Science.gov (United States)

    Hernández-Martínez, Silvia J; De Leíja-Portilla, Julia O; Medellín-Sánchez, Roberto

    2013-01-01

    Central neurocytomas (CNs) are infrequent intraventricular tumors with features of neuronal differentiation that affect young adults and have an excellent prognosis after total resection. The main differential intraoperative diagnoses are oligodendrogliomas, ependymomas and non-Hodgkin's lymphomas; therefore, an accurate and precise intraoperative diagnosis is essential, making the cytologic features the hallmark for cytopathologists, surgical pathologists and neurosurgeons alike. Seven previous reports have described 18 cases of CNs and have addressed the cytodiagnostic criteria during intraoperative assessment in the English medical literature. Three patients (23 years old/male, 29 years old/female and 28 years old/male) were evaluated during intraoperative assessment as CNs. They showed intraventricular tumors that measured 6.5, 3.5 and 6.6 cm, respectively. The cytologic features common in these cases were: (1) monotonous or isomorphic round cells, (2) small nuclei with stippled or granular chromatin, and (3) acellular fibrillary areas or neuropil (islands). Other cytologic features often encountered were: rosette-like structures, micronucleoli, perinuclear haloes, well-formed capillary-sized vessels and calcifications. Differential diagnosis of CNs can be a diagnostic challenge. The integration of radiologic imaging and touch preparations taking into account specific cytologic features and frozen sections is necessary for an optimal intraoperative assessment. Copyright © 2013 S. Karger AG, Basel.

  5. Telomerase activity as a biomarker for (pre)neoplastic cervical disease in scrapings and frozen sections from patients with abnormal cervical smear

    NARCIS (Netherlands)

    Wisman, GBA; Hollema, H; de Jong, S; ter Schegget, J; Tjong-A-Hung, SP; Ruiters, MHJ; Krans, M; de Vries, EGE; van der Zee, AGJ

    1998-01-01

    Purpose: To evaluate the diagnostic value of semiquantitative telomerase activity assessment in cervical scrapings together with human papillomavirus (HPV) typing for detection of (pre)neoplastic cervical lesions and to compare telomerase activity in cervical scrapings and frozen specimens from the

  6. 21 CFR 161.175 - Frozen raw breaded shrimp.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Frozen raw breaded shrimp. 161.175 Section 161.175... § 161.175 Frozen raw breaded shrimp. (a) Frozen raw breaded shrimp is the food prepared by coating one of the optional forms of shrimp specified in paragraph (c) of this section with safe and suitable...

  7. 7 CFR 58.349 - Frozen cream.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Frozen cream. 58.349 Section 58.349 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards... Products Bearing Usda Official Identification § 58.349 Frozen cream. The flavor shall be sweet,...

  8. 21 CFR 158.170 - Frozen peas.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Frozen peas. 158.170 Section 158.170 Food and.... (a) Identity—(1) Product definition. Frozen peas is the food in “package” form as that term is... the words “frozen” or “quick frozen”. The name of the food shall include a declaration of...

  9. 21 CFR 146.137 - Frozen orange juice.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Frozen orange juice. 146.137 Section 146.137 Food... HUMAN CONSUMPTION CANNED FRUIT JUICES Requirements for Specific Standardized Canned Fruit Juices and Beverages § 146.137 Frozen orange juice. (a) Frozen orange juice is orange juice as defined in § 146.135...

  10. 21 CFR 146.146 - Frozen concentrated orange juice.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Frozen concentrated orange juice. 146.146 Section... (CONTINUED) FOOD FOR HUMAN CONSUMPTION CANNED FRUIT JUICES Requirements for Specific Standardized Canned Fruit Juices and Beverages § 146.146 Frozen concentrated orange juice. (a) Frozen concentrated orange...

  11. 48 CFR 852.246-72 - Frozen processed foods.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Frozen processed foods. 852.246-72 Section 852.246-72 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS... Frozen processed foods. As prescribed in 846.302-72, insert the following clause: Frozen Processed...

  12. 7 CFR 58.650 - Requirements for frozen custard.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Requirements for frozen custard. 58.650 Section 58.650... Products Bearing Usda Official Identification § 58.650 Requirements for frozen custard. The same requirements apply as for ice cream except plain frozen custard shall have a minimum egg yolk solids content...

  13. Mass Spectrometry Imaging of Drug Related Crystal-Like Structures in Formalin-Fixed Frozen and Paraffin-Embedded Rabbit Kidney Tissue Sections.

    Science.gov (United States)

    Bruinen, Anne L; van Oevelen, Cateau; Eijkel, Gert B; Van Heerden, Marjolein; Cuyckens, Filip; Heeren, Ron M A

    2016-01-01

    A multimodal mass spectrometry imaging (MSI) based approach was used to characterize the molecular content of crystal-like structures in a frozen and paraffin embedded piece of a formalin-fixed rabbit kidney. Matrix assisted laser desorption/ionization time-of-flight (MALDI-TOF) imaging and desorption electrospray ionization (DESI) mass spectrometry imaging were combined to analyze the frozen and paraffin embedded sample without further preparation steps to remove the paraffin. The investigated rabbit kidney was part of a study on a drug compound in development, in which severe renal toxicity was observed in dosed rabbits. Histological examination of the kidney showed tubular degeneration with precipitation of crystal-like structures in the cortex, which were assumed to cause the renal toxicity. The MS imaging approach was used to find out whether the crystal-like structures were composed of the drug compound, metabolites, or an endogenous compound as a reaction to the drug administration. The generated MALDI-MSI data were analyzed using principal component analysis. In combination with the MS/MS results, this way of data processing demonstrates that the crystal structures were mainly composed of metabolites and relatively little parent drug.

  14. Multiphoton microscopy based cryo-imaging of inflated frozen human lung sections at -60°C in healthy and COPD lungs

    Science.gov (United States)

    Abraham, Thomas; Kayra, Damian; Zhang, Angela; Suzuki, Masaru; McDonough, John; Elliott, W. M.; Cooper, Joel D.; Hogg, James C.

    2013-02-01

    Lung is a complex gas exchanger with interfacial area (where the gas exchange takes place) is about the size of a tennis court. Respiratory function is linked to the biomechanical stability of the gas exchange or alveolar regions which directly depends on the spatial distributions of the extracellular matrix fibers such fibrillar collagens and elastin fibers. It is very important to visualize and quantify these fibers at their native and inflated conditions to have correct morphometric information on differences between control and diseased states. This can be only achieved in the ex vivo states by imaging directly frozen lung specimens inflated to total lung capacity. Multiphoton microscopy, which uses ultra-short infrared laser pulses as the excitation source, produces multiphoton excitation fluorescence (MPEF) signals from endogenously fluorescent proteins (e.g. elastin) and induces specific second harmonic generation (SHG) signals from non-centrosymmetric proteins such as fibrillar collagens in fresh human lung tissues [J. Struct. Biol. (2010)171,189-196]. Here we report for the first time 3D image data obtained directly from thick frozen inflated lung specimens (~0.7- 1.0 millimeter thick) visualized at -60°C without prior fixation or staining in healthy and diseased states. Lung specimens donated for transplantation and released for research when no appropriate recipient was identified served as controls, and diseased lung specimens donated for research by patients receiving lung transplantation for very severe COPD (n=4) were prepared as previously described [N. Engl. J. Med. (2011) 201, 1567]. Lung slices evenly spaced between apex and base were examined using multiphoton microscopy while maintained at -60°C using a temperature controlled cold stage with a temperature resolution of 0.1°C. Infrared femto-second laser pulses tuned to 880nm, dry microscopic objectives, and non-de-scanned detectors/spectrophotometer located in the reflection geometry were

  15. 术中应用保温措施防止剖宫产产妇寒颤%Intraoperative body-temperature maintenance to prevent shivering during Caesarean section

    Institute of Scientific and Technical Information of China (English)

    陈少娟; 郭雅梅; 赖梅; 黄素娟; 张莹

    2010-01-01

    目的 探讨术中应用积极的保温措施对防止剖宫产产妇低体温寒颤的影响.方法 选取拟行剖宫产产妇100例,随机分为保温组和对照组,每组50例.对照组术中按传统护理常规进行护理,保温组采用多种积极的综合保温措施.结果 低体温寒颤发生率对照组为60%,保温组16%,两组比较差异有显著性(P<0.05).结论 术中采取积极有效的保温措施有助于预防剖宫产产妇低体温寒颤的发生.%Objective To explore the effect of aggressive intraoperative body-temperature maintenance on prevention of hypothermia-induced shivering in puerperas during Caesarean section.Methods 100 puerperas undergoing Caesarean section were randomly assigned to receive routine intraoperaive nursing (50 puerperas, control group)or various aggressive approachs for body-temperature maintenance (50 puerperas, study group). Results The rate of hypothermia-induced shivering differed significantly between the control group and the study group (60% vs. 16%, P< 0.05). Conclusions Aggressive intraoperative body-temperature maintenance is helpful for preventing the occurrence of hypothermia-induced shivering in puerperas undergoing Caesarean section.

  16. Multiparametric magnetic resonance imaging and frozen-section analysis efficiently predict upgrading, upstaging, and extraprostatic extension in patients undergoing nerve-sparing robotic-assisted radical prostatectomy

    Science.gov (United States)

    Bianchi, Roberto; Cozzi, Gabriele; Petralia, Giuseppe; Alessi, Sarah; Renne, Giuseppe; Bottero, Danilo; Brescia, Antonio; Cioffi, Antonio; Cordima, Giovanni; Ferro, Matteo; Matei, Deliu Victor; Mazzoleni, Federica; Musi, Gennaro; Mistretta, Francesco Alessandro; Serino, Alessandro; Tringali, Valeria Maria Lucia; Coman, Ioan; De Cobelli, Ottavio

    2016-01-01

    Abstract To evaluate the role of multiparametric magnetic resonance imaging (mpMRI) in predicting upgrading, upstaging, and extraprostatic extension in patients with low-risk prostate cancer (PCa). MpMRI may reduce positive surgical margins (PSM) and improve nerve-sparing during robotic-assisted radical prostatectomy (RARP) for localized prostate cancer PCa. This was a retrospective, monocentric, observational study. We retrieved the records of patients undergoing RARP from January 2012 to December 2013 at our Institution. Inclusion criteria were: PSA <10 ng/mL; clinical stage intraoperative FSA of the posterolateral aspects of the specimen. All the identified lesions were scored according to the Prostate Imaging Reporting and Data System (PIRADS). We considered the lesion with the highest PIRADS score as index lesion. All the included patients underwent nerve-sparing RARP. During surgery, the specimen was sent for FSA of the posterolateral aspects. The surgeon, according to the localization scheme provided by the mpMRI, inked the region of the posterolateral aspect of the prostate that had to be submitted to FSA. We evaluated association between clinical features and PSM, upgrading, upstaging, and presence of unfavorable disease. Two hundred fifty-four patients who underwent nerve-sparing RARP were included. PSM rate was 29.13% and 15.75% at FSA and final pathology respectively. Interestingly, the use of FSA reduced PSM rate in pT3 disease (25.81%). Higher PIRADS scores demonstrated to be related to high probability of upgrading and upstaging. This significativity remains even when considering PIRADS 2–3 versus 4 versus 5 and PIRADS 2–3 versus 4–5. Also PSM at FSA were associated with higher probability of upgrading and upstaging. PIRADS score and FSA resulted to be strictly related to grading and staging, thus being able to predict upgrading and/or upstaging at

  17. Intraoperative consultation on pediatric central nervous system tumors by squash cytology.

    Science.gov (United States)

    Lacruz, César R; Catalina-Fernández, Inmaculada; Bardales, Ricardo H; Pimentel, José; López-Presa, Dolores; Sáenz-Santamaría, Javier

    2015-06-01

    Squash cytology (SC) is a very useful procedure during neurosurgical intraoperative consultation (IOC), and it is especially recommended for the evaluation of soft tumors or tumors that are highly cellular (just the characteristics of pediatric central nervous system [CNS] tumors). The aim of this review is to familiarize pathologists with the range of cytomorphologic appearances that can occur during IOC for pediatric CNS tumors and with the diagnostic dilemmas and pitfalls encountered in this setting. This article is based on the medical literature and the authors' experience with a large series of cases accrued over a 12-year period at 3 institutions. SC is a specially recommended procedure in IOC for pediatric CNS tumors; it reveals the fine cellular details and background features in a manner not seen in corresponding frozen sections. Indeed, a differential diagnosis between histologically look-alike processes can be achieved with more confidence if SC is employed.

  18. Virtual 3D tumor marking-exact intraoperative coordinate mapping improve post-operative radiotherapy

    Directory of Open Access Journals (Sweden)

    Essig Harald

    2011-11-01

    Full Text Available Abstract The quality of the interdisciplinary interface in oncological treatment between surgery, pathology and radiotherapy is mainly dependent on reliable anatomical three-dimensional (3D allocation of specimen and their context sensitive interpretation which defines further treatment protocols. Computer-assisted preoperative planning (CAPP allows for outlining macroscopical tumor size and margins. A new technique facilitates the 3D virtual marking and mapping of frozen sections and resection margins or important surgical intraoperative information. These data could be stored in DICOM format (Digital Imaging and Communication in Medicine in terms of augmented reality and transferred to communicate patient's specific tumor information (invasion to vessels and nerves, non-resectable tumor to oncologists, radiotherapists and pathologists.

  19. 21 CFR 146.126 - Frozen concentrate for colored lemonade.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Frozen concentrate for colored lemonade. 146.126 Section 146.126 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... section 721 of the Federal Food, Drug, and Cosmetic Act. (b) The name of the food is “Frozen...

  20. 21 CFR 135.110 - Ice cream and frozen custard.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Ice cream and frozen custard. 135.110 Section 135....110 Ice cream and frozen custard. (a) Description. (1) Ice cream is a food produced by freezing, while... accomplish specific functions. Ice cream is sweetened with safe and suitable sweeteners and may...

  1. 21 CFR 146.120 - Frozen concentrate for lemonade.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Frozen concentrate for lemonade. 146.120 Section 146.120 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... lemonade is the frozen food prepared from one or both of the lemon juice ingredients specified in...

  2. 40 CFR 407.40 - Applicability; description of the frozen potato products subcategory.

    Science.gov (United States)

    2010-07-01

    ... frozen potato products subcategory. 407.40 Section 407.40 Protection of Environment ENVIRONMENTAL... PROCESSING POINT SOURCE CATEGORY Frozen Potato Products Subcategory § 407.40 Applicability; description of the frozen potato products subcategory. The provisions of this subpart are applicable to...

  3. Texture of Frozen Food

    Science.gov (United States)

    Wani, Kohmei

    Quantitative determination of textural quality of frozen food due to freezing and storage conditions is complicated,since the texture is consisted of multi-dimensiona1 factors. The author reviewed the importance of texture in food quality and the factors which is proposed by a priori estimation. New classification of expression words of textural properties by subjective evaluation and an application of four elements mechanical model for analysis of physical characteristics was studied on frozen meat patties. Combination of freezing-thawing condition on the subjective properties and physiochemical characteristics of beef lean meat and hamachi fish (Yellow-tail) meat was studied. Change of the plasticity and the deformability of these samples differed by freezing-thawing rate and cooking procedure. Also optimum freezing-thawing condition was differed from specimens.

  4. Curation of Frozen Samples

    Science.gov (United States)

    Fletcher, L. A.; Allen, C. C.; Bastien, R.

    2008-01-01

    NASA's Johnson Space Center (JSC) and the Astromaterials Curator are charged by NPD 7100.10D with the curation of all of NASA s extraterrestrial samples, including those from future missions. This responsibility includes the development of new sample handling and preparation techniques; therefore, the Astromaterials Curator must begin developing procedures to preserve, prepare and ship samples at sub-freezing temperatures in order to enable future sample return missions. Such missions might include the return of future frozen samples from permanently-shadowed lunar craters, the nuclei of comets, the surface of Mars, etc. We are demonstrating the ability to curate samples under cold conditions by designing, installing and testing a cold curation glovebox. This glovebox will allow us to store, document, manipulate and subdivide frozen samples while quantifying and minimizing contamination throughout the curation process.

  5. Is intravenous paracetamol a useful adjunct for intraoperative pain?

    OpenAIRE

    Siddique S; Ma, Ali

    2012-01-01

    Background: Paracetamol is a safe and cost effective intravenous (IV) analgesic. This survey was conducted to assess the satisfaction of anesthetics with the intra-operative use of IV paracetamol as an adjunt for intra-operative pain relief.Methods: This cross-sectional survey was conducted for 3 months in a tertiary care university hospital in Karachi, Pakistan. All patients admitted for surgery and received IV paracetamol were enrolled. Data was collected by administering a pre-coded questi...

  6. Intraoperative magnetic resonance imaging.

    Science.gov (United States)

    Hall, Walter A; Truwit, Charles L

    2011-01-01

    Neurosurgeons have become reliant on image-guidance to perform safe and successful surgery both time-efficiently and cost-effectively. Neuronavigation typically involves either rigid (frame-based) or skull-mounted (frameless) stereotactic guidance derived from computed tomography (CT) or magnetic resonance imaging (MRI) that is obtained days or immediately before the planned surgical procedure. These systems do not accommodate for brain shift that is unavoidable once the cranium is opened and cerebrospinal fluid is lost. Intraoperative MRI (ioMRI) systems ranging in strength from 0.12 to 3 Tesla (T) have been developed in part because they afford neurosurgeons the opportunity to accommodate for brain shift during surgery. Other distinct advantages of ioMRI include the excellent soft tissue discrimination, the ability to view the surgical site in three dimensions, and the ability to "see" tumor beyond the surface visualization of the surgeon's eye, either with or without a surgical microscope. The enhanced ability to view the tumor being biopsied or resected allows the surgeon to choose a safe surgical corridor that avoids critical structures, maximizes the extent of the tumor resection, and confirms that an intraoperative hemorrhage has not resulted from surgery. Although all ioMRI systems allow for basic T1- and T2-weighted imaging, only high-field (>1.5 T) MRI systems are capable of MR spectroscopy (MRS), MR angiography (MRA), MR venography (MRV), diffusion-weighted imaging (DWI), and brain activation studies. By identifying vascular structures with MRA and MRV, it may be possible to prevent their inadvertent injury during surgery. Biopsying those areas of elevated phosphocholine on MRS may improve the diagnostic yield for brain biopsy. Mapping out eloquent brain function may influence the surgical path to a tumor being resected or biopsied. The optimal field strength for an ioMRI-guided surgical system and the best configuration for that system are as yet

  7. Creep Behavior of Frozen Sand.

    Science.gov (United States)

    1981-06-01

    temperature and stress range. There was a 2strong stress dependance to S (r =0.95) for saturated Manchester Fine Sand which does not agree with RPT. The...Curves at High Stress 161 Ratio D/Du = 0.505 for Frozen HF’S at w=10% IV-20 Minimum Strain Rate Dependance on Stress 162 Ratio for Frozen MFS IV-21 Minimum...Strain Rate Dependance on Relative 163 Density for Frozen MFS IV-22 Temperature Stage Test on Frozen Saturated 164 MFS under a Load of D=9.24MPa Fig

  8. Intraoperative pathology consultation for pulmonary lesions: errors and deferrals.

    Science.gov (United States)

    Akyildiz, Elif Ulker

    2015-01-01

    The accuracy rate of frozen section constitutes an important step of quality assessment step in pathology practice. This study aimed to investigate pulmonary lesions that were incorrectly diagnosed or postponed for routine examination by pathologists at frozen section examination; it also aimed to discuss the reasons for difficult diagnoses and the various clues enabling the correct diagnosis to be made when such lesions are encountered. This study retrospectively reviewed the medical data of the thoracic surgery cases that underwent frozen section examination between 2009 and 2014. Frozen section errors and deferrals were identified in 25 cases. Fourteen (56%) lesions were of pulmonary parenchymal origin and 11 (44%) were of pleural origin. The number of cases in which the pathologists postponed the diagnosis without making any approach was 14. Of these, 9 (64%) were benign lesions such as bronchiectasis, fibrosis anthracosis, chronic inflammatory cell infiltration, chronic pleuritis, and mesothelial proliferation. The number of misdiagnosed cases was 11. Of these, 7 (64%) were of pulmonary and 4 (36%) were of pleural origin. Because the examination techniques of each pathology department may differ from one another, the comparative examination of frozen sections and routine sections would aid in becoming familiar with various pathologies and would be beneficial for pathologists in minimizing their diagnostic errors.

  9. Targeted intraoperative radiotherapy in oncology

    CERN Document Server

    Keshtgar, Mohammed; Wenz, Frederik

    2014-01-01

    Targeted intraoperative radiotherapy is a major advance in the management of cancer patients. With an emphasis on practical aspects, this book offers an ideal introduction to this innovative  technology for clinicians.

  10. Building Cosmological Frozen Stars

    CERN Document Server

    Kastor, David

    2016-01-01

    Janis-Newman-Winicour (JNW) spacetimes generalize the Schwarzschild solution to include a massless scalar field. Although suffering from naked singularities, they share the `frozen star' features of Schwarzschild black holes. Cosmological versions of the JNW spacetimes were discovered some time ago by Husain, Martinez and Nunez and by Fonarev. Unlike Schwarzschild-deSitter black holes, these solutions are dynamical, and the scarcity of exact solutions for dynamical black holes in cosmological backgrounds motivates their further study. Here we show how the cosmological JNW spacetimes can be built, starting from simpler, static, higher dimensional, vacuum `JNW brane' solutions via two different generalized dimensional reduction schemes that together cover the full range of JNW parameter space. Cosmological versions of a BPS limit of charged dilaton black holes are also known. JNW spacetimes represent a different limiting case of the charged, dilaton black hole family. We expect that understanding this second da...

  11. Frozen waves: experimental generation.

    Science.gov (United States)

    Vieira, Tarcio A; Gesualdi, Marcos R R; Zamboni-Rached, Michel

    2012-06-01

    Frozen waves (FWs) are very interesting particular cases of nondiffracting beams whose envelopes are static and whose longitudinal intensity patterns can be chosen a priori. We present here for the first time (that we know of) the experimental generation of FWs. The experimental realization of these FWs was obtained using a holographic setup for the optical reconstruction of computer generated holograms (CGH), based on a 4-f Fourier filtering system and a nematic liquid crystal spatial light modulator (LC-SLM), where FW CGHs were first computationally implemented, and later electronically implemented, on the LC-SLM for optical reconstruction. The experimental results are in agreement with the corresponding theoretical analytical solutions and hold excellent prospects for implementation in scientific and technological applications.

  12. Intraoperative radiotherapy:principles and prospects

    Institute of Scientific and Technical Information of China (English)

    Omar Abdel-Rahman

    2014-01-01

    Intraoperative radiotherapy (IORT) in its broadest sense refers to the delivery of radiation at the time of an opera-tion. It includes multiple techniques, namely intraoperative electron irradiation, intraoperative brachytherapy and intraopera-tive photon irradiation. It has a wide range of existing and potential y enlarging clinical applications. We wil discuss in this review the rationale for and use of intraoperative irradiation in conjunction with surgical exploration with or without external-beam irradiation (EBRT) and chemotherapy.

  13. In vivo virtual intraoperative surgical photoacoustic microscopy

    Energy Technology Data Exchange (ETDEWEB)

    Han, Seunghoon, E-mail: hsh860504@gmail.com; Kim, Sehui, E-mail: sehui0916@nate.com; Kim, Jeehyun, E-mail: jeehk@knu.ac.kr, E-mail: chulhong@postech.edu [School of Electrical Engineering and Computer Science, Kyungpook National University, Daegu 702-701 (Korea, Republic of); Lee, Changho, E-mail: ch31037@postech.edu; Jeon, Mansik, E-mail: msjeon@postech.edu [Department of Creative IT Engineering, Pohang University of Science and Technology (POSTECH), Pohang 790-784 (Korea, Republic of); Kim, Chulhong, E-mail: jeehk@knu.ac.kr, E-mail: chulhong@postech.edu [Department of Creative IT Engineering, Pohang University of Science and Technology (POSTECH), Pohang 790-784 (Korea, Republic of); Department of Biomedical Engineering, The State University of New York at Buffalo, Buffalo, New York 14221 (United States)

    2013-11-11

    We developed a virtual intraoperative surgical photoacoustic microscopy system by combining with a commercial surgical microscope and photoacoustic microscope (PAM). By sharing the common optical path in the microscope and PAM system, we could acquire the PAM and microscope images simultaneously. Moreover, by employing a beam projector to back-project 2D PAM images onto the microscope view plane as augmented reality, the conventional microscopic and 2D cross-sectional PAM images are concurrently mapped on the plane via an ocular lens of the microscope in real-time. Further, we guided needle insertion into phantom ex vivo and mice skins in vivo.

  14. 9 CFR 327.21 - Inspection procedures for chilled fresh and frozen boneless manufacturing meat.

    Science.gov (United States)

    2010-01-01

    ... fresh and frozen boneless manufacturing meat. 327.21 Section 327.21 Animals and Animal Products FOOD... manufacturing of meat food products. As used in this section, the term “frozen” includes “chilled fresh,” and....21 Inspection procedures for chilled fresh and frozen boneless manufacturing meat. (a)...

  15. 40 CFR 405.70 - Applicability; description of the fluid mix for ice cream and other frozen desserts subcategory.

    Science.gov (United States)

    2010-07-01

    ... mix for ice cream and other frozen desserts subcategory. 405.70 Section 405.70 Protection of... PROCESSING POINT SOURCE CATEGORY Fluid Mix for Ice Cream and Other Frozen Desserts Subcategory § 405.70 Applicability; description of the fluid mix for ice cream and other frozen desserts subcategory. The...

  16. The equine frozen semen industry.

    Science.gov (United States)

    Loomis, P R

    2001-12-03

    Recent acceptance of frozen semen as a method to produce registered foals by two of the worlds largest breed associations, the American Quarter Horse and American Paint Horse, has stimulated new interest in frozen semen technology. This review will: (a) attempt to identify the major impediments to the development of the frozen semen industry, (b) suggest alternative methods for marketing and application of frozen semen, and (c) present the results of a recent study in our laboratory. The objective of which was to compare pregnancy rates of insemination with cooled and frozen semen. Major impediments to the development of the frozen semen industry include 1. Lower fertility with frozen semen as compared to cooled semen for many stallions. 2. Increased costs associated with management of mares for AI with frozen semen using current insemination protocols. 3. Unfavorable marketing practices for frozen semen. Reports of fertility with cooled transported semen in commercial breeding programs indicate seasonal pregnancy rates ranging from 60 to 90%. We compiled data from three commercial transported cooled semen programs in which semen from 16 stallions was used for insemination of 850 mares throughout North America by local veterinarians. During the 1999 and 2000 breeding seasons, first cycle and seasonal pregnancy rates of 59.4 and 74.7% were obtained. During that same period, first cycle and seasonal pregnancy rates of 51.3 and 75.6% were obtained following insemination of 876 mares with frozen semen from 106 different stallions processed by our laboratory and distributed through our commercial distribution program. First cycle and seasonal pregnancy rates were higher for mares bred outside of North America than for mares bred within North America (53.5 and 81.9 versus 49.4 and 65.6%, respectively). Seasonal pregnancy rates were higher presumably because of the better mare management employed for mares bred with exported semen and the fact that some of the domestic

  17. [Intraoperative neuromonitoring in thyroid surgery].

    Science.gov (United States)

    Motos-Micó, José Jacob; Felices-Montes, Manuel; Abad-Aguilar, Teresa

    Intraoperative neuromonitoring of the recurrent laryngeal nerve in thyroid surgery facilitates the identification of anatomical structures in cervical endocrine surgery reducing the frequency of vocal cord paralysis. To study the normal electrophysiological values of the vague and recurrent laryngeal nerves before and after thyroid surgery. To compare rates of injury of recurrent nerve before and after the introduction of the intraoperative neuromonitoring in thyroid surgery. An observational, descriptive and prospective study in which a total of 490 patients were included. Between 2003-2010, surgery was performed on 411 patients (703 nerves at risk) with systematic identification of recurrent laryngeal nerves. Between 2010-2011 neuromonitorization was also systematically performed on 79 patients. Before the introduction of intraoperative neuromonitoring of 704 nerves at risk, there were 14 recurrent laryngeal nerve injuries. Since 2010, after the introduction of the intraoperative neuromonitoring in thyroid surgery, there has been no nerve injury in 135 nerves at risk. We consider the systematic identification of the recurrent laryngeal nerve is the 'gold standard' in thyroid surgery and the intraoperative neuromonitoring of nerves can never replace surgery but can complement it. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  18. Intraoperative monitoring of evoked potentials.

    Science.gov (United States)

    Raudzens, P A

    1982-01-01

    Sensory EPs were recorded intraoperatively in 173 neurosurgical procedures (71 VEPs, 66 BAEPs, and 31 SSEPs) to evaluate the utility of this technique. EPs could be safely recorded in all cases, but the yield of useful results varied with each sensory modality. BAEPs were recorded reliably in 100% of the cases and intraoperative latency changes accurately predicted postoperative hearing deficits in 10%. Potential hearing deficits were detected in another 15%. BAEP changes were associated with brainstem dysfunction in only one case. VEP changes were difficult to interpret intraoperatively because of contamination by a high degree of variability and both false negative and false positive results. Changes in VEP amplitudes related to surgical manipulation of the optic chiasm were only suggested. SSEP changes were recorded reliably in only 75% of the cases and no correlations between SSEP changes and postoperative sensory function were established. Again, intraoperative amplitude attenuation of the SSEP waveform with surgical manipulation only suggested a potential sensory deficit. Intraoperative EP monitoring is a valuable technique that provides a functional analysis of the sensory nervous system during surgical procedures. Specific sensory stimuli and improved data analysis will increase the utility of this CNS monitor.

  19. [The role of intraoperative ultrasonography].

    Science.gov (United States)

    Matsushita, Yoko; Okayama, Yukinari; Matsuo, Shuji

    2008-06-01

    Intraoperative ultrasonography (US) is able to visualize the inside of the viscera in real time, and is also both noninvasive and simple to perform without influence of the bone or alimentary canal gas disturbing the propagation of the ultrasound. US has recently been widely used for neurosurgery or abdominal surgery, 1) to check the position and size of the tumor, which can not be directly visualized, and to evaluate the relationship between the tumor and blood vessel or tissue, 2) to search for lesions not detected before surgery, 3) to search for residual tumor, 4) to carry out ultrasound-guided biopsy or puncture. For effective intraoperative US, thorough knowledge of the US instrument and the local anatomy is necessary. The medical technologists who routinely perform US are qualified to assist with intraoperative US.

  20. Intraoperative Sentinel Lymph Node Evaluation

    DEFF Research Database (Denmark)

    Shaw, Richard; Christensen, Anders; Java, Kapil;

    2016-01-01

    BACKGROUND: Intraoperative analysis of sentinel lymph nodes would enhance the care of early-stage oral squamous cell carcinoma (OSCC). We determined the frequency and extent of cytokeratin 19 (CK19) expression in OSCC primary tumours and surrounding tissues to explore the feasibility of a "clinic......-ready" intraoperative diagnostic test (one step nucleic acid amplification-OSNA, sysmex). METHODS: Two cohorts were assembled: cohort 1, OSCC with stage and site that closely match cases suitable for sentinel lymph node biopsy (SLNB); cohort 2, HNSCC with sufficient fresh tumour tissue available for the OSNA assay (>50...

  1. Intraoperative fracture of phacoemulsification tip

    Directory of Open Access Journals (Sweden)

    Dewang Angmo

    2014-01-01

    Full Text Available Phacoemulsification (phaco is an established procedure for cataract extraction and has undergone a significant advances in techniques, machines and phaco tips. The Aspiration Bypass System (ABS phaco tip was introduced for phacoemulsification in 1998. The ABS tip allows fluid to be drawn through the opening when the phaco tip is occluded by nuclear material. The ABS tip allowed the safe use of high vacuum and flow rates and improved chamber stability by decreasing surge and therefore reducing intraoperative complications. To date, no disadvantages of ABS tips have been reported. We report a unique case of an intraoperative break of an ABS phaco tip during routine cataract surgery.

  2. Intraoperative fracture of phacoemulsification tip.

    Science.gov (United States)

    Angmo, Dewang; Khokhar, Sudarshan K; Ganguly, Anasua

    2014-01-01

    Phacoemulsification (phaco) is an established procedure for cataract extraction and has undergone a significant advances in techniques, machines and phaco tips. The Aspiration Bypass System (ABS) phaco tip was introduced for phacoemulsification in 1998. The ABS tip allows fluid to be drawn through the opening when the phaco tip is occluded by nuclear material. The ABS tip allowed the safe use of high vacuum and flow rates and improved chamber stability by decreasing surge and therefore reducing intraoperative complications. To date, no disadvantages of ABS tips have been reported. We report a unique case of an intraoperative break of an ABS phaco tip during routine cataract surgery.

  3. Intraoperative Fracture of Phacoemulsification Tip

    Science.gov (United States)

    Angmo, Dewang; Khokhar, Sudarshan K.; Ganguly, Anasua

    2014-01-01

    Phacoemulsification (phaco) is an established procedure for cataract extraction and has undergone a significant advances in techniques, machines and phaco tips. The Aspiration Bypass System (ABS) phaco tip was introduced for phacoemulsification in 1998. The ABS tip allows fluid to be drawn through the opening when the phaco tip is occluded by nuclear material. The ABS tip allowed the safe use of high vacuum and flow rates and improved chamber stability by decreasing surge and therefore reducing intraoperative complications. To date, no disadvantages of ABS tips have been reported. We report a unique case of an intraoperative break of an ABS phaco tip during routine cataract surgery. PMID:24669153

  4. [Intraoperative staging of colorectal tumors].

    Science.gov (United States)

    Abdurakhmonov, Iu B; Mel'nikov, O R; Egorenkov, V V; Moiseenko, V M

    2007-01-01

    The effectiveness of intraoperative staging of tumor by sentinel node staining with lymphotropic dyes was evaluated in 60 patients with colorectal tumors (colon carcinoma -39, rectal cancer- 21). High sensitivity (84.6% and 87.5%, respectively) and specificity (100% and 100%, respectively) for regional lymph node assessment were identified for both colonic and rectal cancer.

  5. 49 CFR 173.229 - Chloric acid solution or chlorine dioxide hydrate, frozen.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false Chloric acid solution or chlorine dioxide hydrate, frozen. 173.229 Section 173.229 Transportation Other Regulations Relating to Transportation PIPELINE AND... Than Class 1 and Class 7 § 173.229 Chloric acid solution or chlorine dioxide hydrate, frozen. When the...

  6. 21 CFR 161.176 - Frozen raw lightly breaded shrimp.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Frozen raw lightly breaded shrimp. 161.176 Section 161.176 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION FISH AND SHELLFISH Requirements for Specific Standardized Fish...

  7. [Intraoperative Visual Evoked Potential Monitoring].

    Science.gov (United States)

    Hayashi, Hironobu; Kawaguchi, Masahiko

    2015-05-01

    Visual evoked potential (VEP) is recorded from the back of the head, which is elicited by retinal stimulation transmitted through optic nerve, optic chiasm, optic tract lateral geniculate body, optic radiation and finally cortical visual area. VEP monitoring did not prevail since 1990s because marked intra-individual difference and instability of VEP recording limited the clinical usefulness under inhalation anesthetic management and techniques of VEP monitoring at the time. However, recent advances in techniques including a new light-stimulating device consisting of high-luminosity LEDs and induction of electroretinography to ascertain the arrival of the stimulus at the retina provided better conditions for stable VEP recording under general anesthesia. In addition, the introduction of total intravenous anesthesia using propofol is important for the successful VEP recordings because inhaled anesthetics have suppressive effect on VEP waveform. Intraoperative VEP has been considered to monitor the functional integrity of visual function during neurosurgical procedures, in which the optic pathway is at a risk of injury. Intraoperative VEP monitoring may allow us to detect reversible damage to the visual pathway intraoperatively and enable us to prevent permanent impairment.

  8. Frozen Scope and Grammatical Optimization

    Science.gov (United States)

    Freedman, Michael

    2014-01-01

    The literature on quantifier scope has repeatedly observed that some otherwise expected permutations of scope taking elements are unavailable. Various methods have been proffered explaining these facts. This thesis aims to unify three disparate areas where the scope of operators seems to be frozen: the interaction of universal quantifiers with…

  9. A critical survey of fresh-frozen plasma use.

    Science.gov (United States)

    Blumberg, N; Laczin, J; McMican, A; Heal, J; Arvan, D

    1986-01-01

    The use of 534 units of fresh-frozen plasma (FFP) during 160 transfusion episodes in 135 consecutive patients was reviewed. Only 27 percent of transfusions were indicated by a need for replacement of labile coagulation factors. Other uses included volume repletion (31%), intraoperative bleeding or massive transfusion without coagulopathy (19%), and miscellaneous indications unrelated to labile coagulation factors (23%). Data from other institutions and national sources support the hypothesis that much of the increase in FFP use over the last decade is related to decreases in whole blood availability rather than to use for labile coagulation factor replacement. The use of FFP and red cells as a substitute for, or in preference to, whole blood may have significant adverse implications in terms of the cost and safety of blood transfusion.

  10. The Eccentric Behavior of Nearly Frozen Orbits

    Science.gov (United States)

    Sweetser, Theodore H.; Vincent, Mark A.

    2013-01-01

    Frozen orbits are orbits which have only short-period changes in their mean eccentricity and argument of periapse, so that they basically keep a fixed orientation within their plane of motion. Nearly frozen orbits are those whose eccentricity and argument of periapse have values close to those of a frozen orbit. We call them "nearly" frozen because their eccentricity vector (a vector whose polar coordinates are eccentricity and argument of periapse) will stay within a bounded distance from the frozen orbit eccentricity vector, circulating around it over time. For highly inclined orbits around the Earth, this distance is effectively constant over time. Furthermore, frozen orbit eccentricity values are low enough that these orbits are essentially eccentric (i.e., off center) circles, so that nearly frozen orbits around Earth are bounded above and below by frozen orbits.

  11. Intraoperative visualisation of the trigeminal cistern. Intraoperative Darstellung der Trigeminuszisterne

    Energy Technology Data Exchange (ETDEWEB)

    Bockermann, V.; Dieckmann, G. (Goettingen Univ. (Germany). Abt. Funktionelle Neurochirurgie)

    1991-07-01

    Percutaneous retrogassarian glycerol rhizotomy has passed the test of time as an immediately effective and reliable method for the treatment of trigeminal neuralgia. X-ray-assisted puncture of the trigeminal cistern and contrast-enhanced intraoperative visualisation techniques are absolute requirements of this surgical measure and invariably precede any further steps taken by the surgeon. The use of state-of-the-art fluoroscopic methods ensures that ample information is even obtained from the images of the base-of-scull region. (orig.).

  12. Toxigenic penicillia spoiling frozen chicken nuggets

    DEFF Research Database (Denmark)

    Wigmann, Evelin Francine; Saccomori, Fernanda; Bernardi, Angelica Olivier

    2015-01-01

    Frozen chicken nuggets are classified as pre-prepared frozen meals. These products are convenient to consumers as they are easy to prepare and allow for long storage by freezing. Over the years, spoilage of frozen food products caused by fungi has been a continual problem for the food industry si...... reserved....

  13. Management of the frozen shoulder

    Directory of Open Access Journals (Sweden)

    van de Laar SM

    2014-10-01

    Full Text Available Suzanne Margaretha van de Laar, Peer van der Zwaal Department of Orthopaedic Surgery and Trauma, Medical Center Haaglanden, The Hague, the Netherlands Abstract: Frozen shoulder is a very common condition with a prevalence of 2%–5% in the general population. Decrease in joint volume as a result of fibrosis and hyperplasia of the joint capsule leads to painful and restricted glenohumeral motion. Frozen shoulder is a self-limiting disease with a chronic character, and is mostly treated in a primary care setting. In this review, we set out to address the current evidence-based literature on management of this disabling disease using a PubMed search. Many non-surgical and surgical therapeutic options are described, including supervised neglect, intra-articular corticosteroid injections, physical therapy, manipulation under anesthesia, capsular distension, and arthroscopic capsular release. In the literature, the long-term outcome shows a significant decrease in pain and improvement of shoulder function for all treatment modalities without clear evidence of superiority of one over the other. This possibly indicates that a self-limiting character is the most important factor in the course of the disease. Management of frozen shoulder is primarily conservative. Supervised neglect is combined with analgesia and stretching exercises as the pain subsides. In the early painful phase, intra-articular corticosteroid injections are recommended for pain relief. When the patient has persistent pain and glenohumeral stiffness after adequate conservative treatment, invasive options can be considered, like arthroscopic capsular release, manipulation under anesthesia, or capsular distension. Keywords: frozen shoulder, adhesive capsulitis, treatment, pathophysiology

  14. Intraoperative value of the thompson test.

    Science.gov (United States)

    Cuttica, Daniel J; Hyer, Christopher F; Berlet, Gregory C

    2015-01-01

    The purpose of the present study was to assess the validity of the Thompson sign and determine whether the deep flexors of the foot can produce a falsely intact Achilles tendon.Ten unmatched above-the-knee lower extremity cadaveric specimens were studied. In group 1, the Achilles tendon was sectioned into 25% increments. The Thompson maneuver was performed after each sequential sectioning of the Achilles tendon, including after it had been completely sectioned. If the Thompson sign was still intact after complete release of the Achilles tendon, we proceeded to release the tendon, and tendon flexor hallucis longus, flexor digitorum longus, and posterior tibial tendons. The Thompson test was performed after the release of each tendon. In group 2, the tendon releases were performed in a reverse order to that of group 1, with the Thompson test performed after each release. In group 1, the Thompson sign remained intact in all specimens after sectioning of 25%, 50%, and 75% of the tendon. After complete (100%) release of the tendon, the Thompson sign was absent in all specimens. In group 2, the Thompson sign remained intact after sectioning of the posterior tibial, flexor digitorum longus, and flexor hallucis longus tendons in all specimens. The Thompson sign remained intact in all specimens after sectioning of 25%, 50%, and 75% of the Achilles tendon. After complete release of the tendon, the Thompson sign was absent in all specimens.The Thompson test is an accurate clinical test for diagnosing complete Achilles tendon ruptures. However, it might not be a useful test for diagnosing partial Achilles tendon ruptures. Our findings also call into question the usefulness of the Thompson test in the intraoperative setting.

  15. INTRAOPERATIVE PREDONATION CONTRIBUTES TO BLOOD SAVING

    NARCIS (Netherlands)

    SCHONBERGER, JPAM; BREDEE, JJ; TJIAN, D; EVERTS, PAM; WILDEVUUR, CRH

    1993-01-01

    The merits of reinfusing prebypass-removed autologous blood (intraoperative predonation) to salvage blood and improve postoperative hemostasis are still debated, specifically for patients at a higher risk for bleeding. To evaluate the effect of intraoperative predonation on the platelet count, blood

  16. Intraoperative OCT in Surgical Oncology

    Science.gov (United States)

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

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

  17. Intraoperative Sentinel Lymph Node Evaluation

    DEFF Research Database (Denmark)

    Shaw, Richard; Christensen, Anders; Java, Kapil

    2016-01-01

    BACKGROUND: Intraoperative analysis of sentinel lymph nodes would enhance the care of early-stage oral squamous cell carcinoma (OSCC). We determined the frequency and extent of cytokeratin 19 (CK19) expression in OSCC primary tumours and surrounding tissues to explore the feasibility of a "clinic...... mg). CK19 assays included qRT-PCR, RNA in situ hybridisation (ISH), and immunohistochemistry (IHC), as well as OSNA. RESULTS: CK19 mRNA expression was detected with variable sensitivity, depending on method, in 60-80% of primary OSCC tumours, while protein expression was observed in only 50......% of tumours. Discordance between different techniques indicated that OSNA was more sensitive than qRT-PCR or RNA-ISH, which in turn were more sensitive than IHC. OSNA results showed CK19 expression in 80% of primary cases, so if used for diagnosis of lymph node metastasis would lead to a false-negative result...

  18. Practicality of intraoperative teamwork assessments.

    Science.gov (United States)

    Phitayakorn, Roy; Minehart, Rebecca; Pian-Smith, May C M; Hemingway, Maureen W; Milosh-Zinkus, Tanya; Oriol-Morway, Danika; Petrusa, Emil

    2014-07-01

    High-quality teamwork among operating room (OR) professionals is a key to efficient and safe practice. Quantification of teamwork facilitates feedback, assessment, and improvement. Several valid and reliable instruments are available for assessing separate OR disciplines and teams. We sought to determine the most feasible approach for routine documentation of teamwork in in-situ OR simulations. We compared rater agreement, hypothetical training costs, and feasibility ratings from five clinicians and two nonclinicians with instruments for assessment of separate OR groups and teams. Five teams of anesthesia or surgery residents and OR nurses (RN) or surgical technicians were videotaped in simulations of an epigastric hernia repair where the patient develops malignant hyperthermia. Two anesthesiologists, one OR clinical RN specialist, one educational psychologist, one simulation specialist, and one general surgeon discussed and then independently completed Anesthesiologists' Non-Technical Skills, Non-Technical Skills for Surgeons, Scrub Practitioners' List of Intraoperative Non-Technical Skills, and Observational Teamwork Assessment for Surgery forms to rate nontechnical performance of anesthesiologists, surgeons, nurses, technicians, and the whole team. Intraclass correlations of agreement ranged from 0.17-0.85. Clinicians' agreements were not different from nonclinicians'. Published rater training was 4 h for Anesthesiologists' Non-Technical Skills and Scrub Practitioners' List of Intraoperative Non-Technical Skills, 2.5 h for Non-Technical Skills for Surgeons, and 15.5 h for Observational Teamwork Assessment for Surgery. Estimated costs to train one rater to use all instruments ranged from $442 for a simulation specialist to $6006 for a general surgeon. Additional training is needed to achieve higher levels of agreement; however, costs may be prohibitive. The most cost-effective model for real-time OR teamwork assessment may be to use a simulation technician

  19. Tailoring and histochemical application of fluorescent homo-dimeric styryl dyes using frozen sections: from peroxidase substrates to new cytochemical probes for mast cells, keratin, cartilage and nucleic acids.

    Science.gov (United States)

    Krieg, Reimar; Eitner, Annett; Halbhuber, Karl-Jürgen

    2011-11-01

    Homo-dimers of styryl dyes were chemically tailored in order to become specific cytochemical probes for use in the life sciences. Histochemical applications using fixed cryotome sections are discussed. It is concluded, that homo-dimerization of specific styryl substrates of peroxidase (PO) by way of their covalent linkage, does not necessarily lead to improved detection sensitivity of endogenous and immuno-bound peroxidase (PO) activity. In general, these dimers act less specific towards PO activity than parent monomers. Synergetic interactions of the doubled basic dye compartments with cell constituents cause a pronounced staining of further targets at the cellular level. This behavior depends on the functional groups present in each dye compartment in a crucial manner. However, by way of chemical dye tailoring centering of these initially unwanted staining properties is possible leading to novel highly fluorescent stains for mast cells, nucleic acids, keratin and cartilage tissue. Structure/staining behavior-relationships of these stains are discussed. Copyright © 2011 Elsevier GmbH. All rights reserved.

  20. Practical intraoperative stereo camera calibration.

    Science.gov (United States)

    Pratt, Philip; Bergeles, Christos; Darzi, Ara; Yang, Guang-Zhong

    2014-01-01

    Many of the currently available stereo endoscopes employed during minimally invasive surgical procedures have shallow depths of field. Consequently, focus settings are adjusted from time to time in order to achieve the best view of the operative workspace. Invalidating any prior calibration procedure, this presents a significant problem for image guidance applications as they typically rely on the calibrated camera parameters for a variety of geometric tasks, including triangulation, registration and scene reconstruction. While recalibration can be performed intraoperatively, this invariably results in a major disruption to workflow, and can be seen to represent a genuine barrier to the widespread adoption of image guidance technologies. The novel solution described herein constructs a model of the stereo endoscope across the continuum of focus settings, thereby reducing the number of degrees of freedom to one, such that a single view of reference geometry will determine the calibration uniquely. No special hardware or access to proprietary interfaces is required, and the method is ready for evaluation during human cases. A thorough quantitative analysis indicates that the resulting intrinsic and extrinsic parameters lead to calibrations as accurate as those derived from multiple pattern views.

  1. Efficacy of intraoperative neurophysiological monitoring.

    Science.gov (United States)

    Fisher, R S; Raudzens, P; Nunemacher, M

    1995-01-01

    Intraoperative neurophysiological monitoring is of benefit in protecting tissue at risk for trauma or ischemia during surgical procedures. Monitoring modalities include EEG, computer processed EEG, somatosensory (SEP), auditory (BAEP), and visual evoked potentials (VEP), and cranial nerve monitoring. The efficacy of monitoring is controversial, because no properly controlled prospective study of outcome with and without monitoring has been done. The weight of evidence suggests that loss of spontaneous EEG and SEP correlate well with critical reductions of cerebral blood flow. Meta-analysis of series comprising 3,028 patients undergoing carotid endarterectomies shows that SEP deteriorated in 5.6% of cases, with 20% of these having postoperative deficits, but more might have had deficits if they had not been shunted. SEP monitoring can be useful in surgery affecting brain and cord vasculature. Monitoring is not indicated for routine lumbosacral spine surgery. BAEPs have predictive value for preservation of hearing after acoustic neuroma surgery, and other surgery near the brainstem. VEPs have been too variable to be of major use in the operating room. For neurophysiologic monitoring to be useful, it must be performed by an experienced team, and the surgeon must be willing to act on the findings. Under these circumstances, monitoring can reduce surgical complications in selected cases.

  2. Chronology of the Frozen Dumpling Issue

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    January 30:Japan informed China that some consumers in Tokushima prefecture got food poisoning after they ate frozen dumplings produced by Hebei Tianyang Food Company.According to the Japanese,the food inspection test results showed traces of the pesticides dichlorvos and methamidophos in frozen dumpling samples.

  3. Intraoperative Anaphylactic Reaction: Is it the Floseal?

    Science.gov (United States)

    Martin, David; Schloss, Brian; Beebe, Allan; Samora, Walter; Klamar, Jan; Stukus, David; Tobias, Joseph D.

    2016-01-01

    When hemodynamic or respiratory instability occurs intraoperatively, the inciting event must be determined so that a therapeutic plan can be provided to ensure patient safety. Although generally uncommon, one cause of cardiorespiratory instability is anaphylactic reactions. During anesthetic care, these most commonly involve neuromuscular blocking agents, antibiotics, or latex. Floseal is a topical hemostatic agent that is frequently used during orthopedic surgical procedures to augment local coagulation function and limit intraoperative blood loss. As these products are derived from human thrombin, animal collagen, and animal gelatin, allergic phenomenon may occur following their administration. We present 2 pediatric patients undergoing posterior spinal fusion who developed intraoperative hemodynamic and respiratory instability following use of the topical hemostatic agent, Floseal. Previous reports of such reactions are reviewed, and the perioperative care of patients with intraoperative anaphylaxis is discussed. PMID:27713677

  4. Intraoperative neurophysiological monitoring for the anaesthetist ...

    African Journals Online (AJOL)

    ... of the theory and practice of intraoperative neurophysiological monitoring. ... the incidence of postoperative neurological deficit and allowed radical resection of ... present with decreased myelination and morphological changes to the EPs.

  5. Value of Intraoperative Sonography in Pancreatic Surgery.

    Science.gov (United States)

    Weinstein, Stefanie; Morgan, Tara; Poder, Liina; Shin, Lewis; Jeffrey, R Brooke; Aslam, Rizwan; Yee, Judy

    2015-07-01

    The utility of intraoperative sonography for pancreatic disease has been well described for detection and evaluation of neoplastic and inflammatory pancreatic disease. Intraoperative sonography can help substantially reduce surgical time as well as decrease potential injury to tissues and major structures. Imaging with sonography literally at the point of care--the surgeon's scalpel--can precisely define the location of pancreatic lesions and their direct relationship with surrounding structures in real time during surgery. This article highlights our experience with intraoperative sonography at multiple institutional sites for both open and laparoscopic surgical procedures. We use intraoperative sonography for a wide range of pancreatic disease to provide accurate localization and staging of disease, provide guidance for enucleation of nonpalpable, nonvisible tumors, and in planning the most direct and least invasive surgical approach, avoiding injury to the pancreatic duct or other vital structures. © 2015 by the American Institute of Ultrasound in Medicine.

  6. [Intraoperative monitoring of visual evoked potentials].

    Science.gov (United States)

    Sasaki, Tatsuya; Ichikawa, Tsuyoshi; Sakuma, Jun; Suzuki, Kyouichi; Matsumoto, Masato; Itakura, Takeshi; Kodama, Namio; Murakawa, Masahiro

    2006-03-01

    Our success rate of intraoperative monitoring of visual evoked potential (VEP) had been approximately 30% in the past. In order to improve recording rate of intraoperative VEP, we developed a new stimulating device using high power light emitting diodes. Electroretinogram was simultaneously recorded to understand whether flash stimulation reached the retina. In addition, total venous anesthesia with propofol was used to avoid the adverse effect of inhalation anesthesia. We report the results after introduction of these improvements. Intraoperative monitoring of VEP was attempted in 35 cases. We evaluated success rate of VEP recording, correlation between VEP findings and postoperative visual function, and reasons why recording was not successful. Stable and reproducible waveforms were obtained in 59 sides (84%). Two cases, whose VEP deteriorated intraoperatively, developed postoperative visual disturbance: In 11 sides (16%), stable waveforms were not obtained. There were two main causes. In 8 sides out of 11, the cause was attributed to pre-existing severe visual disturbance. In these 8 sides, VEP in the awake state was not recordable or was recordable, but with very low amplitudes under 1 microV. In the other 3 sides, the cause was attributed to movement of a stimulating device by reflecting the fronto-temporal scalp flap. In conclusion, the successful recording rate was increased to 84% from approximately 30%, after introduction of various trials. We need further improvement in recording intraoperative VEP to establish a reliable intraoperative monitoring method for VEP.

  7. 21 CFR 101.95 - “Fresh,” “freshly frozen,” “fresh frozen,” “frozen fresh.”

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false âFresh,â âfreshly frozen,â âfresh frozen,â âfrozen... fresh,” when used on the label or in labeling of a food, mean that the food was quickly frozen while still fresh (i.e., the food had been recently harvested when frozen). Blanching of the food...

  8. FROZEN SHOULDER TREATMENT: TRIAMCENALONE OR METHYLPREDNISOLONE INJECTION

    Directory of Open Access Journals (Sweden)

    Sanjib

    2015-10-01

    Full Text Available OBJECTIVE: To compare the effectiveness of Triamcinolone acetonide [40mg] and Methylprednisolone acetate [40mg] in 210 patients attending the Outpatient Department of Orthopedics of FAAMCH Barpeta with primary and secondary frozen shoulder. METHODS: A total number o f 210 patients with frozen shoulder who attended the Outpatient clinic of Orthopedics at FAAMCH from Jan 2013 to Jan 2015 were enrolled in our study. The diagnosis of frozen shoulder was made using the guidelines for shoulder complain issued by the Dutch C ollege of General Practitioners. Intra - articular injections of Triamcinolone acetonide [40mg] was used in 110 patients [ M ale - 50, female - 60] and 40mg Methylprednisolone was given to 100 patients [M ale - 35, female 65]. Injection was repeated every 3 weeks [ N o t more than 3 injections] by the posterior route. RESULTS: Triamcinolone acetonide was found to be more effective in diabetic patients with frozen shoulder in comparison to Methyprednisolone acetate. Triamcinolone acetonide was found to be more effective i n those patients presenting with severe grades of frozen shoulder and also these patients required lesser number of injections compared to Methylprednisolone acetate. However both Triamcinolone acatonide and Methyprednisolone were equally effective in prim ary frozen shoulder. CONCLUSION: We conclude that Triamcinolone acetonide and Methylprednisolone acetate are effective in the treatment of painful stiff shoulder; however injection Triamcinolone acetonide is a superior alternative in the treatment of diabe tics with frozen shoulder & resistant cases, with less number of injections.

  9. [Intraoperative crisis and surgical Apgar score].

    Science.gov (United States)

    Oshiro, Masakatsu; Sugahara, Kazuhiro

    2014-03-01

    Intraoperative crisis is an inevitable event to anesthesiologists. The crisis requires effective and coordinated management once it happened but it is difficult to manage the crises properly under extreme stressful situation. Recently, it is reported that the use of surgical crisis checklists is associated with significant improvement in the management of operating-room crises in a high-fidelity simulation study. Careful preoperative evaluation, proper intraoperative management and using intraoperative crisis checklists will be needed for safer perioperative care in the future. Postoperative complication is a serious public health problem. It reduces the quality of life of patients and raises medical cost. Careful management of surgical patients is required according to their postoperative condition for preventing postoperative complications. A 10-point surgical Apgar score, calculated from intraoperative estimated blood loss, lowest mean arterial pressure, and lowest heart rate, is a simple and available scoring system for predicting postoperative complications. It undoubtedly predicts higher than average risk of postoperative complications and death within 30 days of surgery. Surgical Apgar score is a bridge between proper intraoperative and postoperative care. Anesthesiologists should make effort to reduce the postoperative complication and this score is a tool for it.

  10. Chemical Effects during Storage of Frozen Foods.

    Science.gov (United States)

    Powrie, W. D.

    1984-01-01

    Discusses (1) characteristics, interrelationships, and distribution of food constituents (including water) in unfrozen food systems; (2) the freezing process; and (3) chemical changes in food during frozen storage. Protein alterations and lipid oxidation are emphasized. (JN)

  11. Acupuncture Relieves 10 years Frozen Hands

    Institute of Scientific and Technical Information of China (English)

    GuoJiaNadia

    2001-01-01

    The electric acupuncture (EA) treatment is successful in relieving frozen hands in a patient who had sufferred from severe brain damaged. EA is effective in reducing spasms and improving motor function.

  12. Artificial insemination of cranes with frozen semen

    Science.gov (United States)

    Gee, G.F.; Sexton, T.J.; Lewis, J.C.

    1979-01-01

    For the first time (1978) artificial insemination (AI) with frozen greater sandhill crane (Grus canadensis tabida) semen resulted in fertile eggs and chicks. During the 2 year (1977-78) study, 6 of 27 eggs produced were fertile. Three chicks hatched. Semen samples used for insemination were frozen and stored in liquid nitrogen for two months or less. Recent improvements in the laboratory indicated that a more effective sample can be prepared and greater fertility rates should be expected.

  13. Primary hyperparathyroidism: intraoperative PTH-measurements

    DEFF Research Database (Denmark)

    Rolighed, L; Heickendorff, L; Hessov, I

    2004-01-01

    measurement as a predictor of successful cure. MATERIAL AND METHODS: From September 1999 to April 2002 143 patients with pHPT underwent a parathyroid operation (bilateral neck exploration with identification of all parathyroid glands) with intraoperative measurements of plasma PTH (immediately prior......BACKGROUND: With the development of rapid assays and intraoperative measurement of intact parathyroid hormone (PTH), new strategies in the handling of patients with primary hyperparathyroidism (pHPT) have evolved. AIM: The aim of our study was to illustrate the performance of the intraoperative PTH...... to surgery (T0) and 5 minutes after gland excision (T5)). A positive test result was defined as plasma PTH values at T5 below 20% of T0 or a value in the normal range below 7.6 pmol/l. Hence T5 values above 20% of T0 and above 7.6 pmol/l were considered test negative. RESULTS: 122 patients (85%) were test...

  14. Intraoperative cerebral blood flow imaging of rodents

    Science.gov (United States)

    Li, Hangdao; Li, Yao; Yuan, Lu; Wu, Caihong; Lu, Hongyang; Tong, Shanbao

    2014-09-01

    Intraoperative monitoring of cerebral blood flow (CBF) is of interest to neuroscience researchers, which offers the assessment of hemodynamic responses throughout the process of neurosurgery and provides an early biomarker for surgical guidance. However, intraoperative CBF imaging has been challenging due to animal's motion and position change during the surgery. In this paper, we presented a design of an operation bench integrated with laser speckle contrast imager which enables monitoring of the CBF intraoperatively. With a specially designed stereotaxic frame and imager, we were able to monitor the CBF changes in both hemispheres during the rodent surgery. The rotatable design of the operation plate and implementation of online image registration allow the technician to move the animal without disturbing the CBF imaging during surgery. The performance of the system was tested by middle cerebral artery occlusion model of rats.

  15. Magnetic resonance of field-frozen and zero-field-frozen magnetic fluids

    Energy Technology Data Exchange (ETDEWEB)

    Pereira, A.R. E-mail: anarita@fis.ufg.br; Pelegrini, F.; Neto, K. Skeff; Buske, N.; Morais, P.C. E-mail: pcmor@unb.br

    2004-05-01

    In this study magnetic resonance was used to investigate magnetic fluid samples frozen under zero and non-zero (15 kG) external fields. The magnetite-based sample containing 2x10{sup 17} particle/cm{sup 3} was investigated from 100 to 400 K. Analysis of the temperature dependence of the resonance field revealed bigger magnetic structures in the frozen state than in the liquid phase. Also, differences in the mesoscopic organization in the frozen state may explain the data obtained from samples frozen under zero and non-zero fields.

  16. [Scientific ethics and frozen embryos].

    Science.gov (United States)

    Valenzuela, C Y

    2001-05-01

    Scientific Ethics is the theory and praxis of decisions. Philosophical Ethics is presented as the theory and praxis of the good. As the good differs among cultures, Philosophical Ethics is dependent on the endo-cultural good conception. The decision (included that one of adhesion or not to a world vision) depends on neuro-psychic specific factors: i) cognitive factors that include mostly the knowledge of the alternatives and their consequences and the ideological or religious conception of good in relation to the alternatives; ii) affective factors that make alternatives pleasant, unpleasant or neutral, attractive, repulsive or neutral; iii) emotional factors that associate to alternatives anger, peace or neutrality, sadness, happiness or neutrality; iv) value factors that assign importance, triviality or neutrality to alternatives, or assign them significance, irrelevancy or neutrality. There are unspecific factors such as the psychic energy, desire or others. Mixed factors such as attitude, motivation, intention and others. Scientific Ethics deals with the mind as a materio-energetic process which is different from the soul, eggs and embryos of any species are full individuals of that species, because, they have initiated a copy of their genome that specify, give autonomy and define them as individuals. For Scientific Ethics to leave frozen embryos like that for ever, to defrost and get rid of them or to use their cells for science are synonymous of killing them. To defrost them to use their cells as stem cells for somatic cell therapy or to implant them into uteri to continue their development is to maintain alive their cells, but only the implantation allows their maintenance as individuals, thus, being the only compatible with the Christian ethics. The compatibility of these alternatives with other ethics is discussed.

  17. INTRAOPERATIVE NEUROMONITORING DURING HEAD AND NECK SURGERY

    Directory of Open Access Journals (Sweden)

    P. O. Rumyantsev

    2012-01-01

    Full Text Available This clinical trial comparatively analyzed the frequency of postoperative neurological complications due to damage to motor (facial, recurrent, laryngeal, and accessory nerves after head and neck operations using the traditional procedure or intraoperative neuromonitoring. Neuromonitoring made during operations on the thyroid and level VI central neck could reduce the rate of recurrent laryngeal nerve paralysis by more than twice (OR = 0.32; 95 % CI 0.11–0.86; p = 0.028. The author considers the absolute indication for intraoperative neuromonitoring to be high-risk surgery for nondeliberate damage to the motor nerves and impossibility of their visual detection.

  18. Waterproof camera case for intraoperative photographs.

    Science.gov (United States)

    Raigosa, Mauricio; Benito-Ruiz, Jesús; Fontdevila, Joan; Ballesteros, José R

    2008-03-01

    Accurate photographic documentation has become essential in reconstructive and cosmetic surgery for both clinical and scientific purposes. Intraoperative photographs are important not only for record purposes, but also for teaching, publications, and presentations. Communication using images proves to be the superior way to persuade audiences. This article presents a simple and easy method for taking intraoperative photographs that uses a presterilized waterproof camera case. This method allows the user to take very good quality pictures with the photographic angle matching the surgeon's view, minimal interruption of the operative procedure, and minimal risk of contaminating the operative field.

  19. Wide-field optical coherence elastography for intraoperative assessment of tumour margins in breast cancer (Conference Presentation)

    Science.gov (United States)

    Allen, Wes M.; Chin, Lixin; Sampson, David D.; Kennedy, Brendan F.

    2016-03-01

    Incomplete excision of tumour margins is a major issue in breast-conserving surgery. Currently 20 - 60% of cases require a second surgical procedure required as a result of cancer recurrence. A number of techniques have been proposed to assess margin status, including frozen section analysis and imprint cytology. However, the recurrence rate after using these techniques remains very high. Over the last several years, our group has been developing optical coherence elastography (OCE) as a tool for the intraoperative assessment of tumour margins in breast cancer. We have reported a feasibility study on 65 ex vivo samples from patients undergoing mastectomy or wide local excision demonstrates the potential of OCE in differentiating benign from malignant tissue. In this study, malignant tissue was readily distinguished from surrounding relative tissue by a distinctive heterogeneous pattern in micro-elastograms. To date the largest field of view for a micro-elastogram is 20 x 20mm, however, lumpectomy samples are typically ~50 x 50 x 30mm. For OCE to progress as a useful clinical tool, elastograms must be acquired over larger areas to allow a greater portion of the surface area of lumpectomies to be assessed. Here, we propose a wide-field OCE scanner that utilizes a piezoelectric transducer with an internal diameter of 65mm. In this approach partially overlapped elastograms are stitched together forming a mosaic with overall dimensions of 50 x 50mm in a total acquisition time of 15 - 30 minutes. We present results using this approach on both tissue-mimicking phantoms and tissue, and discuss prospects for shorter acquisitions times.

  20. Incidence, influencing factors, and prognostic impact of intraoperative massive blood loss in adolescents with neuromuscular scoliosis

    Science.gov (United States)

    Jia, Rui; Li, Na; Xu, Bi-Yun; Zhang, Wei; Gu, Xiao-ping; Ma, Zheng-Liang

    2017-01-01

    Abstract Factors influencing massive blood loss for neuromuscular scoliosis (NMS) patients. Despite advances in surgical and anesthetic techniques, scoliosis surgery is still associated with intraoperative massive blood loss, which can result in postoperative mortality and morbidity. The aim of this study was to assess the incidence, influencing factors, and prognostic impact of intraoperative massive blood loss in adolescents with NMS. A retrospective review of adolescents who underwent posterior spinal instrumentation and fusion for NMS was performed. Perioperative variables and data were recorded. Massive blood loss was defined as an estimated blood loss that exceeds 30% of total blood volume. We obtained data for 114 patients, of whom 63 (55%) had intraoperative massive blood loss. Compared with those without, patients with massive blood loss were more likely to be older, have lower body mass indexes (BMIs), larger Cobb angles, more fused levels, more osteotomy procedures, and prolonged duration of operation. Logistic regression analysis identified the number of fused levels to be more than 12 (P = 0.003, odds ratio = 6.614, 95% confidence interval [CI]: 1.891–23.131), BMI lower than 16.8 kg/m2 (P = 0.025, odds ratio = 3.293, 95% CI: 1.159–9.357), age greater than 15 years (P = 0.014, odds ratio = 3.505, 95% CI: 1.259–9.761), and duration of operation longer than 4.4 hours (P = 0.016, odds ratio = 3.746, 95% CI: 1.428–9.822) as influencing factors. Patients with massive blood loss are associated with more intraoperative colloids infusion and blood transfusions (red blood cell and fresh frozen plasma), as well as postoperative drainage volume. In adolescents with NMS who underwent posterior spinal instrumentation and fusion operations, intraoperative massive blood loss is common. The number of fused levels, BMI, age, and duration of operation are factors influencing intraoperative massive blood loss. PMID:28296737

  1. Mineralization of cellulose in frozen boreal soils

    Science.gov (United States)

    Oquist, Mats G.; Segura, Javier; Sparrman, Tobias; Nilsson, Mats; Schleucher, Jurgen

    2015-04-01

    Soils of high-latitude ecosystems store a large fraction of the global soil carbon. In boreal forests, the microbial mineralization of soil organic matter (SOM) during winter can affect the ecosystems net carbon balance. Recent research has shown that microorganisms in the organic surface layer of boreal forest soil can mineralize and grow on simple, soluble monomeric substrates under frozen conditions. However, any substantial impacts of microbial activity in frozen soils on long-term soil carbon balances ultimately depends on whether soil microorganisms can utilize and grow the more complex, polymeric constituents of SOM. In order to evaluate the potential for soil microorganisms to metabolize carbon polymers at low temperatures, we incubated boreal forest soil samples amended with [13C]-cellulose and studied the microbial catabolic and anabolic utilization of the substrate under frozen and unfrozen conditions (-4 and +4°C). Freezing of the soil markedly reduced microbial utilization of the cellulose. The [13C]-CO2 production rate in the samples at +4°C were 0.52 mg CO2 SOM -1 day-1 while rates in the frozen samples (-4°C) were 0.01 mg CO2 SOM -1 day-1. However, newly synthetized [13C]-enriched cell membrane lipids, PLFAs, were detected in soil samples incubated both above and below freezing, confirming that cellulose can sustain also anabolic activity of the microbial populations under frozen conditions. The reduced metabolic rates induced by freezing indicate constraints on exoenzymatic activity, as well as substrate diffusion rates that we can attribute to reduced liquid water content of the frozen soil. We conclude that the microbial population in boreal forest soil has the capacity to metabolize, and grow, on polymeric substrates at temperatures below zero, which involves maintaining exoenzymatic activity in frozen soils. This capacity manifests the importance of SOM mineralization during the winter season and its importance for the net carbon balance of

  2. Primary hyperparathyroidism: intraoperative PTH-measurements

    DEFF Research Database (Denmark)

    Rolighed, L; Heickendorff, L; Hessov, I

    2004-01-01

    measurement as a predictor of successful cure. MATERIAL AND METHODS: From September 1999 to April 2002 143 patients with pHPT underwent a parathyroid operation (bilateral neck exploration with identification of all parathyroid glands) with intraoperative measurements of plasma PTH (immediately prior...

  3. Intraoperative endoscopy in obstructive hypopharyngeal carcinoma

    Institute of Scientific and Technical Information of China (English)

    Predrag Pesko; Djordjije Saranovic; Vera Todorovic; Milos Bjelovic; Predrag Sabljak; Dejan Stojakov; Ebrahimi Keramatollah; Dejan Velickovic; Bratislav Spica; Branka Nenadic; Aleksandra Djuric-Stefanovic

    2006-01-01

    AIM: To demonstrate the necessity of intraoperative endoscopy in the diagnosis of secondary primary tumors of the upper digestive tract in patients with obstructive hypopharyngeal carcinoma.METHODS: Thirty-one patients with hypopharyngeal squamous cell carcinoma had been operated, with radical intent, at our Institution in the period between 1978 and 2004. Due to obstructive tumor mass, in 7(22.6%) patients, preoperative endoscopic evaluation of the esophagus and stomach could not be performed. In those patients, intraoperative endoscopy, made through an incision in the cervical esophagus, was standard diagnostic method for examination of the esophagus and stomach.RESULTS: We found synchronous foregut carcinomas in 3 patients (9.7%). In two patients, synchronous carcinomas had been detected during preoperative endoscopic evaluation, and in one (with obstructive carcinoma) using intraoperative endoscopy. In this case, preoperative barium swallow and CT scan did not reveal the existence of second primary tumor within esophagus, despite the fact that small, but T2 carcinoma, was present.CONCLUSION: It is reasonable to use intraoperative endoscopy as a selective screening test in patients with obstructive hypopharyngeal carcinoma.

  4. Intraoperative arteriography during femoral-popliteal bypass.

    Science.gov (United States)

    Liddicoat, J E; Bekassy, S M; DeBakey, M E

    1975-07-01

    Minor technical errors may jeopardize the patency of femoral-popliteal bypass grafts. In an attempt to detect such errors, intraoperative arteriography has been routinely employed. It allows immediate recognition and correction of the most common abnormal findings: intraluminal debris, intimal dissection, distal thrombosis, arterial spasm, and kinking of the graft.

  5. INTRAOPERATIVE ULTRASOUND FOR HEPATIC NEOPLASM DURING SURGERY

    Institute of Scientific and Technical Information of China (English)

    1999-01-01

    Objective.Th purpose of this study was to determine the impact of intraoperative ultrasound(IOUS)on the management of patients with neoplasms of the liver.Methods.Forty-nine patients operated on for liver or other pathologic processes were examined intraopertively with 5.0 MHz special ultrasound transducers during surgical exploration of the abdomen.Subjects were evaluated because of known or suspected disease of the liver.Preoperative imaging studies included percutaneous ultrasound(n=49),magnetic resonance imaging(n=11),and computed tomography(n=34).Intraoperative evaluation on all patients included inspection,bimanual palpation,and ultrasnography.Comparison between preoperative imagings and IOUS were analysed.Results.Sensitivity for detection of hepatic neoplasms showed in intraoperative ultrasound,percutaneous ultrasound,magnetic resonance imaging andcomputed tomography as 100%(23/23),74%(17/23),74%(14/19) and 75%(6/8).Specificity showed 100%(26/26),100%(26/26),93%(14/15) and 67(2/3).In seven patients(14%),the neoplasms were not found by inspection,bimanual palpation,and identified only by IOUS.Conclusions.Intraoperative ultrasound is the most sensitive and specific method for detection and surgery of liver neoplasms,especially the occult neoplasms and small size lesion(<2cm).

  6. Intraoperative ultrasound in neurosurgery - a practical guide.

    Science.gov (United States)

    Ivanov, Marcel; Wilkins, Simone; Poeata, Ion; Brodbelt, Andrew

    2010-10-01

    Intraoperative ultrasound (iUS) provides low-cost real-time imaging that is simple and rapid to use. Recent advances in probe technology, image fusion, 3D techniques and contrast have led to significant improvements in image quality. This article provides an overview of the current uses of iUS, including technical advice for practical use, and future directions.

  7. Quality assesment of a lot of frozen mackerel, respective frozen handcut mackerel fillets (Scomber scombrus)

    NARCIS (Netherlands)

    Bruenner, K.K.

    2003-01-01

    At the request of Van Ameyde Marine in Amsterdam, RIVO BV assessed the quality of a number of blocks of frozen mackerel and a number of blocks of frozen handcut mackerel fillets (Scomber scombrus) by means of sensorial and chemical analysis. The samples were taken from a lot, which was partial "dama

  8. Nuclear probes and intraoperative gamma cameras.

    Science.gov (United States)

    Heller, Sherman; Zanzonico, Pat

    2011-05-01

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

  9. Aortic balloon occlusion for controlling intraoperative hemorrhage in patients with placenta previa increta/percreta.

    Science.gov (United States)

    Wang, Ying-Lan; Su, Fang-Ming; Zhang, Hai-Ying; Wang, Fang; Zhe, Rui-Lian; Shen, Xin-Ying

    2017-11-01

    To investigate whether abdominal aortic balloon occlusion (ABO) effectively reduces intraoperative hemorrhage in patents with placenta previa increta/increta. Forty-three women were diagnosed as placenta previa increta/percreta by ultrasound and MRI. These patients' assessments were taken by their chief physician, and they were under necessity of previous cesarean section as confirmed by the committee of experts during consultation. There was no significant difference in disease risk rating between them in whole process. Although our department provided a more appropriate method, 10 of 43 patients chose intraoperative aortic balloon occlusion (IABO). Other 33 patients who refused that suggestion were considered as control group. Fully informed consents were obtained from all patients in this study group. The intraoperative blood loss, blood transfusion, rate of hysterectomy and complications of mothers and fetus of IABO group and control group were analyzed. The median intraoperative blood loss was 1000 ml in the IABO group compared with 2000 ml in the control group (p  0.05). No IABO-related complications were observed in the mother and fetus. IABO is an effective and safe method to control intraoperative blood loss and blood transfusion in patients with placenta previa increta/percreta.

  10. [Investigate progress of intraoperative periprosthetic fracture of total hip arthroplasty].

    Science.gov (United States)

    Cong, Yu; Zhao, Jian-ning

    2011-02-01

    One of the complications of total hip arthroplasty is intraoperative periprosthetic fracture. Periprosthetic fracture is divided into acetabular fracture and femoral fracture. Risk factors for intraoperative periprosthetic fracture include use of minimally invasive techniques, press-fit cementless stems, revision operations and osteoporosis. It has been recognized that treatment of intraoperative periprosthetic fractures should be based on the classification of the Vancouver system for intraoperative fractures.

  11. 前置胎盘患者自体血浆分离联合术中自体血回收的可行性%Feasibility of autologous plasmapheresis combined with intraoperative blood salvage during cesarean section in patients with placenta previa

    Institute of Scientific and Technical Information of China (English)

    卢子会; 周春波; 黄长顺; 严海雅

    2014-01-01

    Objective To evaluate the efficacy and safety of autologous plasmapheresis combined with intraoperative blood salvage during cesarean section in patients with placenta previa. Methods Sixty patients with placenta previa scheduled for elective cesarean section, were randomly divided into three groups with 20 cases in each group. In group I, blood was with-drawn before anesthesia, to sequester the autologous plasma for re- infusion. An autotransfusion device was used to col ect and re- infuse autologous RBC during the course of the operation in both groups I and II, while an al ogenic blood transfusion was conducted in group III as necessary. Hemoglobin(Hb), hematocrit (Hct), platelet count (Plt), prothrombin time (PT), activated par-tial thromboplastin (aPTT), fibrinogen (FIB) were detected at time points of entering operation room (T1), 10min after col ecting blood(T2), 10 min before autologous re- infusing(T3), 10 min after autologous blood re- infusing(T4), 6h after operation(T5) and 24h after operation (T6). Hemodynamic changes, fetal heart rate, Apger score, umbilical cord artery blood gas analysis, volumes of blood loss and blood transfusion of three groups were documented and compared. Results There were no significant differ-ences in hemodynamic changes, fetal heart rate, Apger score and umbilical cord artery blood gas analysis among three groups. The increase of Plt level of Group I was significantly different from Group II and Group III at T4 and T5 (P<0.05);PT level change in Group I had significant differences compared with Group II and Group III at T4 (P<0.05). The volumes of plasma transfusion in Group II and Group III had significant differences compared with Group I (P<0.05). The volumes of packed red blood cells (RBCs) transfusion in Group III had significant differences compared with Group I and Group II (P<0.05). Conclusion Autolo-gous plasmapheresis combined with intraoperative blood salvage is safe and feasible, which can reduce the al ogeneic

  12. INTRAOPERATIVE PHOTODYNAMIC THERAPY FOR METASTATIC PERITONEAL TUMORS

    Directory of Open Access Journals (Sweden)

    E. A. Suleimanov

    2016-01-01

    Full Text Available This review is devoted to the cytoreductive treatment of malignant tumors of the abdominal organs. The actuality of the issue is determined both by increase of the incidence of abdominal cancer in Russia and in majority of developed countries and by high rate diagnosis on late stages of disease. The methods of treatment of peritoneal carcinomatosis, based on possible effects on the secondary peritoneal tumors after surgical cytoreduction to reduce the risk of local recurrence and disease progression are described. These methods of additional intraoperative specific antitumor action include intraoperative radiation therapy, hyperthermic intraperitoneal chemotherapy, intraoperative photodynamic therapy characterized by differences in difficulty of performance, mechanisms of effect on tumor and healthy tissues, efficiency. Benefits, opportunities and possibilities of application of intraoperative photodynamic therapy (IOPDT for secondary peritoneal tumors are described in details, the results of a number of domestic and foreign clinical studies are shown, the successful application of intraoperative photodynamic therapy in clinical oncology, which allows reducing the risk of secondary tumor lesions of the peritoneum significantly, is demonstrated. Photodynamic therapy – a method with high efficiency and almost no side effects and complications, based on the ability of photosensitizer to accumulate selectively and retain in the high proliferative tissues. The advantages of this type of treatment of patients with peritoneal carcinomatosis are a selective effect on the peritoneal carcinomatosis and on visually detected tumor tissue, high efficiency in patients with malignant tumors of the abdominal cavity and pelvis combined with surgical cytoreduction, minimal effect on normal organs and tissues of the patient, well tolerated procedure.

  13. Comment on the frozen QCD coupling

    CERN Document Server

    Ermolaev, B I; Troyan, S I

    2012-01-01

    The frozen QCD coupling is a parameter often used as an effective fixed coupling. It is supposed to mimic both the running coupling effects and the lack of knowledge of alpha_s in the infrared region. Usually the value of the frozen coupling is fixed from the analysis of the experimental data. We present a novel way to define such coupling(s) independently of the experiments. We argue that there are different frozen couplings which are used in the double- and single- logarithmic approximations. We introduce three kinds of the frozen couplings: the coupling used in DLA with a time-like argument (i.e. the coupling present in the non-singlet scattering amplitudes and DIS structure functions) which we find 0.24 approximately; the DLA coupling with a space-like argument (in e+e- -annihilation, in DY processes and in any scattering amplitude in the hard or backward kinematics) which is a factor two larger, namely 0.48. We also show that the frozen coupling in the single-logarithmic evolution equations like BFKL has...

  14. Construction of a visual determination method on the thickness and surface of APA Microcapsules by optica microscopy with frozen section and the ice emission scanning electron microscopy%采用冰冻切片和冷场发射电镜构建APA微囊的膜厚度及膜表面测定的方法研究

    Institute of Scientific and Technical Information of China (English)

    傅红兴; 李慧; 朱雁林; 赵应征; 吴岚岚; 江玲

    2013-01-01

    目的:建立一种APA微囊的膜厚度以及表面结构的检测方法,并测定微囊在湿状态的膜厚度和干燥后的膜表面结构.方法:采用亚甲蓝染色、冰冻切片结合光学显微镜观察微囊的膜厚度,并将囊膜在37℃孵育30 d后再次观察厚度的变化;对微囊进行冷冻干燥和冷场发射观察囊膜表面和断面结构.结果:APA-Ca和APA-Ba微囊的囊膜厚度并不均匀,孵育1个月后囊膜厚度变化差异无统计学意义(P>0.05);冷场发射扫描电镜下显示,两种微囊表面均光滑、致密;冻干后APA-Ca囊膜厚度达450 ~690 nm,而APA-Ba的囊膜厚度约为350 nm.结论:建立了一种简单、可靠的微囊膜厚度和表面检测方法,为进一步研究APA微囊的质量奠定了基础.%Objective: To explore a visual methold of the membrane thickness of APA microcapsules and their surface structures, and determinate the film thickness and surface characteristics. Methods: We use methyl-ene blue to dye the film of microcapsules, then within frozen section and optical microscope the the thickness of microcapsule were observed; and the thickness of microcapsules hatched in 37 ℃ for a month were also assayed. The surface of membrane were studied by ice emission scanning electron microscopy after lyophilization. Results: The member thickness of each APA microencapsules is not uniform. After incubated for 30 d in 37 ℃, there is no obviously difference in the thichness than befor (P>0.05). Surfaces of two microencapsules are smooth and compact under the scanning electron microscopy. The thickness of APA-Ca microcapsules are 450-690 nm, which of APA-Ba are about 350 nm. Conclusion: The essay provided a simple method on how to determine the membrane thickness and surface, which would be an important reference to expound the APA microcapsules.

  15. Frozen steady states in active systems

    CERN Document Server

    Schaller, Volker; Hammerich, Benjamin; Frey, Erwin; Bausch, Andreas R

    2011-01-01

    Even simple active systems can show a plethora of intriguing phenomena and often we find complexity were we would have expected simplicity. One striking example is the occurrence of a quiescent or absorbing state with frozen fluctuations that at first sight seems to be impossible for active matter driven by the incessant input of energy. While such states were reported for externally driven systems through macroscopic shear or agitation, the investigation of frozen active states in inherently active systems like cytoskeletal suspensions or active gels is still at large. Using high density motility assay experiments, we demonstrate that frozen steady states can arise in active systems if active transport is coupled to growth processes. The experiments are complemented by agent-based simulations which identify the coupling between self-organization, growth and mechanical properties to be responsible for the pattern formation process.

  16. Portable crushers resolve frozen coal problem

    Energy Technology Data Exchange (ETDEWEB)

    Massa, P.; Fuller, L.; Buckley, T. [Public Services of Indiana (PSI), IN (United States)

    2001-11-01

    In 2002, PSI contracted XMS Equipment to design a pair of modularized and portable crushers to overcome the problem of frozen coal during winter months. The rollers of the crusher can be removed during non-winter months, reducing wear. The article describes the design, construction and installation of the system which takes care of the frozen coal in the hoppers and the coal feed systems in the 1000 W Cayuga plant and overcomes the problem of coal freezing in the reclaim hoppers and the open coal storage areas. 4 figs.

  17. Intraoperative identification of adrenal-renal fusion

    Science.gov (United States)

    Boll, Griffin; Rattan, Rishi; Yilmaz, Osman; Tarnoff, Michael E

    2015-01-01

    Adrenal - renal fusion is a rare entity defined as incomplete encapsulation of the adrenal gland and kidney with histologically adjacent functional tissue. This report describes the first published intraoperative identification of this anomaly during laparoscopic adrenalectomy. The patient was a 59-year-old man with chronic hypertension refractory to multiple antihypertensives found to be caused by a right-sided aldosterone-producing adrenal adenoma in the setting of bilateral adrenal hyperplasia. During laparoscopic adrenalectomy, the normal avascular plane between the kidney and adrenal gland was absent. Pathologic evaluation confirmed adrenal - renal fusion without adrenal heterotopia. Identified intraoperatively, this may be misdiagnosed as invasive malignancy, and thus awareness of this anomaly may help prevent unnecessarily morbid resection. PMID:26195881

  18. The Art of Intraoperative Glioma Identification

    Directory of Open Access Journals (Sweden)

    Zoe Z Zhang

    2015-07-01

    Full Text Available A major dilemma in brain tumor surgery is the identification of tumor boundaries to maximize tumor excision and minimize postoperative neurological damage. Gliomas, especially low-grade tumors, and normal brain have a similar color and texture which poses a challenge to the neurosurgeon. Advances in glioma resection techniques combine the experience of the neurosurgeon and various advanced technologies. Intraoperative methods to delineate gliomas from normal tissue consist of 1 image-based navigation, 2 intraoperative sampling, 3 electrophysiological monitoring, and 4 enhanced visual tumor demarcation. The advantages and disadvantages of each technique are discussed. A combination of these methods is becoming widely accepted in routine glioma surgery. Gross total resection in conjunction with radiation, chemotherapy, or immune/gene therapy may increase the rates of cure in this devastating disease.

  19. 21 CFR 104.47 - Frozen “heat and serve” dinner.

    Science.gov (United States)

    2010-04-01

    ... acid, vitamin B-6, and vitamin B-12 are tentative. Final levels will be established when sufficient... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Frozen âheat and serveâ dinner. 104.47 Section 104.47 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED...

  20. Three-dimensional reconstruction of frozen and thawed plant tissues from microscopic images

    Science.gov (United States)

    Histological analysis of frozen and thawed plants has been conducted for many years but the observation of individual sections only provides a 2 dimensional representation of a 3 dimensional phenomenon. Most techniques for viewing internal plant structure in 3 dimensions is either low in resolution...

  1. 9 CFR 381.148 - Processing and handling requirements for frozen poultry products.

    Science.gov (United States)

    2010-01-01

    ... for frozen poultry products. 381.148 Section 381.148 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE AGENCY ORGANIZATION AND TERMINOLOGY; MANDATORY MEAT AND POULTRY PRODUCTS INSPECTION AND VOLUNTARY INSPECTION AND CERTIFICATION POULTRY PRODUCTS INSPECTION...

  2. 75 FR 76754 - Non-Frozen Apple Juice Concentrate From China

    Science.gov (United States)

    2010-12-09

    ... review * * *'' (75 FR 69628). Accordingly, pursuant to section 751(c) of the Tariff Act of 1930 (19 U.S.C... COMMISSION Non-Frozen Apple Juice Concentrate From China AGENCY: United States International Trade Commission... concentrate from China would be likely to lead to continuation or recurrence of material injury. On...

  3. 78 FR 6297 - Certain Frozen Fish Fillets From the Socialist Republic of Vietnam: Preliminary Results of...

    Science.gov (United States)

    2013-01-30

    ... been calculated in accordance with section 772 of the Act. Because Vietnam is a nonmarket economy... Vietnam: Final Results of the Antidumping Duty Administrative Review and New Shipper Reviews, 75 FR 12726... International Trade Administration Certain Frozen Fish Fillets From the Socialist Republic of...

  4. Fluorescence goggle for intraoperative breast cancer imaging

    Science.gov (United States)

    Liu, Yang; Bauer, Adam Q.; Akers, Walter; Sudlow, Gail; Liang, Kexian; Charanya, Tauseef; Mondal, Suman; Culver, Joseph P.; Achilefu, Samuel

    2012-03-01

    We have developed a fluorescence goggle device for intraoperative oncologic imaging. With our system design, the surgeon can directly visualize the fluorescence information from the eyepieces in real time without any additional monitor, which can improve one's coordination and surgical accuracy. In conjunction with targeting fluorescent dyes, the goggle device can successfully detect tumor margins and small nodules that are not obvious to naked eye. This can potentially decrease the incidence of incomplete resection.

  5. Microscope Embedded Neurosurgical Training and Intraoperative System

    OpenAIRE

    Mauro, Alessandro

    2009-01-01

    In the recent years, neurosurgery has been strongly influenced by new technologies. Computer Aided Surgery (CAS) offers several benefits for patients' safety but fine techniques targeted to obtain minimally invasive and traumatic treatments are required, since intra-operative false movements can be devastating, resulting in patients deaths. The precision of the surgical gesture is related both to accuracy of the available technological instruments and surgeon's experience. In this frame, medi...

  6. Near-Infrared Intraoperative Chemiluminescence Imaging

    KAUST Repository

    Büchel, Gabriel E.

    2016-08-03

    Intraoperative imaging technologies recently entered the operating room, and their implementation is revolutionizing how physicians plan, monitor, and perform surgical interventions. In this work, we present a novel surgical imaging reporter system: intraoperative chemiluminescence imaging (ICI). To this end, we have leveraged the ability of a chemiluminescent metal complex to generate near-infrared light upon exposure to an aqueous solution of Ce4+ in the presence of reducing tissue or blood components. An optical camera spatially resolves the resulting photon flux. We describe the construction and application of a prototype imaging setup, which achieves a detection limit as low as 6.9pmolcm-2 of the transition-metal-based ICI agent. As a proof of concept, we use ICI for the invivo detection of our transition metal tracer following both systemic and subdermal injections. The very high signal-to-noise ratios make ICI an interesting candidate for the development of new intraoperative imaging technologies. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  7. Exclusion of Nitrate from Frozen Aqueous Solutions

    Science.gov (United States)

    Marrocco, H. A.; Michelsen, R. R.

    2013-12-01

    Reactions occurring at the surface of ice, sea ice, and snow in Earth's cryosphere have an impact on the composition of the overlying atmosphere. In order to elucidate reaction mechanisms and model their contributions to atmospheric processes, the morphology of frozen aqueous surfaces and amounts of reactants contained therein must be determined. To this end, the exclusion of nitrate ions to the surface of frozen aqueous solutions has been studied by attenuated total reflection infrared spectroscopy (ATR-IR). In this technique the near-surface region of the frozen films are interrogated to a depth of a few hundred nanometers from the film-crystal interface. Aqueous solutions (0.001 to 0.01 M) of sodium nitrate (NaNO3), magnesium nitrate (Mg(NO3)2), and nitric acid (HNO3) were quickly frozen on the germanium ATR crystal and observed at a constant temperature of about -18°C. In addition to ice and the solutes, liquid water in varying amounts was observed in the spectra. The amount of nitrate in the surface liquid is three to four orders of magnitude higher than in the unfrozen solution. While all the nitrate salts exhibit exclusion to the unfrozen surface, the dynamics are different for different counter-ions. Results are compared to freezing point depression data and the predictions of equilibrium thermodynamics.

  8. Frozen yogurt with added inulin and isomalt.

    Science.gov (United States)

    Isik, U; Boyacioglu, D; Capanoglu, E; Erdil, D Nilufer

    2011-04-01

    The objective of this study was to produce a frozen yogurt containing low fat and no added sugar. Samples containing 5% polydextrose, 0.065% aspartame and acesulfame-K mixture, and different levels of inulin and isomalt (5.0, 6.5, and 8.0%) were produced at pilot scale and analyzed for their physical and chemical properties including proximate composition, viscosity, acidity, overrun, melting rate, heat shock stability, as well as sensory characteristics, and viability of lactic acid bacteria. With the addition of inulin and isomalt, viscosity increased by 19 to 52% compared with that of sample B (reduced-fat control). The average calorie values of samples substituted with sweeteners were about 43% lower than that of original sample. Low-calorie frozen yogurt samples melted about 33 to 48% slower than the reduced-fat control sample at 45 min. Based on quantitative descriptive profile test results, statistically significant differences among products were observed for hardness, iciness, foamy melting, whey separation, and sweetness characteristics. The results of principal component analysis showed that the sensory properties of the sample containing 6.5% inulin and 6.5% isomalt were similar to those of control. Lactic acid bacteria counts of frozen yogurt were found to be between 8.12 and 8.49 log values, 3 mo after the production. The overall results showed that it is possible to produce an attractive frozen yogurt product with the incorporation of inulin and isomalt with no added sugar and reduced fat.

  9. SMOKED AND FROZEN FISH CONSUMPTION AND MARKETING ...

    African Journals Online (AJOL)

    Apusigah

    consumers preferred smoked fish while 14% preferred frozen fish. ... hormone thus making people feel satisfied on smaller and more nutritious amounts of food. .... Cost was an important factor in consumer preference by fish type. ... Consumers attributed their choice of smoked fish to the fact that they had nice flavour, good.

  10. Fresh frozen plasma: past, present and future.

    Science.gov (United States)

    McCarthy, L J

    1989-12-01

    Fresh frozen plasma has been transfused for decades. However, the dramatic increase in its use has caused concern that much of it is transfused without the proper indications. Because of this, the National Institutes of Health held a Consensus Conference to clarify its genuine indications and contraindications.

  11. Frozen shoulder and risk of cancer

    DEFF Research Database (Denmark)

    Pedersen, Alma B; Horváth-Puhó, Erzsébet; Ehrenstein, Vera

    2017-01-01

    BACKGROUND: Frozen shoulder might be a complication or a presenting symptom of cancer. We examined the risk of a cancer diagnosis after an incident diagnosis of frozen shoulder. METHODS: We used prospectively collected data from Danish registries to identify patients with frozen shoulder during...... 1995-2013 and followed them for the development of cancer. RESULTS: We observed 2572 incident cancers among 29 098 frozen shoulder patients. The expected number of incident cancers in the general population was 2434. The 6-month cumulative incidence of any cancer was 0.70%, corresponding...... to a standardised incidence ratio (SIR) of 1.38 (95% confidence interval (CI): 1.19-1.58). Risk increases were highest for lung cancer (SIR=2.19, 95% CI: 1.48-3.13), breast cancer (SIR=1.51, 95% CI: 1.02-2.15), and non-Hodgkin's lymphoma (SIR=2.28, 95% CI: 1.09-4.20). The cumulative incidence of any cancer during...

  12. Comparative analysis of wholesale and retail frozen fish marketing ...

    African Journals Online (AJOL)

    Comparative analysis of wholesale and retail frozen fish marketing in Port ... the effects of the marketer's socioeconomic variables on the volume of sales. ... policies that would enhance frozen fish marketers' access to loans in order to increase ...

  13. ELASTO-PLASTIC BACK ANALYSIS OF FROZEN SOIL WALL

    Institute of Scientific and Technical Information of China (English)

    张铭; 翁家杰

    1994-01-01

    The paper briefly describes the range and methods of the research on the stability of frozen wall. Using the Back Analysis Method combining with the model test of frozen wall, the comprchcnsire study on the stability of frozen wall is firstly carried out by the authors. Finally, a new viewpointof adopting limited strain as the major criteria of stability in frozen soil cngincertng is proposed.

  14. Primary classification on drillability of frozen soil using neural networks

    Institute of Scientific and Technical Information of China (English)

    FANG Jiang-hua(方江华); ZHANG Zhi-hong(张志红); MA Qin-yong(马芹永)

    2003-01-01

    Through analysis on drillability of frozen soil, it is concluded that the main factors affecting the drillability of frozen soil are temperature, wave velocity, impact inductility and chiseling specific work. Based on the foundation it is discussed that applying the neural networks method to classify the drillability of frozen soil is simple and feasible, and the inputted vectors quantity of networks don't be restricted, which make the classification on drillability of frozen soil rather well match the objective practice.

  15. Use of fresh versus frozen or blast-frozen grapes for small-scale fermentation

    Directory of Open Access Journals (Sweden)

    Schmid F

    2011-10-01

    Full Text Available Frank Schmid, Vladimir Jiranek School of Agriculture, Food and Wine, The University of Adelaide; and Wine Innovation Cluster, The Waite Campus, Glen Osmond, South Australia, Australia Background: This paper firstly examines the validity of using laboratory-scale fermentations as a means of correlating winemaking outcomes with larger industrial scale fermentations. Secondly, conventional and blast-freezing of whole bunches were investigated for their relative suitability as methods of preservation as determined by the nature of the resulting wines. Methods: Red must fermentations were compared at the laboratory 80 kg scale, and the more industrially representative 500 kg pilot scale. Fermentation profiles and duration for both scales were found to be very similar. Whole bunches were either slow/conventionally frozen (−20°C, or quickly/blast-frozen (−25°C. Results: Wines made from frozen grapes compared well with the wine made from the fresh must. Color and chemical analyses of the wines revealed few differences. A duo-trio sensory evaluation showed that wine from blast-frozen grapes was more similar to the fresh wines than wines from conventional frozen grapes. Conclusion: The findings of this research suggest that whole-bunch blast-freezing of grapes is preferable to conventional freezing. Keywords: wine color, research winemaking, frozen grapes

  16. 48 CFR 846.302-72 - Frozen processed foods.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Frozen processed foods... CONTRACT MANAGEMENT QUALITY ASSURANCE Contract Clauses 846.302-72 Frozen processed foods. The contracting officer shall insert the clause at 852.246-72, Frozen processed foods, in solicitations and contracts...

  17. 48 CFR 870.111-5 - Frozen processed food products.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Frozen processed food... DEPARTMENT SUPPLEMENTARY REGULATIONS SPECIAL PROCUREMENT CONTROLS Controls 870.111-5 Frozen processed food products. (a) The following frozen processed food products must have a label complying with the...

  18. 21 CFR 864.9145 - Processing system for frozen blood.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Processing system for frozen blood. 864.9145... Blood and Blood Products § 864.9145 Processing system for frozen blood. (a) Identification. A processing system for frozen blood is a device used to glycerolize red blood cells prior to freezing to...

  19. Utilization of Frozen Semen of Wild Yak

    Institute of Scientific and Technical Information of China (English)

    阎萍

    2005-01-01

    After domestication of wild yak and utilization of its frozen semen was successful in 1983, frozen semen of wild yak was used to improve domestic yak and local yellow cattle by artificial insemination(AI). Hybrid vigor of their F1 was obvious, i. e. , productive performance of F1 was significantly increased. Their offspring did not only have significant heterosis in performance but also can rejuvenate effectively their adaptability and survival, and can use alpine grassland more efficiently. This resulted in significant social and economic benefits.Compared with dairy cattle, beef cattle and yellow cattle, AI of yak was more difficult. Using AI to improve yak performance was difficult and significant in yak production areas of our country. It is necessary to invest more technique and fund to extend AI.

  20. Frozen shoulder - an effective method of treatment.

    Science.gov (United States)

    Warmington, L E

    1970-09-01

    Although there has been a considerable amount of material published on the pathology and the probable aetiology of the frozen shoulder, the same cannot be said of suggestions for an effective method of physical treatment for all stages of the condition. Some authors claim that exercises mar the recovery process (Cyriax, 1957). Others have found that the condition runs a self-limiting course of anything up to three years, and any physical treatment is "notoriously unsuccessful" in altering this pattern (Crisp and Hume Kendall, 1955). However, all agree that the recovery of frozen shoulders, treated or untreated, is prolonged, and in the acute phase of the condition, physiotherapy plays no part in the treatment of pain (Cyriax, Ibid., Crisp and Hume Kendall, Ibid., Stening, 1961).

  1. The Jefferson Lab frozen spin target

    Energy Technology Data Exchange (ETDEWEB)

    Keith, C.D., E-mail: ckeith@jlab.org [Thomas Jefferson National Accelerator Facility, Newport News, VA 23606 (United States); Brock, J.; Carlin, C.; Comer, S.A.; Kashy, D. [Thomas Jefferson National Accelerator Facility, Newport News, VA 23606 (United States); McAndrew, J. [School of Physics, University of Edinburgh, Edinburgh (United Kingdom); Meekins, D.G.; Pasyuk, E.; Pierce, J.J.; Seely, M.L. [Thomas Jefferson National Accelerator Facility, Newport News, VA 23606 (United States)

    2012-08-21

    A frozen spin polarized target, constructed at Jefferson Lab for use inside a large acceptance spectrometer, is described. The target has been utilized for photoproduction measurements with polarized tagged photons of both longitudinal and circular polarization. Protons in TEMPO-doped butanol were dynamically polarized to approximately 90% outside the spectrometer at 5 T and 200-300 mK. Photoproduction data were acquired with the target inside the spectrometer at a frozen-spin temperature of approximately 30 mK with the polarization maintained by a thin, superconducting coil installed inside the target cryostat. A 0.56 T solenoid was used for longitudinal target polarization and a 0.50 T dipole for transverse polarization. Spin-lattice relaxation times as high as 4000 h were observed. We also report polarization results for deuterated propanediol doped with the trityl radical OX063.

  2. The Jefferson Lab Frozen Spin Target

    Energy Technology Data Exchange (ETDEWEB)

    Christopher Keith, James Brock, Christopher Carlin, Sara Comer, David Kashy, Josephine McAndrew, David Meekins, Eugene Pasyuk, Joshua Pierce, Mikell Seely

    2012-08-01

    A frozen spin polarized target, constructed at Jefferson Lab for use inside a large acceptance spectrometer, is described. The target has been utilized for photoproduction measurements with polarized tagged photons of both longitudinal and circular polarization. Protons in TEMPO-doped butanol were dynamically polarized to approximately 90% outside the spectrometer at 5 T and 200-300 mK. Photoproduction data were acquired with the target inside the spectrometer at a frozen-spin temperature of approximately 30 mK with the polarization maintained by a thin, superconducting coil installed inside the target cryostat. A 0.56 T solenoid was used for longitudinal target polarization and a 0.50 T dipole for transverse polarization. Spin relaxation times as high as 4000 hours were observed. We also report polarization results for deuterated propanediol doped with the trityl radical OX063.

  3. Intraoperative monitoring during surgery for hypoglossal schwannoma.

    Science.gov (United States)

    Ishikawa, Mami; Kusaka, Gen; Takashima, Kouichi; Kamochi, Haruna; Shinoda, Soji

    2010-08-01

    A 54-year-old man presented with an intracranial schwannoma of the hypoglossal nerve between the medulla and the left hypoglossal canal. The condylar fossa approach was used with intra-operative electromyography (EMG) monitoring of the lower cranial nerves. The tumor was then removed carefully without decreasing the tongue EMG responses. EMG monitoring enabled us to remove the tumor while maintaining the function of the hypoglossal nerve. Tongue EMG was easily recorded by stimulating the hypoglossal nerve fibers, which was useful in identifying the hypoglossal nerve and evaluating its function. This suggests that tongue EMG is a useful monitoring tool to enhance neurological outcome following removal of tumors in this region.

  4. 76 FR 15941 - Certain Frozen Fish Fillets From the Socialist Republic of Vietnam: Final Results of the Sixth...

    Science.gov (United States)

    2011-03-22

    .... Frozen whole dressed fish are deheaded, skinned, and eviscerated. Steaks are bone-in, cross- section cuts... final weighted-average margins are listed below in the ``Final Results of the Reviews'' section of this... Joint Stock Company (``CL-Fish''). \\12\\ See Memorandum to the file, from Alex Villanueva,...

  5. Safety of frozen liver for human consumption

    Directory of Open Access Journals (Sweden)

    Ghada A.K. Kirrella

    2017-07-01

    Full Text Available The objective of this study was to ensure and evaluate the safety of imported frozen beef liver traded in supermarkets of Kafr El-Sheikh Governorate, Egypt, through detection of Salmonella typhimurium, Salmonella enteritidies, Escherichia coli O157:H7, antibiotic residues, and aflatoxin B1 residue. Fifty samples of imported frozen liver were randomly collected from different shops at Kafr El-Sheikh Governorate for isolation of S. typhimurium, S. enteritidies, and E. coli O157:H7. The results revealed that for both microorganisms 4% of the examined samples presumed to contain Salmonella and E. coli O157:H7 organisms, according to the colonial character on Harlequin Salmonella ABC agar media and Harlequin SMAC-BCIG agar media. According to biochemical and serological identifications, both organisms could not be detected in the examined samples. A total of 29 (58% samples were positive for antibiotic residues, using the Premi test (a broad-spectrum screening test for the detection of antibiotic residues in meat at or below the maximum residue limits. In addition, aflatoxin B1 was detected in one (2% samples with a concentration of 1.1 μg/kg. The results reflect that there was good hygiene practice for handling and preparation of frozen liver while selling to consumers. However, a high percentage of antibiotic residues reflect ignorance of withdrawal time before slaughtering of animals as well as misuse of antibiotics in veterinary fields. Furthermore, aflatoxin B1 residue was detected in examined frozen liver samples at a concentration below the maximum residual level, which is not enough to cause threat to humans, but it is enough to cause problem if it is eaten regularly reflect contamination of animal feed with aflatoxins.

  6. Frozen soil barriers for hazardous waste confinement

    Energy Technology Data Exchange (ETDEWEB)

    Dash, J.G.; Leger, R. [Univ. of Washington, Seattle, WA (United States); Fu, H.Y. [Univ. of California, Santa Barbara, CA (United States)

    1997-12-31

    Laboratory and full field measurements have demonstrated the effectiveness of artificial ground freezing for the containment of subsurface hazardous and radioactive wastes. Bench tests and a field demonstration have shown that cryogenic barriers are impenetrable to aqueous and non aqueous liquids. As a result of the successful tests the US Department of Energy has designated frozen ground barriers as one of its top ten remediation technologies.

  7. Creep of frozen soil by damage mechanics

    Institute of Scientific and Technical Information of China (English)

    苗天德; 魏雪霞; 张长庆

    1995-01-01

    A microstructure damage theory for creep of frozen soil under the frame of damage mechan-ics is presented.Based on the test study and microscope observation,several internal variables are chosen tocharacterize the microstructure changes and the evolution equations of these internal variables are developed.The theory can describe both the "hardening" and "softening" behavior in the creep process.A detailed analysis hasbeen made for the uniaxial compressure and compared with the test data.

  8. Existence of frozen-in coordinate systems

    Science.gov (United States)

    Chertkov, A. D.

    1995-01-01

    The 'frozen-in' coordinate systems were first introduced in the works on 'reconnection' and 'magnetic barrier' theories (see review by M.l.Pudovkin and V.S.Semenov, Space Sci. Rev. 41,1 1985). The idea was to utilize the mathematical apparatus developed for 'general relativity' theory to simplify obtaining solutions to the ideal MHD equations set. Magnetic field (B), plasma velocity (v), and their vector product were used as coordinate vectors. But there exist no stationary solutions of ideal MHD set that satisfies the required boundary conditions at infinity (A.D.Chertkov, Solar Wind Seven Conf.,Pergamon Press,1992,165) having non-zero vector product of v and B where v and B originate from the same sphere. The existence of a solution is the hidden mine of the mentioned theories. The solution is constructed in the coordinate system, which is unknown and indeterminate before obtaining this solution. A substitution of the final solution must be done directly into the initial MHD set in order to check the method. One can demonstrate that 'solutions' of Petschek's problem, obtained by 'frozen-in' coordinate systems, does not satisfy just the 'frozen-in' equation, i.e. induction equation. It stems from the fact that Petschek's 're-connection' model, treated as a boundary problem, is over determined. This problem was incorrectly formulated.

  9. Intraoperative blood loss and gestational age at pregnancy termination.

    Science.gov (United States)

    Marchiano; Thomas; Lapinski; Balwan; Patel

    1998-07-01

    Objective: To establish the relationship of measured intraoperative blood loss to gestational age at pregnancy termination, and to determine which factors, if any, affect the risk of bleeding.Methods: A single-operator series of 363 consecutive women undergoing pregnancy termination between 5 and 24 weeks gestational age, as dated by ultrasound, was prospectively evaluated. All pregnancies under 13 weeks gestation were terminated by mechanical dilation and suction curettage without preoperative cervical ripening. All pregnancies between 13 and 24 weeks gestation were terminated by preoperative osmotic cervical dilation with laminaria tents and subsequent uterine evacuation by a combination of suction curettage, sharp curettage, and Bierer forceps extraction. All patients over 12 weeks gestation received a postoperative oxytocin infusion. Whenever possible, amniotic fluid and blood were collected and measured separately. Patients were excluded from the data analysis for pregnancy demise, PPROM, Potter's syndrome, or inability to separate blood establish their relationship. After adjustment for gestational age, the results were analyzed to determine if blood loss was related to maternal age, smoking history, body habitus, or operative indication.Results: A curvilinear relationship between blood loss and gestational age was observed. Mean blood loss at 24 weeks exceeded 800 mL. After adjustment for gestational age, no factors significantly affected blood loss at dilation and aspiration of first trimester pregnancies. In those patients undergoing dilation and evacuation in the second trimester, both simple and stepwise regression analyses showed obesity (BMI >/=32.3) to be significantly associated with increased blood loss (P cesarean section, nor smoking history were significantly associated with increased blood loss at dilation and evacuation.Conclusions: With advancing gestational age, intraoperative blood loss increases in curvilinear fashion. Termination providers

  10. A Comparison of Raman Spectral Features of Frozen and Deparaffinized Tissues in Neuroblastoma and Ganglioneuroma

    Science.gov (United States)

    Devpura, Suneetha; Thakur, Jagdish S.; Poulik, Janet M.; Rabah, Raja; Naik, Vaman M.; Naik, Ratna

    2012-02-01

    We have investigated the cellular regions in neuroblastoma and ganglioneuroma using Raman spectroscopy and compared their spectral characteristics with those of normal adrenal gland. Thin sections from both frozen and deparaffinized tissues, obtained from the same tissue specimen, were studied in conjunction with the pathological examination of the tissues. We found a significant difference in the spectral features of frozen sections of normal adrenal gland, neuroblastoma, and ganglioneuroma when compared to deparaffinized tissues. The quantitative analysis of the Raman data using chemometric methods of principal component analysis and discriminant function analysis obtained from the frozen tissues show a sensitivity and specificity of 100% each. The biochemical identification based on the spectral differences shows that the normal adrenal gland tissues have higher levels of carotenoids, lipids, and cholesterol compared to the neuroblastoma and ganglioneuroma frozen tissues. However, deparaffinized tissues show complete removal of these biochemicals in adrenal tissues. This study demonstrates that Raman spectroscopy combined with chemometric methods can successfully distinguish neuroblastoma and ganglioneuroma at cellular level.

  11. Intraoperative MRI in pediatric brain tumors

    Energy Technology Data Exchange (ETDEWEB)

    Choudhri, Asim F. [Le Bonheur Children' s Hospital, Department of Radiology, Memphis, TN (United States); University of Tennessee Health Science Center, Department of Radiology, Memphis, TN (United States); University of Tennessee Health Science Center, Department of Neurosurgery, Memphis, TN (United States); University of Tennessee Health Science Center, Department of Ophthalmology, Memphis, TN (United States); Le Bonheur Children' s Hospital, Le Bonheur Neuroscience Institute, Memphis, TN (United States); Siddiqui, Adeel [University of Tennessee Health Science Center, Department of Radiology, Memphis, TN (United States); Le Bonheur Children' s Hospital, Le Bonheur Neuroscience Institute, Memphis, TN (United States); Klimo, Paul; Boop, Frederick A. [University of Tennessee Health Science Center, Department of Neurosurgery, Memphis, TN (United States); Le Bonheur Children' s Hospital, Le Bonheur Neuroscience Institute, Memphis, TN (United States); Semmes-Murphey Neurologic and Spine Institute, Memphis, TN (United States); St. Jude Children' s Hospital, Division of Neurosurgery, Department of Surgery, Memphis, TN (United States)

    2015-09-15

    Intraoperative magnetic resonance imaging (iMRI) has emerged as an important tool in guiding the surgical management of children with brain tumors. Recent advances have allowed utilization of high field strength systems, including 3-tesla MRI, resulting in diagnostic-quality scans that can be performed while the child is on the operating table. By providing information about the possible presence of residual tumor, it allows the neurosurgeon to both identify and resect any remaining tumor that is thought to be safely accessible. By fusing the newly obtained images with the surgical guidance software, the images have the added value of aiding in navigation to any residual tumor. This is important because parenchyma often shifts during surgery. It also gives the neurosurgeon insight into whether any immediate postoperative complications have occurred. If any complications have occurred, the child is already in the operating room and precious minutes lost in transport and communications are saved. In this article we review the three main approaches to an iMRI system design. We discuss the possible roles for iMRI during intraoperative planning and provide guidance to help radiologists and neurosurgeons alike in the collaborative management of these children. (orig.)

  12. Muscle relaxant use during intraoperative neurophysiologic monitoring.

    Science.gov (United States)

    Sloan, Tod B

    2013-02-01

    Neuromuscular blocking agents have generally been avoided during intraoperative neurophysiological monitoring (IOM) where muscle responses to nerve stimulation or transcranial stimulation are monitored. However, a variety of studies and clinical experience indicate partial neuromuscular blockade is compatible with monitoring in some patients. This review presents these experiences after reviewing the currently used agents and the methods used to assess the blockade. A review was conducted of the published literature regarding neuromuscular blockade during IOM. A variety of articles have been published that give insight into the use of partial pharmacological paralysis during monitoring. Responses have been recorded from facial muscles, vocalis muscles, and peripheral nerve muscles from transcranial or neural stimulation with neuromuscular blockade measured in the muscle tested or in the thenar muscles from ulnar nerve stimulation. Preconditioning of the nervous system with tetanic or sensory stimulation has been used. In patients without neuromuscular pathology intraoperative monitoring using peripheral muscle responses from neural stimulation is possible with partial neuromuscular blockade. Monitoring of muscle responses from cranial nerve stimulation may require a higher degree of stimulation and less neuromuscular blockade. The role of tetanic or sensory conditioning of the nervous system is not fully characterized. The impact of neuromuscular pathology or the effect of partial blockade on monitoring muscle responses from spontaneous neural activity or mechanical nerve stimulation has not been described.

  13. Quality Evaluation of Some Fresh and Imported Frozen Seafood

    Directory of Open Access Journals (Sweden)

    Fatma Hassan Mohamed Ali

    2011-02-01

    Full Text Available This work was done to evaluate the quality parameters of fresh and imported frozen seafood (fillets and shrimp. A total of 120 seafood samples, fillets and shrimp (fresh and imported frozen 30 each, collected from fish markets at Giza Governorate were sensory, bacteriological, chemical investigated. Panelists rejected 5.0 (16.6% and 0.0 (0.0% of fresh fillets and shrimp samples, while the number raised up to 12.0 (40.0% and 15.0 (50.0% of frozen fillets and shrimp samples respectively. Fresh seafood had a significant lower (p<0.05 pH values in compared to frozen products. There were observed significant difference (p<0.05 in the TBA and TVB-N values between the fresh and frozen seafood samples. All fresh and frozen seafood samples were judge as safe food from microbiological point of view. The total proteolytic, lipolytic, psychrotrophic and pseudomonas/aeromonas counts for all examined seafood samples were lie within the standard permissible limits. L. monocytogenes could not be detected from fresh or frozen fillets. Few freqyency of L. monocytogenes found in fresh and imported frozen shrimp. As well as V. parahaemolyticus and Y. enterocolitica were recovered from examined fresh and frozen seafood samples. The public health significance of the isolated organisms was also discussed. The quality of fresh fillets and shrimp were better than that of imported frozen one.

  14. The Resection Map: A proposal for intraoperative hepatectomy guidance

    NARCIS (Netherlands)

    Lamata, P.; Jalote-Parmar, A.; Lamata, F.; Declerck, J.

    2008-01-01

    Objective - To propose a new concept of an intra-operative 3D visualisation system to support hepatectomies. This system aims at improving the transfer of pre-operative planning into the intra-operative stage, both in laparoscopic and open approaches. Materials and methods - User (surgeon) centred d

  15. The Effect of the Excisional Biopsy in the Detection of the Sentinel Lymph Node By Lymphoscintigraphy and Intraoperative Gamma Probe in Breast Cancer

    Directory of Open Access Journals (Sweden)

    Pelin Arıcan

    2011-12-01

    Full Text Available Objective: Sentinel lymph node (SLN scintigraphy is used widespread in breast cancer, but the effect of the radionuclide agent, injec¬tion technique, the method of biopsy, tumor localization, breast size remain controversial. We examined the effects of the excisional biopsy in the rate of the SLN identification with lymphoscintigraphy (LS and intraoperative gamma probe (IGP. Material and Methods: One hundred patients (age range: 28-79 yr with breast cancer were included in the study. They consist¬ed of two groups: Group 1; there were 58 patients without excisional biopsy Group 2; there were 42 patients with excisional biopsy LS: 2 hours before the operation, 37 MBq/ ml Tc 99m colloidal rhenium sulphide was injected at the periaerolar region intradermally Anterior and lateral static images were acquired. IGP: The hot spot of greatest radioactivity were marked on the skin during the surgery with IGP and removed. Excised SLNs were examined with frozen section. After that histopathological and immunohistochemical examinations were performed. Results: SLNs were found in all patients in group 1 (100%, in 39 patients of group 2 (93% with LS. SLNs were excised in 57 of the 58 patients of group 1 (98%, in 38 of the 42 patients of group 2 (90% with IGF? Metastases were found in SLNs in 27 patients (28%. Axillary dissection was performed in these patients. Conclusion: According to results of our study the excisional biopsy was not the only factor but also other factors such as breast mass, calcified or metastatic lymph node may be affected the success rate of the SLN. (MIRT2011;20:100-103

  16. Optical technologies for intraoperative neurosurgical guidance.

    Science.gov (United States)

    Valdés, Pablo A; Roberts, David W; Lu, Fa-Ke; Golby, Alexandra

    2016-03-01

    Biomedical optics is a broadly interdisciplinary field at the interface of optical engineering, biophysics, computer science, medicine, biology, and chemistry, helping us understand light-tissue interactions to create applications with diagnostic and therapeutic value in medicine. Implementation of biomedical optics tools and principles has had a notable scientific and clinical resurgence in recent years in the neurosurgical community. This is in great part due to work in fluorescence-guided surgery of brain tumors leading to reports of significant improvement in maximizing the rates of gross-total resection. Multiple additional optical technologies have been implemented clinically, including diffuse reflectance spectroscopy and imaging, optical coherence tomography, Raman spectroscopy and imaging, and advanced quantitative methods, including quantitative fluorescence and lifetime imaging. Here we present a clinically relevant and technologically informed overview and discussion of some of the major clinical implementations of optical technologies as intraoperative guidance tools in neurosurgery.

  17. Overview of intraoperative MRI in neurosurgery

    Energy Technology Data Exchange (ETDEWEB)

    Shiino, Akihiko; Matsuda, Masayuki [Shiga Univ. of Medical Science, Otsu (Japan)

    2002-01-01

    This review describes usefulness, prospect and present problems of intraoperative MRI in neurosurgery. MRI equipments for the surgery have to have a wide, open space and have those magnets of short cylindrical, biplanar (clam shell), dual air core superconducting solenoidal (double doughnut) and targeted FOV (field of view) type. Devices required for the surgery are specific and in author's facility, they are classified into 4 zones depending on the region of their use. Application of the surgery involves biopsy, drainage of cyst and abscess, hematoma evacuation, nerve block, thermotherapy (interstitial laser, RF ablation, focused untrasonic and cryosurgery), local drug therapy, chemoablation, vascular intervention and tumor extraction, of which actual procedures and pictures are presented together with, in particular, MR-guided thermotherapy, ablation therapy of brain tumors, endoscopic surgery and minimally invasive therapy of the spine. A navigation software, 3D SlicerTM system, is introduced for interventional imaging. Safety measures are emphasized for the operation. (K.H.)

  18. Intraoperative photodynamic therapy for larynx carcinomas

    Science.gov (United States)

    Loukatch, Erwin V.; Latyshevska, Galina; Fekeshgazi, Ishtvan V.

    1995-05-01

    We made an experimental and clinical researches to examine Intraoperative Photodynamic Therapy (IPT) as a method to prevent the recidives of tumors. In experimental researches on models with radio-inducated fibrosarcomas and Erlich carcinomas of mice the best method of IPT was worked out. The therapeutic effect was studied also on patients with laryngeal cancer. In researches on C3H mice the antirecidive effect of IPT established with local administration of methylene blue and Ar-laser. We found that IPT (He-Ne laser combined with methylene blue administration) was endured by patients with laryngeal cancers without problems. We got good results of treatment 42 patients with laryngeal cancers with middle localization during three years with using IPT method. This can show the perspectives of using this method in treatment of other ENT-oncological diseases.

  19. Intra-operative robotics: NeuroArm.

    Science.gov (United States)

    Lang, Michael J; Greer, Alexander D; Sutherland, Garnette R

    2011-01-01

    This manuscript describes the development and ongoing integration of neuroArm, an image-guided MR-compatible robot. A neurosurgical robotics platform was developed, including MR-compatible manipulators, or arms, with seven degrees of freedom, a main system controller, and a human-machine interface. This system was evaluated during pre-clinical trials and subsequent clinical application, combined with intra-operative MRI, at both 1.5 and 3.0 T. An MR-compatible surgical robot was successfully developed and merged with ioMRI at both 1.5 or 3.0 T. Image-guidance accuracy and microsurgical capability were established in pre-clinical trials. Early clinical experience demonstrated feasibility and showed the importance of a master-slave configuration. Surgeon-directed manipulator control improved performance and safety. NeuroArm successfully united the precision and accuracy of robotics with the executive decision-making capability of the surgeon.

  20. Extracting Physics from Topologically Frozen Markov Chains

    CERN Document Server

    Gerber, Urs; Bietenholz, Wolfgang; Mejía-Díaz, Héctor; Hofmann, Christoph P

    2014-01-01

    In Monte Carlo simulations with a local update algorithm, the auto-correlation with respect to the topological charge tends to become very long. In the extreme case one can only perform reliable measurements within fixed sectors. We investigate approaches to extract physical information from such topologically frozen simulations. Recent results in a set of sigma-models and gauge theories are encouraging. In a suitable regime, the correct value of some observable can be evaluated to a good accuracy. In addition there are ways to estimate the value of the topological susceptibility.

  1. Optimal use of fresh frozen plasma.

    Science.gov (United States)

    DomBourian, Melkon; Holland, Lorne

    2012-01-01

    Fresh frozen plasma contains a number of therapeutically useful substances, most notably coagulation factors. As with any transfusion, there are risks associated with plasma transfusion. Ironically, the risk of viral transmission (human immunodeficiency virus or hepatitis), although widely publicized, is extremely small. On the other hand, less well-known, noninfectious complications are common. Indeed, these noninfectious complications are the most significant cause of morbidity and mortality following transfusion. Although certain patients undeniably benefit from plasma transfusion, the benefit for many patients is less clear. This review will discuss indications for plasma transfusion, the associated risks, and special considerations for plasma administration.

  2. Intraoperative patient information handover between anesthesia providers

    Science.gov (United States)

    Choromanski, Dominik; Frederick, Joel; McKelvey, George Michael; Wang, Hong

    2014-01-01

    Abstract Currently, no reported studies have evaluated intraoperative handover among anesthesia providers. Studies on anesthetic handover in the US recovery room setting observed that handover processes are insufficient and, in many instances, significant intraoperative events are disregarded. An online survey tool was sent to anesthesia providers at US anesthesia residency programs nationwide (120 out of the 132 US programs encompassing around 4500 residents and their academic MDAs) and a smaller survey selection of CRNAs (10 institutions about 300 CRNAs in the metropolitan area of Detroit, MI, USA) to collect information on handover practices. The response rate to this survey (n = 216) was comprised of approximately 5% (n = 71) of the resident population in US anesthesia programs, 5% (n = 87) of MDAs , and 20% (n = 58) of the CRNAs. Out of all respondents (n = 212), 49.1 % had no hand-over protocol at their institution and 88% of respondents who did have institutional handover protocols believed them insufficient for effective patient handover. In addiiton, 84.8% of all responders reported situations where there was insufficient information received during a patient handover. Only 7% of the respondents reported never experiencing complications or mismanagement due to poor or incomplete hand-overs. In contrast, 60% reported rarely having complications, 31% reported sometimes having complications, and 3% reported frequent complications. In conclusion, handover transition of patient care is a vulnerable and potentially life-threatening event in the operating room. Our preliminary study suggests that current intraoperatvive handover practices among anesthesia providers are suboptimal and that national patient handover guidelines are required to improve patient safety. PMID:25332710

  3. Best practices to optimize intraoperative photography.

    Science.gov (United States)

    Gaujoux, Sébastien; Ceribelli, Cecilia; Goudard, Geoffrey; Khayat, Antoine; Leconte, Mahaut; Massault, Pierre-Philippe; Balagué, Julie; Dousset, Bertrand

    2016-04-01

    Intraoperative photography is used extensively for communication, research, or teaching. The objective of the present work was to define, using a standardized methodology and literature review, the best technical conditions for intraoperative photography. Using either a smartphone camera, a bridge camera, or a single-lens reflex (SLR) camera, photographs were taken under various standard conditions by a professional photographer. All images were independently assessed blinded to technical conditions to define the best shooting conditions and methods. For better photographs, an SLR camera with manual settings should be used. Photographs should be centered and taken vertically and orthogonal to the surgical field with a linear scale to avoid error in perspective. The shooting distance should be about 75 cm using an 80-100-mm focal lens. Flash should be avoided and scialytic low-powered light should be used without focus. The operative field should be clean, wet surfaces should be avoided, and metal instruments should be hidden to avoid reflections. For SLR camera, International Organization for Standardization speed should be as low as possible, autofocus area selection mode should be on single point AF, shutter speed should be above 1/100 second, and aperture should be as narrow as possible, above f/8. For smartphone, use high dynamic range setting if available, use of flash, digital filter, effect apps, and digital zoom is not recommended. If a few basic technical rules are known and applied, high-quality photographs can be taken by amateur photographers and fit the standards accepted in clinical practice, academic communication, and publications. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Current trends in intraoperative optical imaging for functional brain mapping and delineation of lesions of language cortex.

    Science.gov (United States)

    Prakash, Neal; Uhlemann, Falk; Sheth, Sameer A; Bookheimer, Susan; Martin, Neil; Toga, Arthur W

    2009-08-01

    Resection of a cerebral arteriovenous malformation (AVM), epileptic focus, or glioma, ideally has a prerequisite of microscopic delineation of the lesion borders in relation to the normal gray and white matter that mediate critical functions. Currently, Wada testing and functional magnetic resonance imaging (fMRI) are used for preoperative mapping of critical function, whereas electrical stimulation mapping (ESM) is used for intraoperative mapping. For lesion delineation, MRI and positron emission tomography (PET) are used preoperatively, whereas microscopy and histological sectioning are used intraoperatively. However, for lesions near eloquent cortex, these imaging techniques may lack sufficient resolution to define the relationship between the lesion and language function, and thus not accurately determine which patients will benefit from neurosurgical resection of the lesion without iatrogenic aphasia. Optical techniques such as intraoperative optical imaging of intrinsic signals (iOIS) show great promise for the precise functional mapping of cortices, as well as delineation of the borders of AVMs, epileptic foci, and gliomas. Here we first review the physiology of neuroimaging, and then progress towards the validation and justification of using intraoperative optical techniques, especially in relation to neurosurgical planning of resection AVMs, epileptic foci, and gliomas near or in eloquent cortex. We conclude with a short description of potential novel intraoperative optical techniques.

  5. Morphometric Analysis in Breast Lesions A Rapid Conjunct to Intraoperative Imprint Smears

    Directory of Open Access Journals (Sweden)

    Nisha Marwah

    2012-01-01

    Full Text Available Background: Breast carcinoma is the most common malignant tumor and leading cause of cancer deaths in women. While fine needle aspiration cytology is highly accurate in the diagnosis of breast lesions, it possesses certain drawbacks. In those circumstancesintraoperative imprint cytology assumes importance, however, imprint cytology is subjected to interpretative errors. Computer image analysis has become an important tool in the pathology laboratory for quantitative morphometric analysis. The purpose of this study was to compare the morphometric values of various breast lesions onintraoperative imprint smears with final histopathological sections.Methods: The study group comprised 30 cases of, borderline(suspicious, and malignant lesions. Intraoperative imprint smears were stained with hematoxylin and eosin, and toluidine blue. Morphometry was done on these smears and compared with morphometry on the histopathological sections, followed by statistical correlation. We studied the following five parameters: mean nuclear area, mean nuclear diameter, mean nuclear perimeter, feret circle, and nucleo-cytoplasmic ratio.Results: In the current work, all of the studied parameters with the exception of feret circle showed significantly lower values in benign ductal epithelial cells compared to malignant lesions and concentrate on the importance of morphometry as a diagnostictool that could differentiate benign from malignant lesions, especially if it can be employed on imprint smears intraoperatively. Accurate assessment of intraoperative margins by imprint smears using image analysis automation can prevent multiple reexcisionprocedures in breast conservation surgery.

  6. Frozen Landweber Iteration for Nonlinear Ill-Posed Problems

    Institute of Scientific and Technical Information of China (English)

    J.Xu; B.Han; L.Li

    2007-01-01

    In this paper we propose a modification of the Landweber iteration termed frozen Landweber iteration for nonlinear ill-posed problems.A convergence analysis for this iteration is presented.The numerical performance of this frozen Landweber iteration for a nonlinear Hammerstein integral equation is compared with that of the Landweber iteration.We obtain a shorter running time of the frozen Landweber iteration based on the same convergence accuracy.

  7. Intraoperative radiotherapy in primary rectal cancer; Intraoperative Radiotherapie des primaeren Rektumkarzinoms

    Energy Technology Data Exchange (ETDEWEB)

    Mund, Christian

    2013-06-17

    According to the results of several studies intraoperative radiotherapy seems to influence local control for primary rectal cancer in UICC-Stage II / III positively, though recommendations in therapy cannot be given as studies of high evidence level do not exist. As IORT is rarely available and makes patient recruitment difficult, prospective randomised trials have not been carried out yet. This emphasizes the importance of non-randomised trials for an evaluation of IORT. A comparison of 21 patients with locally advanced rectal cancer who had been treated with intraoperative radiation therapy and 21 similar cases without an application of IORT could not show any significant improvements in prognosis (recurrences, metastases and disease-specific survival). Nevertheless the employment of intraoperative radiation showed a trend in improvement of local control. This hast been shown by several other studies before. Thus the application of IORT in patients with locally advanced rectal cancer is considered a useful part in multimodal treatment and should further be evaluated in specialized centres. In case-control studies 1:1-matching leads to a good comparability of groups and renders conclusions of high internal validity possible. To gain a sufficient power, this type of trials should however primarily be carried out by centres with a high number of cases.

  8. STRENGTH AND WAVE VELOCITY TEST ON ARTIFICIALLY FROZEN SOILS

    Institute of Scientific and Technical Information of China (English)

    马芹永

    1998-01-01

    Theoretical analysis conducted of uniaxial compressive strength and tensile strength ofartificially frozen soil and P waves and S waves and of the relationship between the two. Experi-ments are made on frozen sand and frozen clay respectively at the temperature of - 7 ℃, - 12 ℃and - 17 ℃. Of the data obtained, regression analysis and gray-system correlation are conduct-ed. As indicated by the results, the frozen soil tensile strength is closely correlated with the Pwave velocity and the compressive with the S wave, hence the former is well described by thelatter.

  9. Constitutive theories on viscoelastoplasticity and damage of frozen soil

    Institute of Scientific and Technical Information of China (English)

    何平; 程国栋; 朱元林

    1999-01-01

    The constitutive theory on the viscoelastoplasticity and damage of frozen soil is based on the continuous mechanics and thermodynamics. The basic principles of the theory, dissipation potential function and damage model are presented. The constitutive theory explains the mechanical properties of frozen soils under complicated stresses, especially under high confining pressures which make frozen soil harden and soften. The agreement between the calculated results by the constitutive theory and the experimental results of triaxial creep of frozen soil is seen to be very good.

  10. Frozen Chemistry Effects on Nozzle Performance Simulations

    Science.gov (United States)

    Yoder, Dennis A.; Georgiadis, Nicholas J.; O'Gara, Michael R.

    2009-01-01

    Simulations of exhaust nozzle flows are typically conducted assuming the gas is calorically perfect, and typically modeled as air. However the gas inside a real nozzle is generally composed of combustion products whose thermodynamic properties may differ. In this study, the effect of gas model assumption on exhaust nozzle simulations is examined. The three methods considered model the nozzle exhaust gas as calorically perfect air, a calorically perfect exhaust gas mixture, and a frozen exhaust gas mixture. In the latter case the individual non-reacting species are tracked and modeled as a gas which is only thermally perfect. Performance parameters such as mass flow rate, gross thrust, and thrust coefficient are compared as are mean flow and turbulence profiles in the jet plume region. Nozzles which operate at low temperatures or have low subsonic exit Mach numbers experience relatively minor temperature variations inside the nozzle, and may be modeled as a calorically perfect gas. In those which operate at the opposite extreme conditions, variations in the thermodynamic properties can lead to different expansion behavior within the nozzle. Modeling these cases as a perfect exhaust gas flow rather than air captures much of the flow features of the frozen chemistry simulations. Use of the exhaust gas reduces the nozzle mass flow rate, but has little effect on the gross thrust. When reporting nozzle thrust coefficient results, however, it is important to use the appropriate gas model assumptions to compute the ideal exit velocity. Otherwise the values obtained may be an overly optimistic estimate of nozzle performance.

  11. Stability of Frozen Orbits Around Europa

    Science.gov (United States)

    Cardoso Dos Santos, Josué; Vilhena de Moraes, R.; Carvalho, J. S.

    2013-05-01

    Abstract (2,250 Maximum Characters): A planetary satellite of interest at the present moment for the scientific community is Europa, one of the four largest moons of Jupiter. There are some missions planned to visit Europa in the next years, for example, Jupiter Europa Orbiter (JEO, NASA) and Jupiter IcyMoon Explorer (JUICE, ESA). In this work we are formulating theories and constructing computer programs to be used in the design of aerospace tasks as regards the stability of artificial satellite orbits around planetary satellites. The studies are related to translational motion of orbits around planetary satellites considering polygenic perturbations due to forces, such as the nonspherical shape of the central body and the perturbation of the third body. The equations of motion will be developed in closed form to avoid expansions in eccentricity and inclination. For a description of canonical formalism are used the Delaunay canonical variables. The canonical set of equations, which are nonlinear differential equations, will be used to study the stability of orbits around Europa. We will use a simplified dynamic model, which considers the effects caused by non-uniform distribution of mass of Europa (J2, J3 and C22) and the gravitational attraction of Jupiter. Emphasis will be given to the case of frozen orbits, defined as having almost constant values of eccentricity, inclination, and argument of pericentre. An approach will be used to search for frozen orbits around planetary satellites and study their stability by applying a process of normalization of Hamiltonian. Acknowledges: FAPESP

  12. Searching for Frozen Super Earth via Microlensing

    Science.gov (United States)

    Batista, V.; Beaulieu, J. P.; Cassan, A.; Coutures, C.; Donatowicz, J.; Fouqué, P.; Kubas, D.; Marquette, J. B.

    2009-04-01

    Microlensing planet hunt is a unique method to probe efficiently for frozen Super Earth orbiting the most common stars of our galaxy. It is nicely complementing the parameter space probed by very high accuracy radial velocity measurements and future space based detections of low mass transiting planets. In order to maximize the planet catch, the microlensing community is engaged in a total cooperation among the different groups (OGLE, MicroFUN, MOA, PLANET/RoboNET) by making the real time data available, and mutual informing/reporting about modeling efforts. Eight planets have been published so far by combinations of the different groups, 4 Jovian analogues, one Neptune and two Super Earth. Given the microlensing detection efficiency, it suggests that these Neptunes/Super Earths may be quite common. Using networks of dedicated 1-2m class telescopes, the microlensing community has entered a new phase of planet discoveries, and will be able to provide constraints on the abundance of frozen Super-Earths in the near future. Statistics about Mars to Earth mass planets, extending to the habitable zone will be achieved with space based wide field imagers (EUCLID) at the horizon 2017.

  13. 21 CFR 102.26 - Frozen “heat and serve” dinners.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Frozen âheat and serveâ dinners. 102.26 Section 102.26 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... servings of food (e.g., soup, bread or rolls, beverage, dessert). (b) The common or usual name of the food...

  14. Intraoperative monitoring technician: a new member of the surgical team.

    Science.gov (United States)

    Brown, Molly S; Brown, Debra S

    2011-02-01

    As surgery needs have increased, the traditional surgical team has expanded to include personnel from radiology and perfusion services. A new surgical team member, the intraoperative monitoring technician, is needed to perform intraoperative monitoring during procedures that carry a higher risk of central and peripheral nerve injury. Including the intraoperative monitoring technician on the surgical team can create challenges, including surgical delays and anesthesia care considerations. When the surgical team members, including the surgeon, anesthesia care provider, and circulating nurse, understand and facilitate this new staff member's responsibilities, the technician is able to perform monitoring functions that promote the smooth flow of the surgical procedure and positive patient outcomes.

  15. Intraoperative ultrasonography in detection of hepatic metastases from colorectal cancer

    DEFF Research Database (Denmark)

    Rafaelsen, Søren Rafael; Kronborg, Ole; Fenger, Claus

    1995-01-01

    of the findings by the surgeon. The presence of metastases was further assessed by ultrasonography three months postoperatively, as well as additional surgery and liver biopsy in some of the patients. RESULTS: The sensitivity of intraoperative ultrasonography (62/64) was significantly superior to that of surgical...... exploration (54/64) and that of preoperative ultrasonography (45/64). The lowest sensitivity was presented by liver enzymes. Bilobar metastases were detected in 42 of 46 patients by intraoperative ultrasonography but in only 33 patients by the surgeon. Intraoperative ultrasonography demonstrated the highest...

  16. An unusual cause of intraoperative acute superior vena cava syndrome

    Directory of Open Access Journals (Sweden)

    Adam W Amundson

    2013-01-01

    Full Text Available Acute intraoperative superior vena cava (SVC syndrome is an exceedingly rare complication in the cardiac surgical population. We describe the case of a 71-year-old female undergoing multi-vessel coronary artery bypass grafting who developed acute intraoperative SVC syndrome following internal thoracic artery harvest retractor placement. Her symptoms included severe plethora, facial engorgement and scleral edema, which was associated with hypotension and severe elevation of central venous pressure. Transesophageal echocardiography was crucial in the diagnosis, management, and optimal retractor placement ensuring adequate SVC flow. Potential causes of intraoperative SVC syndrome are reviewed as well as management options.

  17. Coblation tonsillectomy versus dissection tonsillectomy: a comparison of intraoperative time, intraoperative blood loss and post-operative pain.

    Science.gov (United States)

    Izny Hafiz, Z; Rosdan, S; Mohd Khairi, M D

    2014-04-01

    The objective of this study was to compare the intraoperative time, intraoperative blood loss and post operative pain between coblation tonsillectomy and cold tonsillectomy in the same patient. A prospective single blind control trial was carried out on 34 patients whom underwent tonsillectomy. The patients with known bleeding disorder, history of unilateral peritonsillar abscess and unilateral tonsillar hypertrophy were excluded. Operations were done by a single surgeon using cold dissection tonsillectomy in one side while coblation tonsillectomy in the other. Intraoperative time, intraoperative blood loss and post operative pain during the first 3 days were compared between the two methods. Results showed that the intraoperative time was significantly shorter (pcoblation tonsillectomy as compared to cold tonsillectomy. Post operative pain score was significantly less at 6 hours post operation (pcoblation tonsillectomy as compared to cold tonsillectomy. However, there were no differences in the post operative pain scores on day 1, 2 and 3. In conclusion, coblation tonsillectomy does have superiority in improving intraoperative efficiency in term of intraoperative time and bleeding compared to cold dissection tonsillectomy. The patient will benefit with minimal post operative pain in the immediate post surgery duration.

  18. Vibration characteristics of frozen soil under moving track loads

    Institute of Scientific and Technical Information of China (English)

    AiPing Tang; AnPing Zhao; AiHua Wen

    2015-01-01

    Vibration due to moving traffic loads is an important factor which induces frozen soil damage; this paper analyzed these vibration characteristics of frozen soil foundation under track loads. Firstly, seismic observation array (SOA) technology was applied to monitor the three dimensional dynamic characteristics of frozen soil under movable track load in a per-mafrost region and seasonal frozen soil area. Secondly, a numerical simulation for the response of frozen soil under movable track load was performed based on finite element analysis (FEA). The results show that dynamic characteristics of frozen soil in perpendicular and parallel direction of the track are obviously different. In the direction perpendicular to the track, the vertical acceleration amplitude had an abrupt increase in the 9–10 m from the track line. In the direction parallel to the track, the acceleration in vertical and horizontal direction had a quick attenuation compared to the other direction. Lastly, various parameters were analyzed for the purpose of controlling the dynamic response of frozen soil and the vibration attenuation in frozen soil layer.

  19. Status and prospects of frozen soil studies using CT technology

    Institute of Scientific and Technical Information of China (English)

    ShiJie Chen; ShuPing Zhao; Wei Ma; QianTao Zhu; LiLi Xing

    2014-01-01

    This paper introduces the characteristics of Computed Tomography (CT) technology and reviews its history, current situation, representative achievements, and use of using CT technology on frozen soil study, including auxiliary equipment specially de-signed for frozen soil studies. CT numbers are used to analyze frozen soil internal structure change, defining and exploring dam-age evolution, and use of CT images on observing soil mesostructure. Finally, this paper presents existing problems confronted by using CT in frozen soil studies, possible solutions and challenges, among which, we introduce high quality CT image processing for frozen soils, and relations between CT number change and each component change on frozen soil samples within the region of interest. It is shown that present CT technology is one of the most ideal and effective technology to study frozen soil mesostructure using non-destructive testing. CT technology will play a key role in the study and development in the field of frozen soil by means of auxiliary equipment and the digital imaging processing.

  20. Quality Changes of Frozen Meat During Storage and Control Measures

    Institute of Scientific and Technical Information of China (English)

    DU Jiangping

    2010-01-01

    The frozen is a common method of meat storage, generally applications in meat industrial. However, the quality of meat still have taken place changes even in the low temperature, This article discussion on the changes of frozen meat quality during freezing storage, and give the corresponding control measures.

  1. Producing Acoustic 'Frozen Waves': Simulated experiments

    CERN Document Server

    Prego, Jose' L; Recami, Erasmo; Hernandez-Figueroa, Hugo E

    2012-01-01

    In this paper we show how appropriate superpositions of Bessel beams can be successfully used to obtain arbitrary longitudinal intensity patterns of nondiffracting ultrasonic wavefields with very high transverse localization. More precisely, the method here described allows generating longitudinal acoustic pressure fields, whose longitudinal intensity patterns can assume, in principle, any desired shape within a freely chosen interval 0Frozen Waves(FW). The paper presents various cases of FWs in water, and investigates the characteristics of their aperture, such as minimum required size and ring dimensioning, as well as the influence...

  2. Title: Characterizing a Frozen Extrasolar World

    Science.gov (United States)

    Skemer, Andrew J.; Morley, Caroline V.; Allers, Katelyn N.; Geballe, Thomas R.; Marley, Mark S.; Fortney, Jonathan J.; Faherty, Jacqueline K.; Bjoraker, Gordon L.

    2016-01-01

    The recently discovered brown dwarf WISE 0855 presents our first opportunity to study an object outside the Solar System that is nearly as cold as our own gas giant planets. However the traditional methodology for characterizing brown dwarfs-near infrared spectroscopy-is not currently feasible as WISE 0855 is too cold and faint. To characterize this frozen extrasolar world we obtained a 4.5-5.2 micrometers spectrum, the same bandpass long used to study Jupiter's deep thermal emission. Our spectrum reveals the presence of atmospheric water vapor and clouds, with an absorption profile that is strikingly similar to Jupiter. The spectrum is high enough quality to allow the investigation of dynamical and chemical processes that have long been studied in Jupiter's atmosphere, but this time on an extrasolar world.

  3. Intraoperative nitrous oxide as a preventive analgesic.

    Science.gov (United States)

    Stiglitz, D K; Amaratunge, L N; Konstantatos, A H; Lindholm, D E

    2010-09-01

    Preventive analgesia is defined as the persistence of the analgesic effects of a drug beyond the clinical activity of the drug. The N-methyl D-aspartate receptor plays a critical role in the sensitisation of pain pathways induced by injury. Nitrous oxide inhibits excitatory N-methyl D-aspartate sensitive glutamate receptors. The objective of our study was to test the efficacy of nitrous oxide as a preventive analgesic. We conducted a retrospective analysis of data from a subset of patients (n = 100) randomly selected from a previous major multicentre randomised controlled trial on nitrous oxide (ENIGMA trial). Data analysed included postoperative analgesic requirements, pain scores and duration of patient-controlled analgesia during the first 72 postoperative hours. There was no significant difference in postoperative oral morphine equivalent usage (nitrous group 248 mg, no nitrous group 289 mg, mean difference -43 mg, 95% confidence interval 141 to 54 mg). However, patients who received nitrous oxide had a shorter duration of patient-controlled analgesia use (nitrous group 35 hours, no nitrous group 51 hours, mean difference -16 hours, 95% confidence interval -29 to -2 hours, P = 0.022). There was no difference in pain scores between the groups. The shorter patient-controlled analgesia duration in the nitrous oxide group suggests that intraoperative nitrous oxide may have a preventive analgesic effect.

  4. Thin-Profile Transducers for Intraoperative Hemostasis

    Science.gov (United States)

    Zderic, Vesna; Mera, Thomas; Vaezy, Shahram

    2005-03-01

    Our goal has been to develop thin-profile HIFU applicators for intraoperative hemostasis. The HIFU device consisted of a concave PZT element encased in a spoon-shaped aluminum housing with the diameter of 4 cm and thickness of 1 cm. The housing front surface had a thickness of 3/4 ultrasound wavelength in aluminum (0.92 mm) to provide acoustic matching. The device had a resonant frequency of 6.26 MHZ, and efficiency of 42%. The ultrasound field was observed using hydrophone field mapping and radiation force balance. The full-width half-maximum (FWHM) dimensions of the focal region were 0.6 mm and 2.2 mm in lateral and axial direction, respectively. The maximal intensity at the focus was 9,500 W/cm2 (in water). The device was tested using BSA-polyacrylamide gel phantom and rabbit kidney in vivo. HIFU application for 10 s produced lesions in the gel phantom (lesion width of 3 mm), and rabbit kidney in vivo (lesion width of 8 mm). A thin-profile HIFU applicator has advantages of high efficiency, simple design, and small dimensions.

  5. Intraoperative Neural Response Telemetry and Neural Recovery Function: a Comparative Study between Adults and Children

    Science.gov (United States)

    Carvalho, Bettina; Hamerschmidt, Rogerio; Wiemes, Gislaine

    2014-01-01

    Introduction Neural response telemetry (NRT) is a method of capturing the action potential of the distal portion of the auditory nerve in cochlear implant (CI) users, using the CI itself to elicit and record the answers. In addition, it can also measure the recovery function of the auditory nerve (REC), that is, the refractory properties of the nerve. It is not clear in the literature whether the responses from adults are the same as those from children. Objective To compare the results of NRT and REC between adults and children undergoing CI surgery. Methods Cross-sectional, descriptive, and retrospective study of the results of NRT and REC for patients undergoing IC at our service. The NRT is assessed by the level of amplitude (microvolts) and REC as a function of three parameters: A (saturation level, in microvolts), t0 (absolute refractory period, in seconds), and tau (curve of the model function), measured in three electrodes (apical, medial, and basal). Results Fifty-two patients were evaluated with intraoperative NRT (26 adults and 26 children), and 24 with REC (12 adults and 12 children). No statistically significant difference was found between intraoperative responses of adults and children for NRT or for REC's three parameters, except for parameter A of the basal electrode. Conclusion The results of intraoperative NRT and REC were not different between adults and children, except for parameter A of the basal electrode. PMID:25992145

  6. Intraoperative Neural Response Telemetry and Neural Recovery Function: a Comparative Study between Adults and Children

    Directory of Open Access Journals (Sweden)

    Carvalho, Bettina

    2014-04-01

    Full Text Available Introduction Neural response telemetry (NRT is a method of capturing the action potential of the distal portion of the auditory nerve in cochlear implant (CI users, using the CI itself to elicit and record the answers. In addition, it can also measure the recovery function of the auditory nerve (REC, that is, the refractory properties of the nerve. It is not clear in the literature whether the responses from adults are the same as those from children. Objective To compare the results of NRT and REC between adults and children undergoing CI surgery. Methods Cross-sectional, descriptive, and retrospective study of the results of NRT and REC for patients undergoing IC at our service. The NRT is assessed by the level of amplitude (microvolts and REC as a function of three parameters: A (saturation level, in microvolts, t0 (absolute refractory period, in seconds, and tau (curve of the model function, measured in three electrodes (apical, medial, and basal. Results Fifty-two patients were evaluated with intraoperative NRT (26 adults and 26 children, and 24 with REC (12 adults and 12 children. No statistically significant difference was found between intraoperative responses of adults and children for NRT or for REC's three parameters, except for parameter A of the basal electrode. Conclusion The results of intraoperative NRT and REC were not different between adults and children, except for parameter A of the basal electrode.

  7. Intra-Operative Indocyanine Green Angiography of the Parathyroid Gland.

    Science.gov (United States)

    Vidal Fortuny, Jordi; Karenovics, Wolfram; Triponez, Frederic; Sadowski, Samira M

    2016-10-01

    Major complications of thyroid and parathyroid surgery are recurrent laryngeal nerve injuries and definitive hypoparathyroidism. The use of intra-operative Indocyanine Green Angiography for confirmation of vascular status of the parathyroid gland is reported here.

  8. Intraoperative flap complications in lasik surgery performed by ophthalmology residents

    Directory of Open Access Journals (Sweden)

    Lorena Romero-Diaz-de-Leon

    2016-01-01

    Conclusion: Flap-related complications are common intraoperative event during LASIK surgery performed by in-training ophthalmologists. Keratometries and surgeon's first procedure represent a higher probability for flap related complications than some other biometric parameters of patient's eye.

  9. Intraoperative management of the patient with severe lung disease

    African Journals Online (AJOL)

    Intraoperative management strategies in patients with COPD need to consider the potential presence of CO2 ... bullae provided the airway pressures are kept low and that adequate .... relate to the more advanced methodology of the more.

  10. Intraoperative ultrasound control of surgical margins during partial nephrectomy

    Directory of Open Access Journals (Sweden)

    Feras M Alharbi

    2016-01-01

    Conclusions: The intraoperative US control of resection margins in PN is a simple, efficient, and effective method for ensuring negative surgical margins with a small increase in warm ischemia time and can be conducted by the operating urologist.

  11. Macular surgery using intraoperative spectral domain optical coherence tomography

    Directory of Open Access Journals (Sweden)

    Mohammad Riazi-Esfahani

    2015-01-01

    Conclusion: Intraoperative SD-OCT is a useful imaging technique which provides vitreoretinal surgeons with rapid awareness of changes in macular anatomy during surgery and may therefore result in better anatomical and visual outcomes.

  12. Intraoperative contamination influences wound discharge and periprosthetic infection

    NARCIS (Netherlands)

    Knobben, Bas A. S.; Engelsma, Yde; Neut, Danielle

    2006-01-01

    Intraoperative bacterial contamination increases risk for postoperative wound-healing problems and periprosthetic infection, but to what extent remains unclear. We asked whether bacterial contamination of the instruments and bone during primary prosthesis insertion was associated with prolonged

  13. Intraoperative ultrasonography in detection of hepatic metastases from colorectal cancer

    DEFF Research Database (Denmark)

    Rafaelsen, Søren Rafael; Kronborg, Ole; Fenger, Claus

    1995-01-01

    PURPOSE: This study was designed to compare diagnostic accuracies of measuring liver enzymes, preoperative ultrasonography, surgical examination, and intraoperative ultrasonography for detection of liver metastases from colorectal cancer. METHODS: Blind, prospective comparisons of diagnostic...... examinations mentioned above were performed in 295 consecutive patients with colorectal cancer. An experienced ultrasonologist performed the preoperative examinations, and results were unknown to the other experienced ultrasonologist who performed the intraoperative examinations. The latter, also was unaware...... exploration (54/64) and that of preoperative ultrasonography (45/64). The lowest sensitivity was presented by liver enzymes. Bilobar metastases were detected in 42 of 46 patients by intraoperative ultrasonography but in only 33 patients by the surgeon. Intraoperative ultrasonography demonstrated the highest...

  14. Non-radiographic intraoperative fluorescent cholangiography is feasible

    DEFF Research Database (Denmark)

    Larsen, Søren Schytt; Schulze, Svend; Bisgaard, Thue

    2014-01-01

    INTRODUCTION: Intraoperative fluorescent cholangiography (IFC) with concomitant fluorescent angiography was recently developed for non-invasive identification of the anatomy during laparoscopic cholecystectomy. The objective of this study was to assess the time required for routine-use of IFC...

  15. 76 FR 6603 - Certain Frozen Warmwater Shrimp from Thailand; Notice of Amended Final Results of Antidumping...

    Science.gov (United States)

    2011-02-07

    ... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF COMMERCE International Trade Administration Certain Frozen Warmwater Shrimp from Thailand; Notice of Amended Final... antidumping duty order on certain frozen warmwater shrimp (shrimp) from Thailand. See Certain Frozen...

  16. Maternal obesity and major intraoperative complications during cesarean delivery.

    Science.gov (United States)

    Smid, Marcela C; Vladutiu, Catherine J; Dotters-Katz, Sarah K; Boggess, Kim A; Manuck, Tracy A; Stamilio, David M

    2017-06-01

    Multiple studies have demonstrated an association between maternal obesity and postoperative complications, but there is a dearth of information about the impact of obesity on intraoperative complications. To estimate the association between maternal obesity at delivery and major intraoperative complications during cesarean delivery (CD). This is a secondary analysis of the deidentified Maternal-Fetal Medicine Unit Cesarean Registry of women with singleton pregnancies. Maternal body mass index (BMI) at delivery was categorized as BMI 18.5 to 29.9 kg/m(2), BMI 30 to 39.9 kg/m(2), BMI 40 to 49.9 kg/m(2), and BMI ≥ 50 kg/m(2). The primary outcome, any intraoperative complication, was defined as having at least 1 major intraoperative complication, including perioperative blood transfusion, intraoperative injury (bowel, bladder, ureteral injury; broad ligament hematoma), atony requiring surgical intervention, repeat laparotomy, and hysterectomy. Log-binomial models were used to estimate risk ratios of intraoperative complication in 2 models: model 1 adjusting for maternal race, and preterm delivery obese women, there was evidence of effect modification by emergency CD. Compared with nonobese women, neither super obese women undergoing nonemergency CD (ARR, 1.13; 95% CI, 0.84 to 1.52) nor those undergoing emergency CD (ARR, 0.59; 95% CI, 0.32 to 1.10) had an increased risk of intraoperative complication. In contrast to the risk for postcesarean complications, the risk of intraoperative complication does not appear to be increased in obese women, even among those with super obesity. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. [Intraoperative mapping of lymph outflow tracts in colorectal carcinoma].

    Science.gov (United States)

    Mel'nikov, O R; Iaitskiĭ, A N; Danilov, I N; Anishkin, M Iu; Abdurakhmonov, Iu B

    2007-01-01

    Based on an analysis of 60 cases the authors have shown that identification and target investigation of signal lymph nodes using intraoperative staining with special dyes allows correct assessment of the stage of malignant disease. The method also allows treatment of the patient with an adequate, corresponding to up-to-date standards scheme of combined and complex treatment, gives possibilities of exact intraoperative diagnosis of lymphogenic metastasis and, as a result, allows extended operative intervention up to radical volumes.

  18. Intraoperative assessment of laryngeal pathologies with optical coherence tomography integrated into a surgical microscope.

    Science.gov (United States)

    Englhard, Anna S; Betz, Tom; Volgger, Veronika; Lankenau, Eva; Ledderose, Georg J; Stepp, Herbert; Homann, Christian; Betz, Christian S

    2017-07-01

    Endoscopic examination followed by tissue biopsy is the gold standard in the evaluation of lesions of the upper aerodigestive tract. However, it can be difficult to distinguish between healthy mucosa, dysplasia, and invasive carcinoma. Optical coherence tomography (OCT) is a non-invasive technique which acquires high-resolution, cross-sectional images of tissue in vivo. Integrated into a surgical microscope, it allows the intraoperative evaluation of lesions simultaneously with microscopic visualization. In a prospective case series, we evaluated the use of OCT integrated into a surgical microscope during microlaryngoscopy to help differentiating various laryngeal pathologies. 33 patients with laryngeal pathologies were examined with an OCT- microscope (OPMedT iOCT-camera, HS Hi-R 1000G-microscope, Haag-Streit Surgical GmbH, Wedel, Germany) during microlaryngoscopy. The suspected intraoperative diagnoses were compared to the histopathological reports of subsequent tissue biopsies. Hands-free non-contact OCT revealed high-resolution images of the larynx with a varying penetration depth of up to 1.2 mm and an average of 0.6 mm. Picture quality was variable. OCT showed disorders of horizontal tissue layering in dysplasias with a disruption of the basement membrane in carcinomas. When comparing the suspected diagnosis during OCT-supported microlaryngoscopy with histology, 79% of the laryngeal lesions could be correctly identified. Premalignant lesions were difficult to diagnose and falsely classified as carcinoma. OCT integrated into a surgical microscope seems to be a promising adjunct tool to discriminate pathologies of the upper aerodigestive tract intraoperatively. However, picture quality and penetration depth were variable. Although premalignant lesions were difficult to diagnose, the system proved overall helpful for the intraoperative discrimination of benign and malignant tumors. Further studies will be necessary to define its value in the future. Lasers

  19. Intraoperatively Testing the Anastomotic Integrity of Esophagojejunostomy Using Methylene Blue.

    Science.gov (United States)

    Celik, S; Almalı, N; Aras, A; Yılmaz, Ö; Kızıltan, R

    2017-03-01

    Intraoperative testing of gastrointestinal anastomosis effectively ensures anastomotic integrity. This study investigated whether the routine use of methylene blue intraoperatively identified leaks to reduce the postoperative proportion of clinical leaks. This study retrospectively analyzed consecutive total gastrectomies performed from January 2007 to December 2014 in a university hospital setting by a general surgical group that exclusively used the methylene blue test. All surgeries were performed for gastric or junctional cancers (n = 198). All reconstructions (Roux-en Y esophagojejunostomy) were performed using a stapler. The methylene blue test was used in 108 cases (group 1) via a nasojejunal tube. No test was performed for the other 90 cases (group 2). Intraoperative leakage rate, postoperative clinical leakage rate, length of hospitalization, and mortality rate were the outcome measures. The intraoperative leakage rate was 7.4% in group 1. The postoperative clinical leakage rate was 8.6%. The postoperative clinical leakage rate was 3.7% in group 1 and 14.4% in group 2 (p = 0.007). There were no postoperative clinical leaks when an intraoperative leak led to concomitant intraoperative repair. The median length of hospital stay was 6 days in group 1 and 8 days in group 2 (p methylene blue test for esophagojejunostomy is a safe and reliable method for the assessment of anastomosis integrity, especially in cases with difficult esophagojejunostomic construction.

  20. Intraoperative complications in pediatric neurosurgery: review of 1807 cases.

    Science.gov (United States)

    van Lindert, Erik J; Arts, Sebastian; Blok, Laura M; Hendriks, Mark P; Tielens, Luc; van Bilsen, Martine; Delye, Hans

    2016-09-01

    OBJECTIVE Minimal literature exists on the intraoperative complication rate of pediatric neurosurgical procedures with respect to both surgical and anesthesiological complications. The aim of this study, therefore, was to establish intraoperative complication rates to provide patients and parents with information on which to base their informed consent and to establish a baseline for further targeted improvement of pediatric neurosurgical care. METHODS A clinical complication registration database comprising a consecutive cohort of all pediatric neurosurgical procedures carried out in a general neurosurgical department from January 1, 2004, until July 1, 2012, was analyzed. During the study period, 1807 procedures were performed on patients below the age of 17 years. RESULTS Sixty-four intraoperative complications occurred in 62 patients (3.5% of procedures). Intraoperative mortality was 0.17% (n = 3). Seventy-eight percent of the complications (n = 50) were related to the neurosurgical procedures, whereas 22% (n = 14) were due to anesthesiology. The highest intraoperative complication rates were for cerebrovascular surgery (7.7%) and tumor surgery (7.4%). The most frequently occurring complications were cerebrovascular complications (33%). CONCLUSIONS Intraoperative complications are not exceptional during pediatric neurosurgical procedures. Awareness of these complications is the first step in preventing them.

  1. Intraoperative radiation therapy for malignant glioma

    Energy Technology Data Exchange (ETDEWEB)

    Sakai, Noboru; Yamada, Hiromu; Andoh, Takashi; Takada, Mitsuaki; Hirata, Toshifumi; Funakoshi, Takashi; Doi, Hidetaka; Yanagawa, Shigeo (Gifu Univ. (Japan). Faculty of Medicine)

    1989-04-01

    Intraoperative radiation therapy (IOR) is an ideal means of exterminating residual tumor after surgical resection. In this study, the clinical results of IOR using a Scanditronix Microtron MM-22 were evaluated in 14 patients with malignant glioma, five of whom had recurrent tumors. Between July, 1985 and October, 1986, 11 patients with glioblastoma multiforme (GB) were irradiated 18 times (mean, 1.6 times/case), and three with astrocytoma (Kernohan grade III) underwent IOR once each. The target-absorbed dose at 1 to 2 cm deeper than the tumor resection surface was 15 to 50 Gy. During irradiation, a cotton bolus was placed in the dead space after over 91% of the tumor had been resected. As a rule, external irradiation therapy was also given postoperatively at a dose of 30 to 52 Gy. One patient died of pneumonia and disseminated intravascular coagulation syndrome 1 month postoperatively. The 1- and 2-year survival rates of the ramaining 13 patients were 84.6% and 61.5%, respectively; among the 10 with GB, they were 80% and 50%. Generally, the smaller the tumor size, the better the results. There were no adverse effects, despite the dose 15 to 50 Gy applied temporally to the tumor bed. IOR was especially effective against small, localized tumors, but was not always beneficial in cases of large tumors, particularly those with a contralateral focus. The improved survival rate in this series demonstrates that IOR is significantly effective in the 'induction of remission' following surgical excision of malignant gliomas. (author).

  2. Evaluation of Intraoperative Radiotherapy for Gastric Carcinoma

    Institute of Scientific and Technical Information of China (English)

    Huanlong Qin; Chaohong Lin; Xiulong Zhang

    2005-01-01

    OBJECTIVE To study the proper sites and doses of intraoperative radiotherapy (IORT) for gastric carcinoma and the effects of this treatment.METHODS A total of 106 cases of stage Ⅰ- Ⅳ gastric carcinoma who received a D2 or D3 radical resection operation combined with IORT were analyzed. Sixty-seven patients with gastric cancer of the antrum and body received distal gastrectomy. The sites of irradiation were at the celiac artery and hepatoduodenal ligament area. Another 39 patients with carcinoma of the cardia and upper part of the gastric body and whole stomach received proximal gastrectomy or total gastrectomy. The sites of irradiation for this group were the upper margin of the pancreas and the regional paraaorta.The therapeutic effects (including survival and complications) of these 106cases who received a combined operation IORT (IORT group) were compared with 441 cases treated during the same time period by a radical resection operation alone (operation group).RESULTS The radiation dose below 30 Gy was safe. The therapeutic method of the operation combined with IORT did not prolong the survival time of patients with stage Ⅱ and Ⅳ gastric cancer, but the 5-year survival rates of patients with stage Ⅱ and Ⅲ gastric cancers were significantly improved.While the 5-year survival rates of the stage Ⅲ cancer patients receiving D2 resection combined with IORT had marked improvement, for those receiving a D3 radical resection, only the postoperative survival rates at 3 and 4 years of those cases in stages Ⅲ cancers were improved (P<0.005-0.001). The 5-year survival rate for those patients was raised only 4.7%(P>0.05).CONCLUSION The 5-year survival rates of patients with stages Ⅱ and Ⅲ gastric carcinoma who received a D2 lymphadenectomy combined with IORT were improved and had no influence on the postoperative complications and mortality.

  3. Orthovoltage intraoperative radiation therapy for pancreatic adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Kapp Daniel S

    2010-11-01

    Full Text Available Abstract Purpose To analyze the outcomes of patients from a single institution treated with surgery and orthovoltage intraoperative radiotherapy (IORT for pancreatic adenocarcinoma. Methods We retrospectively reviewed 23 consecutive patients from 1990-2001 treated with IORT to 23 discrete sites with median and mean follow up of 6.5 and 21 months, respectively. Most tumors were located in the head of the pancreas (83% and sites irradiated included: tumor bed (57%, vessels (26%, both the tumor bed/vessels (13% and other (4%. The majority of patients (83% had IORT at the time of their definitive surgery. Three patients had preoperative chemoradiation (13%. Orthovoltage X-rays (200-250 kVp were employed via individually sized and beveled cone applicators. Additional mean clinical characteristics include: age 64 (range 41-81; tumor size 4 cm (range 1.4-11; and IORT dose 1106 cGy (range 600-1500. Post-operative external beam radiation (EBRT or chemotherapy was given to 65% and 76% of the assessable patients, respectively. Outcomes measured were infield control (IFC, loco-regional control (LRC, distant metastasis free survival (DMFS, overall survival (OS and treatment-related complications. Results Kaplan-Meier (KM 2-year IFC, LRC, DMFS and OS probabilities for the whole group were 83%, 61%, 26%, and 27%, respectively. Our cohort had three grade 3-5 complications associated with treatment (surgery and IORT. Conclusions Orthovoltage IORT following tumor reductive surgery is reasonably well tolerated and seems to confer in-field control in carefully selected patients. However, distant metastases remain the major problem for patients with pancreatic adenocarcinoma.

  4. Automated intraoperative calibration for prostate cancer brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Kuiran Chen, Thomas; Heffter, Tamas; Lasso, Andras; Pinter, Csaba; Abolmaesumi, Purang; Burdette, E. Clif; Fichtinger, Gabor [Queen' s University, Kingston, Ontario K7L 3N6 (Canada); University of British Columbia, Vancouver, British Columbia V6T 1Z4 (Canada); Acoustic MedSystems, Inc., Champaign, Illinois 61820-3979 (United States); Queen' s University, Kingston, Ontario K7L 3N6 (Canada) and Johns Hopkins University, Baltimore, Maryland 21218-2682 (United States)

    2011-11-15

    Purpose: Prostate cancer brachytherapy relies on an accurate spatial registration between the implant needles and the TRUS image, called ''calibration''. The authors propose a new device and a fast, automatic method to calibrate the brachytherapy system in the operating room, with instant error feedback. Methods: A device was CAD-designed and precision-engineered, which mechanically couples a calibration phantom with an exact replica of the standard brachytherapy template. From real-time TRUS images acquired from the calibration device and processed by the calibration system, the coordinate transformation between the brachytherapy template and the TRUS images was computed automatically. The system instantly generated a report of the target reconstruction accuracy based on the current calibration outcome. Results: Four types of validation tests were conducted. First, 50 independent, real-time calibration trials yielded an average of 0.57 {+-} 0.13 mm line reconstruction error (LRE) relative to ground truth. Second, the averaged LRE was 0.37 {+-} 0.25 mm relative to ground truth in tests with six different commercial TRUS scanners operating at similar imaging settings. Furthermore, testing with five different commercial stepper systems yielded an average of 0.29 {+-} 0.16 mm LRE relative to ground truth. Finally, the system achieved an average of 0.56 {+-} 0.27 mm target registration error (TRE) relative to ground truth in needle insertion tests through the template in a water tank. Conclusions: The proposed automatic, intraoperative calibration system for prostate cancer brachytherapy has achieved high accuracy, precision, and robustness.

  5. Production of a Functional Frozen Yogurt Fortified with Bifidobacterium spp.

    Science.gov (United States)

    Abdelazez, Amro; Muhammad, Zafarullah; Zhang, Qiu-Xue; Zhu, Zong-Tao; Abdelmotaal, Heba; Sami, Rokayya; Meng, Xiang-Chen

    2017-01-01

    Frozen dairy products have characteristics of both yogurt and ice cream and could be the persuasive carriers of probiotics. Functions of the frozen yogurt containing viable bifidobacterial cells are recognized and favored by the people of all ages. We developed a kind of yogurt supplemented by Bifidobacterium species. Firstly, five strains of Bifidobacterium spp. (Bifidobacterium bifidum ATCC 11547, Bifidobacterium longum ATCC 11549, Bifidobacterium infantis ATCC 11551, Bifidobacterium adolescentis ATCC 11550, and Bifidobacterium breve ATCC 11548) were evaluated based on the feasibility criteria of probiotics, comprising acid production, bile tolerance, and adhesion to epithelial cells. Formerly, we combined the optimum strains with yogurt culture (Lactobacillus delbrueckii subsp. bulgaricus EMCC 11102 and Streptococcus salivarius subsp. thermophilus EMCC 11044) for producing frozen yogurt. Finally, physiochemical properties and sensory evaluation of the frozen yogurt were investigated during storage of 60 days at -18°C. Results directed that Bifidobacterium adolescentis ATCC 11550 and Bifidobacterium infantis ATCC 11551 could be utilized with yogurt culture for producing frozen yogurt. Moreover, the frozen yogurt fermented by two bifidobacterial strains and yogurt culture gained the high evaluation in the physiochemical properties and sensory evaluation. In summary, our results revealed that there was no significant difference between frozen yogurt fermented by Bifidobacterium spp. and yogurt culture and that fermented by yogurt culture only.

  6. Production of a Functional Frozen Yogurt Fortified with Bifidobacterium spp.

    Directory of Open Access Journals (Sweden)

    Amro Abdelazez

    2017-01-01

    Full Text Available Frozen dairy products have characteristics of both yogurt and ice cream and could be the persuasive carriers of probiotics. Functions of the frozen yogurt containing viable bifidobacterial cells are recognized and favored by the people of all ages. We developed a kind of yogurt supplemented by Bifidobacterium species. Firstly, five strains of Bifidobacterium spp. (Bifidobacterium bifidum ATCC 11547, Bifidobacterium longum ATCC 11549, Bifidobacterium infantis ATCC 11551, Bifidobacterium adolescentis ATCC 11550, and Bifidobacterium breve ATCC 11548 were evaluated based on the feasibility criteria of probiotics, comprising acid production, bile tolerance, and adhesion to epithelial cells. Formerly, we combined the optimum strains with yogurt culture (Lactobacillus delbrueckii subsp. bulgaricus EMCC 11102 and Streptococcus salivarius subsp. thermophilus EMCC 11044 for producing frozen yogurt. Finally, physiochemical properties and sensory evaluation of the frozen yogurt were investigated during storage of 60 days at −18°C. Results directed that Bifidobacterium adolescentis ATCC 11550 and Bifidobacterium infantis ATCC 11551 could be utilized with yogurt culture for producing frozen yogurt. Moreover, the frozen yogurt fermented by two bifidobacterial strains and yogurt culture gained the high evaluation in the physiochemical properties and sensory evaluation. In summary, our results revealed that there was no significant difference between frozen yogurt fermented by Bifidobacterium spp. and yogurt culture and that fermented by yogurt culture only.

  7. Frozen delivery of brushite calcium phosphate cements.

    Science.gov (United States)

    Grover, Liam M; Hofmann, Michael P; Gbureck, Uwe; Kumarasami, Balamurgan; Barralet, Jake E

    2008-11-01

    Calcium phosphate cements typically harden following the combination of a calcium phosphate powder component with an aqueous solution to form a matrix consisting of hydroxyapatite or brushite. The mixing process can be very important to the mechanical properties exhibited by cement materials and consequently when used clinically, since they are usually hand-mixed their mechanical properties are prone to operator-induced variability. It is possible to reduce this variability by pre-mixing the cement, e.g. by replacing the aqueous liquid component with non-reactive glycerol. Here, for the first time, we report the formation of three different pre-mixed brushite cement formulations formed by freezing the cement pastes following combination of the powder and liquid components. When frozen and stored at -80 degrees C or less, significant degradation in compression strength did not occur for the duration of the study (28 days). Interestingly, in the case of the brushite cement formed from the combination of beta-tricalcium phosphate with 2 M orthophosphoric acid solution, freezing the cement paste had the effect of increasing mean compressive strength fivefold (from 4 to 20 MPa). The increase in compression strength was accompanied by a reduction in the setting rate of the cement. As no differences in porosity or degree of reaction were observed, strength improvement was attributed to a modification of crystal morphology and a reduction in damage caused to the cement matrix during manipulation.

  8. Therapeutic surfactant-stripped frozen micelles

    Science.gov (United States)

    Zhang, Yumiao; Song, Wentao; Geng, Jumin; Chitgupi, Upendra; Unsal, Hande; Federizon, Jasmin; Rzayev, Javid; Sukumaran, Dinesh K.; Alexandridis, Paschalis; Lovell, Jonathan F.

    2016-05-01

    Injectable hydrophobic drugs are typically dissolved in surfactants and non-aqueous solvents which can induce negative side-effects. Alternatives like `top-down' fine milling of excipient-free injectable drug suspensions are not yet clinically viable and `bottom-up' self-assembled delivery systems usually substitute one solubilizing excipient for another, bringing new issues to consider. Here, we show that Pluronic (Poloxamer) block copolymers are amenable to low-temperature processing to strip away all free and loosely bound surfactant, leaving behind concentrated, kinetically frozen drug micelles containing minimal solubilizing excipient. This approach was validated for phylloquinone, cyclosporine, testosterone undecanoate, cabazitaxel and seven other bioactive molecules, achieving sizes between 45 and 160 nm and drug to solubilizer molar ratios 2-3 orders of magnitude higher than current formulations. Hypertonic saline or co-loaded cargo was found to prevent aggregation in some cases. Use of surfactant-stripped micelles avoided potential risks associated with other injectable formulations. Mechanistic insights are elucidated and therapeutic dose responses are demonstrated.

  9. Perioperative coagulation management--fresh frozen plasma.

    Science.gov (United States)

    Kor, Daryl J; Stubbs, James R; Gajic, Ognjen

    2010-03-01

    Clinical studies support the use of perioperative fresh frozen plasma (FFP) in patients who are actively bleeding with multiple coagulation factor deficiencies and for the prevention of dilutional coagulopathy in patients with major trauma and/or massive haemorrhage. In these settings, current FFP dosing recommendations may be inadequate. However, a substantial proportion of FFP is transfused in non-bleeding patients with mild elevations in coagulation screening tests. This practice is not supported by the literature, is unlikely to be of benefit and unnecessarily exposes patients to the risks of FFP. The role of FFP in reversing the effects of warfarin anticoagulation is dependent on the clinical context and availability of alternative agents. Although FFP is commonly transfused in patients with liver disease, this practice needs broad reconsideration. Adverse effects of FFP include febrile and allergic reactions, transfusion-associated circulatory overload and transfusion-related acute lung injury. The latter is the most serious complication, being less common with the preferential use of non-alloimmunised, male-donor predominant plasma. FP24 and thawed plasma are alternatives to FFP with similar indications for administration. Both provide an opportunity for increasing the safe plasma donor pool. Although prothrombin complex concentrates and factor VIIa may be used as alternatives to FFP in a variety of specific clinical contexts, additional study is needed.

  10. Storing natural gas as frozen hydrate

    Energy Technology Data Exchange (ETDEWEB)

    Gudmundsson, J.S.; Khokhar, A.A. (Univ. of Trondheim (Norway)); Parlaktuna, M. (Middle East Technical Univ., Ankara (Turkey))

    1994-02-01

    The formation of natural gas hydrates is a well-known problem in the petroleum and natural gas industries. Hydrates are solid materials that form when liquid water and natural gas are brought in contact under pressure. Hydrate formation need not be a problem. On the contrary, it can be an advantage. The volume of hydrates is much less than that of natural gas. At standard conditions, hydrates occupy 150 to 170 times less volume than the corresponding gas. Typically, natural gas hydrates contain 15% gas and 85% water by mass. It follows that hydrates can be used for large-scale storage of natural gas. Benesh proposed using hydrates to improve the load factor of natural gas supply systems. The author suggested that hydrates could be produced by bringing liquid water into contact with natural gas at the appropriate temperature and high pressure. The hydrate then would be stored at a temperature and pressure where it was stable. When gas was needed for the supply system, the hydrate would be melted at low pressure. The stability of a natural gas hydrate during storage at atmospheric pressure and below-freezing temperatures was studied in the laboratory. The gas hydrate was produced in a stirred vessel at 2- to 6-MPa pressure and temperatures from 0 to 20 C. The hydrate was refrigerated and stored in deep freezers at [minus]5, [minus]10, and [minus]18 C for up to 10 days. The natural gas hydrate remained stable when kept frozen at atmospheric pressure.

  11. A prospective comparison of molecular assay and touch imprint cytology for intraoperative evaluation of sentinel lymph nodes

    Institute of Scientific and Technical Information of China (English)

    CHEN Jia-jian; SHEN Zhen-zhou; WANG Yong-sheng; WU Jiong; YANG Ben-long; CHEN Jia-ying; ZHANG Jia-xin; LI Da-li; XU Wei-ping; XU Xiao-li; YANG Wen-tao; SHAO Zhi-min

    2011-01-01

    Background Accurate intraoperative diagnosis of sentinel lymph node (SLN) metastases enables the selection of patients for axillary lymph node dissections during the same operation, reducing the need for a second operation. The present study aimed to prospectively compare the GeneSearchTM Breast Lymph Node (BLN) Assay with touch imprint cytology (TIC) for intraoperative evaluation of SLNs.Methods SLNs were sectioned in 1.5-3.0 mm pieces. TIC was performed on all pieces and the BLN Assay and postoperative histology evaluations were performed on different alternating node pieces. Overall performance of the BLN Assay was compared with that of TIC relative to the postoperative histology results.Results A total of 90 patients enrolled in the study. Complete intraoperative data for both the BLN Assay and TIC were collected in 86 patients. The sensitivity, specificity, and overall accuracy of the BLN Assay were 82%, 97%, and 92%,respectively on a per patient basis compared with those of TIC which were 67%, 100%, and 90%.Conclusions Performance of the BLN Assay was superior to that of TIC and the additional application of TIC did not help improve the total sensitivity and accuracy of the intraoperative assessment. The existence of ectopic breast tissue might be a possible cause of false positive for the BLN assay. In addition, the BLN Assay complements histopathology assessment and can minimize sampling error without increasing pathologists' workload.

  12. The use of intraoperative computed tomography navigation in pituitary surgery promises a better intraoperative orientation in special cases

    Science.gov (United States)

    Linsler, Stefan; Antes, Sebastian; Senger, Sebastian; Oertel, Joachim

    2016-01-01

    Objective: The safety of endoscopic skull base surgery can be enhanced by accurate navigation in preoperative computed tomography (CT) and magnetic resonance imaging (MRI). Here, we report our initial experience of real-time intraoperative CT-guided navigation surgery for pituitary tumors in childhood. Materials and Methods: We report the case of a 15-year-old girl with a huge growth hormone-secreting pituitary adenoma with supra- and perisellar extension. Furthermore, the skull base was infiltrated. In this case, we performed an endonasal transsphenoidal approach for debulking the adenoma and for chiasma decompression. We used an MRI neuronavigation (Medtronic Stealth Air System) which was registered via intraoperative CT scan (Siemens CT Somatom). Preexisting MRI studies (navigation protocol) were fused with the intraoperative CT scans to enable three-dimensional navigation based on MR and CT imaging data. Intraoperatively, we did a further CT scan for resection control. Results: The intraoperative accuracy of the neuronavigation was excellent. There was an adjustment of <1 mm. The navigation was very helpful for orientation on the destroyed skull base in the sphenoid sinus. After opening the sellar region and tumor debulking, we did a CT scan for resection control because the extent of resection was not credible evaluable in this huge infiltrating adenoma. Thereby, we were able to demonstrate a sufficient decompression of the chiasma and complete resection of the medial part of the adenoma in the intraoperative CT images. Conclusions: The use of intraoperative CT/MRI-guided neuronavigation for transsphenoidal surgery is a time-effective, safe, and technically beneficial technique for special cases. PMID:27695249

  13. The use of intraoperative computed tomography navigation in pituitary surgery promises a better intraoperative orientation in special cases

    Directory of Open Access Journals (Sweden)

    Stefan Linsler

    2016-01-01

    Full Text Available Objective: The safety of endoscopic skull base surgery can be enhanced by accurate navigation in preoperative computed tomography (CT and magnetic resonance imaging (MRI. Here, we report our initial experience of real-time intraoperative CT-guided navigation surgery for pituitary tumors in childhood. Materials and Methods: We report the case of a 15-year-old girl with a huge growth hormone-secreting pituitary adenoma with supra- and perisellar extension. Furthermore, the skull base was infiltrated. In this case, we performed an endonasal transsphenoidal approach for debulking the adenoma and for chiasma decompression. We used an MRI neuronavigation (Medtronic Stealth Air System which was registered via intraoperative CT scan (Siemens CT Somatom. Preexisting MRI studies (navigation protocol were fused with the intraoperative CT scans to enable three-dimensional navigation based on MR and CT imaging data. Intraoperatively, we did a further CT scan for resection control. Results: The intraoperative accuracy of the neuronavigation was excellent. There was an adjustment of <1 mm. The navigation was very helpful for orientation on the destroyed skull base in the sphenoid sinus. After opening the sellar region and tumor debulking, we did a CT scan for resection control because the extent of resection was not credible evaluable in this huge infiltrating adenoma. Thereby, we were able to demonstrate a sufficient decompression of the chiasma and complete resection of the medial part of the adenoma in the intraoperative CT images. Conclusions: The use of intraoperative CT/MRI-guided neuronavigation for transsphenoidal surgery is a time-effective, safe, and technically beneficial technique for special cases.

  14. Intraoperative fluoroscopic dose assessment in prostate brachytherapy patients.

    Science.gov (United States)

    Reed, Daniel R; Wallner, Kent E; Narayanan, Sreeram; Sutlief, Steve G; Ford, Eric C; Cho, Paul S

    2005-09-01

    To evaluate a fluoroscopy-based intraoperative dosimetry system to guide placement of additional sources to underdosed areas, and perform computed tomography (CT) verification. Twenty-six patients with prostate carcinoma treated with either I-125 or Pd-103 brachytherapy at the Puget Sound VA using intraoperative postimplant dosimetry were analyzed. Implants were performed by standard techniques. After completion of the initial planned brachytherapy procedure, the initial fluoroscopic intraoperative dose reconstruction analysis (I-FL) was performed with three fluoroscopic images acquired at 0 (AP), +15, and -15 degrees. Automatic seed identification was performed and the three-dimensional (3D) seed coordinates were computed and imported into VariSeed for dose visualization. Based on a 3D assessment of the isodose patterns additional seeds were implanted, and the final fluoroscopic intraoperative dose reconstruction was performed (FL). A postimplant computed tomography (CT) scan was obtained after the procedure and dosimetric parameters and isodose patterns were analyzed and compared. An average of 4.7 additional seeds were implanted after intraoperative analysis of the dose coverage (I-FL), and a median of 5 seeds. After implantation of additional seeds the mean V100 increased from 89% (I-FL) to 92% (FL) (p sources to supplement inadequately dosed areas within the prostate gland. Additionally, guided implantation of additional source, can significantly improve V100s and D90s, without significantly increasing rectal doses.

  15. Intraoperative Development of Tension Pneumocephalus in a ...

    African Journals Online (AJOL)

    follow-up magnetic resonance imaging, he was found ... his symptoms and uneventful recovery. ... Figure 1: Sagittal (a) and axial (b) sections of computed tomography scan .... pneumocephalus after thoracic spinal cord surgery: A case report.

  16. Effect of frozen period on the chemical, microbiological and sensory ...

    African Journals Online (AJOL)

    JOHN

    Key words: Frozen period, chemical, microbiological, sensory quality, tilapia fish. ... rate of loss of quality and shelf life of fish (Whittle, 1997). ... Proximate composition (dry weight basis) of Nile Tilapia (Sarotherudun galiaenus) subjected to ...

  17. Evaluating model of frozen soil environment change under engineering actions

    Institute of Scientific and Technical Information of China (English)

    WU; Qingbai(吴青柏); ZHU; Yuanlin(朱元林); LIU; Yongzhi(刘永智)

    2002-01-01

    The change of frozen soil environment is evaluated by permafrost thermal stability, thermal thaw sensibility and surface landscape stability and the quantitatively evaluating model of frozen soil environment is proposed in this paper. The evaluating model of frozen soil environment is calculated by 28 ground temperature measurements along Qinghai-Xizang Highway. The relationships of thermal thaw sensibility and freezing and thawing processes and seasonally thawing depth, thermal stability and permafrost table temperature, mean annual ground temperature and seasonally thawing depth, and surface landscape stability and freezing and thawing hazards and their forming possibility are analyzed. The results show that thermal stability, thermal thaw sensibility and surface landscape stability can be used to evaluate and predict the change of frozen soil environment under human engineering action.

  18. A frozen spin polarized target for S134

    CERN Multimedia

    1974-01-01

    The CERN-ETH, Zurich-Helsinki-Imperial College-Southampton Collaboration used a frozen spin polarized target together with the ETH spectrometer magnet to study spin effects (S134). Beam was d31 in South Hall

  19. Exploring the outcomes in studies of primary frozen shoulder

    DEFF Research Database (Denmark)

    Rodgers, Sara; Brealey, Stephen; Jefferson, Laura

    2014-01-01

    PURPOSE: In our study we explored the need to define a core outcome set for primary frozen shoulder. METHODS: We investigated the outcomes used by studies included in a systematic review of the management of primary frozen shoulder; surveyed which primary outcome measures health care professionals...... considered important; and re-examined papers previously obtained for a systematic review of patients' views of interventions for frozen shoulder to investigate their views on outcomes. RESULTS: Thirty-one studies investigated the outcomes range of movement (28 studies), pain (22), function and disability (22...... in modification of activities) and the emotional impact of frozen shoulder. CONCLUSIONS: We identified a diverse range of outcomes that have been used or are considered to be important. The development of a core outcome set would improve the design and reporting of studies and availability of data for evidence...

  20. Revealing the mechanisms and significance of frozen soil infiltration

    Science.gov (United States)

    Stähli, Manfred; Hayashi, Masaki

    2015-04-01

    Frozen soil is one of the most characteristic features of Nordic hydrology. Depending on climate, snow cover and soil properties it can slow down or even inhibit the water's journey from the soil surface to the stream, or it can speed up the journey by generating overland flow. When Harald Grip's and Allan Rhode's book came out in the mid-eighties, state-of-the-art knowledge on frozen soil hydrology was based on numerous cold-chamber experiments and only few field measurements, especially from Alaska. It was already then recognized that frozen soil is not impermeable per se, but its permeability depends on the amount and connectivity of air-filled pores, which in turn depends on ice content. How has our understanding of frozen soil hydrology further developed since then? One important innovation was the application of dye tracers to frozen field plots and soil columns uncovering the flow paths of infiltrating water. A second crucial advance was the development of numerical models to calculate water transfer from the snow cover into soil profiles. These models made researchers aware of the high sensitivity of frozen soil infiltration to boundary conditions (e.g. depth to groundwater) and winter history (e.g. evolution of snow cover, number of mid-winter melt events). A further important insight was that local effects of frozen ground on water flow may vanish at the scale of catchments due to the highly variable topography, vegetation and soil of a landscape. Nevertheless, studies showing the impact of frozen soil on large scale ground-water recharge or stream runoff are still scarce. A recent analysis of long-term runoff data from Switzerland sheds new light on the response of small catchments to frozen ground. Finally, it can be concluded that the Nordic lessons on frozen soil hydrology have been noted by the worldwide research community and are receiving increased attention in the context of climate change and its impacts on seasonally and permanently frozen soil.

  1. Biochemical effects on long-term frozen human costal cartilage

    Energy Technology Data Exchange (ETDEWEB)

    Santin, Stefany P.; Martinho Junior, Antonio C.; Yoshito, Daniele; Soares, Fernando A.N.; Mathor, Monica B., E-mail: mathor@ipen.b [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2011-07-01

    Currently, the progresses on treatment of musculoskeletal diseases with the evolving of artificial implants and the success of tissue transplantation between genetically different individuals have conducted to an increase in radiosterilization. Regarding to tissue transplantation, it is essential to have sterile tissue and many tissue banks use radiosterilization as an effective method to sterilize these tissues. However, high doses of ionizing radiation and the preservation method may induce structural modifications in the tissues, as degradation of structural scaffold, decreasing its mechanical properties. Particularly, cartilage have been preserved in high concentrations of glycerol or deep-frozen at -70 degree C for storage after radiosterilization. Therefore, it is important to study the modifications induced in cartilage by preservation methods and by radiosterilization to determine the appropriated parameters for high quality of human allografts. Costal cartilages were obtained from cadaveric donors and were frozen at -20 degree C for 2 years long in order to compare with previous studies for fresh, deep-frozen and glycerolised cartilages. The mechanical tests were carried out in a universal testing machine until sample failure. According our results, there is no significant statistical difference between stress at break of fresh, long-term - 20 degree C frozen cartilages and deep-frozen cartilage. This early result suggests, regarding to tensile property, that long-term - 20 degree C frozen cartilages corresponds to glycerolised costal cartilages irradiated with 25 kGy or deep-frozen cartilages irradiated with 25 and 50 kGy. Thus, this long-term frozen cartilages may be used for tissue banks, but more studies about effects of ionizing radiation are necessary. (author)

  2. A retrospective study of single frozen-thawed blastocyst transfer.

    Science.gov (United States)

    Hur, Yong Soo; Ryu, Eun Kyung; Song, Seung Hyun; Yoon, San Hyun; Lim, Kyung Sil; Lee, Won Don; Lim, Jin Ho

    2016-06-01

    To study the clinical outcomes of single frozen-thawed blastocyst transfer cycles according to the hatching status of frozen-thawed blastocysts. Frozen-thawed blastocysts were divided into three groups according to their hatching status as follows: less-than-expanded blastocyst (≤EdB), hatching blastocyst (HgB), and hatched blastocyst (HdB). The female age and infertility factors of each group were evaluated. The quality of the single frozen-thawed blastocyst was also graded as grade A, tightly packed inner cell mass (ICM) and many cells organized in the trophectoderm epithelium (TE); grade B, several and loose ICM and TE; and grade C, very few ICM and a few cells in the TE. The clinical pregnancy and implantation rate were compared between each group. The data were analyzed by either t-test or chi-square analysis. There were no statistically significant differences in average female ages, infertility factors, or the distribution of blastocyst grades A, B, and C in each group. There was no significant difference in the clinical pregnancy and implantation rate of each group according to their blastocyst grade. However, there was a significant difference in the clinical pregnancy and implantation rate between each group. In the HdB group, the clinical pregnancy and implantation rate were similar regardless of the blastocyst quality. There was an effect on the clinical outcomes depending on whether the blastocyst hatched during single frozen-thawed blastocyst transfer. When performing single frozen-thawed blastocyst transfer, the hatching status of the frozen-thawed blastocyst may be a more important parameter for clinical outcomes than the quality of the frozen-thawed blastocyst.

  3. Research Progress on Technique of Frozen Embryo Transfer in Sheep

    Institute of Scientific and Technical Information of China (English)

    SHE Qiu-sheng; HU Jian-ye; LOU Peng-yan; TAO Jing; XIE Zhao-hui

    2011-01-01

    The paper introduced the research progress on the technique of frozen embryo transfer in sheep, illustrated selection of donors and receptors, superovulation, synchronization of estrus, embryo cryopreservation and embryo transplantation. Frozen embryo transfer in sheep is another breakthrough in the high-quality sheep raising, and this technique in China is in its infancy recommendation stage, but it will be comprehensively popularized in the future.

  4. Elemental distribution and sample integrity comparison of freeze-dried and frozen-hydrated biological tissue samples with nuclear microprobe

    Energy Technology Data Exchange (ETDEWEB)

    Vavpetič, P., E-mail: primoz.vavpetic@ijs.si [Jožef Stefan Institute, Jamova 39, SI-1000 Ljubljana (Slovenia); Vogel-Mikuš, K. [Biotechnical Faculty, Department of Biology, University of Ljubljana, Jamnikarjeva 101, SI-1000 Ljubljana (Slovenia); Jeromel, L. [Jožef Stefan Institute, Jamova 39, SI-1000 Ljubljana (Slovenia); Ogrinc Potočnik, N. [Jožef Stefan Institute, Jamova 39, SI-1000 Ljubljana (Slovenia); FOM-Institute AMOLF, Science Park 104, 1098 XG Amsterdam (Netherlands); Pongrac, P. [Biotechnical Faculty, Department of Biology, University of Ljubljana, Jamnikarjeva 101, SI-1000 Ljubljana (Slovenia); Department of Plant Physiology, University of Bayreuth, Universitätstr. 30, 95447 Bayreuth (Germany); Drobne, D.; Pipan Tkalec, Ž.; Novak, S.; Kos, M.; Koren, Š.; Regvar, M. [Biotechnical Faculty, Department of Biology, University of Ljubljana, Jamnikarjeva 101, SI-1000 Ljubljana (Slovenia); Pelicon, P. [Jožef Stefan Institute, Jamova 39, SI-1000 Ljubljana (Slovenia)

    2015-04-01

    The analysis of biological samples in frozen-hydrated state with micro-PIXE technique at Jožef Stefan Institute (JSI) nuclear microprobe has matured to a point that enables us to measure and examine frozen tissue samples routinely as a standard research method. Cryotome-cut slice of frozen-hydrated biological sample is mounted between two thin foils and positioned on the sample holder. The temperature of the cold stage in the measuring chamber is kept below 130 K throughout the insertion of the samples and the proton beam exposure. Matrix composition of frozen-hydrated tissue is consisted mostly of ice. Sample deterioration during proton beam exposure is monitored during the experiment, as both Elastic Backscattering Spectrometry (EBS) and Scanning Transmission Ion Microscopy (STIM) in on–off axis geometry are recorded together with the events in two PIXE detectors and backscattered ions from the chopper in a single list-mode file. The aim of this experiment was to determine differences and similarities between two kinds of biological sample preparation techniques for micro-PIXE analysis, namely freeze-drying and frozen-hydrated sample preparation in order to evaluate the improvements in the elemental localisation of the latter technique if any. In the presented work, a standard micro-PIXE configuration for tissue mapping at JSI was used with five detection systems operating in parallel, with proton beam cross section of 1.0 × 1.0 μm{sup 2} and a beam current of 100 pA. The comparison of the resulting elemental distributions measured at the biological tissue prepared in the frozen-hydrated and in the freeze-dried state revealed differences in elemental distribution of particular elements at the cellular level due to the morphology alteration in particular tissue compartments induced either by water removal in the lyophilisation process or by unsatisfactory preparation of samples for cutting and mounting during the shock-freezing phase of sample preparation.

  5. Elemental distribution and sample integrity comparison of freeze-dried and frozen-hydrated biological tissue samples with nuclear microprobe

    Science.gov (United States)

    Vavpetič, P.; Vogel-Mikuš, K.; Jeromel, L.; Ogrinc Potočnik, N.; Pongrac, P.; Drobne, D.; Pipan Tkalec, Ž.; Novak, S.; Kos, M.; Koren, Š.; Regvar, M.; Pelicon, P.

    2015-04-01

    The analysis of biological samples in frozen-hydrated state with micro-PIXE technique at Jožef Stefan Institute (JSI) nuclear microprobe has matured to a point that enables us to measure and examine frozen tissue samples routinely as a standard research method. Cryotome-cut slice of frozen-hydrated biological sample is mounted between two thin foils and positioned on the sample holder. The temperature of the cold stage in the measuring chamber is kept below 130 K throughout the insertion of the samples and the proton beam exposure. Matrix composition of frozen-hydrated tissue is consisted mostly of ice. Sample deterioration during proton beam exposure is monitored during the experiment, as both Elastic Backscattering Spectrometry (EBS) and Scanning Transmission Ion Microscopy (STIM) in on-off axis geometry are recorded together with the events in two PIXE detectors and backscattered ions from the chopper in a single list-mode file. The aim of this experiment was to determine differences and similarities between two kinds of biological sample preparation techniques for micro-PIXE analysis, namely freeze-drying and frozen-hydrated sample preparation in order to evaluate the improvements in the elemental localisation of the latter technique if any. In the presented work, a standard micro-PIXE configuration for tissue mapping at JSI was used with five detection systems operating in parallel, with proton beam cross section of 1.0 × 1.0 μm2 and a beam current of 100 pA. The comparison of the resulting elemental distributions measured at the biological tissue prepared in the frozen-hydrated and in the freeze-dried state revealed differences in elemental distribution of particular elements at the cellular level due to the morphology alteration in particular tissue compartments induced either by water removal in the lyophilisation process or by unsatisfactory preparation of samples for cutting and mounting during the shock-freezing phase of sample preparation.

  6. Factors Associated with Pain, Disability and Quality of Life in Patients Suffering from Frozen Shoulder

    Directory of Open Access Journals (Sweden)

    Farshid Bagheri

    2016-07-01

    Full Text Available Background: Frozen shoulder is resulting in limb disability and reduction of quality of life but the factors associated with patients’ disability and quality of life is not clear. To assess pain, disability, the quality of life and factors associated with them in patients suffering from frozen shoulder.  Methods: We enrolled 120 patients (37 men and 83 women with phase-II idiopathic frozen shoulder in our cross-sectional study. Demographic data were collected and shoulder range of motion was measured in four different directions (elevation, abduction, external and internal rotation in both upper limbs. Patients were asked to fill out Visual Analog Scale for pain (VAS and, Short-Form Health Survey questionnaire (SF-36 as well as Disabilities of the Arm, Shoulder and Hand (DASH questionnaires. We asked the patients to fill out the Hamilton anxiety and depression questionnaires. Results: The mean of VAS pain, DASH, PCS, and MCS scores were 69(18, 53(17, 35(8.0, and 42(10 respectively. All the domains of SF36 questionnaires where below the normal population except physical function. VAS pain score was correlated to Hamilton depression scores in both bivariate and mulivarilable analysis. DASH score were correlated to sex, age, ROM, and both Hamilton anxiety and depression scores; However, DASH score only impact with Hamilton anxiety and ROM independently. PCS is correlated to age and MCS to Hamilton depression. Conclusion: Patient with frozen shoulder are more suffering from pain and disability secondary to psychiatric parameters such as depression and anxiety than demographic features or even restriction of range of motion.

  7. Evidence for indications of fresh frozen plasma.

    Science.gov (United States)

    Stanworth, S J; Hyde, C J; Murphy, M F

    2007-12-01

    There continues to be a general but unfounded enthusiasm for fresh frozen plasma (FFP) usage across a range of clinical specialties in hospital practice. Clinical use of plasma has grown steadily over the last two decades in many countries. In England and Wales, there has not been a significant reduction in the use of FFP over the last few years, unlike red cells. There is also evidence of variation in usage among countries--use in England and Wales may be proportionately less per patient than current levels of usage in other European countries and the United States. Plasma for transfusion is most often used where there is abnormal coagulation screening tests, either therapeutically in the face of bleeding, or prophylactically in non-bleeding subjects prior to invasive procedures or surgery. Little evidence exists to inform best therapeutic plasma transfusion practice. Most studies have described plasma use in a prophylactic setting, in which laboratory abnormalities of coagulation tests are considered a predictive risk factor for bleeding prior to invasive procedures. The strongest randomised controlled trial (RCT) evidence indicates that prophylactic plasma for transfusion is not effective across a range of different clinical settings and this is supported by data from non-randomised studies in patients with mild to moderate abnormalities in coagulation tests. There are also uncertainties whether plasma consistently improves the laboratory results for patients with mild to moderate abnormalities in coagulation tests. There is a need to undertake new trials evaluating the efficacy and adverse effects of plasma, both in bleeding and non-bleeding patients, to understand whether the "presumed" benefits outweigh the "real risks". In addition, new haemostatic tests should be validated which better define risk of bleeding.

  8. [Intraoperative monitoring of oxygen tissue pressure: Applications in vascular neurosurgery].

    Science.gov (United States)

    Arikan, Fuat; Vilalta, Jordi; Torne, Ramon; Chocron, Ivette; Rodriguez-Tesouro, Ana; Sahuquillo, Juan

    2014-01-01

    Ischemic lesions related to surgical procedures are a major cause of postoperative morbidity in patients with cerebral vascular disease. There are different systems of neuromonitoring to detect intraoperative ischemic events, including intraoperative monitoring of oxygen tissue pressure (PtiO2). The aim of this article was to describe, through the discussion of 4 cases, the usefulness of intraoperative PtiO2 monitoring during vascular neurosurgery. In presenting these cases, we demonstrate that monitoring PtiO2 is a reliable way to detect early ischemic events during surgical procedures. Continuous monitoring of PtiO2 in an area at risk allows the surgeon to resolve the cause of the ischemic event before it evolves to an established cerebral infarction. Copyright © 2014 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

  9. Intra-operative neurophysiology during microvascular decompression for hemifacial spasm.

    Science.gov (United States)

    Fernández-Conejero, I; Ulkatan, S; Sen, C; Deletis, V

    2012-01-01

    There is evidence that primary hemifacial spasm (HFS) in the majority of patients is related to a vascular compression of the facial nerve at its root exit zone (REZ). As a consequence, the hyperexcitability of facial nerve generates spasms of the facial muscles. Microvascular decompression (MVD) of the facial nerve near its REZ has been established as an effective treatment of HFS. Intra-operative disappearance of abnormal muscle responses (lateral spread) elicited by stimulating one of the facial nerve branches has been used as a method to predict MVD effectiveness. Other neurophysiologic techniques, such as facial F-wave, blink reflex and facial corticobulbar motor evoked potentials (FCoMEP), are feasible to intra-operatively study changes in excitability of the facial nerve and its nucleus during MVDs. Intra-operative neuromonitoring with the mentioned techniques allows a better understanding of HFS pathophysiology and helps to optimise the MVD.

  10. Anaesthesia management in epilepsy surgery with intraoperative electrocorticography.

    Science.gov (United States)

    Pacreu, S; Vilà, E; Moltó, L; Bande, D; Rueda, M; Fernández Candil, J L

    2017-09-27

    Epilepsy surgery is a well-established treatment for patients with drug-resistant epilepsy. The success of surgery depends on precise presurgical localisation of the epileptogenic zone. There are different techniques to determine its location and extension. Despite the improvements in non-invasive diagnostic tests, in patients for whom these tests are inconclusive, invasive techniques such intraoperative electrocorticography will be needed. Intraoperative electrocorticography is used to guide surgical resection of the epileptogenic lesion and to verify that the resection has been completed. However, it can be affected by some of the anaesthetic drugs used by the anaesthesiologist. Our objective with this case is to review which drugs can be used in epilepsy surgery with intraoperative electrocorticography. Copyright © 2017 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. Intraoperative prediction of compensatory sweating for thoracic sympathectomy.

    Science.gov (United States)

    Fujita, Takeo; Mano, Masayuki; Nishi, Hideyuki; Shimizu, Nobuyoshi

    2005-09-01

    Postoperative compensatory sweating (PCS) is an important problem impacting on quality of life for patients after endoscopic thoracic sympathectomy (ETS). The present study investigated whether intraoperative palmar temperature and blood flow are useful for assessing PCS after ETS. Retrospectively, results were evaluated for ETS in 27 consecutive patients with primary palmar hyperhidrosis between 1996 and 2002. For all patients, bilateral nerve conduction to the palms was interrupted. The relationship between the range of PCS and intraoperative changes in palmar temperature and blood flow was investigated. PCS developed in all cases. After completion of ETS, mean blood flow and temperature increased respectively. Significant correlations were found between the range of PCS and increases in palmar temperature (p<0.05) and blood flow (p<0.05). Intraoperative monitoring of increases in palmar temperature and blood flow may be useful in patients with primary hyperhidrosis, to predict the range of PCS after ETS.

  12. Robust endoscopic pose estimation for intraoperative organ-mosaicking

    Science.gov (United States)

    Reichard, Daniel; Bodenstedt, Sebastian; Suwelack, Stefan; Wagner, Martin; Kenngott, Hannes; Müller-Stich, Beat Peter; Dillmann, Rüdiger; Speidel, Stefanie

    2016-03-01

    The number of minimally invasive procedures is growing every year. These procedures are highly complex and very demanding for the surgeons. It is therefore important to provide intraoperative assistance to alleviate these difficulties. For most computer-assistance systems, like visualizing target structures with augmented reality, a registration step is required to map preoperative data (e.g. CT images) to the ongoing intraoperative scene. Without additional hardware, the (stereo-) endoscope is the prime intraoperative data source and with it, stereo reconstruction methods can be used to obtain 3D models from target structures. To link reconstructed parts from different frames (mosaicking), the endoscope movement has to be known. In this paper, we present a camera tracking method that uses dense depth and feature registration which are combined with a Kalman Filter scheme. It provides a robust position estimation that shows promising results in ex vivo and in silico experiments.

  13. Factors influencing intraoperative blood loss in orthognathic surgery.

    Science.gov (United States)

    Thastum, M; Andersen, K; Rude, K; Nørholt, S E; Blomlöf, J

    2016-09-01

    This retrospective study aimed to identify factors of importance for intraoperative blood loss relative to total blood volume in patients undergoing orthognathic surgery. The study included 356 patients treated consecutively at a Danish university hospital between 1 January 2010 and 31 December 2012. Inclusion criteria were (1) patient age ≥18 years and (2) patient undergoing a three-piece Le Fort I osteotomy, a bilateral sagittal split osteotomy, or a combination of the two. The patient-specific relative blood loss was calculated as a percentage by dividing the intraoperative blood loss by the estimated preoperative total blood volume, and then correlated with body mass index (BMI), age, sex, operating time, and treatment modality in a multivariate stepwise regression analysis. Operating time (Psurgery, a prolonged operating time, and reduced BMI significantly increase the intraoperative relative blood loss in patients undergoing orthognathic surgery.

  14. Navigation, robotics, and intraoperative imaging in spinal surgery.

    Science.gov (United States)

    Ringel, Florian; Villard, Jimmy; Ryang, Yu-Mi; Meyer, Bernhard

    2014-01-01

    Spinal navigation is a technique gaining increasing popularity. Different approaches as CT-based or intraoperative imaging-based navigation are available, requiring different methods of patient registration, bearing certain advantages and disadvantages. So far, a large number of studies assessed the accuracy of pedicle screw implantation in the cervical, thoracic, and lumbar spine, elucidating the advantages of image guidance. However, a clear proof of patient benefit is missing, so far. Spinal navigation is closely related to intraoperative 3D imaging providing an imaging dataset for navigational use and the opportunity for immediate intraoperative assessment of final screw position giving the option of immediate screw revision if necessary. Thus, postoperative imaging and a potential revision surgery for screw correction become dispensable.Different concept of spinal robotics as the DaVinci system and SpineAssist are under investigation.

  15. Intraoperative ultrasonography for presumed brain metastases: a case series study

    Directory of Open Access Journals (Sweden)

    Helder Picarelli

    2012-10-01

    Full Text Available Brain metastases (BM are one of the most common intracranial tumors and surgical treatment can improve both the functional outcomes and patient survival, particularly when systemic disease is controlled. Image-guided BM resection using intraoperative exams, such as intraoperative ultrasound (IOUS, can lead to better surgical results. METHODS: To evaluate the use of IOUS for BM resection, 20 consecutives patients were operated using IOUS to locate tumors, identify their anatomical relationships and surgical cavity after resection. Technical difficulties, complications, recurrence and survival rates were noted. RESULTS: IOUS proved effective for locating, determining borders and defining the anatomical relationships of BM, as well as to identify incomplete tumor resection. No complications related to IOUS were seen. CONCLUSION: IOUS is a practical supporting method for the resection of BM, but further studies comparing this method with other intraoperative exams are needed to evaluate its actual contribution and reliability.

  16. 78 FR 15686 - Certain Frozen Warmwater Shrimp From Thailand: Preliminary Results of Antidumping Duty...

    Science.gov (United States)

    2013-03-12

    ... Transport), Grobest Frozen Foods Co. (Grobest), Ltd., Lucky Union Foods Co., Ltd. (Lucky Union), Namprick..., the Department received no shipment certifications from two additional companies, C Y Frozen Food Co., Ltd. (C Y Frozen Food) and Kosamut Frozen Foods Co., Ltd. (Kosamut). We preliminarily find that...

  17. 76 FR 31575 - United States Standards for Grades of Frozen Onions

    Science.gov (United States)

    2011-06-01

    ... from American Frozen Food Institute (AFFI), requesting the development of new standards for frozen... Agricultural Marketing Service United States Standards for Grades of Frozen Onions AGENCY: Agricultural... United States Standards for Grades of Frozen Onions. USDA has received additional industry comments...

  18. The use of intraoperative computed tomography navigation in pituitary surgery promises a better intraoperative orientation in special cases.

    Science.gov (United States)

    Linsler, Stefan; Antes, Sebastian; Senger, Sebastian; Oertel, Joachim

    2016-01-01

    The safety of endoscopic skull base surgery can be enhanced by accurate navigation in preoperative computed tomography (CT) and magnetic resonance imaging (MRI). Here, we report our initial experience of real-time intraoperative CT-guided navigation surgery for pituitary tumors in childhood. We report the case of a 15-year-old girl with a huge growth hormone-secreting pituitary adenoma with supra- and perisellar extension. Furthermore, the skull base was infiltrated. In this case, we performed an endonasal transsphenoidal approach for debulking the adenoma and for chiasma decompression. We used an MRI neuronavigation (Medtronic Stealth Air System) which was registered via intraoperative CT scan (Siemens CT Somatom). Preexisting MRI studies (navigation protocol) were fused with the intraoperative CT scans to enable three-dimensional navigation based on MR and CT imaging data. Intraoperatively, we did a further CT scan for resection control. The intraoperative accuracy of the neuronavigation was excellent. There was an adjustment of neuronavigation for transsphenoidal surgery is a time-effective, safe, and technically beneficial technique for special cases.

  19. COMPARISON OF PREOPERATIVE NONINVASIVE AND INTRAOPERATIVE MEASUREMENTS OF AORTIC ANNULUS

    Directory of Open Access Journals (Sweden)

    Manish Hinduja

    2016-10-01

    Full Text Available BACKGROUND Precise preoperative assessment of aortic annulus diameter is essential for sizing of aortic valve especially in patients planned for transcatheter aortic valve replacement. Computed Tomographic (CT and echocardiographic measurements of the aortic annulus vary because of elliptical shape of aortic annulus. This study was undertaken to compare the measurement of aortic annulus intraoperatively with preoperative noninvasive methods in patients undergoing aortic valve replacement. MATERIALS AND METHODS Aortic annulus diameter was measured with cardiac CT and Transesophageal Echocardiography (TEE prior to open aortic valve replacement in 30 patients with aortic valve stenosis. In CT, aortic annulus dimensions were measured in coronal plane, sagittal oblique plane and by planimetry. Both 2-dimensional and 3-dimensional TEE were used. These were compared with intraoperative measurements done by valve sizers and Hegar dilators. Pearson analysis was applied to test for degree of correlation. RESULTS CT in coronal and sagittal oblique plane tends to overestimate the diameter of aortic annulus when compared with intraoperative measurements (coefficient of relation, r = 0.798 and 0.749, respectively. CT measurements in single oblique plane showed a weaker correlation with intraoperative measurements than 3D TEE and 2D TEE (r = 0.917 and 0.898, respectively. However, CT measurements by planimetry method were most correlating with the intraoperative measurements (r = 0.951. CONCLUSION Noninvasive investigations with 3-dimensional views (CT-based measurement employing calculated average diameter assessment by planimetry and 3-dimensional TEE showed better correlation with intraoperative measurement of aortic annulus. CT-based aortic annulus measurement by planimetry seems to provide adequate dimensions most similar to operative measurements.

  20. Intraoperative Hypothermia During Surgical Fixation of Hip Fractures.

    Science.gov (United States)

    Frisch, Nicholas B; Pepper, Andrew M; Jildeh, Toufic R; Shaw, Jonathan; Guthrie, Trent; Silverton, Craig

    2016-11-01

    Hip fractures are common orthopedic injuries and are associated with significant morbidity/mortality. Intraoperative normothermia is recommended by national guidelines to minimize additional morbidity/mortality, but limited evidence exists regarding hypothermia's effect on orthopedic patients. The purpose of this study was to determine the incidence of intraoperative hypothermia in patients with operatively treated hip fractures and evaluate its effect on complications and outcomes. Retrospective chart review was performed on clinical records from 1541 consecutive patients who sustained a hip fracture and underwent operative fixation at the authors' institution between January 2005 and October 2013. A total of 1525 patients were included for analysis, excluding those with injuries requiring additional surgical intervention. Patient demographic data, surgery-specific data, postoperative complications, length of stay, and 30-day readmission were recorded. Patients with a mean intraoperative temperature less than 36°C were identified as hypothermic. Statistical analysis with univariate and multivariate logistic regression modeling evaluated associations with hypothermia and effect on complications/outcomes. The incidence of intraoperative hypothermia in operatively treated hip fractures was 17.0%. Hypothermia was associated with an increase in the rate of deep surgical-site infection (odds ratio, 3.30; 95% confidence interval, 1.19-9.14; P=.022). Lower body mass index and increasing age demonstrated increased association with hypothermia (P=.004 and P=.005, respectively). To the authors' knowledge, this is the first and largest study analyzing the effect of intraoperative hypothermia in orthopedic patients. In patients with hip fractures, the study's findings confirm evidence found in other surgical specialties that hypothermia may be associated with an increased risk of deep surgical-site infection and that lower body mass index and increasing age are risk factors

  1. Effectiveness of timely intraoperative iodine irrigation during cataract surgery.

    Science.gov (United States)

    Matsuura, Kazuki; Miyazaki, Dai; Sasaki, Shin-Ichi; Yakura, Keiko; Inoue, Yoshitsugu; Sakamoto, Masako

    2016-11-01

    To determine the antiseptic efficacy of timely intraoperative iodine irrigation during cataract surgery. A total of 198 eyes of 99 cataract surgery patients were studied. The eyes were randomly assigned to treatment with or without timely intraoperative iodine irrigation of the surgical field with an iodine compound equivalent to 0.33 % povidone-iodine. In eyes in the timely intraoperative iodine irrigation group, the ocular surface was irrigated twice intraoperatively-before the initial incision and before insertion of the intraocular lens (IOL). The efficacy of the antiseptic treatment was evaluated by culture tests using scrapings of the surface of the sclerocornea and conjunctiva to the left of the incision and by broad-range real-time PCR for bacterial 16S ribosomal DNA using scrapings from the right side of the incision. Following intraoperative application of the iodine, bacteria were not detected in cultures of the samples. For the control eyes without timely iodine irrigation, cultures of samples from five and two eyes were positive before the initial incision and before IOL insertion, respectively. The bacterial DNA copy number before the initial incision was 1.7 ± 0.5 × 10(3), which was significantly lower than that of the control eyes (1.7 ± 0.6 × 10(4)). For both groups of eyes, the bacterial DNA copy number was significantly lower before the IOL insertion depending on the time course. When the antiseptic effect of the iodine irrigation and time course on bacterial DNA copy number was analyzed using generalized mixed linear regression, both were found to be significantly effective. No significant intraoperative epithelial defect was observed. The postoperative corneal endothelial cell count did not differ significantly between the two groups of eyes. Timely iodine irrigation can serve as a simple and useful adjunctive disinfection step in cataract surgery.

  2. Minimally Invasive Spinal Surgery with Intraoperative Image-Guided Navigation

    Directory of Open Access Journals (Sweden)

    Terrence T. Kim

    2016-01-01

    Full Text Available We present our perioperative minimally invasive spine surgery technique using intraoperative computed tomography image-guided navigation for the treatment of various lumbar spine pathologies. We present an illustrative case of a patient undergoing minimally invasive percutaneous posterior spinal fusion assisted by the O-arm system with navigation. We discuss the literature and the advantages of the technique over fluoroscopic imaging methods: lower occupational radiation exposure for operative room personnel, reduced need for postoperative imaging, and decreased revision rates. Most importantly, we demonstrate that use of intraoperative cone beam CT image-guided navigation has been reported to increase accuracy.

  3. Intraoperative peripheral nerve injury in colorectal surgery. An update.

    Science.gov (United States)

    Colsa Gutiérrez, Pablo; Viadero Cervera, Raquel; Morales-García, Dieter; Ingelmo Setién, Alfredo

    2016-03-01

    Intraoperative peripheral nerve injury during colorectal surgery procedures is a potentially serious complication that is often underestimated. The Trendelenburg position, use of inappropriately padded armboards and excessive shoulder abduction may encourage the development of brachial plexopathy during laparoscopic procedures. In open colorectal surgery, nerve injuries are less common. It usually involves the femoral plexus associated with lithotomy position and self-retaining retractor systems. Although in most cases the recovery is mostly complete, treatment consists of physical therapy to prevent muscular atrophy, protection of hypoesthesic skin areas and analgesics for neuropathic pain. The aim of the present study is to review the incidence, prevention and management of intraoperative peripheral nerve injury.

  4. Practicability of intraoperative microvascular Doppler sonography in aneurysm surgery.

    Science.gov (United States)

    Firsching, R; Synowitz, H J; Hanebeck, J

    2000-09-01

    Inadvertent narrowing of parent or branching vessels is one major cause of unfavorable outcome from aneurysm surgery. Intraoperative micro-Doppler sonography of arterial brain vessels during surgery for cerebral aneurysms of the anterior circulation was performed in 50 patients and compared retrospectively with 50 patients, who were operated upon without micro-Doppler sonography. Intraoperative micro-Doppler sonography demonstrated the need for repositioning of the clip in 12 instances. Outcome after surgery with micro-Doppler sonography appeared slightly better than without. Micro-Doppler sonography is concluded to be a practicable adjunct to routine aneurysm surgery.

  5. The use of intraoperative cholangiogram during laparoscopic double cholecystectomy

    Directory of Open Access Journals (Sweden)

    Gustavo E. Guajardo-Salinas

    2010-09-01

    Full Text Available ouble gallbladder is a rare finding in patients with symptomatic cholelithiasis or acute cholecystitis. The incidence has been described as 1 in every 4000-5000 patients during autopsy. To identify the gallbladder (GB duplication prior to surgical removal of the GB is of upmost importance. It is not unusual to identify this diagnosis intraoperatively, but by using US, ERCP or MRCP more than 50% of the cases are diagnosed preoperatively. The use of intraoperative cholangiogram helps to identify the anatomy and confirm the diagnosis during laparoscopic cholecystectomy in patients with gallbladder duplication.

  6. Intraoperative wide bore nasogastric tube knotting: A rare incidence.

    Science.gov (United States)

    Lamba, Sangeeta; Sethi, Surendra K; Khare, Arvind; Saini, Sudheendra

    2016-01-01

    Nasogastric tubes are commonly used in anesthetic practice for gastric decompression in surgical patients intraoperatively. The indications for its use are associated with a number of potential complications. Knotting of small-bore nasogastric tubes is usually common both during insertion and removal as compared to wide bore nasogastric tubes. Knotting of wide bore nasogastric tube is a rare complication and if occurs usually seen in long standing cases. We hereby report a case of incidental knotting of wide bore nasogastric tube that occurred intraoperatively.

  7. Automatic localization of endoscope in intraoperative CT image: A simple approach to augmented reality guidance in laparoscopic surgery.

    Science.gov (United States)

    Bernhardt, Sylvain; Nicolau, Stéphane A; Agnus, Vincent; Soler, Luc; Doignon, Christophe; Marescaux, Jacques

    2016-05-01

    The use of augmented reality in minimally invasive surgery has been the subject of much research for more than a decade. The endoscopic view of the surgical scene is typically augmented with a 3D model extracted from a preoperative acquisition. However, the organs of interest often present major changes in shape and location because of the pneumoperitoneum and patient displacement. There have been numerous attempts to compensate for this distortion between the pre- and intraoperative states. Some have attempted to recover the visible surface of the organ through image analysis and register it to the preoperative data, but this has proven insufficiently robust and may be problematic with large organs. A second approach is to introduce an intraoperative 3D imaging system as a transition. Hybrid operating rooms are becoming more and more popular, so this seems to be a viable solution, but current techniques require yet another external and constraining piece of apparatus such as an optical tracking system to determine the relationship between the intraoperative images and the endoscopic view. In this article, we propose a new approach to automatically register the reconstruction from an intraoperative CT acquisition with the static endoscopic view, by locating the endoscope tip in the volume data. We first describe our method to localize the endoscope orientation in the intraoperative image using standard image processing algorithms. Secondly, we highlight that the axis of the endoscope needs a specific calibration process to ensure proper registration accuracy. In the last section, we present quantitative and qualitative results proving the feasibility and the clinical potential of our approach.

  8. Intellijoint HIP®: a 3D mini-optical navigation tool for improving intraoperative accuracy during total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Paprosky WG

    2016-11-01

    Full Text Available Wayne G Paprosky,1,2 Jeffrey M Muir3 1Department of Orthopedics, Section of Adult Joint Reconstruction, Department of Orthopedics, Rush University Medical Center, Rush–Presbyterian–St Luke’s Medical Center, Chicago, 2Central DuPage Hospital, Winfield, IL, USA; 3Intellijoint Surgical, Inc, Waterloo, ON, Canada Abstract: Total hip arthroplasty is an increasingly common procedure used to address degenerative changes in the hip joint due to osteoarthritis. Although generally associated with good results, among the challenges associated with hip arthroplasty are accurate measurement of biomechanical parameters such as leg length, offset, and cup position, discrepancies of which can lead to significant long-term consequences such as pain, instability, neurological deficits, dislocation, and revision surgery, as well as patient dissatisfaction and, increasingly, litigation. Current methods of managing these parameters are limited, with manual methods such as outriggers or calipers being used to monitor leg length; however, these are susceptible to small intraoperative changes in patient position and are therefore inaccurate. Computer-assisted navigation, while offering improved accuracy, is expensive and cumbersome, in addition to adding significantly to procedural time. To address the technological gap in hip arthroplasty, a new intraoperative navigation tool (Intellijoint HIP® has been developed. This innovative, 3D mini-optical navigation tool provides real-time, intraoperative data on leg length, offset, and cup position and allows for improved accuracy and precision in component selection and alignment. Benchtop and simulated clinical use testing have demonstrated excellent accuracy, with the navigation tool able to measure leg length and offset to within <1 mm and cup position to within <1° in both anteversion and inclination. This study describes the indications, procedural technique, and early accuracy results of the Intellijoint HIP

  9. Soil Microbial Mineralization of Cellulose in Frozen Soils

    Science.gov (United States)

    Segura, J.; Haei, M.; Sparrman, T.; Nilsson, M. B.; Schleucher, J.; Oquist, M. G.

    2014-12-01

    Soils of high-latitude ecosystems store a large fraction of the global soil carbon pool. In boreal forests, the mineralization of soil organic matter (SOM) during winter by soil heterotrophic activity can affect the ecosystems net carbon balance. Recent research has shown that microorganisms in the organic surface layer of boreal forest soil can mineralize and grow on simple, monomeric substrates under frozen conditions. However, any substantial impacts of microbial activity in frozen soils on long-term soil carbon balances depend on whether soil microorganisms can utilize the more complex, polymeric substrates in SOM. In order to evaluate the potential for soil microorganisms to metabolize carbon polymers at low temperatures, we incubated boreal forest soil samples amended with [13C]-cellulose and studied the microbial catabolic and anabolic utilization of the substrate under frozen and unfrozen conditions (-4 and +4°C). The [13C]-CO2 production rate in the samples at +4°C were 0.524 mg CO2 SOM -1 day-1 while rates in the frozen samples (-4°C) were 0.008 mg CO2 SOM -1 day-1. Thus, freezing of the soil markedly reduced microbial utilization of the cellulose. However, newly synthetized [13C]-enriched cell membrane lipids, PLFAs, were detected in soil samples incubated both above and below freezing, confirming microbial growth also in the frozen soil matrix. The reduced metabolic rates induced by freezing indicate constraints on exoenzymatic activity, as well as substrate diffusion rates that we can attribute to reduced liquid water content of the frozen soil. We conclude that the microbial population in boreal forest soil has the capacity to metabolize, and grow, on polymeric substrates at temperatures below zero. This also involves maintaining exoenzymatic activity in frozen soils. This capacity manifests the importance of SOM mineralization during the winter season and its importance for the net carbon balance of soils of high-latitude ecosystems.

  10. Tissue tablet method: an efficient tissue banking procedure applicable to both molecular analysis and frozen tissue microarray.

    Science.gov (United States)

    Torata, Nobuhiro; Ohuchida, Kenoki; Akagawa, Shin; Cui, Lin; Kozono, Shingo; Mizumoto, Kazuhiro; Aishima, Shinichi; Oda, Yoshinao; Tanaka, Masao

    2014-01-01

    Frozen human tissues are necessary for research purposes, but tissue banking methods have not changed for more than a decade. Many institutions use cryovial tubes or plastic molds with an optimal cutting temperature compound. However, these methods are associated with several problems, such as samples sticking to one another and the need for a larger storing space. We established an efficient tissue freezing and storing procedure ("tissue tablet method") applicable to both molecular analysis and frozen tissue microarray. Tissue samples were chopped into tiny fragments and embedded into tablet-shaped frozen optimal cutting temperature compound using our original tissue-freezing plate. These tablets can be sectioned and stored in cryovial tubes. We compared the tissue quality of tablet-shaped samples with that of conventional optimal cutting temperature blocks and found no significant difference between them. Tissue microarray is a key method to utilize tissue-banking specimens. However, most tissue microarrays require the coring out of cylindrically shaped tissues from formalin-fixed, paraffin-embedded tissue blocks. Antigenic changes and mRNA degradation are frequently observed with formalin-fixed, paraffin-embedded samples. Therefore, we have applied tablet-shaped samples to construct frozen tissue microarrays with our original mounting base. Constructed tissue microarray sections showed good morphology without obvious artifact and good immunohistochemistry and in situ hybridization results. These results suggest that the quality of arrayed samples was sufficiently appropriate for research purposes. In conclusion, the tissue tablet method and frozen tissue microarray procedure can save time, provides easy tissue handling and processing, and satisfies the demands of research methodologies and tissue banking. © 2013.

  11. The effect of preoperative Lugol's iodine on intraoperative bleeding in patients with hyperthyroidism

    Directory of Open Access Journals (Sweden)

    Yeliz Yilmaz

    2016-08-01

    Conclusion: Preoperative Lugol solution treatment was found to be a significant independent determinant of intraoperative blood loss. Moreover, preoperative Lugol solution treatment decreased the rate of blood flow, and intraoperative blood loss during thyroidectomy.

  12. Analyzing agreement patterns of intraoperative central nervous system lesion reporting according to type and grade

    Directory of Open Access Journals (Sweden)

    Sujata Chaturvedi

    2013-01-01

    Conclusions: This study identifies problem areas of CNS intraoperative reporting, in a new center, with reference to tumor typing and grading. It may forewarn upcoming centers of neuropathology about the potential problem areas of intraoperative reporting.

  13. Value of intraoperative radiotherapy in locally advanced rectal cancer

    NARCIS (Netherlands)

    Ferenschild, Floris T. J.; Vermaas, Maarten; Nuyttens, Joost J. M. E.; Graveland, Wilfried J.; Marinelli, Andreas W. K. S.; van der Sijp, Joost R.; Wiggers, Theo; Verhoef, Cornelis; Eggermont, Alexander M. M.; de Wilt, Johannes H. W.

    2006-01-01

    PURPOSE: This study was designed to analyze the results of a multimodality treatment using preoperative radiotherapy, followed by surgery and intraoperative radiotherapy in patients with primary locally advanced rectal cancer. METHODS: Between 1987 and 2002, 123 patients with initial unresectable an

  14. intraoperative colonic irrigation in the management of left sided ...

    African Journals Online (AJOL)

    hi-tech

    2000-11-01

    Nov 1, 2000 ... Surgery, Jos University Teaching Hospital, P.M.B. 2076, Jos, Plateau State, Nigeria. ... Conclusion: The results of this study suggest that intraoperative colonic lavage is an effective ..... Hawley P. J., Hunt K. H. and Dunply J. E. Aetiology of colonic ... Thow G. Emergency left colon resection with primary.

  15. INTRAOPERATIVE IRRADIATION OF THE CANINE PANCREAS - SHORT-TERM EFFECTS

    NARCIS (Netherlands)

    HEIJMANS, HJ; MEHTA, DM; KLEIBEUKER, JH; SLUITER, WJ; OLDHOFF, J; HOEKSTRA, HJ

    1993-01-01

    Intraoperative electron beam radiotherapy (IORT) is clinically used as a potential adjunctive treatment to surgery of locally advanced pancreatic and gastric cancer. The tolerance of the pancreas to IORT was studied in 15 adult beagles, divided in 3 groups of 5 beagles in which 25, 30 or 35 Gy IORT

  16. "Urological cold shower"--a novel treatment for intraoperative erection.

    Science.gov (United States)

    Brierly, R D; Hindley, R G; Challacombe, B J; Popert, R J

    2003-02-01

    Intraoperative penile tumescence during endoscopic surgery is a troublesome complication and a challenge to the urologist. We describe a novel, convenient, safe, and readily available technique. We used an intracavernosal injection of epinephrine using a standard dental syringe and a cartridge of lidocaine 2% and epinephrine 1:80,000 to induce detumescence reliably.

  17. Baseline correction of intraoperative electromyography using discrete wavelet transform.

    Science.gov (United States)

    Rampp, Stefan; Prell, Julian; Thielemann, Henning; Posch, Stefan; Strauss, Christian; Romstöck, Johann

    2007-08-01

    In intraoperative analysis of electromygraphic signals (EMG) for monitoring purposes, baseline artefacts frequently pose considerable problems. Since artefact sources in the operating room can only be reduced to a limited degree, signal-processing methods are needed to correct the registered data online without major changes to the relevant data itself. We describe a method for baseline correction based on "discrete wavelet transform" (DWT) and evaluate its performance compared to commonly used digital filters. EMG data from 10 patients who underwent removal of acoustic neuromas were processed. Effectiveness, preservation of relevant EMG patterns and processing speed of a DWT based correction method was assessed and compared to a range of commonly used Butterworth, Resistor-Capacitor and Gaussian filters. Butterworth and DWT filters showed better performance regarding artefact correction and pattern preservation compared to Resistor-Capacitor and Gaussian filters. Assuming equal weighting of both characteristics, DWT outperformed the other methods: While Butterworth, Resistor-Capacitor and Gaussian provided good pattern preservation, the effectiveness was low and vice versa, while DWT baseline correction at level 6 performed well in both characteristics. The DWT method allows reliable and efficient intraoperative baseline correction in real-time. It is superior to commonly used methods and may be crucial for intraoperative analysis of EMG data, for example for intraoperative assessment of facial nerve function.

  18. What Do We Know About Intraoperative Teaching?: A Systematic Review.

    Science.gov (United States)

    Timberlake, Matthew D; Mayo, Helen G; Scott, Lauren; Weis, Joshua; Gardner, Aimee K

    2017-08-01

    There is increasing attention on enhancing surgical trainee performance and competency. The purpose of this review is to identify characteristics and themes related to intraoperative teaching that will better inform interventions and assessment endeavors. A systematic search was carried out of the Ovid MEDLINE, Ovid MEDLINE InProcess, Ovid Embase, and the Cochrane Library databases to identify all studies that discussed teaching in the operating room for trainees at the resident and fellow level. Evidence for main outcome categories was evaluated with the Medical Education Research Study Quality Instrument (MERSQI). A total of 2101 records were identified. After screening by title, abstract, and full text, 34 studies were included. We categorized these articles into 3 groups on the basis of study methodology: perceptions, best practices, and interventions to enhance operative teaching. Overall strength of evidence for each type of study was as follows: perceptions (MERSQI: 7.5-10); best practices (6.5-11.5), and interventions (8-15). Although very few studies (n = 5) examined interventions for intraoperative teaching, these studies demonstrate the efficacy of techniques designed to enhance faculty teaching behaviors. Interventions have a positive impact on trainee ratings of their faculty intraoperative teaching performance. There is discordance between trainee perceptions of quantity and quality of teaching, compared with faculty perceptions of their own teaching behaviors. Frameworks and paradigms designed to provide best practices for intraoperative teaching agree that effective teaching spans 3 phases that take place before, during, and after cases.

  19. Trends in intraoperative pain relief in anesthesized Nigerian ...

    African Journals Online (AJOL)

    shobha

    opioids and leads to improved patient safety and outcome. ... Méthode: Une étude rétrospective des 652 patients âge pédiatrique subissant diverses interventions chirurgicales a ... safe, and effective intraoperative pain management.

  20. Intraoperative ultrasonography of the vertebral canal in dogs

    Directory of Open Access Journals (Sweden)

    M.A. Bonelli

    2015-06-01

    Full Text Available Intraoperative ultrasound (IOS can provide details on various conditions of the spinal cord and vertebral canal. The aim of the present study was to evaluate the feasibility of using IOS in dogs undergoing spinal surgery and to describe the main findings. The vertebral canal of 21 dogs was examined with intraoperative ultrasonography: 13 underwent spinal surgery for removal of herniated intervertebral disc material, three for stabilization of vertebral fracture/luxation, two for removal of vertebral neoplasia, and three for cauda equina decompression. Particular attention was given to signs of cord compression. Intraoperative ultrasonography was feasible and useful in dogs undergoing surgery for spinal cord or cauda equina decompression and fracture stabilization. It was not paramount for locating the compression when this had been done via computed tomography (CT, but it showed alterations in spinal cord parenchyma not observed on CT and also confirmed adequate decompression of the spinal cord. The main advantages of intraoperative ultrasonography were estimation of vascularization and extent of spinal cord lesion. Most importantly, it allowed real time evaluation of the spinal cord and vertebral canal, which permits the modification of the surgical procedure.

  1. Physics-based shape matching for intraoperative image guidance

    Energy Technology Data Exchange (ETDEWEB)

    Suwelack, Stefan, E-mail: suwelack@kit.edu; Röhl, Sebastian; Bodenstedt, Sebastian; Reichard, Daniel; Dillmann, Rüdiger; Speidel, Stefanie [Institute for Anthropomatics and Robotics, Karlsruhe Institute of Technology, Adenauerring 2, Karlsruhe 76131 (Germany); Santos, Thiago dos; Maier-Hein, Lena [Computer-assisted Interventions, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg 69120 (Germany); Wagner, Martin; Wünscher, Josephine; Kenngott, Hannes; Müller, Beat P. [General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 110, Heidelberg 69120 (Germany)

    2014-11-01

    Purpose: Soft-tissue deformations can severely degrade the validity of preoperative planning data during computer assisted interventions. Intraoperative imaging such as stereo endoscopic, time-of-flight or, laser range scanner data can be used to compensate these movements. In this context, the intraoperative surface has to be matched to the preoperative model. The shape matching is especially challenging in the intraoperative setting due to noisy sensor data, only partially visible surfaces, ambiguous shape descriptors, and real-time requirements. Methods: A novel physics-based shape matching (PBSM) approach to register intraoperatively acquired surface meshes to preoperative planning data is proposed. The key idea of the method is to describe the nonrigid registration process as an electrostatic–elastic problem, where an elastic body (preoperative model) that is electrically charged slides into an oppositely charged rigid shape (intraoperative surface). It is shown that the corresponding energy functional can be efficiently solved using the finite element (FE) method. It is also demonstrated how PBSM can be combined with rigid registration schemes for robust nonrigid registration of arbitrarily aligned surfaces. Furthermore, it is shown how the approach can be combined with landmark based methods and outline its application to image guidance in laparoscopic interventions. Results: A profound analysis of the PBSM scheme based on in silico and phantom data is presented. Simulation studies on several liver models show that the approach is robust to the initial rigid registration and to parameter variations. The studies also reveal that the method achieves submillimeter registration accuracy (mean error between 0.32 and 0.46 mm). An unoptimized, single core implementation of the approach achieves near real-time performance (2 TPS, 7–19 s total registration time). It outperforms established methods in terms of speed and accuracy. Furthermore, it is shown that the

  2. Lumbar Lordosis of Spinal Stenosis Patients during Intraoperative Prone Positioning

    Science.gov (United States)

    Lee, Su-Keon; Song, Kyung-Sub; Park, Byung-Moon; Lim, Sang-Youn; Jang, Geun; Lee, Beom-Seok; Moon, Seong-Hwan; Lee, Hwan-Mo

    2016-01-01

    Background To evaluate the effect of spondylolisthesis on lumbar lordosis on the OSI (Jackson; Orthopaedic Systems Inc.) frame. Restoration of lumbar lordosis is important for maintaining sagittal balance. Physiologic lumbar lordosis has to be gained by intraoperative prone positioning with a hip extension and posterior instrumentation technique. There are some debates about changing lumbar lordosis on the OSI frame after an intraoperative prone position. We evaluated the effect of spondylolisthesis on lumbar lordosis after an intraoperative prone position. Methods Sixty-seven patients, who underwent spinal fusion at the Department of Orthopaedic Surgery of Gwangmyeong Sungae Hospital between May 2007 and February 2012, were included in this study. The study compared lumbar lordosis on preoperative upright, intraoperative prone and postoperative upright lateral X-rays between the simple stenosis (SS) group and spondylolisthesis group. The average age of patients was 67.86 years old. The average preoperative lordosis was 43.5° (± 14.9°), average intraoperative lordosis was 48.8° (± 13.2°), average postoperative lordosis was 46.5° (± 16.1°) and the average change on the frame was 5.3° (± 10.6°). Results Among all patients, 24 patients were diagnosed with simple spinal stenosis, 43 patients with spondylolisthesis (29 degenerative spondylolisthesis and 14 isthmic spondylolisthesis). Between the SS group and spondylolisthesis group, preoperative lordosis, intraoperative lordosis and postoperative lordosis were significantly larger in the spondylolisthesis group. The ratio of patients with increased lordosis on the OSI frame compared to preoperative lordosis was significantly higher in the spondylolisthesis group. The risk of increased lordosis on frame was significantly higher in the spondylolisthesis group (odds ratio, 3.325; 95% confidence interval, 1.101 to 10.039; p = 0.033). Conclusions Intraoperative lumbar lordosis on the OSI frame with a prone

  3. Use of Hydrocolloids as Cryoprotectant for Frozen Foods.

    Science.gov (United States)

    Maity, Tanushree; Saxena, Alok

    2016-05-12

    Freezing is one of the widely used preservation methods to preserve the quality of food products but it also results in deteriorative changes in textural properties of food which in turn affects its marketability. Different foodstuffs undergo different types of changes in texture, taste and overall acceptability upon freezing and subsequent frozen storage. Freezing and thawing of pre-cut or whole fruits and vegetables causes many deleterious effects including texture and drip losses. The major problem in stability of ice-cream is re-crystallization phenomena which happens due to temperature fluctuations during storage and finally impairs the quality of ice-cream. Frozen storage for longer periods causes rubbery texture in meat and fish products. To overcome these problems, hydrocolloids which are polysaccharides of high molecular weight, are used in numerous food applications involving gelling, thickening, stabilizing, emulsifying etc. They could improve the rheological and textural characteristics of food systems by changing the viscosity. They play a major role in retaining texture of fruits and vegetables after freezing. They provide thermodynamic stability to ice cream to control the process of re-crystallization. Hydrocolloids find application in frozen surimi, minced fish and meat products due to their water binding ability. They are also added to frozen bakery products to improve shelf-stability by retaining sufficient moisture and retarding staling. Various hydrocolloids impart different cryoprotective effects to food products depending upon their solubility, water holding capacity, rheological properties, and synergistic effect with other ingredients during freezing and frozen storage.

  4. Stiffness Evolution in Frozen Sands Subjected to Stress Changes

    KAUST Repository

    Dai, Sheng

    2017-04-21

    Sampling affects all soils, including frozen soils and hydrate-bearing sediments. The authors monitor the stiffness evolution of frozen sands subjected to various temperature and stress conditions using an oedometer cell instrumented with P-wave transducers. Experimental results show the stress-dependent stiffness of freshly remolded sands, the dominant stiffening effect of ice, creep after unloading, and the associated exponential decrease in stiffness with time. The characteristic time for stiffness loss during creep is of the order of tens of minutes; therefore it is inevitable that frozen soils experience sampling disturbances attributable to unloading. Slow unloading minimizes stiffness loss; conversely, fast unloading causes a pronounced reduction in stiffness probably attributable to the brittle failure of ice or ice-mineral bonding.

  5. Histological study of fresh versus frozen semitendinous muscle tendon allografts

    Directory of Open Access Journals (Sweden)

    Alexandre Carneiro Bitar

    2010-01-01

    Full Text Available OBJECTIVE: The purpose of this study was to histologically analyze allografts from cadaveric semitendinous muscle after cryopreservation at -80°C in comparison to a control group kept at only -4°C to test the hypothesis that the histological characteristics of the tissue are maintained when the tendons are kept at lower temperatures. METHODS: In a tissue bank, 10 semitendinous tendons from 10 cadavers were frozen at -80ºC as a storage method for tissue preservation. They were kept frozen for 40 days, and then a histological study was carried out. Another 10 tendon samples were analyzed while still "fresh". RESULTS: There was no histological difference between the fresh and frozen samples in relation to seven variables. CONCLUSIONS: Semitendinous muscle tendon allografts can be submitted to cryopreservation at -80ºC without suffering histological modifications.

  6. Usefulness of a rapid immunometric assay for intraoperative parathyroid hormone measurements

    Directory of Open Access Journals (Sweden)

    M.N. Ohe

    2003-06-01

    Full Text Available Intraoperative parathyroid hormone (IO-PTH measurements have been proposed to improve operative success rates in primary, secondary and tertiary hyperparathyroidism (PHP, SHP and THP. Thirty-one patients requiring parathyroidectomy were evaluated retrospectively from June 2000 to January 2002. Sixteen had PHP, 7 SHP and 8 THP. Serum samples were taken at times 0 (before resection, 10, 20 and 30 min after resection of each abnormal parathyroid gland. Samples from 28 patients were frozen at -70ºC for subsequent tests, whereas samples from three patients were tested while surgery was being performed. IO-PTH was measured using the Elecsys immunochemiluminometric assay (Roche, Mannheim, Germany. The time necessary to perform the assay was 9 min. All samples had a second measurement taken by a conventional immunofluorimetric method. We considered as cured patients who presented normocalcemia in PHP and THP, and normal levels of PTH in SHP one month after surgery and who remained in this condition throughout the follow-up of 1 to 20 months. When rapid PTH assay was compared with a routine immunofluorimetric assay, excellent correlation was observed (r = 0.959, P < 0.0001. IO-PTH measurement showed a rapid average decline of 78.8% in PTH 10 min after adenoma resection in PHP and all patients were cured. SHP patients had an average IO-PTH decrease of 89% 30 min after total parathyroidectomy and cure was observed in 85.7%. THP showed an average IO-PTH decrease of 91.9%, and cure was obtained in 87.5% of patients. IO-PTH can be a useful tool that might improve the rate of successful treatment of PHP, SHP and THP.

  7. Intraoperative and external beam radiotherapy for pancreatic carcinoma; Intraoperative und perkutane Radiotherapie des Pankreaskarzinoms

    Energy Technology Data Exchange (ETDEWEB)

    Eble, M.J. [Abt. Klinische Radiologie, Radiologische Universitaetsklinik Heidelberg (Germany); Maurer, U. [Klinikum der Stadt Mannheim (Germany). Inst. fuer Radiologie

    1996-05-01

    Therapeutic strategies in the treatment of pancreatic carcinoma are based on the high number of non-resectable cancers, the high relative radioresistance and the high distant metastases rate. Even in curatively resected carcinomas, a locally effective treatment modality is needed because of the risk of microscopical residual disease in the peripancreatic tissue. The efficacy of radiotherapy is dose dependent. Based on an analysis of published data a dose of more than 50 Gy is recommended, resulting in a high morbidity rate with external beam radiotherapy alone. The use of intraoperative radiotherapy allows locally restricted dose escalation without increased perioperative morbidity. In adjuvant and in primary treatment, local tumor control was improved (70-90%). With palliative intent, pain relief was obtained rapidly in over 60% of patients and led to improved patient performance. As a result of the high distant metastases rate, even in curatively resected carcinomas, the overall prognosis could not be significantly improved. Further dose escalation is limited by the increasing incidence of upper gastrointestinal bleeding (20-30%). (orig.) [Deutsch] Therapiestrategien beim Pankreaskarzinom werden bestimmt durch den hohen Anteil primaer nicht resektabler Karzinome, der hohen relativen Strahlenresistenz und der hohen Fernmetastasierungsrate. Selbst kurativ resezierte Karzinome erfordern durch ihre hohe lokale Tumorzellpersistenz eine lokal effektive adjuvante Behandlungsmassnahme. Die Effektivitaet einer Radiotherapie ist dosisabhaengig. Aus der Analyse publizierter Daten wird eine Dosis von >50 Gy, welche bei der alleinigen perkutanen Bestrahlung mit einer hohen Morbiditaet verbunden ist, empfohlen. Mit der intraoperativen Radiotherapie ist eine lokal begrenzte Dosiseskalation ohne erhoehte perioperative Morbiditaet moeglich. Sowohl in der adjuvanten als auch in der primaeren Behandlung kann die lokale Tumorkontrolle deutlich verbessert werden (70-90%). Unter

  8. Cryoelectrolysis—electrolytic processes in a frozen physiological saline medium

    Science.gov (United States)

    Lugnani, Franco; Macchioro, Matteo

    2017-01-01

    Background Cryoelectrolysis is a new minimally invasive tissue ablation surgical technique that combines the ablation techniques of electrolytic ablation with cryosurgery. The goal of this study is to examine the hypothesis that electrolysis can take place in a frozen aqueous saline solution. Method To examine the hypothesis we performed a cryoelectrolytic ablation protocol in which electrolysis and cryosurgery are delivered simultaneously in a tissue simulant made of physiological saline gel with a pH dye. We measured current flow, voltage and extents of freezing and pH dye staining. Results Using optical measurements and measurements of currents, we have shown that electrolysis can occur in frozen physiological saline, at high subzero freezing temperatures, above the eutectic temperature of the frozen salt solution. It was observed that electrolysis occurs when the tissue resides at high subzero temperatures during the freezing stage and essentially throughout the entire thawing stage. We also found that during thawing, the frozen lesion temperature raises rapidly to high subfreezing values and remains at those values throughout the thawing stage. Substantial electrolysis occurs during the thawing stage. Another interesting finding is that electro-osmotic flows affect the process of cryoelectrolysis at the anode and cathode, in different ways. Discussion The results showing that electrical current flow and electrolysis occur in frozen saline solutions imply a mechanism involving ionic movement in the fluid concentrated saline solution channels between ice crystals, at high subfreezing temperatures. Temperatures higher than the eutectic are required for the brine to be fluid. The particular pattern of temperature and electrical currents during the thawing stage of frozen tissue, can be explained by the large amounts of energy that must be removed at the outer edge of the frozen lesion because of the solid/liquid phase transformation on that interface. Conclusion

  9. REPLICA ORNSTEIN-ZERNIKE EQUATIONS FOR POSITIONALLY FROZEN HEISENBERG SYSTEMS

    Directory of Open Access Journals (Sweden)

    E.Lomba

    2003-01-01

    Full Text Available We present the formulation of the Replica Ornstein-Zernike equations for a model of positionally frozen disordered Heisenberg spin system. The results are obtained for various models, one in which the particle positions correspond to a frozen hard sphere fluid, another system in which the configurations are generated by a random insertion of hard spheres, a system of randomly distributed spins, and finally a system corresponding to a soft sphere fluid quenched at high and low temperatures. We will see that the orientational structure of the spin system is fairly well reproduced by the integral equation which, however, does not correctly account for the critical behaviour.

  10. Cryoelectrolysis—electrolytic processes in a frozen physiological saline medium

    Directory of Open Access Journals (Sweden)

    Franco Lugnani

    2017-01-01

    Full Text Available Background Cryoelectrolysis is a new minimally invasive tissue ablation surgical technique that combines the ablation techniques of electrolytic ablation with cryosurgery. The goal of this study is to examine the hypothesis that electrolysis can take place in a frozen aqueous saline solution. Method To examine the hypothesis we performed a cryoelectrolytic ablation protocol in which electrolysis and cryosurgery are delivered simultaneously in a tissue simulant made of physiological saline gel with a pH dye. We measured current flow, voltage and extents of freezing and pH dye staining. Results Using optical measurements and measurements of currents, we have shown that electrolysis can occur in frozen physiological saline, at high subzero freezing temperatures, above the eutectic temperature of the frozen salt solution. It was observed that electrolysis occurs when the tissue resides at high subzero temperatures during the freezing stage and essentially throughout the entire thawing stage. We also found that during thawing, the frozen lesion temperature raises rapidly to high subfreezing values and remains at those values throughout the thawing stage. Substantial electrolysis occurs during the thawing stage. Another interesting finding is that electro-osmotic flows affect the process of cryoelectrolysis at the anode and cathode, in different ways. Discussion The results showing that electrical current flow and electrolysis occur in frozen saline solutions imply a mechanism involving ionic movement in the fluid concentrated saline solution channels between ice crystals, at high subfreezing temperatures. Temperatures higher than the eutectic are required for the brine to be fluid. The particular pattern of temperature and electrical currents during the thawing stage of frozen tissue, can be explained by the large amounts of energy that must be removed at the outer edge of the frozen lesion because of the solid/liquid phase transformation on that

  11. The Erosion of Frozen Argon by Swift Helium Ions

    DEFF Research Database (Denmark)

    Besenbacher, F.; Bøttiger, Jørgen; Graversen, O.

    1981-01-01

    The temperature, energy, and thickness dependence of the erosion rates of frozen argon films when irradiated with 0.1–3 MeV helium ions have been measured. The erosion yields Y are much too high to be explained by the concentional collisional cascade-sputtering theory and are furthermore unequivo......The temperature, energy, and thickness dependence of the erosion rates of frozen argon films when irradiated with 0.1–3 MeV helium ions have been measured. The erosion yields Y are much too high to be explained by the concentional collisional cascade-sputtering theory and are furthermore...

  12. Argus II retinal prosthesis malrotation and repositioning with intraoperative optical coherence tomography in a posterior staphyloma

    Directory of Open Access Journals (Sweden)

    Seider MI

    2015-11-01

    Full Text Available Michael I Seider, Paul Hahn Duke University Eye Center, Durham, NC, USA Introduction: The Argus II retinal prosthesis may improve visual function in patients with severe vision loss from retinitis pigmentosa. Optimal centration of the electrode array over the macula is important to achieve optimal visual results. Argus tack malrotation is a novel entity that may be encountered during placement, especially in patients with posterior staphyloma.Methods: Retrospective case review.Results: During tacking of the electronics array a clockwise rotation occurred resulting in malposition. We hypothesize this was secondary to undue rotation or posterior pressure applied during tack insertion in conjunction with placement over a previously unrecognized posterior staphyloma. Intraoperative optical coherence tomography, because of the cross-sectional images provided, was helpful in visualizing the distance between the electronics array and the retina, which was difficult to assess using the surgical microscope alone. Repositioning was achieved by adjusting the tack without removal. The patient experienced an improvement in vision as a result of the surgery.Conclusion: Malrotation may occur when tacking the Argus II prosthesis, and the presence of a posterior staphyloma may increase this risk. It is important to differentiate malrotation from tack misplacement – the former may be addressed with array unrotation or partial tack withdrawal and the latter may require tack removal and reinsertion. Also, intraoperative optical coherence tomography may be helpful in characterizing electronics array position during surgery. Keywords: Argus, retinitis pigmentosa, retinal tack

  13. Hemisection spinal cord injury in rat: The value of intraoperative somatosensory evoked potential monitoring

    Science.gov (United States)

    Cloud, Beth A.; Ball, Bret G.; Chen, Bingkun; Knight, Andrew M.; Hakim, Jeffrey S.; Ortiz, Ana M.; Windebank, Anthony J.

    2012-01-01

    Techniques used to produce partial spinal cord injuries in animal models have the potential for creating variability in lesions. The amount of tissue affected may influence the functional outcomes assessed in the animals. The recording of somatosensory evoked potentials (SSEPs) may be a valuable tool for assessing the extent of lesion applied in animal models of traumatic spinal cord injury (SCI). Intraoperative tibial SSEP recordings were assessed during surgically induced lateral thoracic hemisection SCI in Sprague-Dawley rats. The transmission of SSEPs, or lack thereof, was determined and compared against the integrity of the dosal funiculi on each side of the spinal cord upon histological sectioning. An association was found between the presence of an SSEP signal and presence of intact dorsal funiculus tissue. The relative risk is 4.50 (95% confidence interval: 1.83 to 11.08) for having an intact dorsal funiculus when the ipsilateral SSEP was present compared to when it was absent. Additionally, the amount of spared spinal cord tissue correlates with final functional assessments at nine weeks post injury: BBB (linear regression, R2 = 0.618, p <0.001) and treadmill test (linear regression, R2 = 0.369, p = 0.016). Therefore, we propose intraoperative SSEP monitoring as a valuable tool to assess extent of lesion and reduce variability between animals in experimental studies of SCI. PMID:22960163

  14. Preclinical evaluation of intraoperative low-energy photon radiotherapy using sphericalapplicators in locally advanced prostate cancer

    Directory of Open Access Journals (Sweden)

    François eBuge

    2015-09-01

    Full Text Available Background: Surgery plus adjuvant radiotherapy is standard care for locally advanced prostatecancer (stage pT3R1. Intraoperative low-energy photon radiotherapy offers several advantages overexternal beam radiotherapy, and several systems are now available for its delivery, using sphericalapplicators which require only limited shielding. The aim of this study was to evaluate the feasibilityof this technique for the prostate bed.Materials & Methods: Applicators were assessed using MRI image data and cadavericdissection. In cadavers, targeted tissues, defined as a urethral section, both neurovascular bundlesections, the bladder neck and the beds of the seminal vesicles, were marked with metallic surgicalclips. Distances between clips and applicator were measured using CT. A dosimetric study of theapplication of 12 Gy at 5mm depth was performed using CT images of prostatectomized cadavers.Results: Using MRI images from 34 prostate cancer patients, we showed that the ideal applicatordiameter ranges from 45 to 70 mm. Using applicators of different sizes to encompass the prostate bedin nine cadavers, we showed that the distance between target tissues and applicator was less than 2mm for all target tissues except the upper extremity of the seminal vesicles (19 mm. Dosimetric studyshowed a good dose distribution in all target tissues in contact with the applicator, with a lowprobability of rectum and bladder complication.Conclusions: Intraoperative radiotherapy of the prostate bed is feasible, with good coverage oftargeted tissues. Clinical study of safety and efficacy is now required.

  15. Intraoperative bleeding control during cesarean delivery of complete placenta previa with transient occlusion of uterine arteries.

    Science.gov (United States)

    Kim, Ju Hyun; Joung, Eun-Ju; Lee, Soo-Jung; Kwack, Jae Young; Kwon, Yong Soon

    2015-11-01

    There are few methods to control heavy intra-operative bleeding during cesarean delivery of placenta previa. Transient occlusion of uterine arteries (TOUA) during operation has previously been reported as a quick and safe method to control intra-operative uterine bleeding. We reported 2 cases of cesarean delivery with complete placenta previa in which TOUA was performed to safely reduce intra-operative complication, especially heavy intra-operative bleeding. In the 2 cases, cesarean deliveries were safe and without any complications under the TOUA method. TOUA can be a good method to control heavy intra-operative bleeding during cesarean delivery of complete placenta previa with risk of heavy bleeding.

  16. Electrotherapy modalities for adhesive capsulitis (frozen shoulder).

    Science.gov (United States)

    Page, Matthew J; Green, Sally; Kramer, Sharon; Johnston, Renea V; McBain, Brodwen; Buchbinder, Rachelle

    2014-10-01

    Adhesive capsulitis (also termed frozen shoulder) is a common condition characterised by spontaneous onset of pain, progressive restriction of movement of the shoulder and disability that restricts activities of daily living, work and leisure. Electrotherapy modalities, which aim to reduce pain and improve function via an increase in energy (electrical, sound, light, thermal) into the body, are often delivered as components of a physical therapy intervention. This review is one in a series of reviews which form an update of the Cochrane review 'Physiotherapy interventions for shoulder pain'. To synthesise the available evidence regarding the benefits and harms of electrotherapy modalities, delivered alone or in combination with other interventions, for the treatment of adhesive capsulitis. We searched CENTRAL, MEDLINE, EMBASE, CINAHL Plus and the ClinicalTrials.gov and World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) clinical trials registries up to May 2014, unrestricted by language, and reviewed the reference lists of review articles and retrieved trials to identify any other potentially relevant trials. We included randomised controlled trials (RCTs) and controlled clinical trials using a quasi-randomised method of allocation that included adults with adhesive capsulitis and compared any electrotherapy modality to placebo, no treatment, a different electrotherapy modality, or any other intervention. The two main questions of the review focused on whether electrotherapy modalities are effective compared to placebo or no treatment, or if they are an effective adjunct to manual therapy or exercise (or both). The main outcomes of interest were participant-reported pain relief of 30% or greater, overall pain, function, global assessment of treatment success, active shoulder abduction, quality of life, and the number of participants experiencing any adverse event. Two review authors independently selected trials for inclusion

  17. 9 CFR 94.2 - Fresh (chilled or frozen) products (other than meat), and milk and milk products of ruminants and...

    Science.gov (United States)

    2010-01-01

    ... (other than meat), and milk and milk products of ruminants and swine. 94.2 Section 94.2 Animals and... (other than meat), and milk and milk products of ruminants and swine. (a) The importation of fresh (chilled or frozen) products (other than meat and milk and milk products) derived from ruminants or swine...

  18. Cesarean Sections

    Science.gov (United States)

    ... Old Feeding Your 1- to 2-Year-Old Cesarean Sections (C-Sections) KidsHealth > For Parents > Cesarean Sections (C-Sections) A A A What's in this ... babies in the United States are delivered via cesarean section (C-section). Even if you're envisioning a ...

  19. "INTRAOPERATIVE SPINAL STIFFNESS MEASUREMENT IN MANAGEMENT OF SPINAL CANAL STENOSIS "

    Directory of Open Access Journals (Sweden)

    M. Karami

    2005-08-01

    Full Text Available In this study to determine whether spine stiffness is predictive of clinical results after lumbar spinal fusion for spinal stenosis, a total of 78 patients were measured intraoperatively with Kocher clamp manual distraction technique to determine motion segment stiffness then spinal fusion was performed for any loose segment. ‎Statistical analysis revealed that stiffness measurement correlate with clinical results of surgery. During a minimum of 2 years follow up after surgery, patients who had loose motion segment before or after decompression and were fused had the same level of satisfaction with surgical results as patients without loose segments and fusion. ‎We concluded that intraoperative spinal stiffness measurement provide a good indicator to spine fusion after lumbar canal stenosis ‎surgery.

  20. Long-term psychosocial outcomes after intraoperative awareness with recall.

    Science.gov (United States)

    Laukkala, Tanja; Ranta, Seppo; Wennervirta, Johanna; Henriksson, Markus; Suominen, Kirsi; Hynynen, Markku

    2014-07-01

    Posttraumatic stress disorder, a common psychiatric disorder in the general population, may follow a traumatic experience of awareness with recall during general anesthesia. We conducted a matched cohort design with 9 subjects after intraoperative awareness with recall during general anesthesia. A psychiatric diagnostic interview and questionnaire were performed on 9 matched controls and 9 subjects, a median of 17.2 years from their documented awareness episode. The subjects and the matched controls completed a battery of questionnaires related to psychosocial well-being, after which they participated in a diagnostic Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Axis I Disorders. Patients with awareness did not seem to differ from their matched controls in subsequent psychosocial outcome, psychiatric morbidity, or quality of life. We found no indication that intraoperative awareness with recall had any deleterious long-term effects on patients' psychosocial outcome.

  1. Congenital lacrimal sac fistula: intraoperative visualization by polyvinyl siloxane cast.

    Science.gov (United States)

    Bhatnagar, Aparna; Eckstein, Lauren A; Douglas, Raymond S; Goldberg, Robert A

    2008-01-01

    We report the intraoperative use of polyvinyl siloxane impression material to demonstrate the anatomy of the lacrimal sac, canaliculi, and lacrimal duct in a case of congenital lacrimal sac fistula. A 1-week-old boy was examined for tearing since birth. Examination revealed a left congenital lacrimal sac fistula. After a failed surgery to close the fistula with silicone intubation at 6 months of age, the patient underwent endonasal dacryocystorhinostomy performed at 14 months of age, aided by intraoperative injection of polyvinyl siloxane (trade name Reprosil) to mark and protect the nasolacrimal sac and facilitate endonasal visualization. A polyvinyl siloxane cast demonstrated the anatomy of the accessory canaliculus causing nasolacrimal duct obstruction. Postoperatively, the epiphora resolved and the fistula remained closed. The polyvinyl siloxane cast provides a 3-dimensional "ex vivo " model of the lacrimal sac, upper duct, and canalicular anatomy, and can be used in dacryocystorhinostomy surgery to identify and protect the lacrimal sac.

  2. Intraoperative radiological margin assessment in breast-conserving surgery.

    Science.gov (United States)

    Ihrai, T; Quaranta, D; Fouche, Y; Machiavello, J-C; Raoust, I; Chapellier, C; Maestro, C; Marcy, M; Ferrero, J-M; Flipo, B

    2014-04-01

    A prospective study was lead in order to analyze the accuracy of an X-ray device settled in the operating room for margin assessment, when performing breast-conserving surgery. One hundred and seventy patients were included. All lesions were visible on the preoperative mammograms. An intraoperative X-ray of the lumpectomy specimen was systematically performed for margins assessment. Final histological data were collected and the accuracy of intraoperative specimen radiography (IOSR) for margin assessment was analyzed. IOSR allowed an evaluation of margins status in 155 cases (91.2%). After final histological examination, the positive margins rate would have been 6.5% if margin assessment had relied only on IOSR. Margin assessment with a two-dimensional X-ray device would have allowed the achievement of negative margins in 93.5% of the cases. Moreover, this procedure allows important time-saving and could have a substantial economical impact. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. [Intraoperative graft assessment using fluorescent imaging system (SPY)].

    Science.gov (United States)

    Kawashima, T; Naraoka, S; Kakizaki, T

    2009-07-01

    We investigated the efficacy of intraoperative fluorescent imaging system for the assessment of coronary artery bypass grafting (CABG). We used SPY imaging system in 100 CABG (57 off-pump and 43 on-pump CABG), totalling 287 distal anastomoses. The total graft patency rate on postoperative angiography in this series was 96.2% (276/287). Graft revision was done in 10 cases (10.0%) and 13 anastomoses (4.5%) by SPY imaging, which all resulted in good patency at postoperative angiography. On the other hand, 7 distal anastomoses and 1 mammary graft (2.8%) appeared to be successful on intraoperative SPY imaging, but were revealed to be occluded by postoperative angiography. SPY imaging system is useful for graft validation, and may contribute to improvement of coronary bypass graft patency.

  4. Principles for Management of Intraoperative Acute Type A Aortic Dissection.

    Science.gov (United States)

    Gukop, Philemon; Chandrasekaran, Vankatachalam

    2015-12-01

    Intraoperative Type A aortic dissection is a rare pathology with incidence of 0.06-0.32%. It is associated with a high mortality between 30-50%. Some associated risk factors, including hypertension, enlarged aorta, peripheral vascular disease, advanced age, atheroma, and high arterial pressure on cardiopulmonary bypass, have been identified. Modification of these risk factors could reduce the incidence of this event. Prompt diagnosis and management, with the aid of intraoperative trans-esophageal echocardiography and/or epi-aortic ultrasound has been shown to reduce the mortality to 17%. We illustrate the principles of management of this pathology with the case of a 62-year-old female who developed acute Type A aortic dissection while undergoing minimally invasive mitral valve repair.

  5. Transsphenoidal pituitary resection with intraoperative MR guidance: preliminary results

    Science.gov (United States)

    Pergolizzi, Richard S., Jr.; Schwartz, Richard B.; Hsu, Liangge; Wong, Terence Z.; Black, Peter M.; Martin, Claudia; Jolesz, Ferenc A.

    1999-05-01

    The use of intraoperative MR image guidance has the potential to improve the precision, extent and safety of transsphenoidal pituitary resections. At Brigham and Women's Hospital, an open-bore configuration 0.5T MR system (SIGNA SP, GE Medical Systems, Milwaukee, WI) has been used to provide image guidance for nine transsphenoidal pituitary adenoma resections. The intraoperative MR system allowed the radiologist to direct the surgeon toward the sella turcica successfully while avoiding the cavernous sinus, optic chiasm and other sensitive structures. Imaging performed during the surgery monitored the extent of resection and allowed for removal of tumor beyond the surgeon's view in five cases. Dynamic MR imaging was used to distinguish residual tumor from normal gland and postoperative changes permitting more precise tumor localization. A heme-sensitive long TE gradient echo sequence was used to evaluate for the presence of hemorrhagic debris. All patients tolerated the procedure well without significant complications.

  6. PamFreezer: a solution to enable frozen biopsy logistics

    NARCIS (Netherlands)

    Colijn, B.A.; Rios Cruellas, G.; Hashemi-Shabastari, M.; Janssen, X.; van der Leij, A.; Leyte-Gonzalez, R.; Vanapalli, Srinivas; Veldhuizen, P.; Verbiest, G.; Verhaagen, B.

    2012-01-01

    Tissue samples that are taken during a biopsy need to be snap-frozen in order to preserve their properties and use the tissue for contemporary molecular biology technologies that may improve the treatment of the patient. There is currently a lack of (safe) methodologies or devices for snap- freezing

  7. Characteristics of frozen colostrum thawed in a microwave oven

    Energy Technology Data Exchange (ETDEWEB)

    Jones, L.R.; Taylor, A.W.; Hines, H.C.

    1987-09-01

    Use of a microwave oven to thaw frozen colostrum was evaluated. Colostrum was collected from nine cows, four of which were immunized to produce specific colostral antibodies. Colostrum from each cow was frozen, subsequently thawed, and pooled. One-liter aliquots of the pooled colostrum were frozen and assigned randomly to three thawing treatments. Colostrum was thawed using one of three regimens: 10 min in a microwave oven at full power (650 W), 17 min in a microwave oven at half power (325 W), and 25 min in 45 degrees C water. Colostrum thawed in the microwave oven was slightly coagulated and had lower volume and total protein content than colostrum thawed in water. Casein and pH were not different among treatments. Both concentration and total content of immunoglobulin A were higher in the control than in microwave treatments. Neither amount nor concentration of immunoglobulin G and immunoglobulin M were different among treatments. Immunological activity, measured by a hemolytic test, was lower for microwave treatments than the control but did not differ between microwave treatments. Frozen colostrum thawed in a microwave oven should provide a reasonable source of colostrum when fresh high quality colostrum is not available.

  8. 9 CFR 381.158 - Poultry dinners (frozen) and pies.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Poultry dinners (frozen) and pies. 381... AGRICULTURE AGENCY ORGANIZATION AND TERMINOLOGY; MANDATORY MEAT AND POULTRY PRODUCTS INSPECTION AND VOLUNTARY INSPECTION AND CERTIFICATION POULTRY PRODUCTS INSPECTION REGULATIONS Definitions and Standards of Identity...

  9. The effects of commercial fibres on frozen bread dough

    Directory of Open Access Journals (Sweden)

    JELENA FILIPOVIĆ

    2010-02-01

    Full Text Available The daily intake of dietary fibres in highly industrialized countries is at a low level and, therefore, adversely affecting human health. The objective of this research was to analyze the influence of different commercial fibres (originating from sugar beet pulp fibrex, and Jerusalem artichoke inulin HPX and GR in yeast dough at a level of 5 %, on the rheological properties of dough and the quality of bread during frozen storage. Frozen dough characteristics were determined using a Brabender maturograph and test baking was followed according the AACC procedure. The dough was frozen at –18 °C and stored over a period of 60 days. The results concerning the dough (proving time and stability and bread quality (volume and crumb quality were statistically analyzed by multivariance Manova and discriminative analysis, which indicated that there was a significant difference between dough without fibres and dough with different fibres (fibrex, inulin HPX and GR. The discrimination coefficient points that the greatest influence of fibres on the final proof and proving stability is after 30 days (6.250 and after 0 days (6.158, respectively, but the greatest influence of fibres on bread volume and bread crumb quality (15.488 and 3.638, respectively can be expected on non frozen dough, due to above mention their adverse the effect on gluten network.

  10. Cryoprotectant redistribution along the frozen straw probed by Raman spectroscopy.

    Science.gov (United States)

    Karpegina, Yu A; Okotrub, K A; Brusentsev, E Yu; Amstislavsky, S Ya; Surovtsev, N V

    2016-04-01

    The distribution of cryoprotectant (10% glycerol) and ice along the frozen plastic straw (the most useful container for freezing mammalian semen, oocytes and embryos) was studied by Raman scattering technique. Raman spectroscopy being a contactless, non-invasive tool was applied for the straws filled with the cryoprotectant solution and frozen by controlled rate programs commonly used for mammalian embryos freezing. Analysis of Raman spectra measured at different points along the straw reveals a non-uniform distribution of the cryoprotectant. The ratio between non-crystalline solution and ice was found to be increased by several times at the bottom side of the solution column frozen by the standard freezing program. The increase of the cryoprotectant fraction occurs in the area where embryos or oocytes are normally placed during their freezing. Possible effects of the cooling rate and the ice nucleation temperature on the cryoprotectant fraction at the bottom side of the solution column were considered. Our findings highlight that the ice fraction around cryopreserved embryos or oocytes can differ significantly from the averaged one in the frozen plastic straws.

  11. Clinical Features Associated with Frozen Shoulder Syndrome in Parkinson's Disease.

    Science.gov (United States)

    Chang, Ya-Ting; Chang, Wen-Neng; Tsai, Nai-Wen; Cheng, Kuei-Yueh; Huang, Chih-Cheng; Kung, Chia-Te; Su, Yu-Jih; Lin, Wei-Che; Cheng, Ben-Chung; Su, Chih-Min; Chiang, Yi-Fang; Lu, Cheng-Hsien

    2015-01-01

    Background. Frozen shoulder syndrome is a common musculoskeletal disease of idiopathic Parkinson's disease (PD) that causes long-term pain and physical disability. A better understanding of the associated factors can help identify PD patients who will require prevention to improve their quality of life. Methodology. This prospective study evaluated 60 shoulders of 30 PD patients. Correlation analysis was used to evaluate the relationships between clinical factors and shoulder sonography findings. Results. Frozen shoulder syndrome was found in 14 of 30 PD patients affecting 19 shoulders, including bilateral involvement in five and unilateral involvement in nine. There was a significant positive correlation between the parameters of sonography findings and frozen shoulder syndrome (i.e., thickness of bicipital effusion and tendon thickness of the subscapularis and supraspinatus) and mean ipsilateral Unified Parkinson's Disease Rating Scale (UPDRS) III and its subscores (tremor, rigidity, and bradykinesia scores). Conclusions. Higher ipsilateral UPDRS and subscores are associated with increased effusion around the biceps tendon, with increased tendon thickness of subscapularis and supraspinatus. Preventing frozen shoulder syndrome in the high-risk PD group is an important safety issue and highly relevant for their quality of life.

  12. Microbiological deterioration of frozen parfried potatoes upon holding after thawing

    National Research Council Canada - National Science Library

    Michener, H D; Boyle, F P; Notter, G K; Guadagni, D G

    1968-01-01

    Frozen parfried potatoes were thawed and stored at 55, 45, and 34 F (12.8, 7.2, 1.1 C). Significant changes in flavor and texture did not occur at these temperatures until the total bacterial count exceeded 100 million per gram...

  13. PamFreezer: a solution to enable frozen biopsy logistics

    NARCIS (Netherlands)

    Colijn, B.A.; Rios Cruellas, G.; Hashemi-Shabastari, M.; Janssen, X.; Leij, van der A.; Leyte-Gonzalez, R.; Vanapalli, S.; Veldhuizen, P.; Verbiest, G.; Verhaagen, B.

    2012-01-01

    Tissue samples that are taken during a biopsy need to be snap-frozen in order to preserve their properties and use the tissue for contemporary molecular biology technologies that may improve the treatment of the patient. There is currently a lack of (safe) methodologies or devices for snap- freezing

  14. Speakers' Sensitivity to Rules of Frozen Word Order.

    Science.gov (United States)

    Pinker, Steven; Birdsong, David

    1979-01-01

    Two studies elicited native speaker and nonnative speaker judgments regarding preferred word order of the idioms known as "freezes." The results support the notion that rules of frozen word order are psychologically real and reflect universal language rules. (Author/AM)

  15. Premedication with oral Dextromethorphan reduces intra-operative Morphine requirement

    Directory of Open Access Journals (Sweden)

    R Talakoub

    2005-09-01

    Full Text Available Background: Intra-operative pain has adverse effects on hemodynamic parameters. Due to complications of opioids for pain relief, using non-opioids medication is preferred. The purpose of this study was to investigate the effect of oral dextrometorphan premedication on intra-operative Morphine requirement. Methods: After approval of the Ethics committee and informed consent, 40 adult patients who stand in American Society of Anesthesiologists Physical Status I and II, under general anesthesia for elective laparatomy were selected and classified in two equal groups randomly. In group A, oral dextromethorphan (60mg was administered at 10 PM and 6 AM preoperatively. In group B, placebo (dextrose was administered. After induction of general anesthesia and before skin incision, intravenous morphine (0.01 mg/kg was administered. During surgery, when systolic blood pressure or heart rate was increased more than 20% of the preoperative baseline, 0.01 mg/kg morphine was administered. At the end of surgery, the totally prescribed morphine (mg/kg and maximal increase in systolic, diastolic, mean arterial blood pressure and heart rate relative to the baseline values were calculated and statistically compared with student’s t-test. Results: The mean dose of administered morphine during surgery was significantly less in group A than group B (P<0.0001. Also, Maximal increase in systolic, diastolic and mean arterial blood pressure was significantly less in group A (p<0.003, p<0.004, p<0.0001, respectively. There was no significant difference in maximal heart rate increase between two groups (p<0.114. Conclusion: Oral dextromethorphan premedication may decrease intra-operative morphine requirement and reduce maximal increase in systolic and mean arterial blood pressure during surgery. Key words: Dextromethorphan, Morphine, Intra-operative, Premedication Hemodynamic

  16. Intraoperative Manipulation for Flexion Contracture During Total Knee Arthroplasty.

    Science.gov (United States)

    Matsui, Yoshio; Minoda, Yukihide; Fumiaki, Inori; Nakagawa, Sigeru; Okajima, Yoshiaki; Kobayashi, Akio

    2016-11-01

    Joint gap balancing during total knee arthroplasty (TKA) is important for ensuring postoperative joint stability and range of motion. Although the joint gap should be balanced to ensure joint stability, it is not easy to achieve perfect balancing during TKA. In particular, relative extension gap shortening can induce flexion contracture. Intraoperative manipulation is often empirically performed. This study evaluated the tension required for this manipulation and investigated the influence of intraoperative manipulation on the joint gap in cadaveric knees. Total knee arthroplasty was performed in 6 cadaveric knees from whole body cadavers. Flexion contracture was induced using an insert that was 4 mm thicker than the extension gap, and intraoperative manipulation was performed. Study measurements included the changes in the joint gap after manipulation at 6 positions, with the knee bending from extension to 120° flexion, and the manipulation tension that was required to create a 4-mm increase in the gap. The manipulation tension needed to create a 4-mm increase in the extension gap was 303±17 N. The changes in the joint gap after manipulation were 0.4 mm, 0.6 mm, 0.2 mm, -0.2 mm, -0.4 mm, and -0.6 mm at 0°, 30°, 45°, 60°, 90°, and 120° flexion, respectively. Therefore, the joint gap was not significantly changed by the manipulation. Intraoperative manipulation does not resolve flexion contracture. Therefore, if flexion contracture occurs during TKA, treatment with additional bone cutting and soft tissue release is likely more appropriate than manipulation. [Orthopedics. 2016; 39(6):e1070-e1074.]. Copyright 2016, SLACK Incorporated.

  17. Dapsone Induced Methaemoglobinemia: Early Intraoperative Detection by Pulse Oximeter Desaturation

    Directory of Open Access Journals (Sweden)

    Mahmood Rafiq

    2008-01-01

    Case signifies the importance of knowledge of any preoperative drug intake and its anaesthetic implications. Also patients on dapsone therapy especially children should be monitored for methaemoglobin levels. Since children with immune thrombocy-topenic purpura are being treated with dapsone these days and many of these patients would be planned for splenectomy, monitoring of preoperative methaemoglobin levels and methaemoglobinemia as a cause of intraoperative pulse oximeter desaturation should be kept in mind.

  18. Intraoperative augmented reality for minimally invasive liver interventions

    Science.gov (United States)

    Scheuering, Michael; Schenk, Andrea; Schneider, Armin; Preim, Bernhard; Greiner, Guenther

    2003-05-01

    Minimally invasive liver interventions demand a lot of experience due to the limited access to the field of operation. In particular, the correct placement of the trocar and the navigation within the patient's body are hampered. In this work, we present an intraoperative augmented reality system (IARS) that directly projects preoperatively planned information and structures extracted from CT data, onto the real laparoscopic video images. Our system consists of a preoperative planning tool for liver surgery and an intraoperative real time visualization component. The planning software takes into account the individual anatomy of the intrahepatic vessels and determines the vascular territories. Methods for fast segmentation of the liver parenchyma, of the intrahepatic vessels and of liver lesions are provided. In addition, very efficient algorithms for skeletonization and vascular analysis allowing the approximation of patient-individual liver vascular territories are included. The intraoperative visualization is based on a standard graphics adapter for hardware accelerated high performance direct volume rendering. The preoperative CT data is rigidly registered to the patient position by the use of fiducials that are attached to the patient's body, and anatomical landmarks in combination with an electro-magnetic navigation system. Our system was evaluated in vivo during a minimally invasive intervention simulation in a swine under anesthesia.

  19. Intra-operative correction of brain-shift.

    Science.gov (United States)

    Reinertsen, Ingerid; Lindseth, Frank; Askeland, Christian; Iversen, Daniel Høyer; Unsgård, Geirmund

    2014-07-01

    Brain-shift is a major source of error in neuronavigation systems based on pre-operative images. In this paper, we present intra-operative correction of brain-shift using 3D ultrasound. The method is based on image registration of vessels extracted from pre-operative MRA and intra-operative power Doppler-based ultrasound and is fully integrated in the neuronavigation software. We have performed correction of brain-shift in the operating room during surgery and provided the surgeon with updated information. Here, we present data from seven clinical cases with qualitative and quantitative error measures. The registration algorithm is fast enough to provide the surgeon with updated information within minutes and accounts for large portions of the experienced shift. Correction of brain-shift can make pre-operative data like fMRI and DTI reliable for a longer period of time and increase the usefulness of the MR data as a supplement to intra-operative 3D ultrasound in terms of overview and interpretation.

  20. Intraoperative ultrasonography of liver, bile ducts and pancreas

    Directory of Open Access Journals (Sweden)

    Luciana Mendes de Oliveira Cerri

    Full Text Available The use of intraoperative ultrasonography (IOUS to evaluate liver, bile ducts and pancreatic disease, as compared to the results of preoperative ultrasonography and CT, is discussed. Forty-two patients who underwent abdominal surgery for suspected hepatobiliary and/or pancreatic disease were studied. The intraoperative study was carried out with a portable apparatus (Aloka 500, Japan, using 5.0 MHz and 7.5 MHz linear sterile transducers. The main indications for IOUS were the search for and/or evaluation of primary hepatic masses,hepatic abscesses or metastases, obstructive jaundice, or neuroendocrine tumors. In 15 cases (38.5 percent from the hepatobiliary group and in 7 cases (58.3 percent from the pancreatic group, a difference between preoperative and intraoperative findings was observed. The main difference was observed in relation to the number and size of hepatic and pancreatic lesions. The relationship between the lesions and the vascular structures was evaluated through IOUS. The method was also used to guide surgical procedures such as biopsies, the alcoholization of nodules, and the drainage of abscesses. IOUS plays an important role in detecting small hepatic and pancreatic nodules, in the assessment of anatomical relationships between the lesions and the vascular structures, and in the performance of interventionist procedures.

  1. 78 FR 54912 - Frozen Warmwater Shrimp from Indonesia and Thailand; Termination of Investigations

    Science.gov (United States)

    2013-09-06

    ... From the Federal Register Online via the Government Publishing Office INTERNATIONAL TRADE COMMISSION Frozen Warmwater Shrimp from Indonesia and Thailand; Termination of Investigations AGENCY: United...(a)), the countervailing duty investigations concerning frozen warmwater shrimp from Indonesia...

  2. Perinatal outcomes of children born after frozen-thawed embryo transfer

    DEFF Research Database (Denmark)

    Wennerholm, Ulla-Britt; Henningsen, Anna-Karina Aaris; Romundstad, Liv Bente;

    2013-01-01

    What are the risks of adverse outcomes in singletons born after frozen-thawed embryo transfer (FET)?......What are the risks of adverse outcomes in singletons born after frozen-thawed embryo transfer (FET)?...

  3. Redox State of Cytochromes in Frozen Yeast Cells Probed by Resonance Raman Spectroscopy

    National Research Council Canada - National Science Library

    Okotrub, Konstantin A; Surovtsev, Nikolay V

    2015-01-01

    ...). Since most biological methods do not work in a low-temperature frozen environment, the mechanism and details of the depression of cellular activity in the frozen state remain largely uncharacterized...

  4. 78 FR 13325 - Certain Frozen Warmwater Shrimp From the People's Republic of China, Ecuador, India, Indonesia...

    Science.gov (United States)

    2013-02-27

    ...-815] Certain Frozen Warmwater Shrimp From the People's Republic of China, Ecuador, India, Indonesia... frozen warmwater shrimp from the People's Republic of China, Ecuador, India, Indonesia, Malaysia... of China,Ecuador, India, Indonesia, Malaysia, Thailand, and the Socialist Republic of...

  5. Influence of pH on the physicochemical and sensorial characteristics of strawberry frozen yogurt

    OpenAIRE

    2012-01-01

    Frozen yogurt is a frozen fermented dessert which presents structural characteristics similar to ice cream and nutritional and sensorial properties which resemble to yogurt. The acidification of ice cream mix by means of lactic bacteria can influence the properties of frozen yogurt. For that reason, the present work aimed to evaluate the influence of pH on the physicochemical and sensorial characteristics of strawberry frozen yogurt. The formulation consisted of 6 % of milk fat, 10 % of milk ...

  6. Incidence and outcomes of intraoperative vascular surgery consultations.

    Science.gov (United States)

    Danczyk, Rachel C; Coleman, Jake; Allensworth, Jordan; Azarbal, Amir F; Mitchell, Erica L; Liem, Timothy K; Landry, Gregory J; Moneta, Gregory L

    2015-07-01

    Vascular surgeons may aid in primarily nonvascular procedures. Such activity has not been quantified, and hospital administrators may be unaware of the importance of vascular surgeons to support other hospital-based surgical programs. This study reviewed intraoperative consultations by vascular surgeons to support other surgical services. Intraoperative vascular consultations were reviewed from January 2006 to January 2014 for consulting service, indication, and whether consultation occurred with advanced notice. Patient demographics, operative times, estimated blood loss, length of stay, and relative value units (RVUs) assigned for each consultation were also assessed. Consultations for trauma and iatrogenic injuries occurring outside the operating theater were excluded. Vascular surgeons performed 225 intraoperative consultations in support of procedures by nonvascular surgeons. Requesting services were surgical oncology (46%), orthopedics (17%), urology (11%), otolaryngology (7%), and others (19%). Reasons for consultation overlapped and included vascular reconstruction (53%), control of hemorrhage (39%), and assistance with difficult dissections (43%). Seventy-four percent were for intra-abdominal procedures, and venous (53%) and arterial (50%) problems were encountered equally with some overlap. Most patients were male (59%), overweight (56%; body mass index ≥25 kg/m(2)), had previous surgery (72%) and were undergoing elective procedures (89%). Mean total procedural anesthesia time was 9.4 hours, mean procedural operating time was 7.9 hours, and mean total and vascular-related estimated blood loss was 1702 mL and 327 mL, respectively. Mean length of stay was 14.7 days, mean intensive care unit stay was 2.9 days, and 30-day mortality was 6.2%. Mean nonvascular RVUs per operation were 46.0, and mean vascular RVUs per operation were 30.9. Unexpected intraoperative need for vascular surgical expertise occurs often enough that vascular surgeons should be regarded

  7. The use of intraoperative computed tomography navigation in pituitary surgery promises a better intraoperative orientation in special cases

    OpenAIRE

    Stefan Linsler; Sebastian Antes; Sebastian Senger; Joachim Oertel

    2016-01-01

    Objective: The safety of endoscopic skull base surgery can be enhanced by accurate navigation in preoperative computed tomography (CT) and magnetic resonance imaging (MRI). Here, we report our initial experience of real-time intraoperative CT-guided navigation surgery for pituitary tumors in childhood. Materials and Methods: We report the case of a 15-year-old girl with a huge growth hormone-secreting pituitary adenoma with supra- and perisellar extension. Furthermore, the skull base was infi...

  8. 78 FR 30272 - Certain Frozen Warmwater Shrimp from Brazil: Notice of Rescission of Antidumping Duty...

    Science.gov (United States)

    2013-05-22

    ... International Trade Administration Certain Frozen Warmwater Shrimp from Brazil: Notice of Rescission of... Administrative Review'' of the antidumping duty order on certain frozen warmwater shrimp from Brazil for the... review of the antidumping duty order on certain frozen warmwater shrimp from Brazil with respect to...

  9. 75 FR 22370 - Certain Frozen Warmwater Shrimp From Brazil, Ecuador, India, the People's Republic of China...

    Science.gov (United States)

    2010-04-28

    ... Value: Certain Frozen and Canned Warmwater Shrimp From Brazil, 69 FR 76910 (December 23, 2004) (Brazil... Than Fair Value and Antidumping Duty Order: Certain Frozen Warmwater Shrimp from Brazil, 70 FR 5143... International Trade Administration Certain Frozen Warmwater Shrimp From Brazil, Ecuador, India, the...

  10. 77 FR 32498 - Certain Frozen Warmwater Shrimp From Brazil: Notice of Rescission of Antidumping Duty...

    Science.gov (United States)

    2012-06-01

    ... International Trade Administration Certain Frozen Warmwater Shrimp From Brazil: Notice of Rescission of... the antidumping duty order on certain frozen warmwater shrimp from Brazil for the period of review... the antidumping duty order on certain frozen warmwater shrimp from Brazil with respect to...

  11. 75 FR 32915 - Certain Frozen Warmwater Shrimp From Brazil: Notice of Rescission of Antidumping Duty...

    Science.gov (United States)

    2010-06-10

    ... International Trade Administration Certain Frozen Warmwater Shrimp From Brazil: Notice of Rescission of... the antidumping duty order on certain frozen warmwater shrimp from Brazil for the period of review... on certain frozen warmwater shrimp from Brazil. On April 7, 2009, the Department published a...

  12. 78 FR 13324 - Certain Frozen Warmwater Shrimp From the People's Republic of China: Notice of Preliminary...

    Science.gov (United States)

    2013-02-27

    ... the domestic like product to include dusted shrimp. See Certain Frozen Warmwater Shrimp From Brazil... Order: Certain Frozen Warmwater Shrimp From the People's Republic of China, 70 FR 5149 (February 1, 2005... International Trade Administration Certain Frozen Warmwater Shrimp From the People's Republic of China:...

  13. 76 FR 38360 - Certain Frozen Warmwater Shrimp From Brazil: Notice of Rescission of Antidumping Duty...

    Science.gov (United States)

    2011-06-30

    ... International Trade Administration Certain Frozen Warmwater Shrimp From Brazil: Notice of Rescission of... the antidumping duty order on certain frozen warmwater shrimp from Brazil for the period of review... on certain frozen warmwater shrimp from Brazil. On April 1, 2011, the Department published a...

  14. 76 FR 18157 - Certain Frozen Warmwater Shrimp From Brazil, India, and Thailand: Notice of Initiation of...

    Science.gov (United States)

    2011-04-01

    ... and its affiliated subsidiaries (collectively, ``Pakfood''); \\1\\ and Thai Royal Frozen Food Co., Ltd... Adilakshmi Enterprises Allana Frozen Foods Pvt. Ltd Allansons Ltd AMI Enterprises Amulya Sea Foods Ananda... Trading Corporation Private Limited.\\2\\ Coastal Corporation Ltd Cochin Frozen Food Exports Pvt....

  15. 76 FR 64001 - United States Standards for Grades of Frozen Okra

    Science.gov (United States)

    2011-10-17

    ... CFR part 36). Background AMS received a petition from the American Frozen Food Institute (AFFI... Service 7 CFR Part 52 United States Standards for Grades of Frozen Okra AGENCY: Agricultural Marketing... of Agriculture (USDA) has revised the United States Standards for Grades of Frozen Okra. The...

  16. 7 CFR 52.802 - Grades of frozen red tart pitted cherries.

    Science.gov (United States)

    2010-01-01

    ... OTHER PROCESSED FOOD PRODUCTS 1 United States Standards for Grades of Frozen Red Tart Pitted Cherries Product Description and Grades § 52.802 Grades of frozen red tart pitted cherries. (a) “U.S. Grade A” (or... 7 Agriculture 2 2010-01-01 2010-01-01 false Grades of frozen red tart pitted cherries....

  17. 75 FR 22551 - United States Standards for Grades of Frozen Blueberries

    Science.gov (United States)

    2010-04-29

    ..., Agricultural Research Service and the other from the American Frozen Food Institute. Both commenters stated... Agricultural Marketing Service United States Standards for Grades of Frozen Blueberries AGENCY: Agricultural... proposed revision to the United States Standards for Grades of Frozen Blueberries. After considering...

  18. 77 FR 19612 - Certain Frozen Warmwater Shrimp from Brazil, India, and Thailand: Notice of Initiation of...

    Science.gov (United States)

    2012-04-02

    .... Adilakshmi Enterprises Allana Frozen Foods Pvt. Ltd. Allanasons Ltd. AMI Enterprises Amulya Seafoods Anand... Marine Products Blue Fin Frozen Foods Pvt. Ltd. Blue Water Foods & Exports P. Ltd. Bluefin Enterprises... Frozen Food Exports Pvt. Ltd. Coreline Exports Corlim Marine Exports Pvt. Ltd. Damco India Private...

  19. 7 CFR 52.812 - Score sheet for frozen red tart pitted cherries.

    Science.gov (United States)

    2010-01-01

    ..., AND CERTAIN OTHER PROCESSED FOOD PRODUCTS 1 United States Standards for Grades of Frozen Red Tart Pitted Cherries Score Sheet § 52.812 Score sheet for frozen red tart pitted cherries. Size and kind of... 7 Agriculture 2 2010-01-01 2010-01-01 false Score sheet for frozen red tart pitted cherries....

  20. 78 FR 15696 - Certain Frozen Warmwater Shrimp From the People's Republic of China: Preliminary Results of...

    Science.gov (United States)

    2013-03-12

    ... Produce Development Ltd. 44. Shenzhen Yudayuan Trade Ltd. 45. Thai Royal Frozen Food Zhanjiang Co., Ltd... International Trade Administration Certain Frozen Warmwater Shrimp From the People's Republic of China... certain frozen warmwater shrimp (``shrimp'') from the People's Republic of China (``PRC''), covering...

  1. 78 FR 56209 - Certain Frozen Warmwater Shrimp From the People's Republic of China: Final Results of...

    Science.gov (United States)

    2013-09-12

    ...., Shenzhen Yudayuan Trade Ltd., Thai Royal Frozen Food Zhanjiang Co., Ltd., Xiamen Granda Import & Export Co... Anyang Food Co., Ltd., Yangjiang City Yelin Hoi Tat Quick Frozen Seafood Co., Ltd., Yangjiang Wanshida... International Trade Administration Certain Frozen Warmwater Shrimp From the People's Republic of China:...

  2. 75 FR 57501 - Frozen Warmwater Shrimp From Brazil, China, India, Thailand, and Vietnam

    Science.gov (United States)

    2010-09-21

    ... COMMISSION Frozen Warmwater Shrimp From Brazil, China, India, Thailand, and Vietnam AGENCY: United States... orders on frozen warmwater shrimp from Brazil, China, India, Thailand, and Vietnam. SUMMARY: The... orders on frozen warmwater shrimp from Brazil, China, India, Thailand, and Vietnam would be likely...

  3. 78 FR 18957 - Certain Frozen Fish Fillets From the Socialist Republic of Vietnam: Initiation of Antidumping...

    Science.gov (United States)

    2013-03-28

    ... International Trade Administration Certain Frozen Fish Fillets From the Socialist Republic of Vietnam...'') of the antidumping duty (``AD'') order on certain frozen fish fillets (``fish fillets'') from the... Notice of Antidumping Duty Order: Certain Frozen Fish Fillets From the Socialist Republic of Vietnam,...

  4. 77 FR 60675 - Certain Frozen Fish Fillets From the Socialist Republic of Vietnam: Initiation of Antidumping...

    Science.gov (United States)

    2012-10-04

    ... International Trade Administration Certain Frozen Fish Fillets From the Socialist Republic of Vietnam... antidumping duty order on certain frozen fish fillets (``fish'') from the Socialist Republic of Vietnam... request was based.\\3\\ \\1\\ See Notice of Antidumping Duty Order: Certain Frozen Fish Fillets From...

  5. 78 FR 72635 - Certain Frozen Warmwater Shrimp From the Socialist Republic of Vietnam: Rescission of Antidumping...

    Science.gov (United States)

    2013-12-03

    ... International Trade Administration Certain Frozen Warmwater Shrimp From the Socialist Republic of Vietnam... Department'') initiated a new shipper review of the antidumping duty order on certain frozen warmwater shrimp... Certain Frozen Warmwater Shrimp from the Socialist Republic of Vietnam: Initiation of Antidumping Duty...

  6. 75 FR 844 - Certain Frozen Warmwater Shrimp From the Socialist Republic of Vietnam: Extension of Preliminary...

    Science.gov (United States)

    2010-01-06

    ... International Trade Administration Certain Frozen Warmwater Shrimp From the Socialist Republic of Vietnam...'') is extending the time limit for the preliminary results of the new shipper review of certain frozen... order on shrimp from Vietnam for Nhat Duc Co., Ltd. See Certain Frozen Warmwater Shrimp from...

  7. 75 FR 60730 - Certain Frozen Warmwater Shrimp From the Socialist Republic of Vietnam: Initiation of Antidumping...

    Science.gov (United States)

    2010-10-01

    ... International Trade Administration Certain Frozen Warmwater Shrimp From the Socialist Republic of Vietnam... antidumping duty order on certain frozen warmwater shrimp (``shrimp'') from the Socialist Republic of Vietnam...: Certain Frozen Warmwater Shrimp From the Socialist Republic of Vietnam, 70 FR 5152 (February 1,...

  8. 75 FR 48724 - Frozen Warmwater Shrimp From Brazil, China, India, Thailand, and Vietnam

    Science.gov (United States)

    2010-08-11

    ... COMMISSION Frozen Warmwater Shrimp From Brazil, China, India, Thailand, and Vietnam AGENCY: United States... orders on frozen warmwater shrimp from Brazil, China, India, Thailand, and Vietnam. SUMMARY: The... orders on frozen warmwater shrimp from Brazil, China, India, Thailand, and Vietnam would be likely...

  9. 77 FR 2958 - Certain Frozen Warmwater Shrimp From the Socialist Republic of Vietnam: Extension of Preliminary...

    Science.gov (United States)

    2012-01-20

    ... International Trade Administration Certain Frozen Warmwater Shrimp From the Socialist Republic of Vietnam... results of the sixth administrative review of the antidumping duty order on certain frozen warmwater... administrative review of the antidumping duty order on certain frozen warmwater shrimp from Vietnam....

  10. 78 FR 64009 - Frozen Warmwater Shrimp From China, Ecuador, India, Malaysia, and Vietnam

    Science.gov (United States)

    2013-10-25

    ... COMMISSION Frozen Warmwater Shrimp From China, Ecuador, India, Malaysia, and Vietnam Determinations On the... imports from China, Ecuador, India, Malaysia, and Vietnam of frozen warmwater shrimp, provided for in... Commission following notification of preliminary determinations by Commerce that imports of frozen...

  11. 75 FR 22424 - Frozen Warmwater Shrimp From Brazil, China, India, Thailand, and Vietnam

    Science.gov (United States)

    2010-04-28

    ... COMMISSION Frozen Warmwater Shrimp From Brazil, China, India, Thailand, and Vietnam AGENCY: United States... concerning the antidumping duty orders on frozen warmwater shrimp from Brazil, China, India, Thailand, and... antidumping duty orders on frozen warmwater shrimp from Brazil, China, India, Thailand, and Vietnam would...

  12. 76 FR 65178 - Certain Frozen Warmwater Shrimp From the Socialist Republic of Vietnam: Extension of Preliminary...

    Science.gov (United States)

    2011-10-20

    ... International Trade Administration Certain Frozen Warmwater Shrimp From the Socialist Republic of Vietnam... preliminary results of the sixth administrative review of the antidumping duty order on certain frozen... administrative review of the antidumping duty order on certain frozen warmwater shrimp from Vietnam....

  13. 78 FR 59650 - Certain Frozen Warmwater Shrimp From the Socialist Republic of Vietnam: Initiation of Antidumping...

    Science.gov (United States)

    2013-09-27

    ... International Trade Administration Certain Frozen Warmwater Shrimp From the Socialist Republic of Vietnam... that a request for a new shipper review (``NSR'') of the antidumping duty order on certain frozen... Sales at Less Than Fair Value and Antidumping Duty Order: Certain Frozen Warmwater Shrimp From...

  14. 76 FR 50718 - Certain Frozen Warmwater Shrimp From the People's Republic of China: Extension of Preliminary...

    Science.gov (United States)

    2011-08-16

    ... International Trade Administration Certain Frozen Warmwater Shrimp From the People's Republic of China... frozen warmwater shrimp from the People's Republic of China (``PRC''). The review covers the period... duty order on certain frozen warmwater shrimp from the PRC. See Initiation of...

  15. 78 FR 33346 - Certain Frozen Warmwater Shrimp From the People's Republic of China: Preliminary Countervailing...

    Science.gov (United States)

    2013-06-04

    ... International Trade Administration Certain Frozen Warmwater Shrimp From the People's Republic of China... determines that countervailable subsidies are being provided to producers and exporters of certain frozen warmwater shrimp (frozen shrimp) from the People's Republic of China (PRC). The period of investigation...

  16. 75 FR 56988 - Certain Frozen Warmwater Shrimp From the People's Republic of China: Extension of Preliminary...

    Science.gov (United States)

    2010-09-17

    ... International Trade Administration Certain Frozen Warmwater Shrimp From the People's Republic of China... frozen warmwater shrimp from the People's Republic of China (``PRC''). The review covers the period... initiation of the administrative reviews of the antidumping duty orders on certain frozen shrimp from...

  17. 77 FR 20008 - Certain Frozen Fish Fillets From the Socialist Republic of Vietnam: Initiation of Antidumping...

    Science.gov (United States)

    2012-04-03

    ... International Trade Administration Certain Frozen Fish Fillets From the Socialist Republic of Vietnam... antidumping duty order on certain frozen fish fillets (``fish'') from the Socialist Republic of Vietnam... upon which the requests were based. \\1\\ See Notice of Antidumping Duty Order: Certain Frozen...

  18. 75 FR 55740 - Certain Frozen Warmwater Shrimp From the Socialist Republic of Vietnam: Extension of Preliminary...

    Science.gov (United States)

    2010-09-14

    ... International Trade Administration Certain Frozen Warmwater Shrimp From the Socialist Republic of Vietnam... frozen warmwater shrimp from the Socialist Republic of Vietnam (``Vietnam''). The review covers the... of the antidumping duty orders on certain frozen warmwater shrimp from Vietnam and the...

  19. 78 FR 59915 - Certain Frozen Fish Fillets From the Socialist Republic of Vietnam: Initiation of Antidumping...

    Science.gov (United States)

    2013-09-30

    ... International Trade Administration Certain Frozen Fish Fillets From the Socialist Republic of Vietnam...'') of the antidumping duty (``AD'') order on certain frozen fish fillets (``fish fillets'') from the... received an NSR request from Thanh Hung Co., Ltd. D/B/A Thanh Hung Frozen Seafood Processing Import...

  20. 7 CFR 318.13-13 - Movement of frozen fruits and vegetables.

    Science.gov (United States)

    2010-01-01

    ... Regulated Articles From Hawaii and the Territories § 318.13-13 Movement of frozen fruits and vegetables. Frozen fruits and vegetables may be certified for movement from Hawaii, Puerto Rico, Guam, the... 7 Agriculture 5 2010-01-01 2010-01-01 false Movement of frozen fruits and vegetables. 318.13-13...

  1. 7 CFR 319.56-12 - Importation of frozen fruits and vegetables.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 5 2010-01-01 2010-01-01 false Importation of frozen fruits and vegetables. 319.56-12... HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE FOREIGN QUARANTINE NOTICES Fruits and Vegetables § 319.56-12 Importation of frozen fruits and vegetables. Frozen fruits and vegetables may be imported...

  2. 7 CFR 58.318 - Butter, frozen or plastic cream melting machines.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Butter, frozen or plastic cream melting machines. 58... Service 1 Equipment and Utensils § 58.318 Butter, frozen or plastic cream melting machines. Shavers, shredders or melting machines used for rapid melting of butter, frozen or plastic cream shall be...

  3. A digital rat atlas of sectional anatomy

    Science.gov (United States)

    Yu, Li; Liu, Qian; Bai, Xueling; Liao, Yinping; Luo, Qingming; Gong, Hui

    2006-09-01

    This paper describes a digital rat alias of sectional anatomy made by milling. Two healthy Sprague-Dawley (SD) rat weighing 160-180 g were used for the generation of this atlas. The rats were depilated completely, then euthanized by Co II. One was via vascular perfusion, the other was directly frozen at -85 °C over 24 hour. After that, the frozen specimens were transferred into iron molds for embedding. A 3% gelatin solution colored blue was used to fill the molds and then frozen at -85 °C for one or two days. The frozen specimen-blocks were subsequently sectioned on the cryosection-milling machine in a plane oriented approximately transverse to the long axis of the body. The surface of specimen-blocks were imaged by a scanner and digitalized into 4,600 x2,580 x 24 bit array through a computer. Finally 9,475 sectional images (arterial vessel were not perfused) and 1,646 sectional images (arterial vessel were perfused) were captured, which made the volume of the digital atlas up to 369.35 Gbyte. This digital rat atlas is aimed at the whole rat and the rat arterial vessels are also presented. We have reconstructed this atlas. The information from the two-dimensional (2-D) images of serial sections and three-dimensional (3-D) surface model all shows that the digital rat atlas we constructed is high quality. This work lays the foundation for a deeper study of digital rat.

  4. A comparison between post-operative analgesia after intrathecal nalbuphine with bupivacaine and intrathecal fentanyl with bupivacaine after cesarean section

    Directory of Open Access Journals (Sweden)

    Hala Mostafa Gomaa

    2014-10-01

    Conclusion: Either intrathecal nalbuphine 0.8 mg or intrathecal fentanyl 25 μg combined with 10 mg bupivacaine provides good intra-operative and early post-operative analgesia in cesarean section.

  5. Frozen transitions to adulthood of young people in Slovenia?

    Directory of Open Access Journals (Sweden)

    Kuhar Metka

    2012-01-01

    Full Text Available This article reviews key-indicators of youth transitions in Slovenia over the last decades and highlights some of the inherent tensions. Against the background of the metaphor of ‘frozen transitions’, which tries to grasp some of the contradictions between the speed of societal change and the stagnating development of youth towards independence, the article describes and reflects the development of youth transitions in the three domains of employment, housing and parenthood. The basis is a selection of indicators available in international data sets and surveys that allow to trace the change at least over the last two decades after the breakdown of Yugoslavia. Our findings indicate that transitions in Slovenia are frozen in all three domains, which challenges the usefulness of the conventional life course framework for studying post-communist contexts.

  6. First frozen repository for the Great Barrier Reef coral created.

    Science.gov (United States)

    Hagedorn, Mary; van Oppen, Madeleine J H; Carter, Virginia; Henley, Mike; Abrego, David; Puill-Stephan, Eneour; Negri, Andrew; Heyward, Andrew; MacFarlane, Doug; Spindler, Rebecca

    2012-10-01

    To build new tools for the continued protection and propagation of coral from the Great Barrier Reef (GBR), an international group of coral and cryopreservation scientists known as the Reef Recovery Initiative joined forces during the November 2011 mass-spawning event. The outcome was the creation of the first frozen bank for Australian coral from two important GBR reef-building species, Acropora tenuis and Acropora millepora. Approximately 190 frozen samples each with billions of cells were placed into long-term storage. Sperm cells were successfully cryopreserved, and after thawing, samples were used to fertilize eggs, resulting in functioning larvae. Additionally, developing larvae were dissociated, and these pluripotent cells were cryopreserved and viable after thawing. Now, we are in a unique position to move our work from the laboratory to the reefs to develop collaborative, practical conservation management tools to help secure Australia's coral biodiversity.

  7. Quality changes during frozen storage and thawing of mixed bread.

    Science.gov (United States)

    Fik, M; Macura, R

    2001-04-01

    In the present work investigations of the dependence between frozen storage time, the method of thawing (air blast at 50 degrees C and microwave), organoleptic and physico-chemical changes in bread are reported. The quality of the thawed product was analysed directly after thawing and after two days of storage at room temperature. It was found that changes in quality of bread are more affected by frozen storage than by the employed thawing method. The thawing methods had a significant (p bread at room temperature rather than directly after thawing. The results obtained in the present study suggest that bread which underwent microwave thawing had generally better quality in comparison with air blast thawing.

  8. Classification of frozen soil blastability by using perceptron neural network

    Institute of Scientific and Technical Information of China (English)

    马芹永; 张志红

    2002-01-01

    Influence factors of frozen soil blastability are analyzed which mainly conclude the strain energy coefficient, tensile strength, compressive strength, longitudinal wave velocity and transverse wave velocity. According to the principle of perceptron neural network, at first the index factors are standardized by the aid of the efficient function theory, then the blastability of frozen sand at -7, -12 and -17 ℃ are classified three categories. Through adjusting the weight value and threshold value, we can obtain that the clay blastability at -7 ℃ is close to the sand blastability at -12 ℃, they belong to the second category, the clay blastability at -12 ℃ is close to the sand blastability at -17 ℃, thus they are divided into the third category.

  9. Relativistic frozen core potential scheme with relaxation of core electrons

    Science.gov (United States)

    Nakajima, Yuya; Seino, Junji; Hayami, Masao; Nakai, Hiromi

    2016-10-01

    This letter proposes a relaxation scheme for core electrons based on the frozen core potential method at the infinite-order Douglas-Kroll-Hess level, called FCP-CR. The core electrons are self-consistently relaxed using frozen molecular valence potentials after the valence SCF calculation is performed. The efficiency of FCP-CR is confirmed by calculations of gold clusters. Furthermore, FCP-CR reproduces the results of the all-electron method for the energies of coinage metal dimers and the core ionization energies and core level shifts of vinyl acetate and three tungsten complexes at the Hartree-Fock and/or symmetry-adapted cluster configuration interaction levels.

  10. Intraoperative Micro-Doppler in Cerebral Arteriovenous Malformations.

    Science.gov (United States)

    Burkhardt, Till; Siasios, Giannis; Schmidt, Nils Ole; Reitz, Mathias; Regelsberger, Jan; Westphal, Manfred

    2015-11-01

    Intraoperative micro-Doppler (IOMD), intraoperative digital substraction angiography (DSA), and microscope-integrated indocyanine green angiography are methods that guide neurosurgical resection of arteriovenous malformations (AVMs) in the brain and minimize the trauma of healthy tissue. In this study we emphasize the use of IOMD in AVM surgery, analyzing the advantages and the limitations of this method. Patients and A total of 32 patients were diagnosed with an AVM. Supplying arteries and draining veins were analyzed regarding hemodynamic profiles, flow velocities, pulsatility index (PI), and resistance index (RI). Venous drainages were accompanied by arterial blood flow disturbances that showed typical characteristics in all cases. We set an angle of 60 degrees between the examined vessel and the probe to achieve a more reliable and comparable measurement. Postoperative DSA was performed in all patients. Supplying arterial blood vessels of AVMs could be identified by their characteristic blood flow profiles with PI < 0.7 and RI < 0.55. Drainage veins in all 32 cases showed normalized venous flow patterns without arterial flow turbulences at the end of the surgical procedure. Postoperative DSA revealed a residual AVM in one patient. IOMD constitutes a safe, accurate, and low-cost imaging modality for evaluating blood flow velocities and for optimal stepwise AVM elimination without unnecessary sacrifice of veins. PI and RI are reliable parameters in diagnosing cerebrovascular malformations, but systolic and diastolic flow velocities may vary to a greater extent. This phenomenon has never been elucidated previously and therefore needs to be emphasized when using this technique intraoperatively. Georg Thieme Verlag KG Stuttgart · New York.

  11. Alpha antagonists and intraoperative floppy iris syndrome: A spectrum

    Directory of Open Access Journals (Sweden)

    Sharif A Issa

    2008-07-01

    Full Text Available Sharif A Issa, Omar H Hadid, Oliver Baylis, Margaret DayanDepartment of Ophthalmology, Royal Victoria Infirmary, Newcastle upon Tyne, UKBackground: To determine occurrence of features of intraoperative floppy iris syndrome (IFIS during cataract surgery in patients taking systemic alpha-antagonists (AA.Methods: We prospectively studied patients on AA and who underwent phacoemulsification. The following were recorded: pupil diameter preoperatively, iris flaccidity, iris prolapse and peroperative miosis.Results: We studied 40 eyes of 31 subjects. Mean age was 78 years. Overall, 14 eyes (13 patients showed signs of IFIS: 9/13 (69% eyes of patients on tamsulosin, 1/18 (6% eyes in the doxazosin group, 2/2 prazosin patients, 1/4 eyes in the indoramin group, and 1/2 eyes in two patients on a combination of doxazosin and tamsulosin. Most cases (92% had only one or two signs of IFIS. Bilateral cataract surgery was undertaken in 9 patients but only one patient (on tamsulosin had features of IFIS in both eyes, while 4 patients (2 on tamsulosin and 2 on other AA showed signs of IFIS in one eye only, and 4 patients did not show IFIS in either eye.Conclusion: Most AA were associated with IFIS, but it tends to present as a spectrum of signs rather than full triad originally described. Tamsulosin was most likely to be associated with IFIS; however, its intake does not necessarily mean that IFIS will occur. For patients on AA, the behavior of the iris intraoperatively in one eye is a poor predictor of the other eye. Surgeons should anticipate the occurrence of IFIS in any patient on AA.Keywords: alpha blocker, alpha antagonist, cataract surgery, intraoperative floppy iris syndrome, tamsulosin.

  12. Intraoperative Hypothermia in Total Hip and Knee Arthroplasty.

    Science.gov (United States)

    Frisch, Nicholas B; Pepper, Andrew M; Rooney, Edward; Silverton, Craig

    2016-10-25

    Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are common and successful orthopedic procedures, and as their frequency continues to increase substantially, the focus on limiting perioperative complications heightens. Intraoperative normothermia is recommended to minimize additional complications, but limited evidence exists regarding the effect of hypothermia on orthopedic patients. The purpose of this retrospective study was to determine the incidence of perioperative hypothermia in the setting of TKA and THA, and to evaluate its impact on complications and outcomes. The clinical records of 2580 consecutive patients who underwent TKA or THA at a single institution between January 1, 2011, and December 31, 2013 were reviewed. After excluding patients with complex or revision procedures, a total of 2397 patients comprised the study population. Patient demographic data, surgery-specific data, postoperative complications, length of hospital stay, and 30-day readmission were recorded. Patients with a mean intraoperative temperature less than 36°C were identified as hypothermic. Statistical analysis evaluated associations with hypothermia and the effect on complications and outcomes. The incidence of mean intraoperative hypothermia was 37%, 43.9%, and 32.6% for arthroplasty, THA, and TKA, respectively. General anesthesia was significantly associated with hypothermia (P<.001). Women and THA patients were at higher risk for hypothermia. In the arthroplasty and THA cohorts, longer operating room time and re-warmer use were associated with hypothermia (P=.010). Overall, hypothermia was associated with increased estimated blood loss, but no increase in associated transfusion was demonstrated (P=.006). Hypothermia was not associated with postoperative complications. [Orthopedics. 201x; xx(x):xx-xx.].

  13. Using Intraoperative Ultrasonography for Spinal Cord Tumor Surgery.

    Science.gov (United States)

    Ivanov, Marcel; Budu, Alexandru; Sims-Williams, Hugh; Poeata, Ion

    2017-01-01

    Our aim was to evaluate the usefulness of modern intraoperative ultrasonography (iUS) in the resection of a wide variety of spinal intradural pathologic entities. We evaluated patients with spinal cord disease treated between January 2006 and September 2015. Intraoperative standard B-mode images were acquired using a 3.5-MHz to 12-MHz ultrasonographic probes (linear and curvilinear) on various ultrasound machines. The benefits and disadvantages of iUS were assessed for each case. A total number of 158 intradural spinal lesions were operated on using iUS. Of these, 107 lesions (68%) were intradural extramedullary and 51 (32%) were intramedullary. All lesions were clearly visible using the ultrasound probe. The high-frequency linear probes (10-12 MHz) provided a better image quality compared with lower-frequency probes. Color and power-angiography modes were helpful in assessing the vascularization of the tumors and location of the major vessels in the vascular lesions. We document how iUS was used to facilitate safe and efficient spinal tumor resection at each stage of the operation. iUS was beneficial in confirmation of tumor location and extension, planning myelotomy, and estimation of degree of resection of the intramedullary tumors. It was particularly helpful in guiding the approach in redo surgeries for recurrent spinal cord tumors. iUS has a fast learning curve and offers additional intraoperative information that can help improve surgical accuracy and therefore may reduce procedure-related morbidity. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Hydrodynamic study of syringomyelia by MRI and intraoperative ultrasonography

    Energy Technology Data Exchange (ETDEWEB)

    Moritake, Kouzo; Takaya, Mikio; Minamikawa, Jun; Ishikawa, Masatsune; Kikuchi, Haruhiko; Minami, Shunsuke (Kyoto Univ. (Japan). Faculty of Medicine)

    1989-08-01

    Syringomyelic cavities were studied with magnetic resonance imaging (MRI) in eleven patients with special reference to the hemodynamic contribution to the pathogenesis of syringomyelia. They were also studied intraoperatively with ultrasonography (USG) in five patients. Syrinx cavities combined with lumbosacral lipomyelomeningocele or with spinal stenosis did not present a flow-void phenomenon reflecting pulsatile movements of syrinx fluid. On serial MRI study in those the patients, enlargement of the syrinx cavity was not observed. Syrinx cavities occupying the caudal part of the spinal cord did not develop either. These cases were not treated surgically but followed conservatively. On the other hand, the flow-void sign in the syrinx cavities was present on MRI in patients who also had Chiari type I or type II malformations. They were treated with a syringo-subarachnoid shunt. In these cases, intraoperative USG disclosed marked fluctuation of syrinx cavity size synchronous with the motions of pulmonary ventilation. In all of them, clinical signs and symptoms improved postoperatively to various degrees. These results suggest that both the flow-void sign in the syrinx cavity on MRI and marked fluctaution of cavity size on intraoperative USG are indications for the shunt operation and support William's revised theory (1987). Fluctuation of cystic cavity size synchronous with ventilation suggests that venous pressure in the spinal subarachnoid space contributes to the pathogenesis of syringomyelic cavities. Further analysis of the fluctuation of cystic cavities by video monitoring will provide further information on the etiology and other clinical problems of syringomyelia. (author).

  15. On the compressibility and temperature boundary of warm frozen soils

    Science.gov (United States)

    Qi, Jilin; Dang, Boxiang; Guo, Xueluan; Sun, Xiaoyu; Yan, Xu

    2017-04-01

    A silty-clay obtained along the Qinghai-Tibetan railway and a standard Chinese sand were taken as study objects. Saturated frozen soil samples were prepared for testing. Step-load was used and confined compression was carried out on the soils under different temperatures. Compression index and pseudo-preconsolidation pressure (PPC) were obtained. Unlike unfrozen soils, PPC is not associated with stress history. However, it is still the boundary of elastic and plastic deformations. Different compression indexes can be obtained from an individual compression curve under pressures before and after PPC. The parameters at different thermal and stress conditions were analyzed. It is found that temperature plays a critical role in mechanical behaviours of frozen soils. Efforts were then made on the silty-clay in order to suggest a convincing temperature boundary in defining warm frozen soil. Three groups of ice-rich samples with different ice contents were prepared and tested under confined compression. The samples were compressed under a constant load and with 5 stepped temperatures. Strain rates at different temperatures were examined. It was found that the strain rate at around -0.6°C increased abruptly. Analysis of compression index was performed on the data both from our own testing program and from the literature, which showed that at about -1°C was a turning point in the curves for compression index against temperature. Based on both our work and taking into account the unfrozen water content vs. temperature, the range of -1°C to -0.5°C seems to be the temperature where the mechanical properties change greatly. For convenience, -1.0°C can be defined as the boundary for warm frozen soils.

  16. Angular correlation of annihilation photons in frozen aqueous solutions

    DEFF Research Database (Denmark)

    Milosevic-Kvajic, M.; Mogensen, O. E.; Kvajic, G.

    1972-01-01

    Linear‐slit angular correlation curves were obtained at about −140°C for frozen aqueous solutions of HF, HCl, HBr, HI, NH3, FeCl2, FeCl3, NaI, H2SO4, NHO3, MnSO4, KMnO4, K2Cr2O7, NaOH, and LiOH. We found no appreciable influence of a 4% concentration of the last seven impurities. Only halide‐cont...

  17. Viewing the Disney Movie Frozen through a Psychodynamic Lens.

    Science.gov (United States)

    Kowalski, Christopher; Bhalla, Ruchi

    2015-10-14

    The Disney movie Frozen is the fifth highest grossing movie of all time. In order to better understand this phenomenon and to hypothesize as to why the movie resonated so strongly with audiences, we have interpreted the movie using psychodynamic theory. We pay particular attention to the themes of puberty, adolescence and sibling relationships and discuss examples of ego defenses that are employed by the lead character in relation to these concepts.

  18. Functionality of Different Surfactants and Ingredients in Frozen Dough

    OpenAIRE

    Asghar, Ali; Anjum, Faqir Muhammad; Butt, Masood Sadiq; Hussain, Shahzad

    2006-01-01

    Surfactants are widely used in bakeries as dough strengtheners and dough improvers but there is a wide range of compounds available according to their mode of action that could potentially improve the quality of not only the simple breads and doughs but also of frozen dough. These types of product usually have a short shelf-life when compared with normal bakery products. With the increase in modernization and new trends in food products, consumers are becoming more and more aware and consciou...

  19. Effect of freezing time on the quality of Indian mackerel (Rastrelliger kanagurta) during frozen storage.

    Science.gov (United States)

    Lakshmisha, I P; Ravishankar, C N; Ninan, G; Mohan, C O; Gopal, T K S

    2008-09-01

    The present study aims to find the effect of freezing methods on the quality of mackerel (Rastrelliger kanagurta) in commercial plate and air blast freezers during freezing and subsequent frozen storage (-18 degrees C). Total time for freezing was significantly different (P frozen samples compared to plate freezer where protein content decreased in both the samples. Upon freezing and during frozen storage, lipid oxidation products (peroxide value, thiobarbutiric acid value, and free fatty acid value) and volatile bases (total volatile base nitrogen and trimethyl amine nitrogen) showed an increasing trend in both the samples with values slightly higher in air blast frozen samples compared to plate frozen samples. The total plate counts showed a significantly (P frozen samples compared to plate frozen samples. The taste and overall acceptability was significantly different (P frozen samples compared to air blast frozen samples on 3rd month. Both samples were in acceptable condition up to 3 mo but the plate frozen samples quality was slightly better than the air blast frozen samples.

  20. Standard and limitation of intraoperative monitoring of the visual evoked potential

    OpenAIRE

    2010-01-01

    Visual evoked potential (VEP) has been installed as one of the intraoperative visual function monitoring. It remains unclear, however, whether intraoperative VEP monitoring facilitates as a real time visual function monitoring with satisfactory effectiveness and sensitivity. To evaluate this, relationships between VEP waveform changes and postoperative visual function were analysed retrospectively. Intraoperative VEP monitoring was carried out for 106 sides (eyes) in 53 surgeries, including t...

  1. Dermographism: A Rare Cause of Intraoperative Hypotension and Urticaria.

    Science.gov (United States)

    Burbridge, Mark

    2016-07-15

    A 54-year-old man with dermographism presented for spine surgery, and shortly after induction of anesthesia, he experienced severe hypotension and urticaria, resulting in cancellation of the case on suspicion of allergic reaction. For subsequent ventral hernia repair, a perioperative management strategy was devised, which resulted in an uneventful perioperative course. This case report is the first to demonstrate severe intraoperative hypotension and urticaria from dermographism. We discuss the strategy that made the subsequent surgery a success and provide guidance for practitioners who face a patient with a severe form of this chronic disease.

  2. Clinical experience with intraoperative radiotherapy for locally advanced colorectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Shibamoto, Yuta; Takahashi, Masaharu; Abe, Mitsuyuki

    1988-10-01

    Intraoperative radiotherapy (IORT) was performed on 20 patients with colorectal cancer. IORT with a single dose of 20 to 40 Gy was delivered to the residual tumor, tumor bed, and/or lymphnode regions. Although most of the patients had advanced lesions, local control was achieved in 67 % of the patients when IORT was combined with tumor resection, and 4 patients survived more than 5 years. There were no serious complications, except for contracture or atrophy of the psoas muscle seen in 2 patients. IORT combined with external beam radiotherapy should be a useful adjuvant therapy to surgery for locally advanced colorectal cancer.

  3. [Importance of preoperative and intraoperative imaging for operative strategies].

    Science.gov (United States)

    Nitschke, P; Bork, U; Plodeck, V; Podlesek, D; Sobottka, S B; Schackert, G; Weitz, J; Kirsch, M

    2016-03-01

    Recent advances in preoperative and postoperative imaging have an increasing influence on surgical decision-making and make more complex surgical interventions possible. This improves the possibilities for frequently occurring challenges and promoting improved functional and oncological outcome. This manuscript reviews the role of preoperative and intraoperative imaging in surgery. Various techniques are explained based on examples from hepatobiliary surgery and neurosurgery, in particular real-time procedures, such as the online use of augmented reality and in vivo fluorescence, as well as new and promising optical techniques including imaging of intrinsic signals and vibrational spectroscopy.

  4. Vascular aging and hemodynamic stability in the intraoperative period

    Directory of Open Access Journals (Sweden)

    Ferrante S. Gragasin

    2012-04-01

    Full Text Available The proportion of elderly people in the population is steadily increasing, and the inevitable consequence is that this subpopulation is more frequently represented in common medical procedures and surgeries. Understanding the circulatory changes that accompany the aging process is therefore becoming increasingly timely and relevant. In this short review, we discuss aspects of vascular control in aging that are particularly relevant in the maintenance of intraoperative hemodynamic stability. We subsequently review the effects of certain notable anesthetic agents with respect to the aging vasculature.

  5. Effectivity of intraoperative adjustable suture technique in horizontal strabismus

    Directory of Open Access Journals (Sweden)

    Ayse Gul Kocak Altintas

    2013-08-01

    Full Text Available AIM:To compare the long-term effectivity of intraoperative adjustable suture technique with traditional non-adjustable strabismus surgery.METHODS:Two hundred and thirty-three patients, who underwent strabismus surgery either with traditional procedures or one-stage intraoperative adjustable suture technique, were included in our long-term follow-up study. One hundred and eighteen patients were evaluated in traditional surgery group (TSG and 115 who underwent adjustable suture were in the one-stage intraoperative adjustable surgery group (ASG. In this group 9 patients had paralytic strabismus and 16 had reoperations, 2 patients had restrictive strabismus related to thyroid eye disease. The mean follow up in the TSG was 26.2 months and it was 24.8 months in the ASG group.RESULTS:In patients with exotropia (XT the mean correction of deviation for near fixation in ASG (32.4±13.2PD and in TSG (26.4±8.2PD were similar (P=0.112. The correction for distant fixation in ASG (33.2±11.4PD and TSG (30.9±7.2PD were not significantly different (P=0.321. In patients with esotropia (ET even the mean correction of deviation for both near (31±12PD and distant (30.6±12.8PD fixations were higher in ASG than in TSG, for both near (28.27±14.2PD and distant (28.9±12.9PD fixations, the differences were not significant (P=0.346, 0.824 respectively. The overall success rate of XT patient was 78.9% in TSG and 78.78% in ASG, the difference was not significant (P=0.629. The success rates were 78.75% in TSG and 75.51% in ASG in ET patient, which was also not significantly different (P=0.821.CONCLUSION:Although patients in ASG had more complex deviation such as paralysis, reoperations and restrictive strabismus, success rates of this tecnique was as high as TSG which did not contain complicated deviation. One-stage intraoperative adjustable suture technique is a safe and effective method for cooperative patient who has complex deviation.

  6. Intraoperative gastrojejunoscopy-assisted fistulojejunostomy for postoperative pancreatic fistula.

    Science.gov (United States)

    Toihata, Tasuku; Hashimoto, Daisuke; Hayashi, Hiromitsu; Chikamoto, Akira; Beppu, Toru; Baba, Hideo

    2014-11-01

    Postoperative pancreatic fistula is a known complication after pancreaticojejunostomy. When an anastomosis collapses completely, two-stage reconstruction is necessary. Herein, we describe the case of a 70-year-old woman who underwent subtotal stomach-preserving pancreaticoduodenectomy with pancreaticojejunostomy after she had developed a severe postoperative pancreatic fistula. The pancreaticojejunostomy was divided, and an external pancreatic drainage tube was placed. Four months later, fistulojejunostomy between the pancreas and the stump of the jejunum was performed successfully using intraoperative gastrojejunoscopy. © 2014 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and Wiley Publishing Asia Pty Ltd.

  7. Intraoperative photodynamic therapy in laryngeal part of pharynx cancers

    Science.gov (United States)

    Loukatch, Erwin V.; Trojan, Vasily; Loukatch, Vjacheslav

    1996-12-01

    In clinic intraoperative photodynamic therapy (IPT) was done in patients with primal squamous cells cancer of the laryngeal part of the pharynx. The He-Ne laser and methylene blue as a photosensibilizator were used. Cobalt therapy in the postoperative period was done in dose 45 Gr. Patients of control groups (1-th group) with only laser and (2-th group) only methylene blue were controlled during three years with the main group. The statistics show certain differences of recidives in the main group compared to the control groups. These facts are allowing us to recommend the use of IPT as an additional method in ENT-oncology diseases treatment.

  8. Intraoperative neuropathology of glioma recurrence: cell detection and classification

    Science.gov (United States)

    Abas, Fazly S.; Gokozan, Hamza N.; Goksel, Behiye; Otero, Jose J.; Gurcan, Metin N.

    2016-03-01

    Intraoperative neuropathology of glioma recurrence represents significant visual challenges to pathologists as they carry significant clinical implications. For example, rendering a diagnosis of recurrent glioma can help the surgeon decide to perform more aggressive resection if surgically appropriate. In addition, the success of recent clinical trials for intraoperative administration of therapies, such as inoculation with oncolytic viruses, may suggest that refinement of the intraoperative diagnosis during neurosurgery is an emerging need for pathologists. Typically, these diagnoses require rapid/STAT processing lasting only 20-30 minutes after receipt from neurosurgery. In this relatively short time frame, only dyes, such as hematoxylin and eosin (H and E), can be implemented. The visual challenge lies in the fact that these patients have undergone chemotherapy and radiation, both of which induce cytological atypia in astrocytes, and pathologists are unable to implement helpful biomarkers in their diagnoses. Therefore, there is a need to help pathologists differentiate between astrocytes that are cytologically atypical due to treatment versus infiltrating, recurrent, neoplastic astrocytes. This study focuses on classification of neoplastic versus non-neoplastic astrocytes with the long term goal of providing a better neuropathological computer-aided consultation via classification of cells into reactive gliosis versus recurrent glioma. We present a method to detect cells in H and E stained digitized slides of intraoperative cytologic preparations. The method uses a combination of the `value' component of the HSV color space and `b*' component of the CIE L*a*b* color space to create an enhanced image that suppresses the background while revealing cells on an image. A composite image is formed based on the morphological closing of the hue-luminance combined image. Geometrical and textural features extracted from Discrete Wavelet Frames and combined to classify

  9. Intraoperative computed tomography with integrated navigation system in spinal stabilizations.

    Science.gov (United States)

    Zausinger, Stefan; Scheder, Ben; Uhl, Eberhard; Heigl, Thomas; Morhard, Dominik; Tonn, Joerg-Christian

    2009-12-15

    STUDY DESIGN.: A prospective interventional case-series study plus a retrospective analysis of historical patients for comparison of data. OBJECTIVE.: To evaluate workflow, feasibility, and clinical outcome of navigated stabilization procedures with data acquisition by intraoperative computed tomography. SUMMARY OF BACKGROUND DATA.: Routine fluoroscopy to assess pedicle screw placement is not consistently reliable. Our hypothesis was that image-guided spinal navigation using an intraoperative CT-scanner can improve the safety and precision of spinal stabilization surgery. METHODS.: CT data of 94 patients (thoracolumbar [n = 66], C1/2 [n = 12], cervicothoracic instability [n = 16]) were acquired after positioning the patient in the final surgical position. A sliding gantry 40-slice CT was used for image acquisition. Data were imported to a frameless infrared-based neuronavigation workstation. Intraoperative CT was obtained to assess the accuracy of instrumentation and, if necessary, the extent of decompression. All patients were clinically evaluated by Odom-criteria after surgery and after 3 months. RESULTS.: Computed accuracy of the navigation system reached /=2 mm without persistent neurologic or vascular damage in 20/414 screws (4.8%) leading to immediate correction of 10 screws (2.4%). Control-iCT changed the course of surgery in 8 cases (8.5% of all patients). The overall revision rate was 8.5% (4 wound revisions, 2 CSF fistulas, and 2 epidural hematomas). There was no reoperation due to implant malposition. According to Odom-criteria all patients experienced a clinical improvement. A retrospective analysis of 182 patients with navigated thoracolumbar transpedicular stabilizations in the preiCT era revealed an overall revision rate of 10.4% with 4.4% of patients requiring screw revision. CONCLUSION.: Intraoperative CT in combination with neuronavigation provides high accuracy of screw placement and thus safety for patients undergoing spinal stabilization

  10. Result of Intraoperative Mitomycin C Application in Dacryocystorhinostomy

    OpenAIRE

    Sheikh Sajjad Ahmad, Reyaz Ahmad Untoo

    2002-01-01

    Th is study was undertaken to evaluate the long term results 0 f intraoperative mitomyc inC app Iicat ionin dacryocystorh inostomy (DC R) surgery compared \\ ith resul ts of the conventiona I procedure. Inth is prospect ivc random ised controlled study, a tota I 01" 44 eyes diagnosed \\ ith acqu ired nasolacrimalduct obstruction \\ere randomly divided into a cOI1entional DCR group and a mitomycin C groupin \\hich mitomycin C \\3S used during OCR surger). The surgical procedures in both groups \\ere...

  11. Dueling Mechanisms for Dry Zones around Frozen Droplets

    Science.gov (United States)

    Bisbano, Caitlin; Nath, Saurabh; Boreyko, Jonathan

    2016-11-01

    Ice acts as a local humidity sink, due to its depressed saturation pressure relative to that of supercooled water. Hygroscopic chemicals typically exhibit annular dry zones of inhibited condensation; however, dry zones do not tend to form around ice because of inter-droplet frost growth to nearby liquid droplets that have already condensed on the chilled surface. Here, we use a humidity chamber with an embedded Peltier stage to initially suppress the growth of condensation on a chilled surface containing a single frozen droplet, in order to characterize the dry zone around ice for the first time. The length of the dry zone was observed to vary by at least two orders of magnitude as a function of surface temperature, ambient humidity, and the size of the frozen droplet. The surface temperature and ambient humidity govern the magnitudes of the in-plane and out-of-plane gradients in vapor pressure, while the size of the frozen droplet effects the local thickness of the concentration boundary layer. We develop an analytical model that reveals two different types of dry zones are possible: one in which nucleation is inhibited and one where the net growth of condensate is inhibited. Finally, a phase map was developed to predict the parameter space in which nucleation dry zones versus flux dry zones are dominant.

  12. PRESERVING QUALITY OF FROZEN GREEN PEAS DURING LONG TIME STORAGE

    Directory of Open Access Journals (Sweden)

    FELICIA DIMA

    2012-06-01

    Full Text Available The purpose of this study was to analyze the degree which fresh green peas maintain their technological properties and nutritional components during long-term storage, for a period of 24 months, in a defined condition of the air, at maximum -18°C. Peas were blanched, at four different durations of this operation and the same temperature of the blanching water, 95°C. The peas were frozen after end stored. In conditions of long-term storage of frozen peas, it has been found a considerable loss of the initial content of vitamin C and damage of chlorophyll (total, a and b, under the action of chlorophyllase, causing some gray compounds. The conditions of the storage in frozen stage produced a distortion of color and sensorial qualities, higher as the storage temperature was higher than prescribed. It was found that the best results in preserving quality of peas during long-term storage (24 months were obtained for the blanched samples at 4 minutes at 95°C. The reducing of the content of vitamin C, chlorophyll a and b, and sensorial qualities was the lowest, overall.

  13. Miniopen coracohumeral ligament release and manipulation for idiopathic frozen shoulder

    Directory of Open Access Journals (Sweden)

    Abdelsalam Eid

    2012-01-01

    Full Text Available In the management of idiopathic frozen shoulder, manipulation under anaesthesia is known to have serious potential complications including fractures and intra-articular injuries. Arthroscopy is a safer treatment modality but requires special instruments, experience, and involves added cost. The aim of this work was to study the use of miniopen Coracohumeral ligament release and manipulation of the shoulder as a safe and simple method of treating idiopathic frozen shoulder that could be performed as a quick procedure under short duration anaesthesia obtaining a significant improvement of shoulder function while avoiding complications that are feared to occur with the use of manipulation under anaesthesia. Miniopen Coracohumeral ligament release is performed through a 3-cm incision. The Coracohumeral ligament is divided, and then the shoulder is manipulated without undue force. A case series including fifteen patients (19 shoulders with idiopathic frozen shoulder operated by this technique is described. Miniopen Coracohumeral ligament release and manipulation is a quick procedure that may be performed under short duration anaesthesia obtaining a significant improvement of shoulder function meanwhile avoiding complications that are feared to occur with the use of manipulation under anaesthesia.

  14. Renormalization of the frozen Gaussian approximation to the quantum propagator.

    Science.gov (United States)

    Tatchen, Jörg; Pollak, Eli; Tao, Guohua; Miller, William H

    2011-04-07

    The frozen Gaussian approximation to the quantum propagator may be a viable method for obtaining "on the fly" quantum dynamical information on systems with many degrees of freedom. However, it has two severe limitations, it rapidly loses normalization and one needs to know the Gaussian averaged potential, hence it is not a purely local theory in the force field. These limitations are in principle remedied by using the Herman-Kluk (HK) form for the semiclassical propagator. The HK propagator approximately conserves unitarity for relatively long times and depends only locally on the bare potential and its second derivatives. However, the HK propagator involves a much more expensive computation due to the need for evaluating the monodromy matrix elements. In this paper, we (a) derive a new formula for the normalization integral based on a prefactor free HK propagator which is amenable to "on the fly" computations; (b) show that a frozen Gaussian version of the normalization integral is not readily computable "on the fly"; (c) provide a new insight into how the HK prefactor leads to approximate unitarity; and (d) how one may construct a prefactor free approximation which combines the advantages of the frozen Gaussian and the HK propagators. The theoretical developments are backed by numerical examples on a Morse oscillator and a quartic double well potential.

  15. Surgical Tips in Frozen Abdomen Management: Application of Coliseum Technique

    Directory of Open Access Journals (Sweden)

    Ioannis D. Kyriazanos

    2015-01-01

    Full Text Available Wound dehiscence is a serious postoperative complication, with an incidence of 0.5–3% after primary closure of a laparotomy incision, and represents an acute mechanical failure of wound healing. Relatively recently the concept of “intentional open abdomen” was described and both clinical entities share common pathophysiological and clinical pathways (“postoperative open abdominal wall”. Although early reconstruction is the target, a significant proportion of patients will develop adhesions between abdominal viscera and the anterolateral abdominal wall, a condition widely recognized as “frozen abdomen,” where delayed wound closure appears as the only realistic alternative. We report our experience with a patient who presented with frozen abdomen after wound dehiscence due to surgical site infection and application of the “Coliseum technique” for its definitive surgical management. This novel technique represents an innovative alternative to abdominal exploration, for cases of “malignant” frozen abdomen due to peritoneal carcinomatosis. Lifting the edges of the surgical wound upwards and suspending them under traction by threads from a retractor positioned above the abdomen facilitates approach to the peritoneal cavity, optimizes exposure of intra-abdominal organs, and prevents operative injury to the innervation and blood supply of abdominal wall musculature, a crucial step for subsequent hernia repair.

  16. Repair and enumeration of injured coliforms in frozen foods.

    Science.gov (United States)

    Warseck, M; Ray, B; Speck, M L

    1973-12-01

    Two strains of Escherichia coli manifested death and repairable injury after being frozen in water or sterile foods at -20 C. The injured survivors were inhibited from forming colonies on violet red bile agar (VRBA) or deoxycholate lactose agar; this inhibition was greater when enumeration was done by the pour plate method instead of the surface or surface-overlay method. Injured cells repaired rapidly in Trypticase soy broth (TSB), and the repair was about maximum after 1 h at 25 C. When the injured cells were added to different foods and incubated at 25 C, repair also occurred; however, recovery was better and more uniform when the samples were mixed with TSB and incubated 1 h at 25 C. Cell multiplication was not evident until after 90 to 120 min at 25 C. The enumeration of coliforms from commercially frozen foods was increased when the thawed samples were mixed with TSB and the cells were allowed to repair 1 h at 25 C. In some samples, the repair permitted at least a 20-fold increase in the coliform count. The associated flora in the commercially frozen foods gave no evidence of impairing the repair of coliforms, nor did they start multiplication prior to 90 min after being incubated in TSB at 25 C. Generally, the plating gave more reproducible recovery of coliforms than did the most probable number method. Also, a higher number of coliforms were obtained by the surface-overlay method of plating using VRBA.

  17. Platelet-Rich Plasma for Frozen Shoulder: A Case Report

    Directory of Open Access Journals (Sweden)

    Hamidreza Aslani

    2016-01-01

    Full Text Available Frozen shoulder is a glenohumeral joint disorder that perturbs movement because of adhesion and the existence of fibrosis in the shoulder capsule. Platelet-rich plasma can produce collagen and growth factors, which increases stem cells and consequently enhances the healing. To date, there is no evidence regarding the effectiveness of platelet-rich plasma in frozen shoulder. A 45-year-old man with shoulder adhesive capsulitis volunteered for this treatment. He underwent two consecutive platelet-rich plasma injections at the seventh and eighth month after initiation of symptoms. We measured pain, function, and ROM by the visual analogue scale (VAS, and scores from the Disabilities of the Arm, Shoulder and Hand (DASH questionnaire and goniometer; respectively. After the first injection, the patient reported 60% improvement regarding diurnal shoulder pain, and no night pains. Also, two-fold improvement for ROM and more than 70% improvement for function were reported. This study suggests the use of platelet-rich plasma in frozen shoulder to be tested in randomized trials.

  18. Parathyroid Carcinoma: Current Understanding and New Insights into Gene Expression and Intraoperative Parathyroid Hormone Kinetics

    OpenAIRE

    Abdelgadir Adam, Mohamed; Untch, Brian R.; Olson, John A.

    2010-01-01

    This review summarizes the current knowledge on parathyroid carcinoma and describes new information on parathyroid carcinoma gene expression and operative management using intraoperative parathyroid hormone monitoring.

  19. Reinforcement learning versus proportional-integral-derivative control of hypnosis in a simulated intraoperative patient

    National Research Council Canada - National Science Library

    Moore, Brett L; Quasny, Todd M; Doufas, Anthony G

    2011-01-01

    .... We investigated the application of reinforcement learning (RL), an intelligent systems control method, to closed-loop BIS-guided, propofol-induced hypnosis in simulated intraoperative patients...

  20. Implementation of immunohistochemistry on frozen ear notch tissue samples in diagnosis of bovine viral diarrhea virus in persistently infected cattle

    Directory of Open Access Journals (Sweden)

    Bedeković Tomislav

    2011-12-01

    Full Text Available Abstract Background Bovine viral diarrhea is a contagious disease of domestic and wild ruminants and one of the most economically important diseases in cattle. Bovine viral diarrhea virus belongs to the genus Pestivirus, within the family Flaviviridae. The identification and elimination of the persistently infected animals from herds is the initial step in the control and eradication programs. It is therefore necessary to have reliable methods for diagnosis of bovine viral diarrhea virus. One of those methods is immunohistochemistry. Immunohistochemistry on formalin fixed, paraffin embedded tissue is a routine technique in diagnosis of persistently infected cattle from ear notch tissue samples. However, such technique is inappropriate due to complicated tissue fixation process and it requires more days for preparation. On the contrary, immunohistochemistry on frozen tissue was usually applied on organs from dead animals. In this paper, for the first time, the imunohistochemistry on frozen ear notch tissue samples was described. Findings Seventeen ear notch tissue samples were obtained during the period 2008-2009 from persistently infected cattle. Samples were fixed in liquid nitrogen and stored on -20°C until testing. Ear notch tissue samples from all persistently infected cattle showed positive results with good section quality and possibility to determinate type of infected cells. Conclusions Although the number of samples was limited, this study indicated that immunohistochemistry on formalin fixed paraffin embedded tissue can be successfully replaced with immunohistochemistry on frozen ear notch tissue samples in diagnosis of persistently infected cattle.

  1. Cytopathological evaluations combined RNA and protein analyses on defined cell regions using single frozen tissue block.

    Science.gov (United States)

    Li, Hong; Chen, Xiao Yan; Kong, Qing You; Liu, Jia

    2002-06-01

    The co-existence of multiple cell components in tissue samples is the main obstacle for precise molecular evaluation on defined cell types. Based on morphological examination, we developed an efficient approach for paralleled RNA and protein isolations from an identical histological region in frozen tissue section. The RNA and protein samples prepared were sufficient for RT-PCR and Western blot analyses, and the results obtained were well coincident each other as well as with the corresponding parameters revealed from immunohistochemical examinations. By this way, the sampling problem caused by cell-cross contamination can be largely avoided, committing the experimental data more specific to a defined cell type. These novel methods thus allow us to use single tissue block for a comprehensive study by integration of conventional cytological evaluations with nucleic acid and protein analyses.

  2. Cytopathological evaluations combined RNA and protein analyses on defined cell regions using single frozen tissue block

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    The co-existence of multiple cell components in tissue samples is the main obstacle for precise molecular evaluation on defined cell types. Based on morphological examination, we developed an efficient approach for paralleled RNA and protein isolations from an identical histological region in frozen tissue section.The RNA and protein samples prepared were sufficient for RT-PCR and Western blot analyses, and the results obtained were well coincident each other as well as with the corresponding parameters revealed from immunohistochemical examinations. By this way, the sampling problem caused by cell-cross contamination can be largely avoided, committing the experimental data more specific to a defined cell type. These novel methods thus allow us to use single tissue block for a comprehensive study by integration of conventional cytological evaluations with nucleic acid and protein analyses.

  3. Demonstration of a frozen sample aliquotter to prepare plasma and serum aliquots without thawing frozen parent samples.

    Science.gov (United States)

    Ellis, Helena Judge; Venturini, Deborah S

    2013-06-01

    Human biospecimens represent invaluable resources to advance molecular medicine, epidemiology, and biomarker discovery/validation, among other biomedical research. Biobanks typically cryopreserve biospecimens to safeguard their biochemical composition. However, exposing specimens repeatedly to freeze/thaw cycles can degrade their integrity in unforeseen ways. Those biobanks storing liquid samples, thus, regularly make a fundamental compromise at collection time between freezing samples in many small volumes (e.g., 0.5 mL or smaller) or in fewer, larger volumes (e.g., 1.8 mL). The former eliminates the need to expose samples to repeated freeze/thaw cycling, although increasing up-front labor costs, consumables used, and cold storage space requirements. The latter decreases up-front labor costs, consumables, and cold storage requirements, yet exposes samples repeatedly to damaging freeze/thaw cycles when smaller aliquots are needed for analysis. The Rhode Island BioBank at Brown University (RIBB) thoroughly evaluated the performance of an original technology that minimizes a sample's exposure to freeze/thaw cycling by enabling the automated extraction of frozen aliquots from one single frozen parent sample without thawing it. A technology that eliminates unnecessary sample exposures to freeze/thaw cycles could help protect sample integrity, extend its useful life, and effectively rectify and eliminate the aforementioned need to compromise. This report presents the results of the evaluation, and conclusively demonstrates the technology's ability to extract multiple uniform frozen aliquots from a single cryotube of never-thawed frozen human plasma, which faithfully represent the parent sample when analyzed for typical biochemical analytes, showing a coefficient of variability lower than 5.5%.

  4. Optimizing Frozen Sample Preparation for Laser Microdissection: Assessment of CryoJane Tape-Transfer System®.

    Directory of Open Access Journals (Sweden)

    Yelena G Golubeva

    Full Text Available Laser microdissection is an invaluable tool in medical research that facilitates collecting specific cell populations for molecular analysis. Diversity of research targets (e.g., cancerous and precancerous lesions in clinical and animal research, cell pellets, rodent embryos, etc. and varied scientific objectives, however, present challenges toward establishing standard laser microdissection protocols. Sample preparation is crucial for quality RNA, DNA and protein retrieval, where it often determines the feasibility of a laser microdissection project. The majority of microdissection studies in clinical and animal model research are conducted on frozen tissues containing native nucleic acids, unmodified by fixation. However, the variable morphological quality of frozen sections from tissues containing fat, collagen or delicate cell structures can limit or prevent successful harvest of the desired cell population via laser dissection. The CryoJane Tape-Transfer System®, a commercial device that improves cryosectioning outcomes on glass slides has been reported superior for slide preparation and isolation of high quality osteocyte RNA (frozen bone during laser dissection. Considering the reported advantages of CryoJane for laser dissection on glass slides, we asked whether the system could also work with the plastic membrane slides used by UV laser based microdissection instruments, as these are better suited for collection of larger target areas. In an attempt to optimize laser microdissection slide preparation for tissues of different RNA stability and cryosectioning difficulty, we evaluated the CryoJane system for use with both glass (laser capture microdissection and membrane (laser cutting microdissection slides. We have established a sample preparation protocol for glass and membrane slides including manual coating of membrane slides with CryoJane solutions, cryosectioning, slide staining and dissection procedure, lysis and RNA extraction

  5. Quantitative nanoscale water mapping in frozen-hydrated skin by low-loss electron energy-loss spectroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Yakovlev, Sergey [Department of Chemical Engineering and Materials Science, Stevens Institute of Technology, Hoboken, NJ 07030 (United States); Misra, Manoj; Shi, Shanling [Unilever Research and Development, Trumbull, CT 06611 (United States); Firlar, Emre [Department of Chemical Engineering and Materials Science, Stevens Institute of Technology, Hoboken, NJ 07030 (United States); Libera, Matthew, E-mail: mlibera@stevens.edu [Department of Chemical Engineering and Materials Science, Stevens Institute of Technology, Hoboken, NJ 07030 (United States)

    2010-06-15

    Spatially resolved low-loss electron energy-loss spectroscopy (EELS) is a powerful method to quantitatively determine the water distribution in frozen-hydrated biological materials at high spatial resolution. However, hydrated tissue, particularly its hydrophilic protein-rich component, is very sensitive to electron radiation. This sensitivity has traditionally limited the achievable spatial resolution because of the relatively high noise associated with low-dose data acquisition. We show that the damage caused by high-dose data acquisition affects the accuracy of a multiple-least-squares (MLS) compositional analysis because of inaccuracies in the reference spectrum used to represent the protein. Higher spatial resolution combined with more accurate compositional analysis can be achieved if a reference spectrum is used that better represents the electron-beam-damaged protein component under frozen-hydrated conditions rather than one separately collected from dry protein under low-dose conditions. We thus introduce a method to extract the best-fitting protein reference spectrum from an experimental spectrum dataset. This method can be used when the MLS-fitting problem is sufficiently constrained so that the only unknown is the reference spectrum for the protein component. We apply this approach to map the distribution of water in cryo-sections obtained from frozen-hydrated tissue of porcine skin. The raw spectral data were collected at doses up to 10{sup 5} e/nm{sup 2} despite the fact that observable damage begins at doses as low as 10{sup 3} e/nm{sup 2}. The resulting spatial resolution of 10 nm is 5-10 times better than that in previous studies of frozen-hydrated tissue and is sufficient to resolve sub-cellular water fluctuations as well as the inter-cellular lipid-rich regions of skin where water-mediated processes are believed to play a significant role in the phenotype of keratinocytes in the stratum corneum.

  6. Sperm distribution and fertilization after unilateral and bilateral laparoscopic artificial insemination with frozen-thawed goat semen.

    Science.gov (United States)

    Anakkul, Nitira; Suwimonteerabutr, Junpen; Tharasanit, Theerawat; Khunmanee, Sarawanee; Diloksumpan, Paweena; Berg, Debra K; Techakumphu, Mongkol

    2014-11-01

    Generally, laparoscopic artificial insemination (LAI) provides a higher success rate than of cervical insemination in goats. However, the sperm distribution after LAI in goats remains unknown, particularly when frozen-thawed semen is used. This study evaluated the distribution of frozen-thawed goat spermatozoa after LAI and compared the effects of sperm numbers and deposition sites (unilateral and bilateral sites) on pregnancy rate. In experiment 1, the frozen-thawed spermatozoa were stained either with CellTracker Green CMFDA (CT-Green) or CellTracker Red CMPTX (CT-Red), and in vitro evaluations of viability and motility were performed. In experiment 2, the labeled spermatozoa were deposited via LAI into the left (CT-Green) and right (CT-Red) uterine horns (n = 4). After ovariohysterectomy (6 hours after insemination), the distributions of green- and red-colored spermatozoa were assessed via tissue section, flushing, and the oviductal contents were also collected. Experiment 3 was designed to test the pregnancy rates in a group of 120 does after LAI using different numbers of spermatozoa (60 and 120 × 10(6) sperm per LAI) and different deposition sites. The results demonstrated that the fluorochromes used in this study did not impair sperm motility or viability. Frozen-thawed goat spermatozoa can migrate transuterinally after LAI, as evidenced by the observations of both CT-Green- and CT-Red-labeled spermatozoa in both uterine horns. Lower numbers of spermatozoa (60 × 10(6)) that are inseminated unilaterally (either ipsilateral or contralateral to the site of ovulation) can efficiently be used for LAI in goats (with a 56.67% pregnancy rate).

  7. The effect of pre-treatment, temperature and length of frozen storage on the retention of chlorophylls in frozen brassicas

    Directory of Open Access Journals (Sweden)

    Waldemar Kmiecik

    2008-06-01

    Full Text Available The investigation covered broccoli, green cauliflower and Brussels sprouts. The evaluation concerned the raw material; the material after blanching; the material after cooking; and frozen products from blanched (traditional method and cooked (modified method material, stored at –20°C and –30°C then prepared for consumption using water-cooking in the traditional method and thawing by microwave in the modified method after 0, 4, 8 and 12 months of frozen storage. Depending on the investigated sample, the vegetables prepared for consumption after 12 months of frozen storage retained total chlorophylls as follows: broccoli, 45-66% of the content in the raw material; green cauliflower, 30-45%; and Brussels sprouts, 66-78%. In comparison with the traditional method, the mean content of chlorophylls in Brussels sprouts obtained using the modified method was 16% higher; however, in broccoli the content was lower by 23% and in cauliflower by 21% on average. Lower storage temperature resulted in higher content of chlorophylls in all investigated vegetables.

  8. A Taphonomic Study Exploring the Differences in Decomposition Rate and Manner between Frozen and Never Frozen Domestic Pigs (Sus scrofa).

    Science.gov (United States)

    Roberts, Lindsey G; Dabbs, Gretchen R

    2015-05-01

    This research examined differences in decomposition rate and manner of domestic pig subjects (Sus scrofa) in never frozen (control) and previously frozen (experimental) research conditions. Eight control and experimental subjects were placed in an identical outdoor research environment. Daily quantitative and qualitative measurements were collected: abdominal circumference, total body score (TBS), temperature, photographs, descriptive decomposition stages, and visual observations. Field necropsies were performed at accumulated degree days (ADD) between 50 and 300 (Celsius). Paired samples t-tests of ADD to TBS >3.0, TBS >9.5, and TBS >16.0 indicate the rate of decomposition of experimental subjects was significantly slower than controls at both TBS >3 and >9.5 (p = 0.003 and p = 0.002, respectively). A suite of qualitative indicators of predecomposition freezing is also reported. The differences between experimental and control subjects suggest previously frozen subjects should not be used in taphonomic research, as results do not accurately reflect the "normal" taphonomic condition.

  9. 77 FR 27435 - Certain Frozen Fish Fillets From the Socialist Republic of Vietnam: Final Results of the New...

    Science.gov (United States)

    2012-05-10

    ... International Trade Administration Certain Frozen Fish Fillets From the Socialist Republic of Vietnam: Final... order on certain frozen fish fillets (``frozen fish fillets'') from the Socialist Republic of Vietnam..., 2010, through January 31, 2011. \\1\\ See Certain Frozen Fish Fillets From the Socialist Republic...

  10. [Intraoperative Measurement of Refraction with a Hand-Held Autorefractometer].

    Science.gov (United States)

    Gesser, C; Küper, T; Richard, G; Hassenstein, A

    2015-07-01

    The aim of this study was to evaluate an intraoperative measurement of objective refraction with a hand-held retinomax instrument. At the end of cataract surgery objective refraction in a lying position was measured with a retinomax instrument. On the first postoperative day the same measurement was performed with a retinomax and a standard autorefractometer. To evaluate the differences between measurements, the spherical equivalent (SE) and Jackson's cross cylinder at 0° (J0) and 45° (J45) was used. 103 eyes were included. 95 of them had normal cataract surgery. Differences between retinomax at the operative day and the standard autorefractometer were 0.68 ± 2.58 D in SE, 0.05 ± 1.4D in J0 and 0.05 ± 1.4D in J45. There were no statistically significant differences between the groups. Intraoperative measurement of the refraction with a retinomax can predict the postoperative refraction. Nevertheless, in a few patients great differences may occur. Georg Thieme Verlag KG Stuttgart · New York.

  11. Stereoscopic Integrated Imaging Goggles for Multimodal Intraoperative Image Guidance.

    Directory of Open Access Journals (Sweden)

    Christopher A Mela

    Full Text Available We have developed novel stereoscopic wearable multimodal intraoperative imaging and display systems entitled Integrated Imaging Goggles for guiding surgeries. The prototype systems offer real time stereoscopic fluorescence imaging and color reflectance imaging capacity, along with in vivo handheld microscopy and ultrasound imaging. With the Integrated Imaging Goggle, both wide-field fluorescence imaging and in vivo microscopy are provided. The real time ultrasound images can also be presented in the goggle display. Furthermore, real time goggle-to-goggle stereoscopic video sharing is demonstrated, which can greatly facilitate telemedicine. In this paper, the prototype systems are described, characterized and tested in surgeries in biological tissues ex vivo. We have found that the system can detect fluorescent targets with as low as 60 nM indocyanine green and can resolve structures down to 0.25 mm with large FOV stereoscopic imaging. The system has successfully guided simulated cancer surgeries in chicken. The Integrated Imaging Goggle is novel in 4 aspects: it is (a the first wearable stereoscopic wide-field intraoperative fluorescence imaging and display system, (b the first wearable system offering both large FOV and microscopic imaging simultaneously,

  12. Stereoscopic Integrated Imaging Goggles for Multimodal Intraoperative Image Guidance.

    Science.gov (United States)

    Mela, Christopher A; Patterson, Carrie; Thompson, William K; Papay, Francis; Liu, Yang

    2015-01-01

    We have developed novel stereoscopic wearable multimodal intraoperative imaging and display systems entitled Integrated Imaging Goggles for guiding surgeries. The prototype systems offer real time stereoscopic fluorescence imaging and color reflectance imaging capacity, along with in vivo handheld microscopy and ultrasound imaging. With the Integrated Imaging Goggle, both wide-field fluorescence imaging and in vivo microscopy are provided. The real time ultrasound images can also be presented in the goggle display. Furthermore, real time goggle-to-goggle stereoscopic video sharing is demonstrated, which can greatly facilitate telemedicine. In this paper, the prototype systems are described, characterized and tested in surgeries in biological tissues ex vivo. We have found that the system can detect fluorescent targets with as low as 60 nM indocyanine green and can resolve structures down to 0.25 mm with large FOV stereoscopic imaging. The system has successfully guided simulated cancer surgeries in chicken. The Integrated Imaging Goggle is novel in 4 aspects: it is (a) the first wearable stereoscopic wide-field intraoperative fluorescence imaging and display system, (b) the first wearable system offering both large FOV and microscopic imaging simultaneously,

  13. Lightweight distributed computing for intraoperative real-time image guidance

    Science.gov (United States)

    Suwelack, Stefan; Katic, Darko; Wagner, Simon; Spengler, Patrick; Bodenstedt, Sebastian; Röhl, Sebastian; Dillmann, Rüdiger; Speidel, Stefanie

    2012-02-01

    In order to provide real-time intraoperative guidance, computer assisted surgery (CAS) systems often rely on computationally expensive algorithms. The real-time constraint is especially challenging if several components such as intraoperative image processing, soft tissue registration or context aware visualization are combined in a single system. In this paper, we present a lightweight approach to distribute the workload over several workstations based on the OpenIGTLink protocol. We use XML-based message passing for remote procedure calls and native types for transferring data such as images, meshes or point coordinates. Two different, but typical scenarios are considered in order to evaluate the performance of the new system. First, we analyze a real-time soft tissue registration algorithm based on a finite element (FE) model. Here, we use the proposed approach to distribute the computational workload between a primary workstation that handles sensor data processing and visualization and a dedicated workstation that runs the real-time FE algorithm. We show that the additional overhead that is introduced by the technique is small compared to the total execution time. Furthermore, the approach is used to speed up a context aware augmented reality based navigation system for dental implant surgery. In this scenario, the additional delay for running the computationally expensive reasoning server on a separate workstation is less than a millisecond. The results show that the presented approach is a promising strategy to speed up real-time CAS systems.

  14. Experimental study of the intraoperative irradiation for liver cancer

    Energy Technology Data Exchange (ETDEWEB)

    Arii, S.; Takasan, H.; Takahashi, S. (Kyoto Univ. (Japan). Faculty of Medicine)

    1981-07-01

    The resectability rate of the liver cancer is very low. Especially, hepatoma is apt to combine cirrhosis and its curability is poor as compared with malignant neoplasma of other organs. Therefore, the development of more effective adjuvant therapy for liver cancer is desirable. We studied the possibility of intraoperative radiotherapy with electron beams of Betatron. At first, we examined the influence of 5000 rad irradiation to approximately 1/2 area of the liver on the aspect of the serological liver function and histology using the domestic rabbits. Following this experiment, we used V x 2 carcinoma transplanted into the livers of the rabbits as the simulation model of the human liver tumors and examined the effect of irradiation to the tumor and its surrounding liver tissue. Results 1. The rabbits irradiated with 5000 rad to approximately 1/2 area of the liver intraoperatively grew healthily without severe dysfunction of the liver. 2. On the histological examination, degeneration and necrosis of the parenchymal cells appeared at the small parts of the irradiated area at the earlier periods of irradiation, but the necrotic regions did not get wider in range. Subsequently, liver fibrosis progressed gradually. 3. Irradiation to the rabbits transplanted V x 2 carcinoma resulted in the prolongation of the life spans and the diminution of the tumors.

  15. Integrating multimodal information for intraoperative assistance in neurosurgery

    Directory of Open Access Journals (Sweden)

    Eisenmann U.

    2015-09-01

    Full Text Available Computer-assisted planning of complex neurosurgical interventions benefits from a variety of specific functions and tools. However, commercial planning- and neuronavigation systems are rather restrictive concerning the availability of innovative methods such as novel imaging modalities, fiber tracking algorithms or electrical dipole mapping. In this respect there is a demand for modular neurosurgical planning systems offering flexible interfaces for easy enhancement. Furthermore all relevant planning information should be available within neuron-avigation. In this work we present a planning system providing these capabilities and its suitability and application in a clinical setting. Our Multimodal Planning System (MOPS 3D offers a variety of tools such as definition of trajectories for minimally invasive surgery, segmentation of ROIs, integration of functional information from atlas maps or magnetoencephalography. It also supplies plugin interfaces for future extensions. For intraoperative application MOPS is coupled with the neuronavigation system Brainlab Vector Vision Cranial/ENT (VVC. We evaluated MOPS in the Department of Neurosurgery at the University Hospital Heidelberg. Surgical planning and navigation was performed in 5 frequently occurring clinical cases. The time necessary for planning was between 5 and 15 minutes including data import, segmentation and planning tasks. The additional information intraoperatively provided by MOPS 3D was highly appreciated by the neurosurgeons and the performance was satisfactory.

  16. Intraoperative multi-exposure speckle imaging of cerebral blood flow.

    Science.gov (United States)

    Richards, Lisa M; Kazmi, Sm Shams; Olin, Katherine E; Waldron, James S; Fox, Douglas J; Dunn, Andrew K

    2017-01-01

    Multiple studies have demonstrated that laser speckle contrast imaging (LSCI) has high potential to be a valuable cerebral blood flow monitoring technique during neurosurgery. However, the quantitative accuracy and sensitivity of LSCI is limited, and highly dependent on the exposure time. An extension to LSCI called multi-exposure speckle imaging (MESI) overcomes these limitations, and was evaluated intraoperatively in patients undergoing brain tumor resection. This clinical study ( n = 8) recorded multiple exposure times from the same cortical tissue area spanning 0.5-20 ms, and evaluated images individually as single-exposure LSCI and jointly using the MESI model. This study demonstrated that the MESI estimates provided the broadest flow sensitivity for sampling the flow magnitude in the human brain, closely followed by the shorter exposure times. Conservation of flow analysis on vascular bifurcations was used to validate physiological accuracy, with highly conserved flow estimates (blood flow changes after tissue cautery. Results from this study demonstrate that intraoperative MESI can be performed with high quantitative accuracy and sensitivity for cerebral blood flow monitoring.

  17. Improvement of limb salvage procedure using intraoperative radiotherapy for osteosarcoma

    Energy Technology Data Exchange (ETDEWEB)

    Hirano, Toru; Iwasaki, Katsuo; Kamishiro; Toshiyuki; Hayashi, Yasuyuki (Nagasaki Univ. (Japan). School of Medicine)

    1992-10-01

    Clinical outcome of limb salvage procedure combined with intraoperative irradiation was investigated in 6 patients with osteosarcoma in the distal part of femur (n=4) and proximal part of tibia (n=2). They ranged in age from 12 to 54 years, with a mean of 22.5. First, a lesion was separated from the surrounding soft tissue with curatively wide margin. Osteotomy was performed at the portion of diaphysis. After irradiation field was setted up by lifting the lesion, and was exposed to doses ranging from 60 Gy to 85 Gy of intraoperative irradiation, soft tissue and fragile tumor tissue, excluding joint capsule and ligament, were removed as soon as possible. Finally, bone was jointed by means of inner fixation or bone grafting. They had a median follow-up of one year and four months after surgery. Although superficial wound infection and delayed wound adhesion were encountered as postoperative complications in one and two patients, respectively, these were all healed. None of the patients had local recurrence. The ability of salvaged limb was excellent in one, good in 3, and fair in 2 patients. Because both of the two patients with sarcoma in the proximal part of tibia had excellent and good limb ability, this procedure was considered useful especially for sarcoma in the proximal part of tibia. (N.K.).

  18. The resection map, a proposal for intraoperative hepatectomy guidance

    Energy Technology Data Exchange (ETDEWEB)

    Lamata, P.; Declerck, J. [Siemens Molecular Imaging, Oxford (United Kingdom); Jalote-Parmar, A. [Delft University of Technology, Industrial Design Department and Engineering, Delft (Netherlands); Lamata, F. [Hospital Clinico Universitario of Zaragoza, Zaragoza (Spain)

    2008-09-15

    To propose a new concept of an intra-operative 3D visualisation system to support hepatectomies. This system aims at improving the transfer of pre-operative planning into the intra-operative stage, both in laparoscopic and open approaches. User (surgeon) centred developmental process to identify the surgical requirements is applied. The surgical workflow of hepatectomy is analyzed, including observations of liver surgeries and focus group sessions. Based on this analysis, specifications for the ''Resection Map'' are defined. A first implementation is developed, and preliminary clinical acceptance results are gathered. Control of main veins and tumour margins are the two critical aspects. The ''Resection Map'' provides an intuitive visualisation of structures nearby the resection plane without any registration to the patient space. The first prototype subjectively increases the surgeon's confidence and orientation, but it should be further developed for non anatomical resections. The Resection Map is proposed as a pragmatic solution to enhance liver resection accuracy and safety. (orig.)

  19. Intraoperative music application in children and adolescents - a pilot study.

    Science.gov (United States)

    Buehler, P K; Spielmann, N; Buehrer, S; Schmidt, A R; Weiss, M; Schmitz, A

    2017-09-01

    Hospitalization, surgery and anaesthesia may lead to new-onset maladaptive behaviour, emotional distress and trauma. This pilot study aims to investigate the influence of intraoperatively applied music on post-operative behaviour in children and adolescents. Children with an ASA physical state classification of I or II, aged from 4 to 16 years and scheduled for elective circumcision or inguinal hernia repair under combined general and caudal anaesthesia were included. The children were randomized into two groups. They wore headphones during surgery, and were either exposed to music or not. All involved staff were blinded. Post-operative behaviour was documented by parents on day 7, 14 and 28 after surgery, using a questionnaire adapted from the "Post Hospitalization Behavioural Questionnaire" (PHBQ). Overall occurrence of at least one item indicating maladaptive behaviour was the primary outcome. Data are presented as median (interquartile range). In total, 135 children aged 6.6 (5.3-8.5) years, weighing 22 (19-29) kg, were included, with 112 completed questionnaires returned. Overall occurrence of at least one maladaptive item was lower in the music group, with a significantly lower incidence on day 7 (51% vs. 77% in controls; P < 0.01). Intraoperative music application in children undergoing minor surgical procedures may reduce the incidence of post-operative maladaptive behaviour within the first week. © 2017 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  20. Will intraoperative cholangiography prevent biliary duct injury inlaparoscopic cholecystectomy?

    Institute of Scientific and Technical Information of China (English)

    Li Bo Li; Xiu Jun Cai; Jun Da Li; Yi Ping Mu; Yue Dong Wang; Xiao Ming Yuan; Xian Fa Wang; Urs Bryner; Robert K.Finley Jr

    2000-01-01

    AIM To evaluate the role of intraoperative cholangiogram (IOC) in preventing biliary duct injury duringlaparoscopic cholecystectomy.METHODS Injury location, mechanism, time of detection, treatment outcome, and whether anintraoperative cholangiogram was performed were evaluated in 31 cases of bile duct injuries.RESULTS Cholangiograms were done in 22 cases, but they were misinterpreted in 3 of them. In 12 of 19misidentified cases, the cholangiogram was interpreted correctly, and the injury detected intraoperatively.Primary laparoscopic repair or open repair and T-tube drainage solved the problem. No long-termcomplications occurred. However, in 3 of the 19 cases the cholangiogram was misinterpreted and in 4 of the19 cases no cholangiogram was performed. Three of the seven patients required a cholangioentericanastomosis. In 2 cases the diagnosis was delayed and one of these required a two-stage procedure. Morbiditywas increased. Three cases of clim impingement of the common duct had delayed diagnoses, and two of themhad injuries. Thermal injury developed in 4 cases who had cholangiograms.CONCLUSION Routine IOC plays no role in inducing, preventing, detecting, or minimizing any of theinjuries due to clips, lacerations, or electrocautery, IOC does not prevent injuries due to ductmisidentification either. Careful interpretation of IOC would prevent injuries and avoid an open operation.

  1. Intraoperative esophageal Doppler hemodynamic monitoring in free perforator flap surgery.

    Science.gov (United States)

    Figus, Andrea; Wade, Ryckie G; Oakey, Stephen; Ramakrishnan, Venkat V

    2013-03-01

    Goal-directed fluid therapy optimizes cardiac output and flap perfusion during anesthesia. Intraoperative esophageal Doppler (ED) monitoring has been reported as more accurate and reliable, demonstrating improved surgical outcomes compared with central venous pressure and arterial catheter monitoring. A prospective study of patients undergoing free perforator (deep inferior epigastric artery perforator/anterolateral thigh) flap surgery with intraoperative ED monitoring (51 patients) or central venous pressure monitoring (53 patients) was undertaken. Fluid input included crystalloids, colloids, or blood products. Fluid output included urine, blood, or suctioned fluid. Postoperative fluid balance was calculated as fluid input - output. Fluid input between groups was not different. Fluid output was greater in the ED group (P = 0.008). The ED group showed less fluid balance (P = 0.023), less anesthetic time (P = 0.001), less hospital stay (mean 1.9 days; P = 0.147), less monitoring and flap complications (P = 0.062). ED monitoring demonstrated no monitoring complications, provides a favorable postoperative fluid balance, and may reduce flap complications and hospital stay.

  2. Diffractive multifocal intraocular lens interferes with intraoperative view

    Directory of Open Access Journals (Sweden)

    Mami Yoshino

    2010-05-01

    Full Text Available Mami Yoshino1, Makoto Inoue1,2, Nae Kitamura1, Hiroko Bissen-Miyajima11Department of Ophthalmology, Tokyo Dental College Suidobashi Hospital, Tokyo, Japan; 2Kyorin Eye Center, Kyorin University School of Medicine, Tokyo, JapanAbstract: We report an unusual finding during vitreous surgery in an eye implanted with a diffractive multifocal intraocular lens (IOL. A 70-year-old woman reported gradual visual deterioration to 20/40 in the left eye two and a half years after uneventful cataract surgery with implantation of a diffractive multifocal IOL. Funduscopic examination showed an epiretinal membrane (ERM in the left eye. Increased macular traction was believed to cause the visual deterioration. Vitreous surgery with removal of the ERM was performed and triamcinolone acetonide (TA was injected intravitreally to visualize the residual vitreous cortex. Although the ERM was peeled successfully, the ability to focus on the vitreoretinal interface through the IOL required great effort with decreased contrast sensitivity and ghost images of the intravitreal TA crystals. The vision improved to 20/25 4 months postoperatively. Macular surgery can be performed in an eye with a diffractive multifocal IOL; however, decreased contrast sensitivity and ghost images may interfere with the intraoperative view through the diffractive IOL in complicated cases.Keywords: diffractive multifocal intraocular lens, intraoperative view

  3. Solubility and viscosity of herring (Clupea harengus) proteins as affected by freezing and frozen storage.

    Science.gov (United States)

    Geirsdottir, M; Hlynsdottir, H; Thorkelsson, G; Sigurgisladottir, S

    2007-09-01

    The aim of this work was to evaluate the effects of freezing and frozen storage at -24 degrees C on the quality of Icelandic herring fillets, focusing on protein solubility and viscosity at pH 2.7 and 11 used for pH-aided protein isolation. The evaluation of quality was based on chemical analyses, protein degradation measurements, and changes in protein solubility and viscosity at pH 2.7 and 11 after up to 6-mo frozen storage of the herring fillets. Lipid oxidation measured as TBARS values increased significantly during the frozen storage (P frozen storage for 6 mo, where the solubility was about 10% lower after 6-mo frozen storage compared to the beginning (P frozen storage compared to initial solubility (P frozen storage (P frozen storage, compared to fresh herring fillets, but did not increase significantly with further storage (P frozen storage. SDS-PAGE analysis did not reveal any protein cross-linking or aggregation formation, either with frozen storage or due to exposure to low pH.

  4. Ovarian Fibrosarcoma: Clinicopathologic Considerations about the Intraoperative and Post-Surgical Procedures

    Directory of Open Access Journals (Sweden)

    Angel García Jiménez

    2009-01-01

    Full Text Available Primary ovarian fibrosarcomas are very uncommon neoplasms. Since the diagnostic criteria were established in 1981, less than one hundred cases have been reported. This diagnosis can be difficult to establish and other similar appearing mesenchymal processes must be ruled out. In every case this diagnosis is under consideration. Multiple sections of the specimen and immunohistochemical stains will be necessary to support this diagnosis. The difficulty of recognition in frozen section in the majority of the situations implies that the diagnosis should be deferred to the definitive study of the permanent sections with immunohistochemical studies. There exists a histological resemblance between a primary ovarian fibrosarcoma and actively mitotic fibroma. In some cases, it can be impossible to separate exactly these two entities. We report a well-differentiated ovarian fibrosarcoma, with less than 1-2 mitosis HPF and low-grade cytological atypia, similar to active mitotic fibromas, developing liver metastasis one year later. Despite having distant metastasis, some cases with long survival rates have been reported in patients who received chemotherapy after surgery; so that the adjuvant chemotherapy should be considered, especially in young females.

  5. Cardiac responses of vagus nerve stimulation: Intraoperative bradycardia and subsequent chronic stimulation

    NARCIS (Netherlands)

    Ardesch, J.J.; Buschman, H.P.J.; Burgh, van der P.H.; Wagener-Schimmel, L.J.; Aa, van der H.E.; Hageman, G.

    2007-01-01

    OBJECTIVES: Few adverse events on heart rate have been reported with vagus nerve stimulation (VNS) for refractory epilepsy. We describe three cases with intraoperative bradycardia during device testing. PATIENTS AND METHODS: At our hospital 111 patients have received a VNS system. Intraoperative dev

  6. [Intraoperative monitoring: visual evoked potentials in surgery of the sellar region].

    Science.gov (United States)

    Lorenz, M; Renella, R R

    1989-01-01

    During 18 sellar and perisellar operations the optic tract was monitored by visual evoked potentials (VEP). Deteriorations of the cortical responses were recorded in 73%. In this patients there was no close correlation between the intraoperative findings and the postoperative visual function. Only in those patients who showed no remarkable intraoperative changes VEP seemed to be of reliable prognostic value.

  7. Cardiac responses of vagus nerve stimulation: Intraoperative bradycardia and subsequent chronic stimulation

    NARCIS (Netherlands)

    Ardesch, J.J.; Buschman, H.P.J.; van der Burgh, P.H.; Wagener-Schimmel, L.J.; van der Aa, H.E.; Hageman, G.

    OBJECTIVES: Few adverse events on heart rate have been reported with vagus nerve stimulation (VNS) for refractory epilepsy. We describe three cases with intraoperative bradycardia during device testing. PATIENTS AND METHODS: At our hospital 111 patients have received a VNS system. Intraoperative

  8. Utility of Intraoperative Neuromonitoring during Minimally Invasive Fusion of the Sacroiliac Joint

    OpenAIRE

    Michael Woods; Denise Birkholz; Regina MacBarb; Robyn Capobianco; Adam Woods

    2014-01-01

    Study Design. Retrospective case series. Objective. To document the clinical utility of intraoperative neuromonitoring during minimally invasive surgical sacroiliac joint fusion for patients diagnosed with sacroiliac joint dysfunction (as a direct result of sacroiliac joint disruptions or degenerative sacroiliitis) and determine stimulated electromyography thresholds reflective of favorable implant position. Summary of Background Data. Intraoperative neuromonitoring is a well-accepted adjunct...

  9. Intraoperative image updating for brain shift following dural opening.

    Science.gov (United States)

    Fan, Xiaoyao; Roberts, David W; Schaewe, Timothy J; Ji, Songbai; Holton, Leslie H; Simon, David A; Paulsen, Keith D

    2016-09-09

    OBJECTIVE Preoperative magnetic resonance images (pMR) are typically coregistered to provide intraoperative navigation, the accuracy of which can be significantly compromised by brain deformation. In this study, the authors generated updated MR images (uMR) in the operating room (OR) to compensate for brain shift due to dural opening, and evaluated the accuracy and computational efficiency of the process. METHODS In 20 open cranial neurosurgical cases, a pair of intraoperative stereovision (iSV) images was acquired after dural opening to reconstruct a 3D profile of the exposed cortical surface. The iSV surface was registered with pMR to detect cortical displacements that were assimilated by a biomechanical model to estimate whole-brain nonrigid deformation and produce uMR in the OR. The uMR views were displayed on a commercial navigation system and compared side by side with the corresponding coregistered pMR. A tracked stylus was used to acquire coordinate locations of features on the cortical surface that served as independent positions for calculating target registration errors (TREs) for the coregistered uMR and pMR image volumes. RESULTS The uMR views were visually more accurate and well aligned with the iSV surface in terms of both geometry and texture compared with pMR where misalignment was evident. The average misfit between model estimates and measured displacements was 1.80 ± 0.35 mm, compared with the average initial misfit of 7.10 ± 2.78 mm between iSV and pMR, and the average TRE was 1.60 ± 0.43 mm across the 20 patients in the uMR image volume, compared with 7.31 ± 2.82 mm on average in the pMR cases. The iSV also proved to be accurate with an average error of 1.20 ± 0.37 mm. The overall computational time required to generate the uMR views was 7-8 minutes. CONCLUSIONS This study compensated for brain deformation caused by intraoperative dural opening using computational model-based assimilation of iSV cortical surface displacements. The u

  10. Intraoperative near-infrared fluorescent imaging during robotic operations.

    Science.gov (United States)

    Macedo, Antonio Luiz de Vasconcellos; Schraibman, Vladimir

    2016-01-01

    The intraoperative identification of certain anatomical structures because they are small or visually occult may be challenging. The development of minimally invasive surgery brought additional difficulties to identify these structures due to the lack of complete tactile sensitivity. A number of different forms of intraoperative mapping have been tried. Recently, the near-infrared fluorescence imaging technology with indocyanine green has been added to robotic platforms. In addition, this technology has been tested in several types of operations, and has advantages such as safety, low cost and good results. Disadvantages are linked to contrast distribution in certain clinical scenarios. The intraoperative near-infrared fluorescent imaging is new and promising addition to robotic surgery. Several reports show the utility of this technology in several different procedures. The ideal dose, time and site for dye injection are not well defined. No high quality evidence-based comparative studies and long-term follow-up outcomes have been published so far. Initial results, however, are good and safe. RESUMO A identificação intraoperatória de certas estruturas anatômicas, por seu tamanho ou por elas serem ocultas à visão, pode ser desafiadora. O desenvolvimento da cirurgia minimamente invasiva trouxe dificuldades adicionais, pela falta da sensibilidade tátil completa. Diversas formas de detecção intraoperatória destas estruturas têm sido tentadas. Recentemente, a tecnologia de fluorescência infravermelha com verde de indocianina foi associada às plataformas robóticas. Além disso, essa tecnologia tem sido testada em uma variedade de cirurgias, e suas vantagens parecem estar ligadas a baixo custo, segurança e bons resultados. As desvantagens estão associadas à má distribuição do contraste em determinados cenários. A imagem intraoperatória por fluorescência infravermelha é uma nova e promissora adição à cirurgia robótica. Diversas séries mostram

  11. Frozen Autograft-Prosthesis Composite Reconstruction in Malignant Bone Tumors.

    Science.gov (United States)

    Subhadrabandhu, Saran; Takeuchi, Akihiko; Yamamoto, Norio; Shirai, Toshiharu; Nishida, Hideji; Hayashi, Katsuhiro; Miwa, Shinji; Tsuchiya, Hiroyuki

    2015-10-01

    Several methods are available using an endoprosthesis or biological reconstruction for malignant bone tumors. Methods that use allograft-prosthesis composites have shown promising results. In 1999, the authors developed a method of reconstruction that uses a tumor-bearing autograft treated with liquid nitrogen. This technique was modified to produce a pedicle frozen autograft to maintain anatomical continuity on one side. In this study, the results of bone reconstructions using frozen autograft-prosthesis composites were retrospectively evaluated. The demographic data, histological records, surgical procedures, functional scores, and complications of 22 patients who had bone sarcoma or metastasis and at least 2 years of follow-up were reviewed. There were 19 patients with primary bone sarcoma and 3 with bone metastasis. Average age was 36 years (range, 9-73 years), and mean follow-up was 63 months (range, 24-176 months). Reconstructions were performed on 10 proximal femurs, 5 distal femurs, 4 proximal tibias, 1 proximal humerus, 1 proximal radius, and 1 hemipelvis. There were 12 pedicle-freezing and 10 free-freezing procedures. Union rate was 90% (9/10), and average union time was 9.5 months. Average Musculoskeletal Tumor Society score was 89.3%. Complications included 1 fracture, 2 infections, 3 soft tissue recurrences, and 1 posterior interosseous nerve palsy. The authors concluded that the frozen autograft-prosthesis composite demonstrated excellent Musculoskeletal Tumor Society scores, a low complication rate, and a good union rate and was superior when used with the pedicle-freezing technique.

  12. Probiotic culture survival and implications in fermented frozen yogurt characteristics.

    Science.gov (United States)

    Davidson, R H; Duncan, S E; Hackney, C R; Eigel, W N; Boling, J W

    2000-04-01

    Low-fat ice cream mix was fermented with probiotic-supplemented and traditional starter culture systems and evaluated for culture survival, composition, and sensory characteristics of frozen product. Fermentations were stopped when the titratable acidity reached 0.15% greater than the initial titratable acidity (end point 1) or when the pH reached 5.6 (end point 2). Mix was frozen and stored for 11 wk at -20 degrees C. The traditional yogurt culture system contained the strains Streptococcus salivarius ssp. thermophilus and Lactobacillus delbrueckii ssp. bulgaricus. The probiotic-supplemented system contained the traditional cultures as well as Bifidobacterium longum and Lactobacillus acidophilus. We compared recovery of Bifodobacterium by three methods, a repair-detection system with roll-tubes and plates on modified bifid glucose medium and plates with maltose + galactose reinforced clostridial medium. Culture bacteria in both systems did not decrease in the yogurt during frozen storage. The roll-tube method with modified bifid glucose agar and repair detection system provided at least one-half log10 cfu/ml higher recovery of B. longum compared with recoveries using modified bifid glucose agar or maltose + galactose reinforced clostridial agar on petri plates. No change in concentrations of lactose or protein for products fermented with either culture system occurred during storage. Acid flavor was more intense when product was fermented to pH 5.6, but yogurt flavor was not intensified. The presence of probiotic bacteria in the supplemented system seemed to cause no differences in protein and lactose concentration and sensory characteristics.

  13. 'Frozen' media subsidies during a time of media change

    DEFF Research Database (Denmark)

    Nielsen, Rasmus Kleis

    2014-01-01

    documents and secondary sources, I show that media subsidies have largely remained frozen in their late-20th century form. The absence of major reform means that media subsidies are increasingly subject to policy drift, a process by which the operations and effectiveness of policies change not because......Media systems around the world have changed in significant ways in the early 21st century. In this article, I analyse how various forms of media subsidies have changed in response to these transformations in a sample of six different affluent democracies. On the basis of interviews, official......) a perceived shortage of desirable, cost-effective, and governable alternatives to existing policies....

  14. Macro and micro minerals: are frozen fruits a good source?

    Directory of Open Access Journals (Sweden)

    Patricia D.S. Spada

    2010-12-01

    Full Text Available Fruits are rich in minerals, which are essential for a wide variety of metabolic and physiologic processes in the human body. The use of frozen fruits has greatly spread in the last years not only in the preparation of juices, but also as raw material for yogurts, candies, cookies, cakes, ice creams, and children's food. However, up to now there is no data about the mineral profile of frozen fruits. This is the first database to quantify the levels of minerals in 23 samples of frozen fruits, including the most used around the world and some native fruits from the Amazon rainforest in Brazil. Considering the Dietary Reference Intakes, 100g of frozen fruits can provide 0.2 to 2.8% of macro and 2.5 to 100% of microminerals for adults (31-50 years old. Although geographical differences should be considered, these data can help to plan diets and to develop population interventions aiming to prevent chronic diseases.As frutas são ricas em minerais, sendo estes essenciais para uma grande variedade de processos metabólicos e fisiológicos no corpo humano. A utilização de frutas congeladas tem se ampliado nos últimos anos, não só na preparação de sucos, mas também como matéria-prima para iogurtes, doces, biscoitos, bolos, sorvetes e alimentos infantis. No entanto, até o momento não há dados sobre o perfil mineral de frutas congeladas. Este trabalho é o primeiro banco de dados para quantificar os níveis de minerais em 23 amostras de frutas congeladas, bastante consumidas em todo o mundo e de algumas frutas nativas da floresta amazônica, Brasil. Considerando-se as Referências de Ingestão Diárias, 100g de frutas congeladas podem fornecer 0,2-2,8% de macro e de 2,5 a 100% dos mi-crominerais para adultos (31-50 anos. Embora as diferenças geográficas devam ser consideradas, estes dados ajudam para o plano de dietas e desenvolvimento de intervenções junto à população co o objetivo de prevenir doenças crônicas.

  15. The Numerical Scheme Development of a Simplified Frozen Soil Model

    Institute of Scientific and Technical Information of China (English)

    LI Qian; SUN Shufen; DAI Qiudan

    2009-01-01

    In almost all frozen soil models used currently,three variables of temperature,ice content and moisture content are used as prognostic variables and the rate term,accounting for the contribution of the phase change between water and ice,is shown explicitly in both the energy and mass balance equations.The models must be solved by a numerical method with an iterative process,and the rate term of the phase change needs to be pre-estimated at the beginning in each iteration step.Since the rate term of the phase change in the energy equation is closely related to the release or absorption of the great amount of fusion heat,a small error in the rate term estimation will introduce greater error in the energy balance,which will amplify the error in the temperature calculation and in turn,cause problems for the numerical solution convergence.In this work,in order to first reduce the trouble,the methodology of the variable transformation is applied to a simplified frozen soil model used currently,which leads to new frozen soil scheme used in this work.In the new scheme,the enthalpy and the total water equivalent are used as predictive variables in the governing equations to replace temperature,volumetric soil moisture and ice content used in many current models.By doing so,the rate terms of the phase change are not shown explicitly in both the mass and energy equations and its pre-estimation is avoided.Secondly,in order to solve this new scheme more functionally,the development of the numerical scheme to the new scheme is described and a numerical algorithm appropriate to the numerical scheme is developed.In order to evaluate the new scheme of the frozen soil model and its relevant algorithm,a series of model evaluations are conducted by comparing numerical results from the new model scheme with three observational data sets.The comparisons show that the results from the model are in good agreement with these data sets in both the change trend of variables and their

  16. Frozen impacted drop: From fragmentation to hierarchical crack patterns

    CERN Document Server

    Ghabache, Elisabeth; Séon, Thomas

    2016-01-01

    We investigate experimentally the quenching of a liquid pancake, obtained through the impact of a water drop on a cold solid substrate ($0$ to $-60^\\circ$C). We show that, below a certain substrate temperature, fractures appear on the frozen pancake and the crack patterns change from a 2D fragmentation regime to a hierarchical fracture regime as the thermal shock is stronger. The different regimes are discussed and the transition temperatures are estimated through classical fracture scaling arguments. Finally, a phase diagram presents how these regimes can be controlled by the drop impact parameters.

  17. [Use of fresh frozen plasma in a Swiss hospital district].

    Science.gov (United States)

    Schlesinger, P; Frey-Wettstein, M

    1983-11-01

    The causes of a unexpected rise in the consumption of fresh frozen plasma (FFP) in the years 1977-1980 are analyzed. FFP appears to be used increasingly in the department of surgery, and more specifically cardiac surgery, in the University Hospital. No basic changes are registered regarding the type of operations performed or the indications for prescribing FFP. At the same time, consumption of FFP in nonspecialized regional hospitals has increased to only a minor extent. It is pointed out that FFP is collected from blood donations and, as a product of human origin, should be used with moderation.

  18. Guidelines for the use of fresh frozen plasma.

    Science.gov (United States)

    De Backer, D; Vandekerckhove, B; Stanworth, S; Williamson, L; Hermans, C; Van der Linden, P; Hübner, R; Baele, P; Jochmans, K; Ferrant, A; Lambermont, M; Muylle, L; Toungouz, M

    2008-01-01

    Recommendations, which aim at standardising and rationalising clinical indications for the transfusion of fresh frozen plasma (FFP) in Belgium, were drawn up by a working group of the Superior Health Council. For this purpose the Superior Health Council organised an expert meeting devoted to "Transfusion Guidelines: Pathogen reduction, products and indications for the transfusion of plasma" in collaboration with the Belgian Haematological Society.The experts discussed the indications for the transfusion of FFP, pathogen reduction for FFP and the practical issues of administering FFP and plasma-derived concentrates. The recommendations formulated by the experts were validated by the working group with the purpose of harmonising FFP transfusion in Belgian hospitals.

  19. In Vivo Near Infrared Virtual Intraoperative Surgical Photoacoustic Optical Coherence Tomography

    Science.gov (United States)

    Lee, Donghyun; Lee, Changho; Kim, Sehui; Zhou, Qifa; Kim, Jeehyun; Kim, Chulhong

    2016-01-01

    Since its first implementation in otolaryngological surgery nearly a century ago, the surgical microscope has improved the accuracy and the safety of microsurgeries. However, the microscope shows only a magnified surface view of the surgical region. To overcome this limitation, either optical coherence tomography (OCT) or photoacoustic microscopy (PAM) has been independently combined with conventional surgical microscope. Herein, we present a near-infrared virtual intraoperative photoacoustic optical coherence tomography (NIR-VISPAOCT) system that combines both PAM and OCT with a conventional surgical microscope. Using optical scattering and absorption, the NIR-VISPAOCT system simultaneously provides surgeons with real-time comprehensive biological information such as tumor margins, tissue structure, and a magnified view of the region of interest. Moreover, by utilizing a miniaturized beam projector, it can back-project 2D cross-sectional PAM and OCT images onto the microscopic view plane. In this way, both microscopic and cross-sectional PAM and OCT images are concurrently displayed on the ocular lens of the microscope. To verify the usability of the NIR-VISPAOCT system, we demonstrate simulated surgeries, including in vivo image-guided melanoma resection surgery and in vivo needle injection of carbon particles into a mouse thigh. The proposed NIR-VISPAOCT system has potential applications in neurosurgery, ophthalmological surgery, and other microsurgeries. PMID:27731390

  20. Correlation between Density and Resorption of Fresh-Frozen and Autogenous Bone Grafts

    Directory of Open Access Journals (Sweden)

    Simone Lumetti

    2014-01-01

    Full Text Available Trial Design. This analysis compared the outcome of fresh-frozen versus autologous bone block grafts for horizontal ridge augmentation in patients with Cawood and Howell class IV atrophies. Methods. Seventeen patients received autologous grafts and 21 patients received fresh-frozen bone grafts. Patients underwent CT scans 1 week and 6 months after surgery for graft volume and density analysis. Results. Two autologous and 3 fresh-frozen grafts failed. Autologous and fresh-frozen grafts lost, respectively, 28% and 46% of their initial volume (P=0.028. It is noteworthy that less dense fresh-frozen blocks lost more volume than denser grafts (61% versus 16%. Conclusions. According to these 6-month results, only denser fresh-frozen bone graft may be an acceptable alternative to autologous bone for horizontal ridge augmentation. Further studies are needed to investigate its behaviour at longer time points.