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Sample records for invasive percutaneous facet

  1. A novel minimally invasive percutaneous facet augmentation device for the treatment of lumbar radiculopathy and axial back pain: technical description, surgical technique and case presentations

    OpenAIRE

    Khoo, Larry T.; Chen, Nan Fu; Armin, Sean; Stiner, Eric; Dipp, Juan; Flores, Ricardo; Palmer, Sylvain

    2009-01-01

    OBJECTIVE: to describe a new posterior minimally invasive method of facet stabilization for treatment of the degenerating lumbar motion segment. The biomechanics of this Percudyn (Interventional Spine; Irvine, CA) system are distinct from that of other interspinous dynamic stabilization systems as it acts bilaterally directly within the middle column of the spine. Based on biomechanical evalution, the paired prosthesis supports, cushions, and reinforces the facet complexes by limiting both ex...

  2. Percutaneous fusion of lumbar facet with bone allograft

    Directory of Open Access Journals (Sweden)

    Félix Dolorit Verdecia

    2015-03-01

    Full Text Available OBJECTIVE: To assess the evolution of the cases treated with percutaneous facet fusion with bone allograft in lumbar facet disease. METHOD: Between 2010 and 2014, 100 patients (59 women and 41 men diagnosed with lumbar facet disease underwent surgery. RESULTS: The lumbar facet fusion with bone allograft shows good clinical results, is performed on an outpatient basis, and presents minimal complications and rapid incorporation of the patient to the activities of daily living. CONCLUSIONS: The lumbar facet fusion with bone allograft appears to be an effective treatment for lumbar facet disease.

  3. Facet Joint Violation During Percutaneous Pedicle Screw Placement: A Comparison of Two Techniques.

    Science.gov (United States)

    Tannous, Oliver; Jazini, Ehsan; Weir, Tristan B; Banagan, Kelley E; Koh, Eugene Y; Greg Anderson, D; Gelb, Daniel E; Ludwig, Steven C

    2017-08-01

    A comparative study of facet joint violation (FJV) using two percutaneous surgical techniques. To compare the rate of iatrogenic FJV and medial pedicle wall breach between two methods of percutaneous pedicle screw instrumentation in the thoracic and lumbar spine. Variable iatrogenic damage to the facet joints has been reported to occur with percutaneous pedicle screw techniques, compared with the open approach, which has been associated with adjacent segment disease. Technical variations of percutaneous pedicle screw placement may pose different risks to the facet joint. Attending spine surgeons percutaneously placed pedicle screws in seven human cadaveric spines from T2 to L5. At each level, screws were instrumented on one side using the 9 or 3 o'clock reference point of the pedicle on the posteroanterior view with a lateral-to-medial trajectory (LMT) and on the contralateral side using the center of the pedicle with an owl's eye trajectory (OET). Postoperative screw placement was assessed with computed tomography and then open cadaveric dissection. Outcome measures included FJV and medial pedicle wall breach. Overall, 17 of 105 screws placed with an LMT versus 49 of 105 screws placed with an OET violated or abutted the facet joint (P L1), and lumbar (L2-L5) levels (P = 0.003, 0.035, and 0.018, respectively). Medial pedicle wall breach occurred with 11 LMT screws and seven OET screws (P = 0.077), and no breach was considered critical. A significantly higher FJV rate was observed using the OET versus the LMT in the thoracic, thoracolumbar, and lumbar spine. No statistically significant differences in medial pedicle wall breach occurred between the techniques. Thus, the LMT of minimally invasive pedicle screw fixation may reduce iatrogenic damage to the facet joints. 3.

  4. Percutaneous Facet Screw Fixation in the Treatment of Symptomatic Recurrent Lumbar Facet Joint Cyst: A New Technique

    International Nuclear Information System (INIS)

    Amoretti, Nicolas; Gallo, Giacomo; Bertrand, Anne-Sophie; Bard, Robert L.; Kelekis, Alexis

    2016-01-01

    We present a case of percutaneous treatment of symptomatic recurrent lumbar facet joint cyst resistant to all medical treatments including facet joint steroid injection. Percutaneous transfacet fixation was then performed at L4–L5 level with a cannulated screw using CT and fluoroscopy guidance. The procedure time was 30 min. Using the visual analog scale (VAS), pain decreased from 9.5, preoperatively, to 0 after the procedure. At 6-month follow-up, an asymptomatic cystic recurrence was observed, which further reduced at the 1-year follow-up. Pain remained stable (VAS at 0) during all follow-ups. CT- and fluoroscopy-guided percutaneous cyst rupture associated with facet screw fixation could be an alternative to surgery in patients suffering from a symptomatic recurrent lumbar facet joint cyst

  5. Percutaneous Facet Screw Fixation in the Treatment of Symptomatic Recurrent Lumbar Facet Joint Cyst: A New Technique

    Energy Technology Data Exchange (ETDEWEB)

    Amoretti, Nicolas, E-mail: amorettinicolas@yahoo.fr; Gallo, Giacomo, E-mail: giacomo.gallo83@gmail.com; Bertrand, Anne-Sophie, E-mail: asbertrand3@hotmail.com [Centre Hospitalier Universitaire de Nice (France); Bard, Robert L., E-mail: rbard@cancerscan.com [New York Medical College (United States); Kelekis, Alexis, E-mail: akelekis@med.uoa.gr [University General Hospital “ATTIKON” (Greece)

    2016-01-15

    We present a case of percutaneous treatment of symptomatic recurrent lumbar facet joint cyst resistant to all medical treatments including facet joint steroid injection. Percutaneous transfacet fixation was then performed at L4–L5 level with a cannulated screw using CT and fluoroscopy guidance. The procedure time was 30 min. Using the visual analog scale (VAS), pain decreased from 9.5, preoperatively, to 0 after the procedure. At 6-month follow-up, an asymptomatic cystic recurrence was observed, which further reduced at the 1-year follow-up. Pain remained stable (VAS at 0) during all follow-ups. CT- and fluoroscopy-guided percutaneous cyst rupture associated with facet screw fixation could be an alternative to surgery in patients suffering from a symptomatic recurrent lumbar facet joint cyst.

  6. Percutaneous Iliac Screws for Minimally Invasive Spinal Deformity Surgery

    Directory of Open Access Journals (Sweden)

    Michael Y. Wang

    2012-01-01

    Full Text Available Introduction. Adult spinal deformity (ASD surgeries carry significant morbidity, and this has led many surgeons to apply minimally invasive surgery (MIS techniques to reduce the blood loss, infections, and other peri-operative complications. A spectrum of techniques for MIS correction of ASD has thus evolved, most recently the application of percutaneous iliac screws. Methods. Over an 18 months 10 patients with thoracolumbar scoliosis underwent MIS surgery. The mean age was 73 years (70% females. Patients were treated with multi-level facet osteotomies and interbody fusion using expandable cages followed by percutaneous screw fixation. Percutaneous iliac screws were placed bilaterally using the obturator outlet view to target the ischial body. Results. All patients were successfully instrumented without conversion to an open technique. Mean operative time was 302 minutes and the mean blood loss was 480 cc, with no intraoperative complications. A total of 20 screws were placed successfully as judged by CT scanning to confirm no bony violations. Complications included: two asymptomatic medial breaches at T10 and L5, and one patient requiring delayed epidural hematoma evacuation. Conclusions. Percutaneous iliac screws can be placed safely in patients with ASD. This MIS technique allows for successful caudal anchoring to stress-shield the sacrum and L5-S1 fusion site in long-segment constructs.

  7. Percutaneous & Mini Invasive Achilles tendon repair

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    Carmont Michael R

    2011-11-01

    Full Text Available Abstract Rupture of the Achilles tendon is a considerable cause of morbidity with reduced function following injury. Recent studies have shown little difference in outcome between the techniques of open and non-operative treatment using an early active rehabilitation programme. Meta-analyses have shown that non-operative management has increased risk of re-rupture whereas surgical intervention has risks of complications related to the wound and iatrogenic nerve injury. Minimally invasive surgery has been adopted as a way of reducing infections rates and wound breakdown however avoiding iatrogenic nerve injury must be considered. We discuss the techniques and outcomes of percutaneous and minimally invasive repairs of the Achilles tendon.

  8. Accuracy of percutaneous lung biopsy for invasive pulmonary aspergillosis

    International Nuclear Information System (INIS)

    Hoffer, F.A.; Gow, K.; Davidoff, A.; Flynn, P.M.

    2001-01-01

    Background. Invasive pulmonary aspergillosis is fulminant and often fatal in immunosuppressed patients. Percutaneous biopsy may select patients who could benefit from surgical resection. Objective. We sought to determine the accuracy of percutaneous biopsy for pediatric invasive pulmonary aspergillosis. Materials and methods. We retrospectively reviewed 28 imaging-guided percutaneous biopsies of the lungs of 24 children with suspected pulmonary aspergillosis. Twenty-two were being treated for malignancy and two for congenital immunodeficiency; 15 had received bone-marrow transplants. The accuracy of the percutaneous lung biopsy was determined by subsequent surgical resection, autopsy, or clinical course. Results. Histopathological studies showed ten biopsy specimens with septate hyphae, indicating a mold, and seven with Aspergillus flavus colonies in culture. The remaining 18 biopsies revealed no fungi. No patient had progressive aspergillosis after negative biopsy. Invasive pulmonary mold was detected by percutaneous biopsy with 100 % (10/10) sensitivity and 100 % (18/18) specificity. Percutaneous biopsy results influenced the surgical decision in 86 % (24 of 28) of the cases. Bleeding complicated the biopsy in 46 % (13/28) and hastened one death. Conclusion. Percutaneous biopsy of the lung is an accurate technique for the diagnosis of invasive pulmonary aspergillosis and correctly determines which immunosuppressed pediatric patients would benefit from therapeutic pulmonary resection. (orig.)

  9. A review of percutaneous techniques for low back pain and neuralgia: current trends in epidural infiltrations, intervertebral disk and facet joint therapies.

    Science.gov (United States)

    Filippiadis, Dimitrios K; Kelekis, Alexis

    2016-01-01

    Low back pain and neuralgia due to spinal pathology are very common symptoms debilitating numerous patients with peak prevalence at ages between 45 and 60 years. Intervertebral discs and facet joints act as pain sources in the vast majority of the cases. Diagnosis is based on the combination of clinical examination and imaging studies. Therapeutic armamentarium for low back pain and neuralgia due to intervertebral discs and/or facet joints includes conservative therapy, injections, percutaneous therapeutic techniques and surgical options. Percutaneous, therapeutic techniques are imaging-guided, minimally invasive treatments which can be performed as outpatient procedures. In cases of facet joint syndrome, they include, apart from injections, neurolysis with radiofrequency/cryoablation, MR-guided high-intensity focused ultrasound and percutaneous fixation techniques. In case of discogenic pain, apart from infiltrations, therapeutic techniques can be classified in to two main categories: decompression (mechanical, thermal, chemical) techniques and biomaterials implantation/disc cell therapies. Strict sterility measures are a prerequisite and should include extensive local sterility and antibiotic prophylaxis. This article will report clinical and imaging findings for each pathology type and the association with treatment decision. In addition, we will describe in detail all possible treatment techniques for low back pain and neuralgia, and we will report recently published results of these techniques summarizing the data concerning safety and effectiveness as well as the level of evidence. Finally, we will try to provide a rational approach for the therapy of low back pain and neuralgia by means of minimally invasive imaging-guided percutaneous techniques.

  10. Long-term outcomes of percutaneous lumbar facet synovial cyst rupture

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Ambrose J.; Bos, Stijn A.; Torriani, Martin; Simeone, F.J.; Chang, Connie Y.; Pomerantz, Stuart R.; Bredella, Miriam A. [Massachusetts General Hospital and Harvard Medical School, Department of Radiology, Boston, MA (United States)

    2017-01-15

    To evaluate the therapeutic value, safety, and long-term clinical outcomes of percutaneous lumbar facet synovial cyst (LFSC) rupture. Our study was institutional review board (IRB)-approved and Health Insurance Portability and Accountability Act (HIPAA)-compliant. The study group comprised 71 patients (44 women, mean age: 65 ± 17 years) who underwent CT- or fluoroscopy-guided percutaneous LFSC rupture. The technical success of LFSC rupture, the long-term clinical outcome, including repeat procedures or surgery, and imaging findings on MRI and CT were recorded. Seventy-nine LFSC ruptures were performed in 71 patients. CT guidance was used in 57 cases and fluoroscopy guidance in 22 cases. LFSC rupture was technically successful in 58 out of 79 cases (73 %). Mean injection volume for cyst rupture was 3.6 ± 2.2 mL and a combination of steroid and anesthetic was injected in all cases. Over a mean follow-up time of 44 months, 12 % of patients underwent repeat cyst rupture, and 46 % eventually underwent surgery, whereas the majority of patients (55 %) experienced symptomatic relief and did not undergo surgery. There was no significant association between a successful outcome and age, sex, level, or size of LFSC (p > 0.1). LFSCs with T2 hypointensity were more likely to require surgery (p = 0.02). There was one complication, a bacterial skin infection that completely resolved following antibiotic therapy. Percutaneous LFSC rupture is an effective and safe nonsurgical treatment option for LFSC. More than half of treated patients were able to avoid subsequent surgery. Therefore, percutaneous LFSC rupture should be considered before surgical intervention. (orig.)

  11. Complications of Minimally Invasive Percutaneous Plating for Distal Tibial Fractures

    OpenAIRE

    Muzaffar, Nasir; Bhat, Rafiq; Yasin, Mohammad

    2016-01-01

    Background The management of distal tibia fractures continues to remain a source of controversy and debate. Objectives The aim of this study was to evaluate the various complications of minimally invasive percutaneous plate osteosynthesis (MIPPO) using a locking plate for closed fractures of distal tibia in a retrospective study. Patients and Methods Twenty-five patients with dista...

  12. Effects of Facet Joint Injection Reducing the Need for Percutaneous Vertebroplasty in Vertebral Compression Fractures

    Energy Technology Data Exchange (ETDEWEB)

    Im, Tae Seong; Lee, Joon Woo; Lee, Eugene; Kang, Yusuhn; Ahn, Joong Mo, E-mail: joongmoahn@gmail.com; Kang, Heung Sik [Seoul National University Bundang Hospital, Department of Radiology (Korea, Republic of)

    2016-05-15

    ObjectiveTo evaluate the effects of facet joint injection (FJI) reducing the need for percutaneous vertebroplasty (PVP) in cases of vertebral compression fracture (VCF).Materials and MethodsA total of 169 patients who were referred to the radiology department of our institution for PVP between January 2011 and December 2014 were retrospectively evaluated. The effectiveness of FJI was evaluated by the proportion of patients who cancelled PVP and who experienced reduced pain. In addition, by means of medical chart and MRI review, those clinical factors (age, sex, history of trauma, amount of injected steroids and interval days elapsed between VCF and FJI) and MR image factors (kyphosis angle, height loss, single or multiple level of VCF, burst fracture, central canal compromise, posterior element injury) that were believed to be significant for the effectiveness of FJI were statistically analysed.ResultsIn the 26 patients with FJI prior to PVP, six (23 %) patients cancelled PVP with considerable improvement in reported pain. In the 20 patients with PVP after FJI, improvement in pain after FJI was reported by six patients, resulting in a total of 12 patients (46 %) who experienced reduced pain after FJI. Clinical factors and MR image factors did not show any statistically significant difference between those groups, divided by PVP cancellation and by improvement of pain.ConclusionAfter FJI prior to PVP, about one quarter of patients cancelled PVP due to reduced pain and overall about half of the patients experienced reduced pain.

  13. Percutaneous posterior cervical fusion with the DTRAX Facet System for single-level radiculopathy: results in 60 patients.

    Science.gov (United States)

    McCormack, Bruce M; Bundoc, Rafael C; Ver, Mario R; Ignacio, Jose Manuel F; Berven, Sigurd H; Eyster, Edward F

    2013-03-01

    The authors present 1-year results in 60 patients with cervical radiculopathy due to spondylosis and stenosis that was treated with a bilateral percutaneous facet implant. The implant consists of a screw and washer that distracts and immobilizes the cervical facet for root decompression and fusion. Clinical and radiological results are analyzed. Between 2009 and 2011, 60 patients were treated with the DTRAX Facet System in a multicenter prospective single-arm study. All patients had symptomatic clinical radiculopathy, and conservative management had failed. The majority of patients had multilevel radiographically confirmed disease. Only patients with single-level radiculopathy confirmed by history, physical examination, and in some cases confirmatory nerve blocks were included. Patients were assessed preoperatively with Neck Disability Index, visual analog scale, quality of life questionnaire (Short Form-12 version 2), CT scans, MRI, and dynamic radiographs. Surgery was percutaneous posterior bilateral facet implants consisting of a screw and expandable washer and iliac crest bone aspirate. Patients underwent postoperative assessments at 2 weeks, 6 weeks, 3 months, 6 months, and 1 year with validated outcome questionnaires. Alterations of segmental and overall cervical lordosis, foraminal dimensions, device retention and fusion criteria were assessed for up to 1 year with CT reconstructions and radiographs. Fusion criteria were defined as bridging trabecular bone between the facets, translational motion cervical lordosis. There was a 1.6° loss of segmental lordosis at the treated level at 1 year that was significant. Foraminal width, volume, and posterior disc height was significantly increased at 6 months and returned to baseline levels at 1 year. There was no significant decrease in foraminal width and height at adjacent levels. There were no reoperations or surgery- or device-related complications, including implant failure or retained hardware. Results

  14. Complications of Minimally Invasive Percutaneous Plating for Distal Tibial Fractures.

    Science.gov (United States)

    Muzaffar, Nasir; Bhat, Rafiq; Yasin, Mohammad

    2016-07-01

    The management of distal tibia fractures continues to remain a source of controversy and debate. The aim of this study was to evaluate the various complications of minimally invasive percutaneous plate osteosynthesis (MIPPO) using a locking plate for closed fractures of distal tibia in a retrospective study. Twenty-five patients with distal tibial fractures, treated by minimally invasive percutaneous plate osteosynthesis, were evaluated in a retrospective study. We studied the rate, probable etiological factors and preventive and corrective measures of various complications associated with minimally invasive plating of distal tibia. Mean age of the patients was 41.16 years (range 22 - 65). There were 13 male and 12 female patients. All fractures united at an average duration of 16.8 weeks. There were two cases of superficial and two cases of deep infection, and deep infections required removal of hardware for cure. There were four cases of ankle stiffness, most of them occurring in intra-articular fractures, three cases of palpable implant, three cases of malunion, one case of loss of reduction and one patient required reoperation. The average AO foot and ankle score was 83.6. We found MIPPO using locking plate to be a safe and effective method for the treatment of distal tibial fractures in properly selected patients yet can result in a variety of complications if proper precautions before, during and after surgery are not taken care of.

  15. Minimally invasive percutaneous endoscopic discectomy and drainage for infectious spondylodiscitis

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    Tsai-Sheng Fu

    2013-08-01

    Full Text Available The primary goals for treating infectious spondylodiscitis are to make an accurate diagnosis, isolate the causative organism, and prescribe effective antibiotic therapy based on the culture data. A positive culture of the responsible organism is not required for diagnosis, although it is extremely important for successful treatment and prevention of further morbidity. Surgical intervention is usually reserved for cases that are unresponsive to antibiotic therapy and for patients who have developed progressive spinal deformity or instability, epidural abscesses, or neurological impairment. However, the incidence of perioperative morbidity is particularly increased in elderly patients or in those with poor general condition. With improved endoscopic instruments and techniques, our clinical experiences demonstrate that spinal infections can be successfully treated by minimally invasive percutaneous endoscopic debridement. Direct endoscopic observation and collection of sufficient quantities of samples for microbiological examinations from the infected region are usually possible. This article summarizes the diagnostic and therapeutic values of percutaneous endoscopic discectomy and drainage (PEDD used to treat patients with spondylodiscitis. Our clinical evidence-based survey suggests that PEDD can provide adequate retrieval of specimens and has high diagnostic efficacy, thereby enabling prompt and sensitive antibiotic therapy to the offending pathogens. We propose that PEDD is an effective alternative for treating infectious spondylodiscitis and should be considered prior to extensive anterior surgery in selected cases. This method is particularly suitable for patients with early-stage spinal infection or serious medical conditions.

  16. Minimally invasive percutaneous plate fixation of distal tibia fractures.

    LENUS (Irish Health Repository)

    Bahari, Syah

    2007-10-01

    We report a series of 42 patients reviewed at a mean of 19.6 months after treatment of distal tibial and pilon fractures using the AO distal tibia locking plate with a minimally invasive percutaneous plate osteosynthesis (MIPPO) technique. Mean time to union was 22.4 weeks. All fractures united with acceptable alignment and angulation. Two cases of superficial infection were noted, with one case of deep infection. Mean SF36 score was 85 and mean AOFAS score was 90 at a mean of 19 months follow-up. We report satisfactory outcomes with the use of the AO distal tibia locking plate in treatment of unstable distal tibial fractures. Eighty-nine percent of the patients felt that they were back to their pre injury status and 95% back to their previous employment.

  17. A novel minimally invasive percutaneous facet augmentation device for the treatment of lumbar radiculopathy and axial back pain: technical description, surgical technique and case presentations Un nuevo dispositivo percutáneo mínimamente invasivo de aumento facetáreo para el tratamiento de radiculopatía lumbar y dolor axial lumbar: descripción técnica, técnica quirúrgica y presentación de casos Um novo dispositivo percutâneo minimamente invasivo de aumento facetário para o tratamento da radiculopatia lombar e dor axial lombar: descrição técnica, técnica cirúrgica e apresentação de casos

    OpenAIRE

    Larry T. Khoo; Nan Fu Chen; Sean Armin; Eric Stiner; Juan Dipp; Ricardo Flores; Sylvain Palmer

    2009-01-01

    OBJECTIVE: to describe a new posterior minimally invasive method of facet stabilization for treatment of the degenerating lumbar motion segment. The biomechanics of this Percudyn (Interventional Spine; Irvine, CA) system are distinct from that of other interspinous dynamic stabilization systems as it acts bilaterally directly within the middle column of the spine. Based on biomechanical evalution, the paired prosthesis supports, cushions, and reinforces the facet complexes by limiting both ex...

  18. A novel minimally invasive percutaneous facet augmentation device for the treatment of lumbar radiculopathy and axial back pain: technical description, surgical technique and case presentations Un nuevo dispositivo percutáneo mínimamente invasivo de aumento facetáreo para el tratamiento de radiculopatía lumbar y dolor axial lumbar: descripción técnica, técnica quirúrgica y presentación de casos Um novo dispositivo percutâneo minimamente invasivo de aumento facetário para o tratamento da radiculopatia lombar e dor axial lombar: descrição técnica, técnica cirúrgica e apresentação de casos

    Directory of Open Access Journals (Sweden)

    Larry T. Khoo

    2009-03-01

    Full Text Available OBJECTIVE: to describe a new posterior minimally invasive method of facet stabilization for treatment of the degenerating lumbar motion segment. The biomechanics of this Percudyn (Interventional Spine; Irvine, CA system are distinct from that of other interspinous dynamic stabilization systems as it acts bilaterally directly within the middle column of the spine. Based on biomechanical evalution, the paired prosthesis supports, cushions, and reinforces the facet complexes by limiting both extension and lateral bending thereby maintaining central and foraminal volumes. METHODS: the Percudyn device consists of a pedicle anchor upon which sits a cushioning polycarbonate-urethane stabilizer that serves as a mechanically reinforcing stop between the inferior and superior articular facets. A 1.5 cm skin incision is made bilaterally over the lower pedicle of the treated segment through which a Jamshidi needle is percutaneously targeted under biplanar fluoroscopic guidance into the caudal aspect of the superior articular process directly underneath the lip of the inferior facet from the level above. Progressive onestep tubular dilation is then performed to secure a small disposable working portal. Through this access, the Percudyn stabilizers are then placed over the wire and anchored bilaterally into the inferior pedicles of the degenerated motion segment. RESULTS: three patients (ages 26-41, male with significant low back pain as well as radiculopathy with lateral recess stenosis from a large disc herniation/ ligamentum and facet hypertrophy (L4-5 and/or L5-S1 underwent a minimally invasive decompression/ discectomy and bilateral Percudyn placement at each disease level. Each patient had significant relief of both his radiculopathy and axial back pain post-operatively and was discharged home within 18 hours without sequelae. CONCLUSION: this novel technique of percutaneous posterior facet augmentation allows for safe placement of bilateral middle

  19. Minimally invasive percutaneous lateral plate osteosynthesis in humeral shaft fractures.

    Directory of Open Access Journals (Sweden)

    Luis Sebastian Ruchelli

    2016-08-01

    Full Text Available Introduction: The aim of this study is to retrospectively assess functional and radiological outcomes, and immediate and long term postsurgical complications in a series of patients with humeral fractures treated with osteosynthesis with minimally invasive technique. Material and Methods: Retrospective Multicentric study of 14 patients with humeral fractures treated with minimally invasive plate osteosynthesis through lateral approaches between 2007 and 2013. Seven were females and 7 males, age averaged 48.7 years (range 21 -73. Fractures were classified according to the AO classification A1 12 n: 1; 12 B1 n: 1; 12B2 n: 3; C1 n 12: 6; 12C2 n: 1; 12C3 n: 2. Two lateral incisions were used proximal and distal. The plates were slid submuscular, and the radial nerve was protected.  Results: Follow - up averaged 30 months.Union was achieved in 13 cases (92.85%, time to union averaged three months (range, 2 to 6. Flexion averaged 174.8 °, external rotation  67.2°, abduction 173.8º and internal rotation 72.1°. Elbow flexion and extension ROM averaged 140.5 °. Constant´s score averaged 82.66 points; DASH score averaged 15.27 points. Four patients had radial nerve neurapraxia (23.5%.  Discussion: Percutaneous osteosynthesis with plates using a lateral minimally invasive approach has proven effective for the treatment of humeral shaft fractures, applying the principle of bridge plate. It is a biological procedure, technically demanding, and not exempt of complications.

  20. Treatment of large lumbar disc herniation with percutaneous ozone injection via the posterior-lateral route and inner margin of the facet joint.

    Science.gov (United States)

    Lu, Wei; Li, Yan-Hao; He, Xiao-Feng

    2010-03-28

    To evaluate the effects of percutaneous ozone injection via the posterior-lateral route and inner margin of the facet joint in the treatment of large lumbar disc herniation. Fifty-eight patients with large lumbar disc herniation were treated with percutaneous injection of ozone via the posterior-lateral route and inner margin of the facet joint under digital subtraction angiography. Second injections were performed 5 d after the initial injection. All patients were followed up for 6-18 mo. A modified Macnab method was used for assessing clinical outcomes after oxygen-ozone therapy. Successful puncture was obtained in all patients. The overall efficacy was 91.4%; the outcome was the excellent in 37 cases (63.8%), good in 16 cases (27.6%) and fair/poor in 5 cases (8.6%) according to the Macnab criteria. No severe complications were found throughout this study. Percutaneous intradiscal ozone injection via the posterior-lateral route and inner margin of the facet joint is effective and safe for treatment of large lumbar disc herniation.

  1. Treatment of intervertebral disc degenerative disease using percutaneous nucleotomy–an overview of less invasive procedures

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    Miran Jeromel

    2014-04-01

    Full Text Available Background: Less invasive treatment methods for intervertebral disc disease and decompression of neural structures as a consequence of contained disc herniation represent an alternative to surgical procedure. Percutaneus nucleotomy uses a percutaneous approach to the intervertebral disc. The article presents the evolution of numerous procedureds in clinical practice.Methods: Percutaneous nucleoplasty is a fluoroscopy-guided procedure which enables controlled and safe entrance into the intervertebral disc. The procedure is performed under strict aseptic conditions, using a local anaesthesia with the patient under analgosedation. Based on the principle of therapeutic intradiscal action, the procedures can be divided into three groups: chemical (chemonucleolysis with chimopapain, alcohol, ozone, mechanical (automated percutaneous lumbar discectomy – APLD, arthroscopic discectomy and thermical methods (laser, radiofrequency ablation, intradiscal electrothermal annuloplasty – IDET, Coblation®.Results: Percutaneous nucleotomy by the majority of the mentioned procedures results in a therapeutic effect (reduction of pain and decompression of neural structures. Fast recovery represents a major advantage of less invasive treatment.Conclusions: Less invasive method (nucleotomy using different procedures represents a successful alternative approach to surgical discectomy. Proper patient selection and safe technique are mandatory in order to achieve a good clinical outcome.

  2. Mini-Open Sinus Tarsi Approach with Percutaneous Screw Fixation of Displaced Calcaneal Fractures: A Prospective Computed Tomography-Based Study

    NARCIS (Netherlands)

    Nosewicz, Tomasz; Knupp, Markus; Barg, Alexej; Maas, Mario; Bolliger, Lilianna; Goslings, J. Carel; Hintermann, Beat

    2012-01-01

    Background: Open reduction and internal fixation (ORIF) of calcaneal fractures using an extended lateral approach results in soft tissue disruption and theoretically subtalar joint stiffness. A minimally invasive sinus tarsi approach for posterior facet exposure and percutaneous screw fixation of

  3. Ultra-mini-percutaneous nephrolithotomy: A minimally-invasive option for percutaneous stone removal

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    Madhu Sudan Agrawal

    2016-01-01

    Full Text Available Introduction: Percutaneous nephrolithotomy (PCNL has witnessed rapid advancements, the latest being ultra-mini-percutaneous nephrolithotomy (UMP, which makes the use of 11-13F sheaths as compared to 24-30F sizes used in conventional PCNL. This miniaturization aims to reduce morbidity and improve patient outcomes. We evaluated the safety and efficacy of UMP and report our ourtcomes. Patients and Methods: A total of 120 patients underwent UMP from July 2012 to March 2014. These patients had a single unilateral renal stone measuring between 8 and 20 mm. All patients underwent UMP using a 3F nephroscope, 7.5F inner sheath, and 11F or 13F outer metallic cannula, which served as the Amplatz sheath. Stone fragmentation and clearance were achieved with holmium laser. No nephrostomy or stent was used routinely. Results: Complete stone fragmentation was achieved in 114 out of 120 patients (95% using UMP; whereas the remaining 6 were converted into mini-PCNL using a 12.5F nephroscope and 15F Amplatz sheath. The mean operative time was 39.7 ± 15.4 min, and the mean postoperative hospital stay was 22.3 ± 2.2 h. Postoperatively, 6 (5% patients had residual fragments measuring ≤4 mm. At the 2 weeks follow-up, the stone-free status was >99% (119/120. There were no significant postoperative complications. Conclusion: This study shows UMP to be an effective and safe procedure for managing stones up to 20 mm. This procedure offers an attractive alternative to shock wave lithotripsy and retrograde intrarenal surgery for managing small stones.

  4. Minimally invasive mini open split-muscular percutaneous pedicle screw fixation of the thoracolumbar spine

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    Murat Ulutaş

    2015-03-01

    Full Text Available We prospectively assessed the feasibility and safety of a new percutaneous pedicle screw (PPS fixation technique for instrumentation of the thoracic and lumbar spine in this study. All patients were operated in the prone position under general anesthesia. A 6 to 8 cm midline skin incision was made and wide sub-cutaneous dissection was performed. The paravertebral muscles were first dissected subperiosteally into the midline incision of the fascia for lumbar microdiscectomy with transforaminal lumbar interbody fusion cage implantation. After the secondary paramedian incisions on the fascia, the PPSs were inserted via cleavage of the multifidus muscles directly into the pedicles under fluoroscopy visualization. A total of 35 patients underwent surgery with this new surgical technique. The control group for operative time, blood loss and analgesic usage consisted of 35 randomly selected cases from our department. The control group underwent surgery via conventional pedicle screw instrumentation with paramedian fusion. All patients in the minimal invasive surgery series were ambulatory with minimal pain on the first postoperative day. The operation time and blood loss and the postoperative analgesic consumption were significantly less with this new technique. In conclusion, the minimal invasive mini open split-muscular percutaneous pedicle screw fixation technique is safe and feasible. It can be performed via a short midline skin incision and can also be combined with interbody fusion, causing minimal pain without severe muscle damage.

  5. [Features of the new minimally invasive techniques facet fixation system «Facet Wedge» in the treatment of degenerative diseases of the lumbar spine in elderly patients.

    Science.gov (United States)

    Byvaltsev, V A; Kalinin, A A; Okoneshnikova, A K

    2017-01-01

    The aim of the study was a comparative analysis of the clinical and radiographic effectiveness of the use of interbody fusion and open pedicle screw stabilization of simultaneous and new minimally invasive techniques facet fixation system «Facet Wedge» in the treatment of degenerative diseases of the lumbar spine in elderly patients. The study included 39 elderly patients (older than 60), which carries out the transforaminal interbody fusion Cage «T-pal»: open transpedicaular stabilization was used in 1st group (n=23), ipsilateral open transpedicular stabilization with contralateral transfaset installing titanium Cage «facet Wedge» -in 2nd group (n=16). We used intraoperative interventions and specific post-operative patient management, clinical data and radiographic outcomes for a comparative analysis of the parameters. Dynamic assessment was made in a period of 8 to 36 months after surgery (median 24 mo.). As a result, it found that the use of the system «facet Wedge» allows you to achieve the best clinical outcomes and fewer postoperative complications compared with open transpedicular stabilization in similar radiographic findings of bone block formation. Low traumatic facet fixation makes it possible to use methods for the treatment of elderly patients with degenerative diseases of the lumbosacral spine.

  6. Percutaneous treatment with amphotericin B in a case of invasive pulmonary aspergillosis

    International Nuclear Information System (INIS)

    Ruiz, A.; Lonjedo, E.; Agramunt, M.; Martinez-Rodrigo, J. J.; Palomero, J.

    2001-01-01

    Invasive pulmonary aspergillosis (IPA) is a serious complications that occurs in immunocompromised patients. We need a rapid and effective treatment both to treat the aspergillosis as well as to be able to continue, as soon as possible, treatment of the baseline disease. We present a case of a percutaneous treatment of the pulmonary lesions in a 55 year old male with IPA in the context of acute myeloid leukemia (AML). With Computerized Tomography (CT) control and using a fine needle, we injected intralesionally a solution of Amphotericin B (AB) (5 mg/cc of 5% glucose solution). We evaluated the complications and efficacy in relationship to the clinical improvement and reduction in lesion size. (Author) 18 refs

  7. Lumbar Spinal Stenosis Minimally Invasive Treatment with Bilateral Transpedicular Facet Augmentation System

    Energy Technology Data Exchange (ETDEWEB)

    Masala, Salvatore, E-mail: salva.masala@tiscali.it [Interventional Radiology and Radiotherapy, University of Rome ' Tor Vergata' , Department of Diagnostic and Molecular Imaging (Italy); Tarantino, Umberto [University of Rome ' Tor Vergata' , Department of Orthopaedics and Traumatology (Italy); Nano, Giovanni, E-mail: gionano@gmail.com [Interventional Radiology and Radiotherapy, University of Rome ' Tor Vergata' , Department of Diagnostic and Molecular Imaging (Italy); Iundusi, Riccardo [University of Rome ' Tor Vergata' , Department of Orthopaedics and Traumatology (Italy); Fiori, Roberto, E-mail: fiori.r@libero.it; Da Ros, Valerio, E-mail: valeriodaros@hotmail.com; Simonetti, Giovanni [Interventional Radiology and Radiotherapy, University of Rome ' Tor Vergata' , Department of Diagnostic and Molecular Imaging (Italy)

    2013-06-15

    Purpose. The purpose of this study was to evaluate the effectiveness of a new pedicle screw-based posterior dynamic stabilization device PDS Percudyn System Trade-Mark-Sign Anchor and Stabilizer (Interventional Spine Inc., Irvine, CA) as alternative minimally invasive treatment for patients with lumbar spine stenosis. Methods. Twenty-four consecutive patients (8 women, 16 men; mean age 61.8 yr) with lumbar spinal stenosis underwent implantation of the minimally invasive pedicle screw-based device for posterior dynamic stabilization. Inclusion criteria were lumbar stenosis without signs of instability, resistant to conservative treatment, and eligible to traditional surgical posterior decompression. Results. Twenty patients (83 %) progressively improved during the 1-year follow-up. Four (17 %) patients did not show any improvement and opted for surgical posterior decompression. For both responder and nonresponder patients, no device-related complications were reported. Conclusions. Minimally invasive PDS Percudyn System Trade-Mark-Sign has effectively improved the clinical setting of 83 % of highly selected patients treated, delaying the need for traditional surgical therapy.

  8. Use of a Novel Flexible Mini-nephroscope in Minimally Invasive Percutaneous Nephrolithotomy.

    Science.gov (United States)

    Mishra, Dilip Kumar; Agrawal, Madhu Sudan

    2017-05-01

    To assess the feasibility and safety of a novel flexible mini-nephroscope in minimally invasive percutaneous nephrolithotomy (PCNL). Presumably, limiting the size and number of tracts during PCNL has the potential of decreasing the morbidity of the procedure. We present our experience with this new technique. A retrospective analysis of patients with multiple kidney stones treated with mini-PCNL combined with a novel flexible mini-nephroscope was performed. Minimally invasive PCNL was done with rigid 12 F MIP-M nephroscope, followed by flexible mini-nephroscopy for smaller stones in other inaccessible calyces. Record was made of the operating time, stone-free rates, postoperative pain, morbidity, hospital stay, time to recovery, complication rates, and ancillary procedures. Matched-pair analysis was done with cases operated by flexible ureteroscopy performed with Flex X-2 or Flex X-c scope. Twenty-five patients in the study group were matched with 25 cases from the flexible ureteroscopy group. Both groups were comparable in terms of age, laterality, and mean composite stone burden. The mean operating time was 40.1 ± 10.6 minutes in the mini-PCNL group and 51.2 ± 8.8 minutes in the flexible ureteroscopy group. Mean hospital stay was similar in both groups. The primary stone clearance rate of 92% (23 of 25) in the mini-PCNL group was better than the clearance rate of 80% (20 of 25) in the flexible ureteroscopy group. Eight percent in the mini-PCNL group required ancillary procedures as compared with 20% of cases in the flexible ureteroscopy group. Postoperative pain and analgesia requirement in these patients was minimal. There were no significant complications. Flexible mini-nephroscope is an effective adjuvant to minimally invasive PCNL in achieving high clearance rate with minimum morbidity. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Percutaneous cerclage wiring and minimally invasive plate osteosynthesis (MIPO): a percutaneous reduction technique in the treatment of Vancouver type B1 periprosthetic femoral shaft fractures.

    Science.gov (United States)

    Apivatthakakul, Theerachai; Phornphutkul, C; Bunmaprasert, T; Sananpanich, K; Fernandez Dell'Oca, Alberto

    2012-06-01

    Periprosthetic femoral fractures (PPFs) associated at or near a well-fixed femoral prostheses (Vancouver type-B1) present a clinical challenge due to the quality of the bone stock and instability of the fracture. The purpose of this study was to present a novel reduction technique and analyze clinical and radiographic outcome in patients with Vancouver type-B1 fractures treated with percutaneous cerclage wiring for fracture reduction and maintenance of reduction with minimally invasive plate osteosynthesis (MIPO) utilizing a locking compression plate (LCP). Between March 2007 and December 2008, ten consecutive patients with spiral, oblique or wedge Vancouver type-B1 were treated with closed percutaneous cerclage wiring using a new cerclage passer instrument (Synthes) through small 2-3 cm incisions for reduction and maintenance of reduction. Internal fixation with MIPO was obtained utilizing a long LCP Synthes bridging the fracture. The reduction time, fixation time and operative time were recorded. The rehabilitation protocol consisted of partial weight bearing as tolerated. Clinical and radiographic outcomes included evidence of union, return to pre-injury mobility, and surgical complications were recorded. There were three men and seven women with an average age of 74 years (range 47-84 years) at the time the fracture occured. The average follow-up was 13.2 months. One patient died 2 months after surgery due to cardiovascular problems and was excluded. The average reduction time with percutaneous cerclage wiring was 24.4 min (range 7-45 min). The average fixation time was 79 min (range 53-100 min). The average operative time was 103 min (range 75-140 min). Blood loss was minimal and only two patients needed a blood transfusion. All fractures healed with a mean time to union of 18 weeks (range 16-20 weeks). There was one implant which bent 10° in the post-operative period but went on to heal uneventfully within 16 weeks. There was no evidence of loosening of any

  10. Superior Facet Joint Violations during Single Level Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Preliminary Retrospective Clinical Study

    Directory of Open Access Journals (Sweden)

    Long Jia

    2018-01-01

    Full Text Available Background. Facet joint violation (FV was reported as variable iatrogenic damage that can be a crucial risk factor leading to the adjacent segment degeneration (ASD. “Blind” screw placement technique in minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF contributes to the increasing incidence of FV that can be influenced by several potential factors. Many controversies about these factors and clinical outcomes of different types of FV patients exist, yet they have not been analyzed. Methods. 99 cases undergoing single-segment MIS-TLIF from July 2013 to December 2015 were retrospectively analyzed. Computed tomography (CT was applied to determine the incidence of FV, and then the correlation between FV and relevant factors, including gender, age, body mass index (BMI, top-screw level, and decompression, was analyzed. A total of 53 cases were followed up after one year, 31 cases in noninjury (A group and 22 patients in FV injury (B group. Results. The incidence of FV was 39. 39% (39/99 in the patients and 23.23% (46/198 in the screws. Logistic regression analysis showed that screw at L5 in patients with BMI > 30 kg/m2 was vulnerable to FV (P<0.05. Moreover, postoperative average intervertebral disc height (AIDH of fusion segment, visual analog scale (VAS, and Oswestry disability index (ODI scores improved significantly in group A and B when compared with preoperative data (P<0.05. Adjacent superior average intervertebral disc height (ASAIDH presented decrease, but adjacent superior intervertebral disc Cobb angle (ASIDCA appeared to increase in the two groups at the final follow-up compared with postoperative 3 days (P<0.05. Low back VAS and ODI scores in group A (31 cases were lower than those in group B (22 cases in the final follow-up (P<0.05. Conclusion. MIS-TLIF is an effective treatment for lumbar degenerative disease, but FV occurred at a higher incidence. Facet joints should be protected in MIS-TLIF to avoid FV.

  11. Minimally invasive percutaneous compression plating versus dynamic hip screw for intertrochanteric fractures: a randomized control trial

    Directory of Open Access Journals (Sweden)

    HU Ning

    2014-10-01

    Full Text Available 【Abstract】Objective: Intertrochanteric femur fracture is a common injury in elderly patients. The dynamic hip screw (DHS has served as the standard choice for fixation; however it has several drawbacks. Studies of the percutaneous compression plate (PCCP are still inconclusive in regards to its effi cacy and safety. By comparing the two methods, we assessed their clinical therapeutic outcome. Methods: A total of 121 elderly patients with intertrochanteric femur fractures (type AO/OTA 31.A1- A2, Evans type 1 were divided randomly into two groups undergoing either a minimally invasive PCCP procedure or a conventional DHS fi xation. Results: The mean operation duration was signifi cantly shorter in the PCCP group (55.2 min versus 88.5 min, P<0.01. The blood loss was 156.5 ml±18.3 ml in the PCCP group and 513.2 ml±66.2 ml in the DHSgroup (P<0.01. Among the patients treated with PCCP, 3.1% needed blood transfusions, compared with 44.6% of those that had DHS surgery (P<0.01. The PCCP group displayed less postoperative complications (P<0.05. The mean American Society of Anesthesiologists score and Harris hip score in the PCCP group were better than those in the DHS group. There were no signifi cant differences in the mean hospital stay, mortality rates, or fracture healing. Conclusion: Due to several advantages, PCCP has the potential to become the ideal choice for treating intertrochanteric fractures (type AO/OTA 31.A1-A2, Evans type 1, particularly in the elderly. Key words: Hip fractures; Osteoporotic fractures; Surgical procedures, minimally invasive; Fracture fixation, internal

  12. New minimally invasive discectomy technique through the interlaminar space using a percutaneous endoscope.

    Science.gov (United States)

    Dezawa, A; Sairyo, K

    2011-05-01

    The serial dilating technique used to access herniated discs at the L5-S1 space using percutaneous endoscopic discectomy (PED) via an 8 mm skin incision can possibly injure the S1 nerve root. In this paper, we describe in detail a new surgical procedure to safely access the disc and to avoid the nerve root damage. This small-incision endoscopic technique, small-incision microendoscopic discectomy (sMED), mimics microendoscopic discectomy and applies PED. The sMED approach is similar to the well-established microendoscopic discectomy technique. To secure the surgical field, a duckbill-type PED cannula is used. Following laminotomy of L5 using a high-speed drill, the ligamentum flavum is partially removed using the Kerrison rongeur. Using the curved nerve root retractor, the S1 nerve root is gradually and gently moved caudally. Following the compete retraction of the S1 nerve root to the caudal side of the herniated nucleus pulposus (HNP), the nerve root is retracted safely medially and caudally using the bill side of the duckbill PED cannula. Next, using the HNP rongeur for PED, the HNP is removed piece by piece until the nerve root is decompressed. A total of 30 patients with HNP at the L5-S1 level underwent sMED. In all cases, HNP was successfully removed and patients showed improvement following surgery. Only one patient complained of moderate radiculopathy at the final visit. No complications were encountered. We introduced a minimally invasive technique to safely remove HNP at the L5-S1 level. sMED is possibly the least invasive technique for HNP removal at the L5-S1 level. © 2011 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and Blackwell Publishing Asia Pty Ltd.

  13. Accordion technique combined with minimally invasive percutaneous decortication for the treatment of bone non-union.

    Science.gov (United States)

    Zhang, Qun; Zhang, Wei; Zhang, Zhuo; Tang, Peifu; Zhang, Lihai; Chen, Hua

    2017-10-01

    A variety of approaches have been used to treat oligotrophic or atrophic non-union. Conventional methods are often associated with great operative trauma, increased blood loss, a risk of re-infection, higher medical costs, and complications at the donor site. This study aimed to assess the clinical efficacy of the accordion technique combined with Minimally Invasive Percutaneous Decortication (MIPD) for these types of bone non-union. From January 2010 to December 2015, 20 patients with long bone aseptic non-unions of the lower extremities without bone defects who were treated with the accordion technique combined with MIPD. The limb-length discrepancy (LLD) was less than 2cm in all patients. None of the patients received autogenous bone grafts during follow-up. All surgeries were performed by the same surgeon, and the modified Application of methods of Ilizarov (ASAMI) criteria were used to evaluate the operative effectiveness. A total of 20 patients were included in this study, and 1 patient was lost during follow-up. Fifteen of these patients presented with oligotrophic non-unions, and 5 patients presented with atrophic non-unions. The average follow-up period in these patients was 12.1 months (range: 8-42 months). The alternative compression and distraction procedure was repeated 1-3 times. Blood loss was 30 to 250ml during surgery. Ultimately, bone union was achieved in 19 patients and failed in 1 patient. The fractures healed within 4-8 months (average time: 5.9 months), and fracture healing was considered excellent in 19 patients and poor in 1 patient. Postoperative function was evaluated as excellent in 9 patients, good in 6 patients, fair in 4 patients, and poor in 1 patient. The accordion technique combined with MIPD, which is a simple, minimally invasive procedure that does not require autologous bone grafting, resulted in a high bone union rate and good postoperative function. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. The Effect of Comprehensive Care on the Patients Received Minimally Invasive Percutaneous Nephrolithotomy.

    Science.gov (United States)

    Wei, Xue-Li; Xue, Mei-Fang; Qin, Zhao-Xia; Bai, Xing-Yun; Dong, Fang-Fang; Zhang, Jin-Jin; Lv, Ning; Chen, Hui; Zhang, Jia

    2017-07-01

    We analyzed the effect of comprehensive care on the patients who received minimally invasive percutaneous nephrolithotomy (MPCNL). Patients hospitalized from 2013-2014 in Zhumadian Central Hospital (n=124) were enrolled and divided into two groups on random basis. The control group was treated with routine nursing model while the observation group was given comprehensive care additionally. The surgery time, degree of comfort, complications and successful cases, hospitalization time, sleep quality, nursing satisfaction and changes of systolic pressure, pulse and respiratory at different time were observed and analyzed. The surgery time of the control group was significantly longer than that of observation group ( P observation group felt more comfortable and showed more significant successful cases than the control group. Moreover, the hospitalization time were significantly reduced in observation group when compared with control group ( P observation group was significantly better than that of the control group ( P postoperative 30 min and other moments were significantly different. The incidence of complications in the control group was significantly higher than that in the observation group. The nursing satisfaction of the observation group was significantly higher than that of the control group. The comprehensive care on the patients undergoing MPCNL was effective, and it can dramatically shorten surgery time, improve the success rate, improve the sleep quality of patients, keep life sign stable and minimize the complications.

  15. A review of percutaneous techniques for low back pain and neuralgia: current trends in epidural infiltrations, intervertebral disk and facet joint therapies

    OpenAIRE

    Filippiadis, Dimitrios K; Kelekis, Alexis

    2015-01-01

    Low back pain and neuralgia due to spinal pathology are very common symptoms debilitating numerous patients with peak prevalence at ages between 45 and 60 years. Intervertebral discs and facet joints act as pain sources in the vast majority of the cases. Diagnosis is based on the combination of clinical examination and imaging studies. Therapeutic armamentarium for low back pain and neuralgia due to intervertebral discs and/or facet joints includes conservative therapy, injections, percutaneo...

  16. Percutaneous treatment with amphotericin B of mycotic lung lesions from invasive aspergillosis: results in 10 immunocompromised patients

    Energy Technology Data Exchange (ETDEWEB)

    Veltri, A.; Anselmetti, G.C.; Bartoli, G.; Martina, M.C.; Galli, J. [Sezione di Scienze Radiologiche, DiUniv. Torino (Italy); Regge, D. [Servizio di Radiodiagnostica, Istituto di Ricerca e Cura per il Cancro, Ordine Mauriziano, Candiolo (Italy); Bertini, M. [U.O.A. Ematologia, Azienda Ospedaliera San Giovanni Battista, Torino (Italy)

    2000-12-01

    The aim of this study was to evaluate the efficacy of percutaneous treatment of pulmonary lesions from invasive aspergillosis in immunocompromised patients. From 1992 to 1998, ten patients (seven men and three women; mean age 56 years) affected by hematological neoplasms (8 acute myeloid leukemias, 2 non-Hodgkin's lymphomas) and post-chemotherapy prolonged neutropenia developed pulmonary lesions from invasive aspergillosis. A total of 13 lesions (diameter 2-7 cm, median 5 cm) were treated percutaneously due to insufficiency of the high-dose i. v. therapy; under CT guidance, a median of 10 cm{sup 3} per session of a 1 mg/cm{sup 3} diluted solution of amphotericin B was injected through a fine needle (21-22 G); 45 sessions overall were performed (one to five per lesion, median four), according to the volume of the nodules, tolerance, and complications. The results were retrospectively evaluated either radiologically or clinically. Complications were cough, mild hemoptysis, and small pneumothorax and/or pleural effusion. No major complications occurred. One month after the beginning of treatment, 8 lesions completely resolved, 4 greatly improved, and 1 was not significantly reduced. In all ten patients symptoms improved (eight of ten could restart chemotherapy as scheduled). After antiblastic retreatment, 1 patient had mycotic recurrence. In our experience transthoracic topical treatment with amphotericin B of single or few lung lesions from invasive aspergillosis was effective, affording a rapid improvement of the lesions and symptoms, and allowing continuation of chemotherapy as scheduled, thereby reducing the risk of recurrences. (orig.)

  17. [Minimally invasive percutaneous plate osteosynthesis for the treatment of acetabulum anterior column fracture with intact true pelvic brim].

    Science.gov (United States)

    Mo, Ting-Ting; Su, Yong-Bin; Zhang, Wei-Kang

    2017-06-25

    To discuss feasibility and clinical effects of minimally invasive percutaneous plate osteosynthesis in treating acetabulum anterior column fracture with intact true pelvic brim. From May 2013 to December 2015, 8 patients with acetabulum anterior column fracture with intact true pelvic brim were reviewed retrospectively. According to Judet-Letournel classification, all were simple unstable acetabulum anterior column fracture. Among them, there were 5 males and 3 females with an average age of 42.8 years old ranging from 22 to 63. The injury was caused by crush in 4 cases, smash of heavy object in 3 cases, and falling down in 1 case. The time from injury to operation was ranged from 5 to 19 days with an average of 9.5 days. Preoperative CT showed high anterior column fracture of acetabulum with intact true pelvic brim, the fracture separation was less than 1 cm. All the patients were treated with closed reduction and minimally invasive percutaneous plate osteosynthesis. The quality of fracture reduction, operation time, blood loss, fracture healing time, hip function and postoperative complications were observed and recorded. All patients were followed up from 10 to 19 months with an average of 14.5 months. The quality of reduction was classified as anatomical in 4 patients, imperfect in 3, poor in 1 by Matta's score system. The operation time was 30 to 80 min, averaged 51.3 min;the blood loss was 50 to 120 ml, averaged 86.2 ml; fracture healing time was 10 to 19 weeks, averaged 13.3 weeks. At the latest follow-up, the hip function was evaluated by Merle D'Aubigne scoring system, 5 cases got excellent results, 2 cases in good, and 1 case in fair. No vascular nerve injury, wound infection, bleeding, deep vein thrombosis and other complications occurred in 8 patients. Minimally invasive percutaneous plate osteosynthesis in treating acetabulum anterior column fracture with intact true pelvic brim has advantages of less trauma, less bleeding, quick recovery and good

  18. Minimally invasive percutaneous nephrolithotomy guided by ultrasonography to treat upper urinary tract calculi complicated with severe spinal deformity

    Directory of Open Access Journals (Sweden)

    Zhaohui He

    Full Text Available ABSTRACT Objective: To report our experience of minimally invasive percutaneous nephrolithotomy(MPCNL in managing upper urinary tract calculi complicated with severe spinal deformity. Materials and Methods: Between August 2001 to December 2012, 16 upper urinary calculi in 13 patients with severe spinal deformity were treated by MPCNL. Preoperative investigation of the respiratory function, evaluation of anatomy by intravenous urography (IVU and CT scan, and preoperative kidney ultrasonagraphy with simulation of the percutaneous puncture were performed in all patients. The percutaneous puncture was guided by ultrasonography. Results: A total of 19 MPCNL procedures were performed in 16 kidneys, with an average 1.2 procedures in each kidney. Three kidneys needed two sessions of MPCNL, and 2 kidneys needed combined treatment with retrograde flexible ureterscopic lithotripsy. All procedures were successfully completed with no major complications during or after surgery. The mean (range operative duration was 67 (20-150 min and the mean postoperative haemoglobin drop was 1.0 (0.2-3.1 g/dL. Complete stone-free status was achieved in 14 kidneys. At a mean follow-up of 48(3-86 months, recurrence of small lower calyx stone was detected in one patient. Recurrent UTI was documented by urine culture in two patients and managed with sensitive antibiotics. Conclusion: PCNL for patients with severe spinal deformities is challenging. Ultrasonography-assisted puncture can allow safe and successfully establishment of PCN tract through a narrow safety margin of puncture and avoid the injury to the adjacent organs. However, the operation should be performed in tertiary centers with significant expertise in managing complex urolithiasis.

  19. Minimally invasive percutaneous nephrolithotomy guided by ultrasonography to treat upper urinary tract calculi complicated with severe spinal deformity

    Science.gov (United States)

    He, Zhaohui; Zhang, Caixia; Zeng, Guohua

    2016-01-01

    ABSTRACT Objective: To report our experience of minimally invasive percutaneous nephrolithotomy(MPCNL) in managing upper urinary tract calculi complicated with severe spinal deformity. Materials and Methods: Between August 2001 to December 2012, 16 upper urinary calculi in 13 patients with severe spinal deformity were treated by MPCNL. Preoperative investigation of the respiratory function, evaluation of anatomy by intravenous urography (IVU) and CT scan, and preoperative kidney ultrasonagraphy with simulation of the percutaneous puncture were performed in all patients. The percutaneous puncture was guided by ultrasonography. Results: A total of 19 MPCNL procedures were performed in 16 kidneys, with an average 1.2 procedures in each kidney. Three kidneys needed two sessions of MPCNL, and 2 kidneys needed combined treatment with retrograde flexible ureterscopic lithotripsy. All procedures were successfully completed with no major complications during or after surgery. The mean (range) operative duration was 67 (20-150) min and the mean postoperative haemoglobin drop was 1.0 (0.2-3.1) g/dL. Complete stone-free status was achieved in 14 kidneys. At a mean follow-up of 48(3-86) months, recurrence of small lower calyx stone was detected in one patient. Recurrent UTI was documented by urine culture in two patients and managed with sensitive antibiotics. Conclusion: PCNL for patients with severe spinal deformities is challenging. Ultrasonography-assisted puncture can allow safe and successfully establishment of PCN tract through a narrow safety margin of puncture and avoid the injury to the adjacent organs. However, the operation should be performed in tertiary centers with significant expertise in managing complex urolithiasis. PMID:27509373

  20. Randomized clinical trial on percutaneous minimally invasive osteosynthesis of fractures of the distal extremity of the radius,

    Directory of Open Access Journals (Sweden)

    Marcio Aurélio Aita

    2014-06-01

    Full Text Available OBJECTIVES: the purpose of this study was to compare the postoperative radiological and clinical outcomes with minimally invasive percutaneous osteosynthesis using three implants: volar locking plate, intramedullary nail system and nonbridging external fixator for distal radius fractures.METHODS: forty-eight patients (A group, 16; B group 16; C group 16 underwent minimally invasive percutaneous osteosynthesis of reductible and unstable displaced (Type IIB by Rayhack Classification distal radius fractures. In B group intramedullary nail system was used, in A group the patients were treated with volar locking plate and in C group the patients were treated by nonbridging external fixator from January 2011 to December 2012. The mean follow-up period was 12 months. Radiologic parameters, range of motion, grip strength, and disability of the arm, shoulder, and hand score were evaluated at each examination (3rd and 6th week, and 12th months. The visual analog scale of wrist pain and complications were assessed at the final follow-up.RESULTS: the groups did not differ significantly in radiological outcomes after 12 months, but the clinical results, VAS scale and dash score in group A (volar locking plate and B (nail intramedullary were statistically significantly better than that of C group (nonbridging external fixator. One patient underwent an osteosynthesis with nail intramedullary and another with external fixator (C group developed persistent pain near the site of the superficial radial nerve because of the distal's screw and pins, respectively.CONCLUSION: in clinical parameters, significant differences in outcomes were found between groups A and B after six weeks versus C group.

  1. Faceted Search

    CERN Document Server

    Tunkelang, Daniel

    2009-01-01

    We live in an information age that requires us, more than ever, to represent, access, and use information. Over the last several decades, we have developed a modern science and technology for information retrieval, relentlessly pursuing the vision of a "memex" that Vannevar Bush proposed in his seminal article, "As We May Think." Faceted search plays a key role in this program. Faceted search addresses weaknesses of conventional search approaches and has emerged as a foundation for interactive information retrieval. User studies demonstrate that faceted search provides more

  2. Treatment of degenerative lumbar spondylolisthesis by using minimally invasive transforaminal lumbar interbody fusion and percutaneous pedicle screw fixation

    Directory of Open Access Journals (Sweden)

    Hao WU

    2016-04-01

    Full Text Available Objective To discuss clinical therapeutic effects of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF combined with percutaneous pedicle screw fixation for degenerative lumbar spondylolisthesis (DLS.  Methods A total of 32 DLS patients treated by MIS-TLIF and percutaneous pedicle screw fixation from January 2013 to September 2015 in Xuanwu Hospital, Capital Medical University were retrospectively reviewed. Visual Analogue Scale (VAS, Oswestry Disability Index (ODI and Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36 scores were assessed and compared between preoperation and one week, 3 months after operation and in the last follow-up. Lumbar lordosis angle, coronal Cobb angle, coronal and sagittal body shifting, complication, the degree of spondylolisthesis (Meyerding classification and the rate of spondylolisthesis were measured according to preoperative and postoperative spinal X-ray examination. Fusion rate was evaluated according to X-rays or CT in the last follow-up, and MRI was used to assess the degree of decompression.  Results Thirty-two patients were under test with mean operation time 160 min, intraoperative blood loss 120 ml, postoperative hospital stay 7.22 d and follow-up 10.83 months. Decompression and fusion levels ranged from L2-S1 and interbody fusion was performed in 32 patients and 41 levels were fused. Compared with preoperation, the VAS and ODI scores were significantly increased at one week, 3 months after operation and in the last follow-up (P = 0.000, for all, while SF-36 score (P = 0.002, 0.000, 0.000, lumbar lordotic angle (P = 0.000, for all, coronal Cobb angle (P = 0.000, for all and slippage rate (P = 0.000, for all were significantly decreased. The fusion rate was 92.22%, and the improvement rate of ODI was (80.51 ± 6.02% in the last follow-up. There were 3 cases appeared complications, including one case of infection and 2 cases of cerebrospinal fluid (CSF fistula, and were

  3. Percutaneous reduction and fixation of intraarticular calcaneal fractures

    NARCIS (Netherlands)

    Schepers, Tim; Vogels, Lucas M. M.; Schipper, Inger B.; Patka, Peter

    2008-01-01

    Percutaneous reduction by distraction and subsequent percutaneous screw fixation to restore calcaneal and posterior talocalcaneal facet anatomy. The aim of this technique is to improve functional outcome and to diminish the rate of secondary posttraumatic arthrosis compared to conservative treatment

  4. Percutaneous Needle Biopsies of the Breast in Women Younger than 35 Years: Minimally or Excessively Invasive?

    Science.gov (United States)

    Abou-Zamzam, Aida; Somers, Scott; Cora, Cherie; Pairawan, Seyed; Lum, Sharon

    2017-10-01

    Percutaneous needle biopsy (PNB) of the breast is commonly used for diagnosis of breast pathology, but has been less studied in young women. We sought to determine the effectiveness and necessity of PNB in patients younger than 35 years of age. The charts of sequential patients BIRADS) ≥4 in 137 (75.7%) cases, with mass on imaging in 139 (76.8%). Carcinoma was diagnosed in 12 (6.6%), PNB in eight unique patients (6.3%). Other PNB pathology included atypia in four (2.2%) patients; papillary lesion, five (2.8%); benign lymph node, 10 (5.5%); fibroepithelial lesion, 15 (8.3%); benign breast tissue, 63 (34.8%); and fibroadenoma, 72 (39.8%). Women with atypia or malignancy were older than those with benign findings (30.9 vs 28.0 years, P = 0.002). No other patient or imaging factors were significantly associated with pathologic diagnosis on PNB. Routine PNB for all BIRADS 4 findings may be over-used in young women as most results are benign and subsequent surgical findings are concordant. Improved diagnostic accuracy of breast imaging is warranted to reduce unnecessary procedures.

  5. [The management of post-surgical pain in the patient treated for hallux valgus with percutaneous and minimally invasive technique].

    Science.gov (United States)

    Di Giorgio, L; Sodano, L; Touloupakis, G; Chiominto, M G; Rocco, A

    2014-01-01

    In today's literature there are no defined guidelines for the treatment of postoperative pain in corrective surgery of hallux valgus. In this study we evaluated the use of a new treatment protocol designed to minimize the postoperative pain related to the surgical treatment of hallux valgus. The study involved 20 female patients (20 feet) treated for moderate to severe hallux valgus between September 2011 and December of 2012 with a percutaneous technique (10 feet) and minimally invasive surgery (Endolog System) (10 feet). All patients received postoperative as analgesic therapy 1 cp etoricoxib 120 mg/ day for 5 days + oxycodone hydrochloride/naloxone 5mg 1cp × 2/day for 15 days. The evaluation forms of pain VAS/VRS have been used for the evaluation of pre and postoperative pain at 15 and 30 days. In both groups we found a significant reduction of pain in the days following surgery. At 30 days the VAS score was similar in between the two groups. Few and mild side effects were reported (1 case). The co-administration of an anti-cox2 and an opioid in the first postoperative hours is useful to reduce soft tissue swelling and to control pain without causing significant side effects. The therapeutic protocol adopted, along with an adequate anesthesiological approach, has proved to be very effective for pain management in peri-and post-operative treatment of hallux valgus.

  6. Minimally Invasive Percutaneous Nephrolithotomy versus Retrograde Intrarenal Surgery for Upper Urinary Stones: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Hongyang Jiang

    2017-01-01

    Full Text Available Minimally invasive percutaneous nephrolithotomy (mini-PCNL and retrograde intrarenal surgery (RIRS are both alternatives for PCNL to treat renal calculi. This study is aimed at comparing the stone-free rate (SFR and other surgery parameters of two approaches for treating upper urinary calculi. We performed this meta-analysis in September 2016 by searching studies about mini-PCNL and RIRS for treating upper urinary calculi in various databases, and RevMan v.5.3 was applied. Three randomized controlled trials and ten nonrandomized trials were included, involving a total of 1317 patients. Meta-analysis showed that mini-PCNL group led to a higher SFR [odds ratio: 1.96; 95% confidence interval: 1.46–2.64; P<0.00001] but brought a larger postoperative decrease in hemoglobin levels compared with RIRS. RIRS provided a shorter hospital time. There was no significant difference in operation time. Higher postoperative complications were detected in the mini-PCNL, but the difference was not significant. Grade I and III complications did not vary between two procedures, but grade II complications were of lower incidence in RIRS group. In the light of these results, compared with RIRS, mini-PCNL provided significantly higher SFR and efficiency quotient for managing calculi; however, it resulted in higher incidence of postoperative complications, larger hemoglobin drops, and longer hospital stay.

  7. Clinical study on minimally invasive transforaminal lumbar interbody fusion combined with percutaneous pedicle screw fixation for degenerative lumbar scoliosis

    Directory of Open Access Journals (Sweden)

    Hao WU

    2016-04-01

    Full Text Available Objective To discuss the operative essentials and therapeutic effects of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF combined with percutaneous pedicle screw fixation for degenerative lumbar scoliosis (DLS.  Methods A total of 17 DLS patients without prior spinal diseases were treated by MIS-TLIF and percutaneous pedicle screw fixation from January 2013 to September 2015 in Xuanwu Hospital, Capital Medical University. The operation time, intraoperative blood loss, hospital stay, and postoperative complication were recorded in each patient. Visual Analogue Scale (VAS and Oswestry Disability Index (ODI were used to evaluate postoperative improvement of low back and leg pain, and clinical effects were assessed according to Medical Outcome Study 36-Item Short-Form Health Survey (SF-36. Coronal Cobb angle, sagittal lordosis angle and spinal deviation distances on coronal and sagittal plane were measured before operation, one week, 3 months after operation and in the last follow-up in spinal full-length X-ray examination. Fusion rate was calculated according to X-ray or CT scan, and the degree of decompression was evaluated by MRI.  Results Decompression and fusion levels ranged from T12-S1 vertebrae, and interbody fusion was performed in 17 patients and 56 levels were fused. Average operation time was 200 min (180-300 min, intraoperative blood loss was 320 ml (200-1000 ml and hospital stay was 8.21 d (5-12 d. All patients were followed-up for 12.13 months (5-24 months. Compared with preoperation, VAS (P = 0.000, for all and ODI scores (P = 0.000, for all decreased significantly, SF-36 score increased (P = 0.000, for all, coronal Cobb angle (P = 0.000, for all, sagittal lordosis angle (P = 0.000, for all, coronal and sagittal deviation (P = 0.000, for all decreased significantly one week and 3 months after operation and in the last follow-up. The improvement rate of ODI was (86.51 ± 6.02%, fusion rate of vertebral bodies

  8. Towards Clinically Optimized MRI-guided Surgical Manipulator for Minimally Invasive Prostate Percutaneous Interventions: Constructive Design*

    Science.gov (United States)

    Eslami, Sohrab; Fischer, Gregory S.; Song, Sang-Eun; Tokuda, Junichi; Hata, Nobuhiko; Tempany, Clare M.; Iordachita, Iulian

    2013-01-01

    This paper undertakes the modular design and development of a minimally invasive surgical manipulator for MRI-guided transperineal prostate interventions. Severe constraints for the MRI-compatibility to hold the minimum artifact on the image quality and dimensions restraint of the bore scanner shadow the design procedure. Regarding the constructive design, the manipulator kinematics has been optimized and the effective analytical needle workspace is developed and followed by proposing the workflow for the manual needle insertion. A study of the finite element analysis is established and utilized to improve the mechanism weaknesses under some inevitable external forces to ensure the minimum structure deformation. The procedure for attaching a sterile plastic drape on the robot manipulator is discussed. The introduced robotic manipulator herein is aimed for the clinically prostate biopsy and brachytherapy applications. PMID:24683502

  9. Minimally invasive percutaneous nephrolithotomy in preschool age children with kidney calculi (including stones induced by melamine-contaminated milk powder).

    Science.gov (United States)

    Yan, Xiang; Al-Hayek, Samih; Gan, Weidong; Zhu, Wei; Li, Xiaogong; Guo, Hongqian

    2012-10-01

    This study was undertaken to assess the safety and efficacy of minimally invasive percutaneous nephrolithotomy (mini-PCNL) using ureteroscope and pneumatic intracorporeal lithotripsy in preschool age children with kidney calculi. We studied 27 renal units in 20 patients of preschool age (≤ 6 years) who underwent mini-PCNL at our institute. The mean age was 42.6 months (range 14-68 months). The average stone burden was 1.85 cm (range 0.9-2.8 cm). Eight patients aged 14 to 58 months had been exposed to melamine-tainted powdered formula. The mini-PCNL was performed with an X-ray-guided peripheral puncture. Minimal tract dilatation was undertaken to fit a 14-16 Fr peel-away sheath. Ureteroscope and pneumatic intracorporeal lithotripsy were used to fragment the stones. Complete clearance was achieved in 23 renal units (85.2 %) with mini-PCNL monotherapy. This has increased to 92.6 % after adjunctive ESWL. The average fall in hemoglobin was 1.28 g/dL. None of the patients required blood transfusion. The median length of hospital stay was 8.2 days. Patients were followed up every 6 months for 2 years. There has been only one recurrence of stone and no long-term complications. Mini-PCNL is a effective treatment for pediatric kidney stones refractory to extracorporeal shock wave lithotripsy, including stones induced by melamine-contaminated milk powder. The "mini-PCNL" technique, which uses ureteroscope and pneumatic intracorporeal lithotripsy, is a safe and feasible modality for treating renal calculi in preschool age children.

  10. Percutaneous vertebroplasty

    International Nuclear Information System (INIS)

    Hierholzer, J.; Fuchs, H.; Depriester, C.; Venz, S.; Maier-Hauff, K.; Schulz, R.; Koch, K.

    2002-01-01

    Purpose: To describe the procedure of percutaneous vertebroplasty and to present our first clinical results of patients treated for benign or malignant painful vertebral body disease. Material and Methods: We performed percutaneous vertebroplasty in 31 painful lesions of the spine. Liquid bone cement was injected into the affected vertebral body using fluoroscopic guidance through a bilateral transpedicular approach. Etiology of the bone disease was assessed by biopsy. Pain intensity was assessed before and 1 week after the procedure by standardized catalogue. Results: Percutaneous vertebroplasty was performed in 17 thoracic and in 14 lumbar spine bodies of benign (n = 23) or malignant (n = 8) disease; no clinically relevant complications occurred. All patients reported significant pain relief 1 week after the intervention. One week after treatment, patients were pain-free in 15/31 vertebral bodies, and reported mild residual pain not necessitating narcotic medication in 16/31 cases. Conclusion: In accordance with the literature, percutaneous vertebroplasty proved to be a highly effective, minimal invasive interventional procedure to treat severely painful bone lesions of benign and malignant origin. (orig.) [de

  11. Facets: Ersatz, Resource and Tag

    Science.gov (United States)

    Frické, Martin H.

    2013-01-01

    Introduction: Faceted classification appears to be of utmost importance. Ersatz facets, resource faceting and tag faceting: The distinctions are drawn between facets and ersatz facets, and between faceted resources and faceted tags. Single tag resource faceting and multiple tag information object faceting: The basic features are explored of single…

  12. Facet analysis

    DEFF Research Database (Denmark)

    Hjørland, Birger

    2013-01-01

    , such as the Dewey Decimal Classification (DDC) and is also applied in many websites. It still has a strong position in the field and it is the most explicit and “pure” theoretical approach to knowledge organization (KO) (but it is not by implication necessarily also the most important one). The strength......The facet-analytic paradigm is probably the most distinct approach to knowledge organization within Library and Information Science, and in many ways it has dominated what has be termed “modern classification theory”. It was mainly developed by S.R. Ranganathan and the British Classification...... Research Group, but it is mostly based on principles of logical division developed more than two millennia ago. Colon Classification (CC) and Bliss 2 (BC2) are among the most important systems developed on this theoretical basis, but it has also influenced the development of other systems...

  13. Unenhanced low-dose versus standard-dose CT localization in patients with upper urinary calculi for minimally invasive percutaneous nephrolithotomy (MPCNL).

    Science.gov (United States)

    Licheng, Jiang; Yidong, Fan; Ping, Wang; Keqiang, Yan; Xueting, Wang; Yingchen, Zhang; Lei, Gao; Jiyang, Ding; Zhonghua, Xu

    2014-03-01

    With the ethical concern about the dose of CT scan and wide use of CT in protocol of suspected renal colic, more attention has been paid to low dose CT. The aim of the present study was to make a comparison of unenhanced low-dose spiral CT localization with unenhanced standard-dose spiral CT in patients with upper urinary tract calculi for minimally invasive percutaneous nephrolithotomy (MPCNL) treatment. Twenty eight patients with ureter and renal calculus, preparing to take MPCNL, underwent both abdominal low-dose CT (25 mAs) and standard-dose CT (100 mAs). Low-dose CT and standard-dose CT were independently evaluated for the characterization of renal/ureteral calculi, perirenal adjacent organs, blood vessels, indirect signs of renal or ureteral calculus (renal enlargement, pyeloureteral dilatation), and the indices of localization (percutaneous puncture angulation and depth) used in the MPCNL procedure. In all 28 patients, low-dose CT was 100 per cent coincidence 100 per cent sensitive and 100 per cent specific for depicting the location of the renal and ureteral calculus, renal enlargement, pyeloureteral dilatation, adjacent organs, and the presumptive puncture point and a 96.3 per cent coincidence 96 per cent sensitivity and 93 per cent specificity for blood vessel signs within the renal sinus, and with an obvious lower radiation exposure for patients when compared to standard-dose CT (Plow-dose CT achieves a sensitivity and accuracy similar to that of standard-dose CT in assessing the localization of renal ureteral calculus and adjacent organs conditions and identifying the maximum calculus transverse diameter on the axial surface, percutaneous puncture depth, and angulation in patients, with a significant lower radiation exposure, who are to be treated by MPCNL, and can be used as an alternative localization method.

  14. Percutaneous treatment with amphotericin B in a case of invasive pulmonary aspergillosis; Tratamiento percutaneo con anfotericina B en un caso de aspergilosis pulmonar invasiva

    Energy Technology Data Exchange (ETDEWEB)

    Ruiz, A.; Lonjedo, E.; Agramunt, M.; Martinez-Rodrigo, J. J.; Palomero, J. [Hospital Universitario Dr. Peset. Valencia (Spain)

    2001-07-01

    Invasive pulmonary aspergillosis (IPA) is a serious complications that occurs in immunocompromised patients. We need a rapid and effective treatment both to treat the aspergillosis as well as to be able to continue, as soon as possible, treatment of the baseline disease. We present a case of a percutaneous treatment of the pulmonary lesions in a 55 year old male with IPA in the context of acute myeloid leukemia (AML). With Computerized Tomography (CT) control and using a fine needle, we injected intralesionally a solution of Amphotericin B (AB) (5 mg/cc of 5% glucose solution). We evaluated the complications and efficacy in relationship to the clinical improvement and reduction in lesion size. (Author) 18 refs.

  15. Technical success, technique efficacy and complications of minimally-invasive imaging-guided percutaneous ablation procedures of breast cancer: A systematic review and meta-analysis.

    Science.gov (United States)

    Mauri, Giovanni; Sconfienza, Luca Maria; Pescatori, Lorenzo Carlo; Fedeli, Maria Paola; Alì, Marco; Di Leo, Giovanni; Sardanelli, Francesco

    2017-08-01

    To systematically review studies concerning imaging-guided minimally-invasive breast cancer treatments. An online database search was performed for English-language articles evaluating percutaneous breast cancer ablation. Pooled data and 95% confidence intervals (CIs) were calculated. Technical success, technique efficacy, minor and major complications were analysed, including ablation technique subgroup analysis and effect of tumour size on outcome. Forty-five studies were analysed, including 1,156 patients and 1,168 lesions. Radiofrequency (n=577; 50%), microwaves (n=78; 7%), laser (n=227; 19%), cryoablation (n=156; 13%) and high-intensity focused ultrasound (HIFU, n=129; 11%) were used. Pooled technical success was 96% (95%CI 94-97%) [laser=98% (95-99%); HIFU=96% (90-98%); radiofrequency=96% (93-97%); cryoablation=95% (90-98%); microwave=93% (81-98%)]. Pooled technique efficacy was 75% (67-81%) [radiofrequency=82% (74-88); cryoablation=75% (51-90); laser=59% (35-79); HIFU=49% (26-74)]. Major complications pooled rate was 6% (4-8). Minor complications pooled rate was 8% (5-13%). Differences between techniques were not significant for technical success (p=0.449), major complications (p=0.181) or minor complications (p=0.762), but significant for technique efficacy (p=0.009). Tumour size did not impact on variables (p>0.142). Imaging-guided percutaneous ablation techniques of breast cancer have a high rate of technical success, while technique efficacy remains suboptimal. Complication rates are relatively low. • Imaging-guided ablation techniques for breast cancer are 96% technically successful. • Overall technique efficacy rate is 75% but largely inhomogeneous among studies. • Overall major and minor complication rates are low (6-8%).

  16. Marine Microbiology: Facets & Opportunities

    Digital Repository Service at National Institute of Oceanography (India)

    Ramaiah, N.

    The book titled “Marine Microbiology: Facets & Opportunities” is an attempt to bring together some facets of marine microbiology as have been made out by many contemporaries in particular from the tropical marine regions. There are 18 contributed...

  17. The comparison of minimally invasive percutaneous nephrolithotomy and retrograde intrarenal surgery for stones larger than 2 cm in patients with a solitary kidney: a matched-pair analysis.

    Science.gov (United States)

    Zeng, Guohua; Zhu, Wei; Li, Jiasheng; Zhao, Zhijian; Zeng, Tao; Liu, Chenli; Liu, Yang; Yuan, Jian; Wan, Shaw P

    2015-08-01

    To compare the treatment outcomes between retrograde intrarenal surgery (RIRS) and minimally invasive percutaneous nephrolithotomy (MPCNL) for the management of stones larger than 2 cm in patients with solitary kidney. Between December 2012 and March 2014, 53 patients with a solitary kidney suffering from urinary stones larger than 2 cm were treated with RIRS. The outcomes of these patients were compared to a cohort of similar solitary kidney stone patients who underwent MPCNL using a matched-pair analysis (1:1 scenario). Cases were matched sequentially using the following criteria: size, number and location of stones, age, BMI, gender and previous ipsilateral open surgery. A stone-free rate (SFR) of 43.4 % was achieved after a single procedure in patients treated with RIRS and a SFR of 71.70 % in patients treated with MPCNL (p = 0.003). The operative time for RIRS was longer (p = 0.002), but the median hospital stay was shorter (p kidney suffering from stones larger than 2 cm in size who undergo MPCNL had a higher SFR than RIRS. The complications were comparable in both groups. Even though RIRS patients spent less time in hospital, this procedure might not be an effective treatment as MPCNL in solitary kidneys with larger and multiple stones.

  18. Percutaneous reduction and fixation of intraarticular calcaneal fractures

    NARCIS (Netherlands)

    T. Schepers (Tim); L.M.M. Vogels (Lucas); I.B. Schipper (Inger); P. Patka (Peter)

    2008-01-01

    textabstractObjective: Percutaneous reduction by distraction and subsequent percutaneous screw fixation to restore calcaneal and posterior talocalcaneal facet anatomy. The aim of this technique is to improve functional outcome and to diminish the rate of secondary posttraumatic arthrosis compared to

  19. Robot guidance for percutaneous minimally invasive placement of pedicle screws for pyogenic spondylodiscitis is associated with lower rates of wound breakdown compared to conventional fluoroscopy-guided instrumentation.

    Science.gov (United States)

    Alaid, Awad; von Eckardstein, Kajetan; Smoll, Nicolas Roydon; Solomiichuk, Volodymyr; Rohde, Veit; Martinez, Ramon; Schatlo, Bawarjan

    2018-04-01

    Postoperative wound healing can pose a problem in patients undergoing instrumented surgery for pyogenic spondylodiscitis. Robotic guidance allows the minimally invasive placement of pedicle screws in the thoracolumbar spine. We assessed whether using this technique to perform minimally invasive surgery had an impact on wound healing in patients with pyogenic spondylodiscitis when compared to conventional open fluoroscopy-guided surgery. We reviewed charts of 206 consecutive patients who underwent instrumentation for pyogenic spondylodiscitis. The need for wound revision was the primary outcome measure. Patient variables and comorbidities as well as surgical technique (robotic versus fluoroscopy-guided) were analyzed. We also compared fluoroscopy times between the two groups. Multivariate regression analysis was performed to identify predictors of wound breakdown. A total of 206 patients underwent surgery for spondylodiscitis. Robotic surgical assistance was used for percutaneous instrumentation in 47.6% of cases (n = 98). Wound healing problems requiring revision occurred in 30 out of 206 patients (14.6%). Univariate analysis revealed a potential association of wound breakdown with (1) robotic technique, (2) age > 70 years, and (3) the presence of methicillin-resistant Staphylococcus aureus. After multivariate correction however, only robotic technique retained significance with an odds ratio of 0.39 (CI 95% 0.16-0.94; p = 0.035). Wound revision was required in eight out of 98 patients (8.1%) in the robot group and 22/108 (20%) in the conventional surgery group. Fluoroscopy times were significantly lower in the robot group with a mean of 123 ± 86 s in comparison with a mean of 157 ± 99 s in the conventional group (p = 0.014). While initially designed to improve the accuracy of pedicle screw placement, robot-assisted minimally invasive technique had a tangible effect on both radiation exposure and the rate of wound breakdown in patients with pyogenic

  20. The Photodynamic Bone Stabilization System: a minimally invasive, percutaneous intramedullary polymeric osteosynthesis for simple and complex long bone fractures.

    Science.gov (United States)

    Vegt, Paul; Muir, Jeffrey M; Block, Jon E

    2014-01-01

    The treatment of osteoporotic long bone fractures is difficult due to diminished bone density and compromised biomechanical integrity. The majority of osteoporotic long bone fractures occur in the metaphyseal region, which poses additional problems for surgical repair due to increased intramedullary volume. Treatment with internal fixation using intramedullary nails or plating is associated with poor clinical outcomes in this patient population. Subsequent fractures and complications such as screw pull-out necessitate additional interventions, prolonging recovery and increasing health care costs. The Photodynamic Bone Stabilization System (PBSS) is a minimally invasive surgical technique that allows clinicians to repair bone fractures using a light-curable polymer contained within an inflatable balloon catheter, offering a new treatment option for osteoporotic long bone fractures. The unique polymer compound and catheter application provides a customizable solution for long bone fractures that produces internal stability while maintaining bone length, rotational alignment, and postsurgical mobility. The PBSS has been utilized in a case series of 41 fractures in 33 patients suffering osteoporotic long bone fractures. The initial results indicate that the use of the light-cured polymeric rod for this patient population provides excellent fixation and stability in compromised bone, with a superior complication profile. This paper describes the clinical uses, procedural details, indications for use, and the initial clinical findings of the PBSS.

  1. Percutaneous minimally invasive fetoscopic surgery for spina bifida aperta. Part III: neurosurgical intervention in the first postnatal year.

    Science.gov (United States)

    Graf, K; Kohl, T; Neubauer, B A; Dey, F; Faas, D; Wanis, F A; Reinges, M H T; Uhl, E; Kolodziej, M A

    2016-02-01

    To evaluate the need for postnatal neurosurgical intervention after fetoscopic patch coverage of spina bifida aperta (SBA). This was a retrospective analysis of a cohort of 71 fetuses which underwent minimally invasive fetoscopic patch coverage of SBA between 21 + 0 and 29 + 1 weeks of gestation. Postnatal neurosurgical procedures were classified into two types: re-coverage of the SBA within the first 3 months following birth, and shunt placement as treatment of associated hydrocephalus within the first year. Location of the SBA was lumbosacral in 59 cases, lumbar in seven, thoracic in three and sacral in two. In total, 20/71 (28%) patients underwent early postnatal neurosurgical intervention by means of re-coverage of the SBA. This was performed because of cerebrospinal fluid leakage in seven (35%), adhesions with functional deterioration in three (15%), incomplete coverage in five (25%) and skin defect in five (25%) cases. Ventriculoperitoneal shunt placement within 1 year was required in 32 (45%) cases and was preceded by ventriculostomy in two. Three (4%) infants needed Chiari decompression surgery in the first 12 months following birth, because of syringomyelia or gait disturbance. Fetoscopic patch coverage of SBA may require postnatal re-coverage in some cases. In most cases, conservative wound treatment shows good results, without requiring neurosurgical intervention. The low 1-year-shunt rate is comparable to data of the Management of Myelomeningocele Study and lower compared with published data of patients with postnatal only coverage of SBA. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.

  2. Vertebroplastia percutânea: uma efetiva técnica cirúrgica minimamente invasiva Percutaneous vertebroplasty: an effective, minimally invasive surgical technique

    Directory of Open Access Journals (Sweden)

    Nicolas Gerardo Gómez Cordero

    2008-02-01

    ' experience at the Portuguese Hospital in Bahia, Brazil, with the percutaneous vertebroplasty, showing the clinical and radiographic evolution of the patients. METHODS: Retrospective analysis of the data of 25 patients with compression fracture of the vertebrae, five male and 25 female, ages ranging from 65 to 88 years, submitted to percutaneous vertebroplasty between 2003 and 2006. Results and complications were observed. Inclusion criteria were: intense pain in the spinal column with functional inability as a result of a frequent fracture; failure of the conservative treatment analgesic medication and physiotherapy and patients with clinical stability compatible with submission to anesthetic procedure. 22 of the patients had osteoporotic fractures, one had hemangioma, another had a fracture due to a lymphoma, and two had vertebral fracture due to multiple myeloma. Patients were followed weekly during the first month, and then at three month intervals for a minimum of 12 months and a maximum of 36 months after the percutaneous procedure. Evaluation of pain, daily life activities, and the need to take analgesic medication was performed by one of the authors, based on a subjective questionnaire previously prepared for that purpose. RESULTS: Excellent to good clinical results were seen in 23 patients (92% and regular to poor results were seen in two patients (8%. Deterioration due to complication was seen in one case. All patients (100% returned to their prior activities; four patients (16% changed the practice of their daily life activities. CONCLUSION: Percutaneous vertebroplasty is a minimally invasive surgical technique that in our series had quick and meaningful pain relief and improvement in the quality of daily life activities of the patients submitted to this procedure.

  3. Biomechanical assessment and 3D finite element analysis of the treatment of tibial fractures using minimally invasive percutaneous plates

    Science.gov (United States)

    Hu, Xin-Jia; Wang, Hua

    2017-01-01

    The aim of the present study was to investigate the biomechanical effects of varying the length of a limited contact-dynamic compression plate (LC-DCP) and the number and position of screws on middle tibial fractures, and to provide biomechanical evidence regarding minimally invasive plate osteosynthesis (MIPO). For biomechanical testing, 60 tibias from cadavers (age at mortality, 20–40 years) were used to create middle and diagonal fracture models without defects. Tibias were randomly grouped and analyzed by biomechanic and three-dimensional (3D) finite element analysis. The differences among LC-DCPs of different lengths (6-, 10- and 14-hole) with 6 screws, 14-hole LC-DCPs with different numbers of screws (6, 10 and 14), and 14-hole LC-DCPs with 6 screws at different positions with regard to mechanical characteristics, including compressing, torsion and bending, were examined. The 6-hole LC-DCP had greater vertical compression strain compared with the 10- and 14-hole LC-DCPs (P0.05). However, plates with 14 screws had greater vertical strain compared with those fixed with 6 or 10 screws (P<0.01). For 4-hole LC-DCPs with screws at different positions, vertical compression strain values were lowest for plates with screws at positions 1, 4, 7, 8, 11 and 14 (P<0.01). The lateral strain values and vertical strain values for plates with screws at positions 1, 3, 6, 9, 12 and 14 were significantly lower compared with those at the other positions (P<0.01), and torque values were also low. Thus, the 14-hole LC-DCP was the most stable against vertical compression, torsion and bending, and the 6-hole LC-DCP was the least stable. However, the use of 14 screws with a 14-hole LC-DCP provided less stability against bending than did 6 or 10 screws. Furthermore, fixation with distributed screws, in which some screws were close to the fracture line, provided good stability against compression and torsion, while fixation with screws at the ends of the LC-DCP provided poor

  4. Temporary Percutaneous Instrumentation and Selective Anterior Fusion for Thoracolumbar Fractures.

    Science.gov (United States)

    Charles, Yann Philippe; Walter, Axel; Schuller, Sébastien; Steib, Jean-Paul

    2017-05-01

    Prospective clinical trial in thoracolumbar trauma with 5-year follow-up. To analyze clinical and radiographic outcomes of minimal invasive surgery, and the rational of circumferential fracture treatment with regard to age, degenerative changes, bone mineral density, and global sagittal balance. Non-neurologic fractures with anterior column defect can be treated by posterior percutaneous instrumentation and selective anterior fusion. After consolidation, instrumentation can be removed at 1 year to provide mobility in non-fused segments. Fifty-one patients, 47 (18-75) years, were operated for A2, A3, or B-type fractures. Visual analog scale (VAS) for back pain and Oswestry Disability Index (ODI) were assessed. Radiographic measurements were: sagittal index, regional kyphosis, T4-T12 kyphosis, L1-S1 lordosis, pelvic incidence, pelvic tilt, sacral slope, and T9 tilt. Anterior fusion and facet joints were analyzed on computed tomography (CT) at 1 year. The ODI was 8.8 before accident, 35.4 at 3 months, 17.8 at 2 years, 14.4 at 5 years. The VAS was 2.0 at 3 months and 1.0 at 5 years. The sagittal index was 18.0° preoperatively and 1.0° at 3 months (P fractured vertebra fused regularly. Spontaneous facet joint fusions were observed in two patients at the fracture level in B-type injuries. Percutaneous instrumentation and selective anterior fusion using autologous bone and mesh cages lead to high fusion rates, which provided good long-term clinical results in younger patients with thoracolumbar fractures. Sagittal alignment was maintained after instrumentation removal without damaging paravertebral muscles. Outcomes were worse in elderly patients presenting osteopenia or osteoporosis. 3.

  5. An update on percutaneous nephrolithotomy

    DEFF Research Database (Denmark)

    Tefekli, A; Cordeiro, E; de la Rosette, J J M C H

    2013-01-01

    Since its introduction in late 1970's, percutaneous nephrolithotomy (PNL) has undergone an evolution in both equipment and technique. This evolution still continues today in the era of minimally invasive treatment options, and is evidenced by the numerous publications. PNL is generally advantageo...

  6. Percutaneous transluminal coronary angioplasty

    International Nuclear Information System (INIS)

    Przybojewski, J.Z.; Weich, H.F.H.

    1984-01-01

    The purpose of this article is to review PTCA, percutaneous transluminal coronary angioplasty, which can be considered to be a truly revolutionary and fairly simple invasive form of intervention to atherosclerotic obstruction. The 'epidemic' of IHD, ischaemic heart disease, in the Republic of South Africa calls for the employment of this technique, which has already been carried out in a few teaching hospitals in this country. Very recently, modified balloon dilatation catheters have been used percutaneously in the non-operative transluminal correction of congenital coarctation of the aorta in infants and children, congenital pulmonary value stenosis, and hypoplasia and stenosis of the pulmonary arteries. It has also been employed for PTCA and for the simultaneous occlusion of coronary-bronchial artery anastomosis using a detachable balloon. The isotopes thallium 201 and technetium 99 were also used in scintiscanning

  7. Facets of Subjectification

    Science.gov (United States)

    Visconti, Jacqueline

    2013-01-01

    Subjectification, as the diachronic facet of subjectivity, has raised in the last two decades a number of interesting questions in grammaticalization and semantic change theory. In this paper I shall reflect on the nature and construal of subjectification, focusing on the question, formulated by Traugott (2010a, p. 58), "whether it is possible to…

  8. Facet joint syndrome

    International Nuclear Information System (INIS)

    Zigrai, M.; Zakovic, J.; Brezinova, M.; Pavlovicova, M.

    2002-01-01

    It is the purpose of the study to demonstrate the clinical relevance of degenerative changes in the facet joint of patients with low back pain irradiating to the lower extremities, and discuss some problems relating to diagnosis and different diagnosis. 119 patients presenting the listed bellow syndromes are covered by the study: scoliosis, polytopic pain vertebral syndrome, paresis and history of trauma. all patients undergo comprehensive neurological examination with special attention focused on the spine: CT and plain x-rays are taken of the lumbosacral segment to assess the condition of the facet joints. The neurological examination demonstrates in all cases pain syndrome in the lumbar spine referred to one or both lower extremities. In 56% it is a matter of persisting pain, and in 44% - recurrent. More than half of the patients complain of sacroiliac (SI) dislocation and palpatory pain. Unilateral or bilateral degenerative changes are documented by imaging studies in all patients, including: subchondral thickening, osteopathy narrowing the lateral or central part of the spinal canal with ensuing nerve root compression. The lumbosacral zygoapophyseal joints are source of pseudoradicular pain. A correlation between clinical picture and GT changes is noted in all patients with facet joint syndrome. CT is an indispensable method in diagnosing facet joint syndrome. (authors)

  9. Functional and radiographic outcomes of hallux valgus correction by mini-invasive surgery with Reverdin-Isham and Akin percutaneous osteotomies: a longitudinal prospective study with a 48-month follow-up.

    Science.gov (United States)

    Biz, Carlo; Fosser, Michele; Dalmau-Pastor, Miki; Corradin, Marco; Rodà, Maria Grazia; Aldegheri, Roberto; Ruggieri, Pietro

    2016-12-05

    Minimally invasive surgery (MIS) represents one of the most innovative surgical treatments of hallux valgus (HV). However, long-term outcomes still remain a matter of discussion within the orthopaedic community. The purpose of this longitudinal prospective study was to evaluate radiographic and functional outcomes in patients with mild-to-severe HV who underwent Reverdin-Isham and Akin percutaneous osteotomy, following exostosectomy and lateral release. Eighty patients with mild-to-severe symptomatic HV were treated by MIS. Clinical evaluation was assessed preoperatively, as well as at 3 and 12 months after surgery and at final follow-up of 48 months, using the American Orthopaedic Foot and Ankle Society (AOFAS) hallux grading system. Patient satisfaction and complications were recorded. Computer-assisted measurement of antero-posterior radiographs was taken preoperatively, as well as at 3 and 12 months after surgery and at 48-month follow-up, analysing the intermetatarsal angle (IMA), the hallux valgus angle (HVA), the distal metatarsal articular angle (DMAA) and the tibial sesamoid position. Also, the bridging bone/callus formation was evaluated at the different radiographic follow-ups, while the articular surface congruency and the metatarsal index were calculated only preoperatively and at the last follow-up. Patient satisfaction was assessed using the visual analogue score (VAS). Statistical analysis was carried out using the paired t test. Statistical significance was set at p surgery with Reverdin-Isham and Akin percutaneous osteotomy, in combination with previous exostosectomy and subsequent lateral soft-tissue release, is a safe, effective and reliable procedure for correction of mild-to-moderate HV. However, it requires a long learning curve because of the inherent difficulty of the mixed different surgical procedures. ClinicalTrials.gov PRS Protocol Registration and Results System: NCT02886221.

  10. FACETS: multi-faceted functional decomposition of protein interaction networks

    Science.gov (United States)

    Seah, Boon-Siew; Bhowmick, Sourav S.; Forbes Dewey, C.

    2012-01-01

    Motivation: The availability of large-scale curated protein interaction datasets has given rise to the opportunity to investigate higher level organization and modularity within the protein–protein interaction (PPI) network using graph theoretic analysis. Despite the recent progress, systems level analysis of high-throughput PPIs remains a daunting task because of the amount of data they present. In this article, we propose a novel PPI network decomposition algorithm called FACETS in order to make sense of the deluge of interaction data using Gene Ontology (GO) annotations. FACETS finds not just a single functional decomposition of the PPI network, but a multi-faceted atlas of functional decompositions that portray alternative perspectives of the functional landscape of the underlying PPI network. Each facet in the atlas represents a distinct interpretation of how the network can be functionally decomposed and organized. Our algorithm maximizes interpretative value of the atlas by optimizing inter-facet orthogonality and intra-facet cluster modularity. Results: We tested our algorithm on the global networks from IntAct, and compared it with gold standard datasets from MIPS and KEGG. We demonstrated the performance of FACETS. We also performed a case study that illustrates the utility of our approach. Contact: seah0097@ntu.edu.sg or assourav@ntu.edu.sg Supplementary information: Supplementary data are available at the Bioinformatics online. Availability: Our software is available freely for non-commercial purposes from: http://www.cais.ntu.edu.sg/∼assourav/Facets/ PMID:22908217

  11. Percutaneous cholecystostomy

    Energy Technology Data Exchange (ETDEWEB)

    Akhan, Okan E-mail: akhano@tr.net; Akinci, Devrim; Oezmen, Mustafa N

    2002-09-01

    Percutaneous cholecystostomy (PC), a technique that consists of percutaneous catheter placement in the gallbladder lumen under imaging guidance, has become an alternative to surgical cholecystostomy in recent years. Indications of PC include calculous or acalculous cholecystitis, cholangitis, biliary obstruction and opacification of biliary ducts. It also provides a potential route for stone dissolution therapy and stone extraction. Under aseptic conditions and ultrasound guidance, using local anesthesia, the procedure is carried out by using either modified Seldinger technique or trocar technique. Transhepatic or transperitoneal puncture can be performed as an access route. Several days after the procedure transcatheter cholangiography is performed to assess the patency of cystic duct, presence of gallstones and catheter position. The tract is considered mature in the absence of leakage to the peritoneal cavity, subhepatic, subcapsular, or subdiaphragmatic spaces. Response rates to PC in the literature are between the range of 56-100% as the variation of different patient population. Complications associated with PC usually occur immediately or within days and include haemorrhage, vagal reactions, sepsis, bile peritonitis, pneumothorax, perforation of the intestinal loop, secondary infection or colonisation of the gallbladder and catheter dislodgment. Late complications have been reported as catheter dislodgment and recurrent cholecystitis. PC under ultrasonographic guidance is a cost-effective, easy to perform and reliable procedure with low complication and high success rates for critically ill patients with acute cholecystitis. It is generally followed by elective cholecystectomy, if possible. However, it may be definitive treatment, especially in acalculous cholecystitis.

  12. Superior facet syndrome

    International Nuclear Information System (INIS)

    Kubo, Yoshichika; Igarashi, Seishi; Koyama, Tsunemaro

    1985-01-01

    Sciatica caused by root entrapment in the lateral recess was named superior facet syndrome by Epstein in 1972. Few reports on this subject based on large numbers of cases have been documented to date. Of the patients with sciatica, 32 patients were diagnosed to have root entrapment at the lateral recess L 5 or/and S 1 lumbar spine. Out of 32 patients, 20 patients were operated on and the lateral entrapment was recognized in all of surgical cases. Neuroradiological findings, especially of metrizamide CT (met. CT), were documented in detail. Thirty two patients were classified in three types according to radiological findings. They were congenital or developmental, degenerative, and combined type, respectively, Fourteen cases belonged to the congenital type, 13 to the degenerative and 5 to the combined type. Each group had the mean ages of 23.4, 53.8, and 36.8 years old, respectively. Of 32 cases the entrapment occured in 47 L 5 roots and 11 S 1 roots. There was no remarkable laterality. In operation the unroofing of the lateral recess were done and the sciatica subsided postoperatively in all of surgical cases. Met. CT revealed extreme medial protrusion of the superior articular joint in 18 of 24 cases(75%) and none filling of the root in the lateral recess in 21 of 24 cases (87.5%). In the degenerative type, met. CT showed some degenerative changes that were hypertrophy or deformity of the articular joints and spur formation of the vertebral body. In contrast to met. CT, metrizamide myelography revealed only slight changes, which were poor filling of the root before it turned out the pedicle of lateral compression of the root. In plain films or lumbar spine articular joints at Lsub(4/5) were formed in coronal plane in 69% of cases of the L 5 root entrapment. Met. CT using ReView technique was of great diagnostic value in superior facet syndrome. (author)

  13. The Many Facets of PISA

    Science.gov (United States)

    Berliner, David C.

    2015-01-01

    Trying to understand PISA is analogous to the parable of the blind men and the elephant. There are many facets of the PISA program, and thus many ways to both applaud and critique this ambitious international program of assessment that has gained enormous importance in the crafting of contemporary educational policy. One of the facets discussed in…

  14. Facet Approach to Applied Research.

    Science.gov (United States)

    Canter, David

    1982-01-01

    The contribution of facet theory to applied psychological research is shown to be its ability to define problems and the solutions to them in terms relevant to those wishing to make practical use of research findings. Three examples illustrate the use of facet theory in applied research. (Author/CM)

  15. Quantitative Discomanometry: Correlation of Intradiscal Pressure Values to Pain Reduction in Patients With Intervertebral Disc Herniation Treated With Percutaneous, Minimally Invasive, Image-Guided Techniques

    Energy Technology Data Exchange (ETDEWEB)

    Filippiadis, Dimitrios K., E-mail: dfilippiadis@yahoo.gr; Mazioti, A., E-mail: argyromazioti@yahoo.gr; Papakonstantinou, O., E-mail: sogofianol@gmail.com; Brountzos, E., E-mail: ebrountz@med.uoa.gr [University General Hospital ' Attikon' , Second Radiology Department (Greece); Gouliamos, A., E-mail: agouliam@med.uoa.gr [University General Hospital ' Areteion' , First Radiology Department (Greece); Kelekis, N., E-mail: kelnik@med.uoa.gr; Kelekis, A., E-mail: akelekis@med.uoa.gr [University General Hospital ' Attikon' , Second Radiology Department (Greece)

    2012-10-15

    Purpose: To illustrate quantitative discomanometry's (QD) diagnostic efficacy and predictive value in discogenic-pain evaluation in a prospective study correlating intradiscal pressure values with pain reduction after percutaneous image-guided technique (i.e., percutaneous decompression, PD). Materials and Methods: During the last 3 years, 36 patients [21 male and 15 female (mean age 36 {+-} 5.8 years)] with intervertebral disc hernia underwent QD before PD. Under absolute sterilization and fluoroscopy, a mixture of contrast medium and normal saline (3:1 ratio) was injected. A discmonitor performed a constant rate injection and recorded pressure and volume values, thus producing the relative pressure-volume curve. PD was then performed. Pain reduction and improved mobility were recorded at 3, 12, and 24 months after PD using clinical evaluation and a numeric visual scale (NVS; 0 to 10 units). Results: Mean pain values of 7.5 {+-} 1.9 (range 4 to 8) NVS units were recorded before PD; these decreased to 2.9 {+-} 2.44 at 3 months, 1.0 {+-} 1.9 at 12 months, and 1.0 {+-} 1.9 NVS units at 24 months after PD. Recorded correlations (pressure, volume, significant pain-reduction values) with bilateral statistical significance included a maximum injected volume of 2.4 ml (p = 0.045), P{sub o} < 14 psi [initial pressure required to inject 0.1 ml of the mixture inside the disc (p = 0.05)], P{sub max} {<=} 65 psi [greatest pressure value on the curve (p = 0.018)], and P{sub max} - P{sub o} {<=} 47 psi (p = 0.038). Patients meeting these pressure or volume cut-off points, either independently or as a total, had significant pain reduction (>4 NVS units) after PD. No complications were noted. Conclusions: QD is an efficient technique that may have predictive value for discogenic pain evaluation. It might serve as a useful tool for patient selection for intervertebral disc therapies.

  16. Asymmetric Facet Joint Osteoarthritis and Its Relationships to Facet Orientation, Facet Tropism, and Ligamentum Flavum Thickening.

    Science.gov (United States)

    Liu, Hai-Xiao; Shen, Yue; Shang, Ping; Ma, Yan-Xu; Cheng, Xiao-Jie; Xu, Hua-Zi

    2016-11-01

    The degrees of osteoarthritis of the left and right facet joints were evaluated by using computerized tomography among elderly patients with low back or leg pain. To reveal the phenomenon of asymmetry regarding facet joint osteoarthritis (FJOA) in old patients and establish its relationships to spinal level, facet orientation, facet tropism and ligamentum flavum (LF) thickening. There were few reports regarding left-right asymmetry among severity of FJOA and its relationships to spinal level, facet orientation, facet tropism, and LF thickening remained unclear. The grade of bilateral FJOA was evaluated using 4-grade scale on computerized tomography images at the L3-4, L4-5, and L5-S1 levels of patients with age ranging from 60 to 80 years. All subjects were divided into 2 groups: symmetric FJOA group (FJOA I-II on both sides or FJOA III-IV on both sides) and asymmetric FJOA group (FJOA I-II on one side and FJOA III-IV on the other side). The relationships of FJOA to spinal level, facet orientation, facet tropism, and LF hypertrophy were evaluated. No association between asymmetric FJOA and spinal level was noted (P>0.05). In asymmetric FJOA group, significant difference in facet orientation between 2 sides was observed at the L4-5 (P=0.018) and L5-S1 levels (P=0.033). Compared with symmetric FJOA, asymmetric FJOA showed significant difference in prevalence of facet tropism at the L5-S1 level (P0.05). Asymmetric FJOA is associated with facet orientation and tropism, but not with spinal level. There is a close relationship between severity of FJOA and LF thickness.

  17. Types of subtalar joint facets.

    Science.gov (United States)

    Jung, Min-Ho; Choi, Byoung Young; Lee, Ji Yong; Han, Chang Sung; Lee, Jin Suk; Yang, Young Chul; Cho, Byung Pil

    2015-08-01

    Articular facets of the clinical subtalar joint (CSTJ) were analyzed using a total of 118 (right 57, left 61) dry, paired calcanei and tali from 68 Korean adult cadavers. The CSTJ facets were classified into the following three types depending on their continuity: type A, all three facets are separated; type B, the anterior and middle facets are partially connected; and type C, the anterior and middle facets are fused to form a single facet. The continuity between the anterior and middle facets was represented by the degree of separation (DS), which ranged between 2.00 (type A) and 1.00 (type C). Type A was most common (39.0 %) in calcanei and rarest (11.0 %) in tali. Matching of calcaneus-talus pairs yielded five combined types: A-A (11.0 %), A-B (28.0 %), B-B (18.6 %), B-C (13.6 %), and C-C (28.8 %). The mean DS was slightly greater in calcanei (1.53) than in tali (1.32), and decreased in the order of types A-A, A-B, B-B, B-C, and C-C. The intersecting angles between the anterior and middle facets, which are related to the mobility of the CSTJ, were inversely related to the DS. These findings indicate that the anterior and middle facets are fused more frequently in tali than in calcanei, and combinations of different CSTJ facet types (A-B, B-C) exist over 40 % of feet. Our results indicate that types with a smaller DS (such as B-C and C-C) are relatively mobile but less stable compared to those with a greater DS (such as A-A and A-B).

  18. Arthrography of the lumber facet joint and facet block

    International Nuclear Information System (INIS)

    Cho, Hee Kyung; Chung, Tae Sub; Kim, Young Soo; Park, Hyung Chun; Moon, Jae Ho; Suh, Jung Ho; Kim, Dong Ik

    1988-01-01

    In spite of numerous clinical and patho-anatomical studied made in the past, there are still different opinions concerning the mechanism of low back pain. We have focused attention on the posterior structures as an alternative source of low back pain with sciatica. So we have studied and analyzed the finding of arthrography of facet joint and effect of the injection of methyprednisolone acetate suspension (Depomedrol) 20mg into the each facet joint. Our results are as follows: 1. Abnormal findings of facet joint arthrogram were degenerative osteoarthritis of facet joint (70.5%), synovial cyst (11.8%), accessory bone (11.8%), and spondylolysis (5.9%). 2. The mean facet angulations of patients of facet syndrome were abnormal on lower lumbar facet joint in 9 of 13 cases (69.2%). 3. On initial assessment, 11 of 17 cases (64.7%) showed complete relief and one month later, 6 of 11 cases (35.3%) showed continuous relief, after steroid injection.

  19. Arthrography of the lumber facet joint and facet block

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Hee Kyung; Chung, Tae Sub; Kim, Young Soo; Park, Hyung Chun; Moon, Jae Ho; Suh, Jung Ho; Kim, Dong Ik [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1988-12-15

    In spite of numerous clinical and patho-anatomical studied made in the past, there are still different opinions concerning the mechanism of low back pain. We have focused attention on the posterior structures as an alternative source of low back pain with sciatica. So we have studied and analyzed the finding of arthrography of facet joint and effect of the injection of methyprednisolone acetate suspension (Depomedrol) 20mg into the each facet joint. Our results are as follows: 1. Abnormal findings of facet joint arthrogram were degenerative osteoarthritis of facet joint (70.5%), synovial cyst (11.8%), accessory bone (11.8%), and spondylolysis (5.9%). 2. The mean facet angulations of patients of facet syndrome were abnormal on lower lumbar facet joint in 9 of 13 cases (69.2%). 3. On initial assessment, 11 of 17 cases (64.7%) showed complete relief and one month later, 6 of 11 cases (35.3%) showed continuous relief, after steroid injection.

  20. Percutaneous Tracheostomy

    Science.gov (United States)

    Mehta, Chitra; Mehta, Yatin

    2017-01-01

    Percutaneous dilatational tracheostomy (PDT) is a commonly performed procedure in critically sick patients. It can be safely performed bedside by intensivists. This has resulted in decline in the use of surgical tracheostomy in intensive care unit (ICU) except in few selected cases. Most common indication of tracheostomy in ICU is need for prolonged ventilation. About 10% of patients requiring at least 3 days of mechanical ventilator support get tracheostomised during ICU stay. The ideal timing of PDT remains undecided at present. Contraindications and complications become fewer with increase in experience. Various methods of performing PDT have been discovered in last two decades. Preoperative work up, patient selection and post tracheostomy care form key components of a successful PDT. Bronchoscopy and ultrasound have been found to be useful procedural adjuncts, especially in presence of unfavorable anatomy. This article gives a brief overview about the use of PDT in ICU. PMID:28074819

  1. Percutaneous gastroenterostomy

    Energy Technology Data Exchange (ETDEWEB)

    Wittich, G.R.; Van Sonnenberg, E.; Casola, G.; Jantsch, H.; Walter, R.; Lechner, G.

    1987-05-01

    Percutaneous gastrostomies or gastroenterostomies serve for temporary or permanent enteric feeding in patients with obstruction or functional derangement of the esophagus or hypopharynx. In addition, this radiological procedure may be indicated for small bowel decompression. The authors present their experience in 71 patients. Insufflation of air through a nasogastric tube or catheter is the preferred method for gastric distension. The inferior margin of the left lobe of the liver and the transverse colon are localized sonographically and fluoroscopically prior to puncture. Either Seldinger or Trocartechniques have proven effective in establishing access to the stomach. The feeding tube is advanced into the proximal jejunum to reduce the likelyhood of gastroesophageal reflux and possible aspiration. Complications were encountered in four patients and included catheter dislocation in three and respiratory distress in one patient.

  2. Percutaneous angioscopy

    International Nuclear Information System (INIS)

    Beck, A.

    1987-01-01

    In dogs and 11 patients a new endoscopic method for arteries has been developed. The approach is transfemoral, and endoscopy is combined with angiography, percutaneous transluminal angioplasty (PTA), and local lysis. An ultrathin endoscope with a diameter of 2.4 mm is used, which also provides a working channel with a diameter of 0.4 mm. Guide wires, contrast media, and drugs for local lysis can be inserted through this channel. Under fluoroscopic control, the endoscope is placed in the region of interest, followed by a special method for decreasing blood flow. Endoscopy is documented by video or by a high-speed camera. No complications have occurred. In all patients, it was possible to demonstrate the results of dilatation, recanalization, or local lysis before and after the interventional procedure. (orig.) [de

  3. Radiological evaluation of percutaneous endoscopic lumbar discectomy: a three-year follow-up study

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Seung Eun; Lee, Sang Ho; Ahn, Yong; Shin, Song Woo; Jo, Byung June; Park, Jee Young [Wooridul Spine Hospital, Seoul (Korea, Republic of); Kim, Tae Hong [Inje University College of Medicine, Seoul (Korea, Republic of)

    2006-05-15

    We wanted to analyze the radiological changes of the patients who underwent percutaneous endoscopic lumbar discectomy (PELD) for treating soft disc herniation. We retrospectively reviewed 30 patients (32 cases) who were observed for a minimum of 3 years after they underwent PELD. The authors investigated the postoperative radiological changes after PELD and the related clinical outcomes. All the patients received plain X-rays, CT and MRI both preoperatively and at the final follow-up. The radiological parameters were evaluated, including the disc height, the disc signal intensity, the subchondral marrow signal intensity, the sagittal plane instability and the facet joint osteoarthritis. The average amount of removed disc was 1.363 g and a significant correlation was detected between the narrowing of disc height and the amount of removed disc. Although the disc height and the disc height ratio were significantly decreased (-0.97 mm and 86.9%, respectively), the angle of sagittal rotation was well maintained. There were 18 (56.3%) cases of disc signal changes, six cases (18.8%) of subchondral marrow signal changes, and three cases (9.4%) of facet joint osteoarthritis. The success rate was 90.6%. Although disc height narrowing was observed, there was no postoperative instability and the overall clinical outcome was satisfactory. Our results show that PELD is a useful and minimal invasive procedure for the selected patients who are suffering with lumbar disc herniation.

  4. Facets of a life

    International Nuclear Information System (INIS)

    Sakharov, A.

    1991-01-01

    This book is physicist's tribute to Andrei Dmitrievich Sakharov. This out-standing person - a talented physicist and citizen of the world - has played an extremely important role in the deep-going changes occurring in our country. His name belongs to history. Accounts of people who met him and are capable of assessing his scientific work and public activism are just beginning to pour in. In our view, this collection of reminiscences is only a small but essential, contribution to the restoration of A.D. Sakharov's image. Most of the authors, physicists, mathematicians and computer scientists from many countries, knew him as a colleague. To a varying extent, they were a part of his difficult life. This is what this collection is about. Both professional and humanistic facets of his life are described. The book begins with the texts published when he ran for a post of a people's deputy of the USSR and the biographical note printed in the Uspekhi Fizicheskikh Nauk journal after his death. They are mutually complementary for the former contains a short description of his biography and human rights activism, and the latter emphasizes Sakharov's scientific work. The authors' index contains basic data about them. The Annexes contain some previously unpublished Sakharov's documents. Among them there is 'The Letter to Soviet Scientists' with an appeal which, unfortunately, did not get the support it deserved

  5. Effectiveness of percutaneous laser disc decompression versus conventional open discectomy in the treatment of lumbar disc herniation; Design of a prospective randomized controlled trial

    NARCIS (Netherlands)

    P.A. Brouwer (Patrick); W.C. Peul (Wilco); R. Brand (René); M.P. Arts (Mark); B.W. Koes (Bart); A.A. van den Berg (Annette); M.A. van Buchem (Mark)

    2009-01-01

    textabstractBackground. The usual surgical treatment of refractory sciatica caused by lumbar disc herniation, is open discectomy. Minimally invasive procedures, including percutaneous therapies under local anesthesia, are increasingly gaining attention. One of these treatments is Percutaneous Laser

  6. Percutaneous Achilles Tendon Lengthening

    Science.gov (United States)

    ... All Site Content AOFAS / FootCareMD / Treatments Percutaneous Achilles Tendon Lengthening Page Content ​ Pre-operative incision markings along ... What is the goal of a percutaneous Achilles tendon lengthening? The goal of this procedure is to ...

  7. Minimally invasive therapeutic interventional procedures in the spine: an evidence-based review.

    Science.gov (United States)

    Karnezis, Ioannis A

    2008-01-01

    This chapter evaluates the current evidence on common minimally invasive therapeutic spinal procedures based on the Levels of Evidence and Grades of Recommendation developed by the Centre for Evidence-Based Medicine (Oxford, United Kingdom). The results of the evaluation of current clinical evidence allow the following recommendations to be made: epidural adhesiolysis performed repeatedly every 3 months to 4 months is effective in the "post lumbar laminectomy" syndrome; epidural steroid injections may provide only short-term relief from pain in lumbar radiculopathy but have no long-term effect; selective nerve root injections of corticosteroids have no therapeutic effect on the long-term natural history of radiculopathy symptoms; intra-articular facet joint injections of corticosteroids have no therapeutic effect on lower back pain (grade of recommendation: A). Furthermore, percutaneous vertebroplasty and balloon kyphoplasty provide immediate pain relief from osteoporotic spinal fractures but no significant long-lasting benefit (grade of recommendation: B). Finally, there is limited evidence (grade of recommendation: C) of the value of medial branch (facet) neurotomy, sacroiliac joint injection of steroids, and intradiscal electrothermal therapy, as well as of the advantages of percutaneous endoscopic lumbar discectomy over open microdiscectomy. As the level of evidence is generally low, more prospective randomized-controlled studies are needed to establish the value of the considered methods.

  8. Dynamic of Faceted Colloidal Clusters

    Science.gov (United States)

    Sindoro, Melinda; Jee, Ah-Young; Yu, Changqian; Granick, Steve

    2014-03-01

    We study the emulsion induced clustering of faceted metal organic frameworks (MOFs) and their dynamics. Our approach to anisotropic building block is through the rational synthesis of water stable and highly uniform MOFs. This generates colloidal-sized MOFs of defined polyhedral shape with tunable size in micrometer range that are suitable for in situ imaging. The 3D clusters formations are promoted by hydrophilic MOFs particles confined in aqueous droplets of binary water-lutidine mixture at transition temperature. Below this temperature, the water droplet decreases in volume due to one phase mixing with lutidine which forces the N-mers of faceted particles to aggregate in close contact. We compare the faceted clusters formed to those made of spherical particles in term of the building block sphericity. Other focus of our study involves the dynamic of the clusters. We found that, unlike spherical clusters, these faceted N-mers are highly stable on large scale of temperature due to their dominant capillary force on their facet-to-facet contact.

  9. [Locked plating with minimally invasive percutaneous plate osteosynthesis versus intramedullary nailing of distal extra-articular tibial fracture: a retrospective study].

    Science.gov (United States)

    Yao, Qi; Ni, Jie; Peng, Li-bin; Yu, Da-xin; Yuan, Xiao-ming

    2013-12-17

    To compare the efficacies of minimally invasive plate osteosynthesis (MIPPO) and interlocking intramedullary nailing (IMN) in the treatment of extra-articular fractures of distal tibia. Retrospective reviews were conducted for 126 patients with extra-articular distal tibia fractures. Treatment was either MIPPO (n = 61) or IMN (n = 65). The outcomes were assessed by comparing operating duration, time to union, the last follow-up American Orthopedic Foot and Ankle Society (AOFAS) score and complication rate. The average follow-up period was 23.7 (12-53) months. In the minimally invasive plate osteosynthesis group, there were deep infections (n = 2), superficial infections (n = 5), delayed union (n = 2), malunion (n = 2) and knee joint pain (n = 10) were observed. In addition, the average operating duration (85.9 ± 18.9 min), average time to union (17.3 ± 3.8 weeks) and average AOFAS (83.2 ± 11.9) were analyzed. In the interlocking intramedullary nailing group, there were delayed union (n = 3), malunion (n = 12) and knee joint pain (n = 22). And the average operating duration (83.3 ± 15.7 min), average time to union (16.5 ± 3.1 weeks) and average AOFAS (84.9 ± 12.0) were analyzed. No statistical significance existed in operating duration, time to union and the last follow-up AOFAS between two groups (P > 0.05). However, the rates of malformation and knee joint pain were higher in the intramedullary nail group than those in the plate group. And the difference was statistically significant (P = 0.015, P = 0.025). Both MIPPO and IMN are effective for extra-articular fractures of distal tibia. However, the former has the advantage of lowers rate of malformation and knee joint pain. Therefore a surgeon should consider the degree of injury while managing extra-articular fracture of distal tibia.

  10. PERCUTANEOUS ELECTROHEMOSTASIS AFTER PERCUTANEOUS NEPHROLITHOTOMY

    Directory of Open Access Journals (Sweden)

    R. N. Trushkin

    2017-01-01

    Full Text Available The article describes the clinical case in a patient with bilateral nephrolithiasis, chronic kidney disease of the 4th stage, after which bleeding from the left kidney developed after simultaneous bilateral percutaneous nephrolithotomy (PNL, leading to severe hemic hypoxia. Conservative therapy, blood transfusion did not lead to a persistent effect, the bleeding continued to recur. Given the presence of chronic renal failure (CRF from the embolization of the branches of the renal artery, it was decided to abstain, given the extremely high risk of aggravation of nephropathy after the administration of the contrast drug. Left-sided nephrectomy would inevitably lead to the development of terminal chronic renal failure. Patients performed an electrocoagulation of the fistula wall with a Karl Storz 26C resectoscope in 60W mode. The bleeding was completely stopped. The patient is discharged from the hospital in a satisfactory condition. At the time of discharge in the conduct of replacement renal therapy did not need. When analyzing publications in The Cochrane Library, PubMed, Medline and Web of Science, we did not find a description of such a method of hemostasis.

  11. Completeness of revascularization and its impact on the outcomes of a staged approach of percutaneous coronary intervention followed by minimally invasive valve surgery for patients with concomitant coronary artery and valvular heart disease.

    Science.gov (United States)

    Pineda, Andrés M; Chandra, Ramesh; Gowani, Saqib A; Santana, Orlando; Mihos, Christos G; Kirtane, Ajay J; Stone, Gregg W; Kurlansky, Paul; Smith, Craig R; Beohar, Nirat

    2016-09-01

    A staged approach of percutaneous coronary intervention (PCI) followed by minimally invasive valve surgery (MIVS) is an alternative to the conventional combined coronary artery bypass and valve surgery for patients with concomitant coronary artery and valve disease. Limited data exist on degree of the completeness of revascularization achieved with this approach and its impact on outcomes. A total of 138 patients, who underwent a staged approach between January 2009 and June 2013, were retrospectively evaluated. Coronary angiograms were reviewed by two cardiologists blinded to outcomes and were then categorized into two groups: complete or incomplete revascularization, which was defined as ≥1 major epicardial coronary arteries of at least 2.0 mm diameter with ≥70% untreated obstruction after the index PCI and before MIVS. Complete and incomplete revascularization was achieved in 105 (76%) and 33 (24%) patients, respectively. The patients with incomplete revascularization had a lower ejection fraction, a higher STS score, and more prior myocardial infarctions and multi-vessel coronary artery disease. There were no differences in the post-operative complications, 30-day mortality, or 3-year survival (84 vs. 83%, P = 0.68). After a median follow-up of 29 months, incompletely revascularized patients had a higher incidence of acute coronary syndrome (2.9 vs. 12.9%, P = 0.05). In patients undergoing a staged approach of PCI followed by MIVS, incomplete revascularization did not significantly impact the short or mid-term survival, but was associated with an increased incidence of acute coronary syndrome at follow-up. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

  12. A Randomized Study of Minimally Invasive Percutaneous Nephrolithotomy (MPCNL) with the aid of a patented suctioning sheath in the treatment of renal calculus complicated by pyonephrosis by one surgery.

    Science.gov (United States)

    Huang, Jianrong; Song, Leming; Xie, Donghua; Li, Monong; Deng, Xiaolin; Hu, Min; Peng, Zuofeng; Liu, Tairong; Du, Chuance; Yao, Lei; Liu, Shengfeng; Guo, Shulin; Zhong, Jiuqing

    2016-12-08

    Calculus pyonephrosis is difficult to manage. The aim of this study is to explore the value of a patented suctioning sheath assisted minimally invasive percutaneous nephrolithotomy (MPCNL) in the treatment of calculus pyonephrosis. One hundred and eighty two patients with calculus pyonephrosis were randomizely divided into observation group (n = 91) and control group (n = 91). The control group was treated with MPCNL traditionally using peel-away sheath while the observation group was treated with MPCNL using the patented suctioning sheath. All the patients in the observation group underwent one stage surgical treatment, 14 patients in the control group underwent first-stage surgery with the rest of the group underwent one stage surgery. The complication rate was 12.1% in the observation group, significantly lower than the rate in the control group which was 51.6%; One surgery stone clearance in the observation group was 96.7% while it was 73.6% in the control group; operative time in the observation group was (54.5 ± 14.5) min, compared to (70.2 ± 11.7) min in the control group; the bleeding amount in the observation group was (126.4 ± 47.2) ml, compared to (321.6 ± 82.5) ml in the control group; the hospitalization duration for the observation group was (6.4 ± 2.3) days, compared to (10.6 ± 3.7) days in the control group. Comparison of the above indicators, the observation group was better than the control group with significant difference (p calculus pyonephrosis in one surgery is economic, practical, and warrants clinical promotion. This study was registered with Chinese Clinical Trial Registry on May 18, 2016 (retrospective registration) with a trial registration number of ChiCTR-IOR-16008490 .

  13. Minimally Invasive Transforaminal Lumbar Interbody Fusion with Percutaneous Bilateral Pedicle Screw Fixation for Lumbosacral Spine Degenerative Diseases. A retrospective database of 40 consecutive treated cases and literature review.

    Science.gov (United States)

    Millimaggi, Daniele Francesco; DI Norcia, Valerio; Luzzi, Sabino; Alfiero, Tommaso; Galzio, Renato Juan; Ricci, Alessandro

    2017-04-12

    To report our results about minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) with bilateral pedicle screw fixation, in patients with degenerative lumbosacral spine disease. To describe the indications, surgical technique and results of a consecutive series of 40 patients undergone MI-TLIF. Despite the limited number of clinical studies, published data suggest tremendous potential advantages of this technique. Forty patients with radiological findings of degenerative lumbosacral spine disease were undergone MI-TLIF between July 2012 and January 2015. Clinical outcomes were assessed by means of Oswestry Disability Index (ODI) and Health Survey Scoring (SF36) before surgery and at first year follow-up. Furthermore, the following parameters were retrospectively reviewed: age, sex, working activity, body mass index (BMI), type of degenerative disease, number of levels of fusion, operative time, blood loss, length of hospital stay. Average operative time was of 230 minutes, mean estimated blood loss 170 mL, average length of hospital stay 5 days. The ODI improved from a score of 59, preoperatively, to post-operative score of 20 at first year follow-up. Average SF36 score increased from 36 to 54 (Physical Health) and from 29 to 50 (Mental Health) at first year outcome evaluation. MI-TLIF with bilateral pedicle screw fixation is an excellent choice for selected patients suffering from symptomatic degenerative lumbosacral spine disease, especially secondary to recurrent disk herniations.

  14. Comparison of percutaneous cannulated screw fixation and calcium sulfate cement grafting versus minimally invasive sinus tarsi approach and plate fixation for displaced intra-articular calcaneal fractures: a prospective randomized controlled trial.

    Science.gov (United States)

    Feng, Yongzeng; Shui, Xiaolong; Wang, Jianshun; Cai, Leyi; Yu, Yang; Ying, Xiaozhou; Kong, Jianzhong; Hong, Jianjun

    2016-07-15

    The management of displaced intra-articular calcaneal fractures (DIACFs) remains challenging and controversial. A prospective randomized controlled trial was conducted to compare percutaneous reduction, cannulated screw fixation and calcium sulfate cement (PR+CSC) grafting with minimally invasive sinus tarsi approach and plate fixation (MISTA) for treatment of DIACFs. Ultimately, 80 patients with a DIACFs were randomly allocated to receive either PR+CSC (N = 42) or MISTA (N = 38). Functional outcomes were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot scores. Radiological results were assessed using plain radiographs and computed tomography (CT) scans, and postoperative wound-related complications were also recorded. The average time from initial injury to operation and the average operation time in the PR+CSC group were both significantly shorter than those in the MISTA group (p < 0.05). There were significantly fewer complications in the PR+CSC group than those in the MISTA group (7.1 % vs 28.9 %, p < 0.001). The calcaneal width immediate postoperatively and at the final follow-up in the MISTA group were obviously improved compared to those in the PR+CSC group (p < 0.001). The variables of sagittal motion and hindfoot motion of the AOFAS scoring system in the PR+CSC group were significantly higher than those in the MISTA group (p < 0.05). The good and excellent results in the two groups were comparable for Sanders Type-II calcaneal fractures, but the good to excellent rate in the MISTA group was significantly higher for Sanders Type-III fractures (p < 0.05). The clinical outcomes are comparable between the two minimally invasive techniques in the treatment of Sanders Type-II DIACFs. The PR+CSC grafting is superior to the MISTA in terms of the average time between initial injury and operation, operation time, wound-related complications and subtalar joint activity. However, the MISTA has its own

  15. Image-guided lumbar facet joint infiltration in nonradicular low back pain

    International Nuclear Information System (INIS)

    Chaturvedi, Arti; Chaturvedi, Sunil; Sivasankar, Rajiv

    2009-01-01

    To assess the efficacy of facet joint infiltrations for pain relief in 44 selected patients with chronic nonradicular low back pain (LBP). Forty-four patients with chronic LBP of more than 3 months' duration were selected for facet joint infiltration. The majority (n = 24) had facetal pain with no evidence of significant facetal arthropathy on imaging. Fifteen patients had radiological evidence of facetal arthropathy, one had a facet joint synovial cyst, three were post–lumbar surgery patients, and two patients had spondylolysis. Facet joint injections were carried out under fluoroscopic guidance in 39 patients and under CT guidance in 5 cases. Pain relief was assessed using the visual analog scale at 1 h post-procedure and, thereafter, at 1, 4, 12, and 24 weeks. A total of 141 facet joints were infiltrated in 44 patients over a 2-year period. There was significant pain relief in 81.8% patients 1 h after the procedure, in 86.3% after 1 week, in 93.3% after 4 weeks, in 85.7% after 12 weeks, and in 62.5% after 24 weeks. No major complications were encountered. Facet nerve block was found to be a simple, minimally invasive, and safe procedure. With meticulous patient selection, we achieved long-term success rates of over 60%. We conclude that this method represents an important alternative treatment for nonradicular back pain

  16. Relationship between facet tropism and facet joint degeneration in the sub-axial cervical spine

    Directory of Open Access Journals (Sweden)

    Xin Rong

    2017-02-01

    Full Text Available Abstract Background Facet tropism is the angular asymmetry between the left and right facet joint orientation. Although debatable, facet tropism was suggested to be associated with disc degeneration, facet degeneration and degenerative spondylolisthesis in the lumbar spine. The purpose of this study was to explore the relationship between facet tropism and facet degeneration in the sub-axial cervical spine. Methods A total of 200 patients with cervical spondylosis were retrospectively analyzed. Facet degeneration was categorized into 4 grade: grade I, normal; grade II, degenerative changes including joint space narrowing, cyst formation, small osteophytes (3 mm without fusion of the joint; grade IV, bony fusion of the facet joints. Facet orientations and facet tropisms with respect to the transverse, sagittal and coronal plane were calculated from the reconstructed cervical spine, which was based on the axial CT scan images. The paired facet joints were then categorized into three types: symmetric, moderated tropism and severe tropism. Univariate and multivariate analysis were performed to evaluate the relationship between any demographic and anatomical factor and facet degeneration. Results The mean age of enrolled patients was 46.23 years old (ranging from 30 to 64 years old. There were 114 males and 86 females. The degrees of facet degeneration varied according to cervical levels and ages. Degenerated facet joints were most common at C2-C3 level and more common in patients above 50 years old. The facet orientations were also different from level to level. By univariate analysis, genders, ages, cervical levels, facet orientations and facet tropisms were all significantly different between the normal facets and degenerated facets. However, results from multivariate logistic regression suggested only age and facet tropism with respect to the sagittal plane were related to facet degeneration. Conclusion Facet degeneration were more common at

  17. Relationship between facet tropism and facet joint degeneration in the sub-axial cervical spine.

    Science.gov (United States)

    Rong, Xin; Liu, Ziyang; Wang, Beiyu; Pan, Xuelin; Liu, Hao

    2017-02-20

    Facet tropism is the angular asymmetry between the left and right facet joint orientation. Although debatable, facet tropism was suggested to be associated with disc degeneration, facet degeneration and degenerative spondylolisthesis in the lumbar spine. The purpose of this study was to explore the relationship between facet tropism and facet degeneration in the sub-axial cervical spine. A total of 200 patients with cervical spondylosis were retrospectively analyzed. Facet degeneration was categorized into 4 grade: grade I, normal; grade II, degenerative changes including joint space narrowing, cyst formation, small osteophytes (3 mm) without fusion of the joint; grade IV, bony fusion of the facet joints. Facet orientations and facet tropisms with respect to the transverse, sagittal and coronal plane were calculated from the reconstructed cervical spine, which was based on the axial CT scan images. The paired facet joints were then categorized into three types: symmetric, moderated tropism and severe tropism. Univariate and multivariate analysis were performed to evaluate the relationship between any demographic and anatomical factor and facet degeneration. The mean age of enrolled patients was 46.23 years old (ranging from 30 to 64 years old). There were 114 males and 86 females. The degrees of facet degeneration varied according to cervical levels and ages. Degenerated facet joints were most common at C2-C3 level and more common in patients above 50 years old. The facet orientations were also different from level to level. By univariate analysis, genders, ages, cervical levels, facet orientations and facet tropisms were all significantly different between the normal facets and degenerated facets. However, results from multivariate logistic regression suggested only age and facet tropism with respect to the sagittal plane were related to facet degeneration. Facet degeneration were more common at C2-C3 level. Older age and facet tropism with respect to the

  18. THEORY OF INCOMMENSURATE CRYSTAL FACETS

    NARCIS (Netherlands)

    VANSMAALEN, S

    1993-01-01

    The morphology of incommensurately modulated crystals is considered. A surface free energy model is constructed which interprets the stabilization of the incommensurate facets as due to surface pinning of the phase of the modulation wave. The stepped nature of the true crystal surface restricts the

  19. Preamble to marine microbiology: Facets and opportunities

    Digital Repository Service at National Institute of Oceanography (India)

    Ramaiah, N.

    The book titled 'Marine Microbiology: Facets & Opportunities' is an attempt to bring together some facets of marine microbiology as have been made out by many contemporaries in particular from the tropical marine regions. There are 18 contributed...

  20. Image-guided facet joint injection

    OpenAIRE

    Peh, WCG

    2011-01-01

    Chronic spine pain poses a peculiar diagnostic and therapeutic challenge due to multiple pain sources, overlapping clinical features and nonspecific radiological findings. Facet joint injection is an interventional pain management tool for facet-related spinal pain that can be effectively administered by a radiologist. This technique is the gold standard for identifying facet joints as the source of spinal pain. The major indications for facet injections include strong clinical suspicion of t...

  1. Bilateral locked facets in the thoracic spine

    NARCIS (Netherlands)

    M.H.A. Willems; Braakman, R. (Reinder); B. van Linge (Bert)

    1984-01-01

    textabstractTwo cases of traumatic bilateral locked facets in the thoracic spine are reported. Both patients had only minor neurological signs. They both made a full neurological recovery after surgical reduction of the locked facets. Bilateral locked facets are very uncommon in the thoracic spine.

  2. Percutaneous vertebroplasty in the treatment of vertebral body compression fracture secondary to osteogenesis imperfecta

    Energy Technology Data Exchange (ETDEWEB)

    Rami, Parag M.; Heatwole, Eric V.; Boorstein, Jeffrey M. [Center for Vascular and Interventional Radiology, St. Vincent Mercy Medical Center, Toledo, OH (United States); McGraw, Kevin J. [Riverside Methodist Hospital, Columbus, OH (United States)

    2002-03-01

    Percutaneous vertebroplasty, a minimally invasive interventional radiological procedure, has recently been used effectively for the treatment of symptomatic vertebral body compression fractures. Primary indications for vertebroplasty include osteoporotic compression fracture, osteolytic vertebral metastasis and myeloma, and vertebral hemangioma. We present a case and extend the indication of percutaneous vertebroplasty in a patient with a vertebral body compression fracture secondary to osteogenesis imperfecta. (orig.)

  3. Bending stresses in Facetted Glass Shells

    DEFF Research Database (Denmark)

    Bagger, Anne; Jönsson, Jeppe; Almegaard, Henrik

    2008-01-01

    A shell structure of glass combines a highly effective structural principle with a material of optimal permeability to light. A facetted shell structure has a piecewise plane geometry, and together the facets form an approximation to a curved surface. A distributed load on a plane-based facetted...... structure will locally cause bending moments in the loaded facets. The bending stresses are dependent on the stiffness of the joints. Approximate solutions are developed to estimate the magnitude of the bending stresses. A FE-model of a facetted glass shell structure is used to validate the expressions...

  4. Facets of Facebook: Use and Users

    OpenAIRE

    2016-01-01

    The debate on Facebook raises questions about the use and users of this information service. This collected volume gathers a broad spectrum of social science and information science articles about Facebook.Facebook has many facets, and we just look forward above all to the use and users. The facet of users has sub-facets, such as different age, sex, and culture. The facet of use consists of sub-facets of privacy behavior after the Snowden affair, dealing with friends, unfriending and becoming...

  5. Quantum mechanical facets of chemical bonds

    International Nuclear Information System (INIS)

    Daudel, R.

    1976-01-01

    To define the concept of bond is both a central problem of quantum chemistry and a difficult one. The concept of bond appeared little by little in the mind of chemists from empirical observations. From the wave-mechanical viewpoint it is not an observable. Therefore there is no precise operator associated with that concept. As a consequence there is not a unique approach to the idea of chemical bond. This is why it is preferred to present various quantum mechanical facets, e.g. the energetic facet, the density facet, the partitioning facet and the functional facet, of that important concept. (Auth.)

  6. Computed Tomography of the lumbar facet joints

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Mi Ryoung; Kim, Yung Soon; Lee, Joo Hyuk; Jeon, Hae Sang; Kim, Dae Yung [Kang Nam General Hospital, Seoul (Korea, Republic of)

    1989-08-15

    The lumbar facet disease is a frequently overlooked cause of sciatic pain, but the lumbar facet joints are well-recognized source of low back pain and radiating leg pain which can be confused with sciatica due to herniated disc. We measured the angulation of the facet joints on axial spine CT films in 149 cases which contains 41 normal group and 108 abnormal group and studied the relationship between the angulation and degeneration of the facets, the asymmetry of each sided facets and facet degeneration, the asymmetry and disc protrusion, and the asymmetry and annular bulging of the disc. The results were as follows: 1. Facet angulation in abnormal group were more sagittally oriented than the normal group. 2. The angulation of right facet was more sagittally oriented than the left in L4-5 level of abnormal group. 3. Degeneration of facet joints occur asymmetrically, and the more facet joint degenerates, the more it orients sagittally, particularly in L4-5. 4. Asymmetry in facet joint degeneration and unilateral disc protrusion of L5-SI level is greater than the normal gro0008.

  7. IMPLANTATION METASTASIS OF LARYNGEAL CANCER AFTER PERCUTANEOUS ENDOSCOPIC GASTROSTOMY

    Directory of Open Access Journals (Sweden)

    A. O. Guz

    2017-01-01

    Full Text Available Squamous cell head and neck carcinoma is frequently associated with dysphagia. An adequate enteral nutrition is the key to successful treatment and rehabilitation of these patients. Percutaneous endoscopic gastrostomy is the preferred route of feeding and nutritional support in head and neck cancer patients with dysphagia. We report a rare case of implantation metastasis of laryngeal cancer following percutaneous endoscopic gastrostomy. Our experience in treating this complication has been described. Percutaneous endoscopic gastrostomy is a less-invasive procedure than open gastrostomy. Percutaneous endoscopic gastrostomy can be accompanied by severe complications such as implantation metastasis at gastrostomy site. Careful monitoring can provide early detection of this complication and early treatment. 

  8. Technology improvements for image-guided and minimally invasive spine procedures.

    Science.gov (United States)

    Cleary, Kevin; Clifford, Mark; Stoianovici, Dan; Freedman, Matthew; Mun, Seong K; Watson, Vance

    2002-12-01

    This paper reports on technology developments aimed at improving the state of the art for image-guided minimally invasive spine procedures. Back pain is a major health problem with serious economic consequences. Minimally invasive procedures to treat back pain are rapidly growing in popularity due to improvements in technique and the substantially reduced trauma to the patient versus open spinal surgery. Image guidance is an enabling technology for minimally invasive procedures, but technical problems remain that may limit the wider applicability of these techniques. The paper begins with a discussion of low back pain and the potential shortcomings of open back surgery. The advantages of minimally invasive procedures are enumerated, followed by a list of technical problems that must be overcome to enable the more widespread dissemination of these techniques. The technical problems include improved intraoperative imaging, fusion of images from multiple modalities, the visualization of oblique paths, percutaneous spine tracking, mechanical instrument guidance, and software architectures for technology integration. Technical developments to address some of these problems are discussed next. The discussion includes intraoperative computerized tomography (CT) imaging, magnetic resonance imaging (MRI)/CT image registration, three-dimensional (3-D) visualization, optical localization, and robotics for percutaneous instrument placement. Finally, the paper concludes by presenting several representative clinical applications: biopsy, vertebroplasty, nerve and facet blocks, and shunt placement. The program presented here is a first step to developing the physician-assist systems of the future, which will incorporate visualization, tracking, and robotics to enable the precision placement and manipulation of instruments with minimal trauma to the patient.

  9. Percutaneous necrosectomy in patients with acute, necrotizing pancreatitis

    Energy Technology Data Exchange (ETDEWEB)

    Bruennler, T.; Langgartner, J.; Lang, S.; Salzberger, B.; Schoelmerich, J. [University Hospital of Regensburg, Department of Internal Medicine 1, Regensburg (Germany); Zorger, N.; Herold, T.; Feuerbach, S.; Hamer, O.W. [University Hospital of Regensburg, Department of Radiology, Regensburg (Germany)

    2008-08-15

    The objective of this retrospective study was to evaluate the outcome of patients with acute necrotizing pancreatitis treated by active percutaneous necrosectomy. By searching the radiological, surgical and internal medicine databases, all patients with acute necrotizing pancreatitis treated by active percutaneous necrosectomy between 1992 and 2004 were identified. Demographic, laboratory, and clinical data, and details about invasive procedures were collected by reviewing patient charts, radiological and surgical reports. The computed tomography severity index (CTSI) scores were determined by reviewing CT images. Eighteen patients were identified. Median Ranson score on admission was 2. The Acute Physiology and Chronic Health Evaluation (APACHE) II score was median 22. Median CTSI score was 7. Initially all patients were treated with CT-guided drainage placement. Because passive drainage proved not to be effective, subsequent minimally invasive, percutaneous necrosectomy was performed. Eight out of 18 patients recovered fully without the need for surgery. Ten of 18 patients required additional surgical necrosectomy. For one of ten patients, percutaneous necrosectomy allowed postponing surgery by 39 days. Four of ten surgically treated patients died: three from septic multiorgan failure, one from pulmonary embolism. Percutaneous minimally invasive necrosectomy can be regarded as a safe and effective complementary treatment modality in patients with necrotizing pancreatitis. It is suitable for a subset of patients to avoid or delay surgery. (orig.)

  10. Percutaneous transhepatic biliary drainage

    International Nuclear Information System (INIS)

    Park, Jae Hyung; Hong, Seong Mo; Han, Man Chung

    1982-01-01

    Percutaneous transhepatic biliary drainage was successfully made 20 times on 17 patients of obstructive jaundice for recent 1 year since June 1981 at Department of Radiology in Seoul National University Hospital. The causes of obstructive jaundice was CBD Ca in 13 cases, metastasis in 2 cases, pancreatic cancer in 1 case and CBD stone in 1 case. Percutaneous transhepatic biliary drainage is a relatively ease, safe and effective method which can be done after PTC by radiologist. It is expected that percutaneous transhepatic biliary drainage should be done as an essential procedure for transient permanent palliation of obstructive jaundice

  11. Percutaneous dilatational tracheostomy

    DEFF Research Database (Denmark)

    Johnsen, R.

    2015-01-01

    Introduction Since the introduction and development of percutaneous dilatational tracheostomy (PDT), this procedure is accepted and incorporated in ICUs worldwide. In spite of obvious benefits for the patients, who obtain more comfort and mobility and less use of sedatives, the procedure also...... providers' notes are entered. When searching for -percutaneous dilatation tracheostomy' in the electronic system, we found all patients who had undergone this specific procedure. Afterwards we analyzed each of these patients' hospital records, looking for any periprocedure or postprocedure complications...

  12. Percutaneous pin fixation of Gartland Type III supraconylar fractures ...

    African Journals Online (AJOL)

    The remaining three (7.5%) had poor results due to varus deformity that neededcorrective surgery. One case of pin tract infection was recorded. The average hospital stay was 1.2 days. The study confirmed that percutaneous pin fixation is an effective, minimally invasive and safe method of fixation of these difficult fractures ...

  13. CT‑guided percutaneous transthoracic lung biopsy: First experience ...

    African Journals Online (AJOL)

    Percutaneous lung biopsy had been described in the nineteenth century by Leyden, but image- guided needle chest biopsy only gained widespread acceptance in the 1970s. Currently, tissue sampling of a thoracic lesion is indicated when the diagnosis cannot be obtained by the non-invasive techniques and cytological ...

  14. Different facets of market orientation

    DEFF Research Database (Denmark)

    Ormrod, Robert P.; Henneberg, Stephan C.

    2009-01-01

    In this study we employ the concept of political market orientation to better understand how the main political parties in the UK and Germany relate to other stakeholders in the political sphere through an exploratory content analysis of their core election offering, the manifesto. This study has...... two aims: firstly, we will discuss the different facets of the market orientation of the main UK and German parties in their respective 2005 General Elections through an exploratory content analysis, and secondly, we will compare characteristics of market orientation between the two countries. Whilst...... the UK parties generally exhibited similar levels of market orientation on each of the relevant construct dimensions, the German parties had more distinct profiles; thus the applied dimensions of political market orientation show discriminatory power within and across electoral systems. In the UK...

  15. FacetGist: Collective Extraction of Document Facets in Large Technical Corpora

    Science.gov (United States)

    Siddiqui, Tarique; Ren, Xiang; Parameswaran, Aditya; Han, Jiawei

    2017-01-01

    Given the large volume of technical documents available, it is crucial to automatically organize and categorize these documents to be able to understand and extract value from them. Towards this end, we introduce a new research problem called Facet Extraction. Given a collection of technical documents, the goal of Facet Extraction is to automatically label each document with a set of concepts for the key facets (e.g., application, technique, evaluation metrics, and dataset) that people may be interested in. Facet Extraction has numerous applications, including document summarization, literature search, patent search and business intelligence. The major challenge in performing Facet Extraction arises from multiple sources: concept extraction, concept to facet matching, and facet disambiguation. To tackle these challenges, we develop FacetGist, a framework for facet extraction. Facet Extraction involves constructing a graph-based heterogeneous network to capture information available across multiple local sentence-level features, as well as global context features. We then formulate a joint optimization problem, and propose an efficient algorithm for graph-based label propagation to estimate the facet of each concept mention. Experimental results on technical corpora from two domains demonstrate that Facet Extraction can lead to an improvement of over 25% in both precision and recall over competing schemes. PMID:28210517

  16. Infective complication following percutaneous nephrolithotomy

    Directory of Open Access Journals (Sweden)

    Bannakij Lojanapiwat

    2016-03-01

    Full Text Available Percutaneous nephrolithotomy (PCNL is a minimally invasive procedure for patients with large renal and upper ureteric stones. Although it is less invasive than open surgery, infection is still the most common complication arising from this procedure and some patients develop septicemia and septic shock, resulting in increase in mortality and morbidity. The incidence of septic shock following PCNL is 1%; however, its mortality rate is as high as 66–80%. Endourologists who perform this procedure need to know how to prevent and manage this common complication. Large calculi, staghorn calculi, positive pelvic urine and stone culture, prolonged operative time, and diabetes are factors that increase the incidence of postoperative infection. Recently, several studies suggested the importance of intraoperative microbiologic evaluation of factors such as intraoperative pelvic urine and stone cultures for selection of suitable postoperative antibiotics. The selection of prophylactic antibiotics, postoperative antibiotics, and specific PCNL techniques play an important role in preventing infection following PCNL. We reviewed the general background, the factors, and role of intraoperative microbiologic evaluation in the management of post-PCNL infection.

  17. Image-guided facet joint injection.

    Science.gov (United States)

    Peh, Wcg

    2011-01-01

    Chronic spine pain poses a peculiar diagnostic and therapeutic challenge due to multiple pain sources, overlapping clinical features and nonspecific radiological findings. Facet joint injection is an interventional pain management tool for facet-related spinal pain that can be effectively administered by a radiologist. This technique is the gold standard for identifying facet joints as the source of spinal pain. The major indications for facet injections include strong clinical suspicion of the facet syndrome, focal tenderness over the facet joints, low back pain with normal radiological findings, post-laminectomy syndrome with no evidence of arachnoiditis or recurrent disc disease, and persistent low back pain after spinal fusion. The contraindications are more ancillary, with none being absolute. Like any synovial joint degeneration, inflammation and injury can lead to pain on motion, initiating a vicious cycle of physical deconditioning, irritation of facet innervations and muscle spasm. Image-guided injection of local anesthetic and steroid into or around the facet joint aims to break this vicious cycle and thereby provide pain relief. This outpatient procedure has high diagnostic accuracy, safety and reproducibility but the therapeutic outcome is variable.

  18. Utilizing Faceted Structures for Information Systems Design.

    Science.gov (United States)

    Priss, Uta; Jacob, Elin

    1999-01-01

    Suggests that a faceted thesaurus should be used as the basis for organizing a small-scale institutional Web site. Contends that a faceted approach to knowledge organization can make the process of organization less random and more manageable. Reports on an informal survey of three Web sites, underscoring the problems of organization that can…

  19. Assessment of dental anxiety: A facet approach.

    NARCIS (Netherlands)

    Stouthard, M.E.; Mellenbergh, G.J.; Hoogstraten, J.

    1993-01-01

    Used a facet design to construct a new Dental Anxiety Inventory (DAI), which was tested in 5 studies among 1,401 undergraduates and 174 patients. Facets chosen were time (made up of 4 elements: at home, on your way to the dentist, in the dentist's waiting room, in the dental chair), situation (3

  20. Minimally-invasive posterior lumbar stabilization for degenerative low back pain and sciatica. A review

    Energy Technology Data Exchange (ETDEWEB)

    Bonaldi, G., E-mail: bbonaldi@yahoo.com [Neuroradiology Department, Ospedale Papa Giovanni XXIII, Bergamo (Italy); Brembilla, C. [Department of neurosurgery, Ospedale Papa Giovanni XXIII, Bergamo (Italy); Cianfoni, A. [Neuroradiology of Neurocenter of Italian Switzerland, Lugano, CH (Switzerland)

    2015-05-15

    The most diffused surgical techniques for stabilization of the painful degenerated and instable lumbar spine, represented by transpedicular screws and rods instrumentation with or without interbody cages or disk replacements, require widely open and/or difficult and poorly anatomical accesses. However, such surgical techniques and approaches, although still considered “standard of care”, are burdened by high costs, long recovery times and several potential complications. Hence the effort to open new minimally-invasive surgical approaches to eliminate painful abnormal motion. The surgical and radiological communities are exploring, since more than a decade, alternative, minimally-invasive or even percutaneous techniques to fuse and lock an instable lumbar segment. Another promising line of research is represented by the so-called dynamic stabilization (non-fusion or motion preservation back surgery), which aims to provide stabilization to the lumbar spinal units (SUs), while maintaining their mobility and function. Risk of potential complications of traditional fusion methods (infection, CSF leaks, harvest site pain, instrumentation failure) are reduced, particularly transitional disease (i.e., the biomechanical stresses imposed on the adjacent segments, resulting in delayed degenerative changes in adjacent facet joints and discs). Dynamic stabilization modifies the distribution of loads within the SU, moving them away from sensitive (painful) areas of the SU. Basic biomechanics of the SU will be discussed, to clarify the mode of action of the different posterior stabilization devices. Most devices are minimally invasive or percutaneous, thus accessible to radiologists’ interventional practice. Devices will be described, together with indications for patient selection, surgical approaches and possible complications.

  1. The current situation and related problems of percutaneous vertebroplasty in clinical treatment of osteoporosis vertebral compression fracture

    International Nuclear Information System (INIS)

    Wang Luchang; Wu Chungen; Cheng Yongde

    2011-01-01

    As an effective, safe and less-invasive technique in interventional radiology, percutaneous vertebroplasty has satisfactory therapeutic results with fewer complications in treating osteoporosis vertebral compression fracture. This paper aims to make a comprehensive review of the current situation and related problems of percutaneous vertebroplasty in clinical treatment of osteoporosis vertebral compression fracture. (authors)

  2. Facets of the balanced minimal evolution polytope.

    Science.gov (United States)

    Forcey, Stefan; Keefe, Logan; Sands, William

    2016-08-01

    The balanced minimal evolution (BME) method of creating phylogenetic trees can be formulated as a linear programming problem, minimizing an inner product over the vertices of the BME polytope. In this paper we undertake the project of describing the facets of this polytope. We classify and identify the combinatorial structure and geometry (facet inequalities) of all the facets in dimensions up to five, and classify even more facets in all dimensions. A full set of facet inequalities would allow a full implementation of the simplex method for finding the BME tree-although there are reasons to think this an unreachable goal. However, our results provide the crucial first steps for a more likely-to-be-successful program: finding efficient relaxations of the BME polytope.

  3. Lumbar Facet Tropism: A Comprehensive Review.

    Science.gov (United States)

    Alonso, Fernando; Kirkpatrick, Christina M; Jeong, William; Fisahn, Christian; Usman, Sameera; Rustagi, Tarush; Loukas, Marios; Chapman, Jens R; Oskouian, Rod J; Tubbs, R Shane

    2017-06-01

    Scattered reports exist in the medical literature regarding facet tropism. However, this finding has had mixed conclusions regarding its origin and impact on the normal spine. We performed a literature review of the anatomy, embryology, biomechanics, and pathology related to lumbar facet tropism. Facet tropism is most commonly found at L4-L5 vertebral segments and there is some evidence that this condition may lead to facet degenerative spondylolisthesis, intervertebral disc disease, and other degenerative conditions. Long-term analyses of patients are necessary to elucidate relationships between associated findings and facet tropism. In addition, a universally agreed definition that is more precise should be developed for future investigative studies. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Percutaneous transhepatic sphincterotomy

    International Nuclear Information System (INIS)

    Gandin, G.; Zanon, E.; Righi, D.; Fonio, P.; Ferrari, A.; Recchia, S.

    1990-01-01

    The authors describe the techique employed for percutaneous trans-hepatic sphincterotomy as performed on 3 patients with common bile duct (CBD) stones. In all patients, previous endoscopic attempt had failed for anatomical reasons (Billroth II gastric resection or partial gastric resection with brown anastomosis), and the ampulla could not be correctly incannulated with the sphincterotome. In all aptients endoscopy was useful to check the position of the diethermic loop inserted percutaneously. Conplete and immediate success was obtained in all 3 cases. No major complications occurred during transhepatic treatment. To date, 1 recurrence has been observed, and the patient has been retreated with bilioplasty. All patients were followed after 5-6 months with US, plain X-rays of the abdomen and blood tests (γGt, alkaline phosphatase, and bilirubinemia). The authors suggest that percutaneous transhepatic sphincterotomy be employed electively in patients with biliary tree diseases in case the endoscopic approach failes

  5. Percutaneous Penetration - Methodological Considerations

    DEFF Research Database (Denmark)

    Holmgaard, Rikke; Benfeldt, Eva; Nielsen, Jesper B

    2014-01-01

    developed to replace methods involving experimental animals. The results obtained from these methods are decided not only by the chemical or product tested, but to a significant degree also by the experimental set-up and decisions made by the investigator during the planning phase. The present Mini......Studies on percutaneous penetration are needed to assess the hazards after unintended occupational skin exposures to industrial products as well as the efficacy after intended consumer exposure to topically applied medicinal or cosmetic products. During recent decades, a number of methods have been...... and their relevance for the prediction of percutaneous penetration are given. Which method to prefer will depend on the product to be tested and the question asked. Regulatory guidelines exist for studies on percutaneous penetration, but researchers as well as regulatory bodies need to pay specific attention...

  6. Percutaneous intervention in obstructive

    International Nuclear Information System (INIS)

    Souftas, V.

    2012-01-01

    Percutaneous intervention procedures in obstructive uropathy include percutaneous nephrostomy tube placements, nephroureteral stents, percutaneous nephrostomy combined with ureteral embolization, percutaneous management of stone disease, suprapubic tube placements into the bladder, and perinephric/retroperitoneal urinomas/abscesses drainages. Percutaneous nephrostomy is performed to relieve urinary obstruction or divert the urinary stream away from the ureter or bladder. Patients are given preprocedure antibiotics. Percutaneous nephrostomies can be emergent cases because of risk of pyuria and sepsis from a stagnant urine collection. The procedure is performed using both ultrasound and fluoroscopy (or fluoroscopy alone using anatomic landmarks, or an internal radiopaque calculus, or delayed phase excretion of the contrast into the renal collecting system) under local anesthesia or conscious sedation. Ureteral stents are placed to bypass an obstructing stone or to stent across of an area of stricture or ureteral laceration. Stents may be placed by the urologist via a transurethral approach or by the interventional radiologist via a percutaneous approach. The decision as to method of stent placement is based upon the location and accessibility of the ureteral pathology. Ureteral embolization is performed in patients with unresectable tumors of the pelvis with long-standing nephrostomy tubes and distal urine leaks refractory to other treatments. Coils, gelfoam and liquid embolic materials can be used. Ureteral embolization for ureteral fistulas and incontinence is technically successful in 100% of the patients. Complications include bleeding, infection, ureteral or renal injury, and deployment (or movement) of the coils within the renal pelvis. Percutaneous management of stone disease, including renal, ureteral, and bladder stones requires close cooperation between the urologist and interventional radiologist, because of availability of sonographic lithotripsy

  7. [Minimally invasive approach for cervical spondylotic radiculopathy].

    Science.gov (United States)

    Ding, Liang; Sun, Taicun; Huang, Yonghui

    2010-01-01

    To summarize the recent minimally invasive approach for cervical spondylotic radiculopathy (CSR). The recent literature at home and abroad concerning minimally invasive approach for CSR was reviewed and summarized. There were two techniques of minimally invasive approach for CSR at present: percutaneous puncture techniques and endoscopic techniques. The degenerate intervertebral disc was resected or nucleolysis by percutaneous puncture technique if CSR was caused by mild or moderate intervertebral disc herniations. The cervical microendoscopic discectomy and foraminotomy was an effective minimally invasive approach which could provide a clear view. The endoscopy techniques were suitable to treat CSR caused by foraminal osteophytes, lateral disc herniations, local ligamentum flavum thickening and spondylotic foraminal stenosis. The minimally invasive procedure has the advantages of simple handling, minimally invasive and low incidence of complications. But the scope of indications is relatively narrow at present.

  8. Facet orientation and tropism: associations with spondylolysis.

    Science.gov (United States)

    Kalichman, Leonid; Guermazi, Ali; Li, Ling; Hunter, David J; Suri, Pradeep

    2010-04-01

    Cross-sectional study. To evaluate the association between lumbar spine facet joint orientation, facet joint tropism, and spondylolysis identified by multidetector computed tomography (CT) in the community-based Framingham Heart Study. The association between lumbar spondylolysis and facet orientation and tropism remains unclear. This study was an ancillary project to the Framingham Heart Study. Three thousand five hundred twenty-nine participants of the Framingham Heart Study aged 40 to 80 years underwent multidetector CT imaging to assess aortic calcification. One hundred ninety-one subjects were included in this ancillary study. Facet joint features and spondylolysis were evaluated on CT scans. The final analyzed sample included 104 men with mean age 51.90+/-11.25 years and 84 women with mean age 53.61+/-10.20 years. The association between spondylolysis and facet orientation and tropism was examined using univariate and multivariate analyses. Spondylolysis was prevalent in 11.5% of the total population. chi2 test demonstrated a significant sex difference in prevalence of spondylolysis (P=0.0154), with almost 3 times higher prevalence among men. There was no statistically significant difference in facet orientation and continuous facet tropism between individuals with and without spondylolysis at the L5 level (P=0.49 to 0.91). After adjustment for age, sex, and body mass index, no significant association between the occurrence of spondylolysis and facet orientation and tropism was found. In the studied sample the prevalence of facet joint osteoarthritis was significantly higher in individuals with spondylolysis than in those without spondylolysis at both sides of L4-L5 spinal level (P=0.044 at the right side and P=0.003 at the left side) and at left side of L5-S1 level (P=0.038). We did not find an association between facet orientation, facet tropism, and spondylolysis. One of the possible explanations for this is that the high prevalence of facet joint

  9. Percutaneous Zenith endografting for abdominal aortic aneurysms.

    Science.gov (United States)

    Heyer, Kamaldeep S; Resnick, Scott A; Matsumura, Jon S; Amaranto, Daniel; Eskandari, Mark K

    2009-03-01

    A completely percutaneous approach to infrarenal abdominal aortic aneurysm (AAA) endografting has the theoretic benefits of being minimally invasive and more expedient. Our goal was to demonstrate the utility of this approach using a suprarenal fixation device and a suture-mediated closure system. We conducted a single-institution, retrospective review of 14 patients who underwent percutaneous AAA repair with the Zenith device between August 2003 and March 2007. Immediate and delayed access-related outcomes were examined over a mean follow-up of 12.1+/-2.0 months. Mean AAA size was 5.6 cm. Immediate arterial closure and technical success rate was 96% (27/28 vessels). One immediate hemostatic failure required open surgical repair. Over follow-up, one vessel required operative repair for new-onset claudication. No other immediate or delayed complications (thrombosis, pseudoaneurysm, infection, or deep venous thrombosis) were detected. A percutaneous approach for the treatment of AAA has several advantages over femoral artery cutdown but also has its own unique set of risks in the immediate and late postoperative period. Ultimately, the "preclose technique" can be safely applied for the Zenith device despite its large-bore delivery system.

  10. Imaging in percutaneous ablation for atrial fibrillation

    Energy Technology Data Exchange (ETDEWEB)

    Maksimovic, Ruzica [Erasmus Medical Center, Department of Radiology, GD Rotterdam (Netherlands); Institute for Cardiovascular Diseases of the University Medical Center, Belgrade (Czechoslovakia); Dill, Thorsten [Kerckhoff-Heart Center, Department of Cardiology, Bad Nauheim (Germany); Ristic, Arsen D.; Seferovic, Petar M. [Institute for Cardiovascular Diseases of the University Medical Center, Belgrade (Czechoslovakia)

    2006-11-15

    Percutaneous ablation for electrical disconnection of the arrhythmogenic foci using various forms of energy has become a well-established technique for treating atrial fibrillation (AF). Success rate in preventing recurrence of AF episodes is high although associated with a significant incidence of pulmonary vein (PV) stenosis and other rare complications. Clinical workup of AF patients includes imaging before and after ablative treatment using different noninvasive and invasive techniques such as conventional angiography, transoesophageal and intracardiac echocardiography, computed tomography (CT) and magnetic resonance imaging (MRI), which offer different information with variable diagnostic accuracy. Evaluation before percutaneous ablation involves assessment of PVs (PV pattern, branching pattern, orientation and ostial size) to facilitate position and size of catheters and reduce procedure time as well as examining the left atrium (presence of thrombi, dimensions and volumes). Imaging after the percutaneous ablation is important for assessment of overall success of the procedure and revealing potential complications. Therefore, imaging methods enable depiction of PVs and the anatomy of surrounding structures essential for preprocedural management and early detection of PV stenosis and other ablation-related procedures, as well as long-term follow-up of these patients. (orig.)

  11. Method for partially coating laser diode facets

    Science.gov (United States)

    Dholakia, Anil R. (Inventor)

    1990-01-01

    Bars of integral laser diode devices cleaved from a wafer are placed with their p regions abutting and n regions abutting. A thin BeCu mask having alternate openings and strips of the same width as the end facets is used to mask the n region interfaces so that multiple bars can be partially coated over their exposed p regions with a reflective or partial reflective coating. The partial coating permits identification of the emitting facet from the fully coated back facet during a later device mounting procedure.

  12. Percutaneous Transhepatic Cholangiography

    African Journals Online (AJOL)

    1974-03-30

    Mar 30, 1974 ... Percutaneous transhepatic cholangiography can play a major role in expediting the early diagnosis of surgically correctable jaundice. The need for this is emphasised by the fact that in a group of 46 patients the delay between the onset of jaundice and diagnosis ranged from 20 to 90 days. Transhepatic ...

  13. FACET CLASSIFICATIONS OF E-LEARNING TOOLS

    Directory of Open Access Journals (Sweden)

    Olena Yu. Balalaieva

    2013-12-01

    Full Text Available The article deals with the classification of e-learning tools based on the facet method, which suggests the separation of the parallel set of objects into independent classification groups; at the same time it is not assumed rigid classification structure and pre-built finite groups classification groups are formed by a combination of values taken from the relevant facets. An attempt to systematize the existing classification of e-learning tools from the standpoint of classification theory is made for the first time. Modern Ukrainian and foreign facet classifications of e-learning tools are described; their positive and negative features compared to classifications based on a hierarchical method are analyzed. The original author's facet classification of e-learning tools is proposed.

  14. STUDY OF CUSTOMERS’ LOYALTY: DIMENSIONS AND FACETS

    Directory of Open Access Journals (Sweden)

    Claudia BOBÂLCĂ

    2013-06-01

    Full Text Available The purpose of this study is to identify the main aspects investigated in the study of customer loyalty regarding different dimensions and facets of loyalty. Analyzing the academic literature on this subject, we identified two main directions: (a the approachings of loyalty on its dimensions (one, two or four dimensions; (b the approachings of loyalty on its facets (effects. The main facets of loyalty are repatronage intentions, word-of-mouth intentions and buying frequency. Our approach is a theoretical one and we used documentary research. Identifying and analyzing the dimensions and facets of loyalty are important stages for any loyalty program that a company should implement, regardless of its field of activity.

  15. Migration mechanisms of a faceted grain boundary

    Science.gov (United States)

    Hadian, R.; Grabowski, B.; Finnis, M. W.; Neugebauer, J.

    2018-04-01

    We report molecular dynamics simulations and their analysis for a mixed tilt and twist grain boundary vicinal to the Σ 7 symmetric tilt boundary of the type {1 2 3 } in aluminum. When minimized in energy at 0 K , a grain boundary of this type exhibits nanofacets that contain kinks. We observe that at higher temperatures of migration simulations, given extended annealing times, it is energetically favorable for these nanofacets to coalesce into a large terrace-facet structure. Therefore, we initiate the simulations from such a structure and study as a function of applied driving force and temperature how the boundary migrates. We find the migration of a faceted boundary can be described in terms of the flow of steps. The migration is dominated at lower driving force by the collective motion of the steps incorporated in the facet, and at higher driving forces by the step detachment from the terrace-facet junction and propagation of steps across the terraces. The velocity of steps on terraces is faster than their velocity when incorporated in the facet, and very much faster than the velocity of the facet profile itself, which is almost stationary. A simple kinetic Monte Carlo model matches the broad kinematic features revealed by the molecular dynamics. Since the mechanisms seem likely to be very general on kinked grain-boundary planes, the step-flow description is a promising approach to more quantitative modeling of general grain boundaries.

  16. CT guided percutaneous calcaneoplasty: a case of metastatic intra-articular calcaneus fracture.

    Science.gov (United States)

    Kamalian, S; Hirsch, A E; Growney, M L; Raskin, K A; Yoo, A J; Krag, K J; Hirsch, J A

    2009-12-01

    Symptomatic bone metastases to the calcaneus are rare.1 Minimally invasive percutaneous augmentation is an option in the palliative management of patients with metastatic bone disease, and has been commonly used in the setting of vertebral compression fractures.2 Calcaneal augmentation can potentially allow for earlier weight bearing and a shorter period of disability. A case report is presented of percutaneous intra-articular calcaneal fracture augmentation using polymethyl methacrylate.

  17. Percutaneous management of bile duct injury after laparoscopic cholecystectomy

    International Nuclear Information System (INIS)

    Islim, F.; Ors, S.; Salik, A.; Guven, K.; Yanar, F.; Alis, H.

    2012-01-01

    Full text: Introduction: The risk of bile duct injury after laparoscopic cholecystectomy is higher than open cholecystectomy. Objective: To discuss the importance of minimally invasive treatment options in the management of bile duct injuries after laparoscopic cholecystectomy and to present our approach in the management. Materials and methods: Management of 25 patients with symptomatic bile duct injury after laparoscopic cholecystectomy was retrospectively evaluated. Percutaneous collection drainage, endoscopic retrograde cholangiopancreatography (ERCP), percutaneous transhepatic cholangiography (PTC) and percutaneous biliary drainage were performed for the management of the patients. Results: Mean age of the patients (15 women, 10 men) was 55. Either ultrasonography or computed tomography guided percutaneous drainage was performed in 13 patients. 9 of them completely recovered only with percutaneous drainage. In 4 of them ERCP was performed because of high drainage volume. In 9 of the patients with jaundice and high bilirubin levels ERCP was performed as the first option. And 3 patients were reoperated because of acute abdomen signs. ERCP, MRCP and PTC revealed type A in 7, type E2 in 3, type E3 in 3 and type E4 in 1 of the patients according to Strasberg classification. Conclusion: Presenting symptoms of the patients with symptomatic bile duct injury are useful in the determination of the treatment option.

  18. Percutaneous Treatment of Splenic Cystic Echinococcosis: Results of 12 Cases

    Energy Technology Data Exchange (ETDEWEB)

    Akhan, Okan, E-mail: akhano@tr.net; Akkaya, Selçuk, E-mail: selcuk.akkaya85@gmail.com [Hacettepe University, Department of Radiology, School of Medicine (Turkey); Dağoğlu, Merve Gülbiz, E-mail: drmgkartal@gmail.com [Istanbul University, Department of Radiology, Istanbul School of Medicine (Turkey); Akpınar, Burcu, E-mail: burcu-akpinar@yahoo.com [Hacettepe University, Department of Radiology, School of Medicine (Turkey); Erbahçeci, Aysun, E-mail: aysunerbahceci@yahoo.com [Istanbul Bakirkoy Dr. Sadi Konuk Education and Research Hospital, Department of Radiology (Turkey); Çiftçi, Türkmen, E-mail: turkmenciftci@yahoo.com [Hacettepe University, Department of Radiology, School of Medicine (Turkey); Köroğlu, Mert, E-mail: mertkoroglu@hotmail.com [Antalya Education and Research Hospital, Department of Radiology (Turkey); Akıncı, Devrim, E-mail: akincid@hotmail.com [Hacettepe University, Department of Radiology, School of Medicine (Turkey)

    2016-03-15

    PurposeCystic echinococcosis (CE) in the spleen is a rare disease even in endemic regions. The aim of this study was to examine the efficacy of percutaneous treatment for splenic CE.Materials and MethodsTwelve patients (four men, eight women) with splenic CE were included in this study. For percutaneous treatment, CE1 and CE3A splenic hydatid cysts were treated with either the PAIR (puncture, aspiration, injection, respiration) technique or the catheterization technique.ResultsEight of the hydatid cysts were treated with the PAIR technique and four were treated with catheterization. The volume of all cysts decreased significantly during the follow-up period. No complication occurred in seven of 12 patients. Abscess developed in four patients. Two patients underwent splenectomy due to cavity infection developed after percutaneous treatment, while the spleen was preserved in 10 of 12 patients. Total hospital stay was between 1 and 18 days. Hospital stay was longer and the rate of infection was higher in the catheterization group. Follow-up period was 5–117 months (mean, 44.8 months), with no recurrence observed.ConclusionThe advantages of the percutaneous treatment are its minimal invasive nature, short hospitalization duration, and its ability to preserve splenic tissue and function. As the catheterization technique is associated with higher abscess risk, we suggest that the PAIR procedure should be the first percutaneous treatment option for splenic CE.

  19. Percutaneous lumbar discectomy

    International Nuclear Information System (INIS)

    Xiao Chengjiang; Su Huanbin; Xu Sui; He Xiaofeng; Li Yanhao

    2004-01-01

    Objective: To probe the therapeutic effects, indications and safety of the percutaneous lumbar discectomy (PLDP). Methods: To ameliorate percutaneous punctured route based on classic PLD and modified jaw structure of pulpiform nacleus forceps, with statistic analysis of the therapeutic results of 352 cases of patient undergone PLDP and follow up ranging from 6 to 38 months retrospectively. Results: The effective ratios were excellent in 45.5%, good for 45.4% and bad in 9.1%. 44 of 352 cases with pulps prolapse were cured. No intervertebral inflammation and paradisc hematoma took place. One case complicated with cauda equina injury and 4 cases with appliances broken inside the disc. Conclusions: PLDP is effective and safe, not only adaptive to the contained disc herniation, but also for noncontained herniation. (authors)

  20. Percutaneous treatment of calcaneus fractures associated with underlying bone cysts.

    Science.gov (United States)

    Chen, Linwei; Zhang, Guoyou; Li, Shi; Wu, Zhipeng; Yuan, Wen; Hong, Jianjun

    2012-05-01

    Calcaneal bone cysts with pathological fractures are rare. There is no clear consensus on their management with a few reports of open curettage, bone grafting and internal fixation in the treatment of pathological calcaneal fractures. No minimally invasive management has been reported before. We reviewed our experience in treating five patients with pathologic calcaneus fractures associated with pre-existing bone cysts who underwent percutaneous cyst curettage, fracture reduction, screw fixation and calcium sulfate cement injection between 2004 and 2009. All of the pathologic fractures healed with satisfactory radiological results. There were no soft tissue complications or cyst recurrences. Partial weightbearing with plaster cast immobilization was allowed at 4 weeks postoperatively and full weightbearing was allowed at 6 weeks postoperatively. This percutaneous technique provided a minimally invasive option for treatment of a calcaneal bone cyst with pathologic fracture.

  1. Mindfulness facets and Big Five personality facets in persons with recurrent depression in remission

    NARCIS (Netherlands)

    Spinhoven, Philip; Huijbers, Marloes J.; Zheng, Yixia; Ormel, Johan; Speckens, Anne E. M.

    2017-01-01

    Studies examining mindfulness in relation to personality traits have been mainly conducted in non-clinical samples and resulted in mixed findings. The present cross-sectional study examined which mindfulness facets are most strongly associated with Big Five personality domains and facets implicated

  2. Cervical facet joint dysfunction: a review.

    Science.gov (United States)

    Kirpalani, Dhiruj; Mitra, Raj

    2008-04-01

    To review the relevant literature on cervical facet joint dysfunction and determine findings regarding its anatomy, etiology, prevalence, clinical features, diagnosis, and treatment. A computer-aided search of several databases was performed, including Medline (1966 to present), Ovid (1966 to present), and the Cochrane database (1993 to present). Selected articles had the following criteria: (1) all articles analyzed cervical facet joint pain-anatomy, prevalence, etiology, diagnosis, treatment; (2) only full, published articles were studied, not abstracts; and (3) all articles were published in English. All articles were critically evaluated and included the following categories: randomized controlled trials, meta-analyses, uncontrolled clinical trials, uncontrolled comparison studies, nonquantitative systematic reviews, and literature-based reviews. We examined 45 references that consisted of 44 journal articles and relevant sections from 1 textbook. Cervical facet joints have been well established in the literature as a common nociceptive pain generator, with an estimated prevalence that ranges from 25% to 66% of chronic axial neck pain. No studies have reported clinical examination findings that are diagnostic for cervical facet mediated pain. Overall the literature provides very limited information regarding the treatment of this condition, with only radiofrequency neurotomy showing evidence of effectively reducing pain from cervical facet joint dysfunction.

  3. Facets of Conscientiousness and risk of dementia.

    Science.gov (United States)

    Sutin, A R; Stephan, Y; Terracciano, A

    2017-09-06

    Multiple studies have found Conscientiousness to be protective against dementia. The purpose of this study is to identify which specific aspects, or facets, of Conscientiousness are most protective against cognitive impairment and whether these associations are moderated by demographic factors and/or genetic risk. Health and Retirement Study participants were selected for analysis if they completed the facets of Conscientiousness measure, scored in the range of normal cognitive functioning at the baseline personality assessment, and had at least one follow-up assessment of cognition over the up to 6-year follow-up (N = 11 181). Cox regression was used to test for risk of incident dementia and risk of incident cognitive impairment not dementia (CIND). Over the follow-up, 278 participants developed dementia and 2186 participants developed CIND. The facet of responsibility had the strongest and most consistent association with dementia risk: every standard deviation increase in this facet was associated with a nearly 35% decreased risk of dementia; self-control and industriousness were also protective. Associations were generally similar when controlling for clinical, behavioral, and genetic risk factors. These three facets were also independent predictors of decreased risk of CIND. The present research indicates that individuals who see themselves as responsible, able to control their behavior, and hard workers are less likely to develop CIND or dementia and that these associations persist after accounting for some common clinical, behavioral, and genetic risk factors.

  4. CT-Guided Percutaneous Biopsy of Intrathoracic Lesions

    Energy Technology Data Exchange (ETDEWEB)

    Lai, Hira; Neyaz, Zafar; Nath, Alok; Borah, Samudra [Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow (India)

    2012-03-15

    Percutaneous CT-guided needle biopsy of mediastinal and pulmonary lesions is a minimally invasive approach for obtaining tissue for histopathological examination. Although it is a widely accepted procedure with relatively few complications, precise planning and detailed knowledge of various aspects of the biopsy procedure is mandatory to avert complications. In this pictorial review, we reviewed important anatomical approaches, technical aspects of the procedure, and its associated complications.

  5. Percutaneous Transhepatic Cholangiography | Goldin | South ...

    African Journals Online (AJOL)

    Percutaneous Transhepatic Cholangiography. AR Goldin, EM Bass. Abstract. Our experience with percutaneous transhepatic cholangiography in 46 cases is presented and compared with other series. The technique is safe, simple and accurate and can play a major role in the early diagnosis of obstructive jaundice.

  6. [PERCUTANEOUS ENCOSCOPIC GASTROSTOMY

    Science.gov (United States)

    Tagle A, Martín

    1998-01-01

    Percutaneous endoscopic gastrostomy is an increasingly utilized method of enteral nutrition in patients who for a variety of reasons, are unable to swallow or possess a high risk of aspiration. This method has replaced both surgical gastrostomy and the prolonged used of nasogastric tubes since its creation, in 1980. The most frequent indications are severe neurological diseases such as cerebrovascular accidents, Parkinson's, multiple sclerosis and other processes such as severe trauma, multi-infarct dementia or diverse head and neck tumors. The procedure involves the performance of an upper endoscopy in the usual manner, followed by an insertion of a plastic catheter percutaneously in the area of maximum contact between the gastric and abdominal walls, under direct endoscopic view. Then, a guidewire is introduced through the lumen of the catheter and is enlaced by a polypectomy snare passed through the working channel of the endoscope, utilizing the guidewire to tie the distal portion of the feeding tube, which will be pulled to its final position. The complications associated to this procedure are minimal, most of them related to the endoscopy itself, like reactions to sedation, aspiration of oropharyngeal secretions, etc. There is also a possibility of local infection at the insertion site, perforation of the colon and excessive leaking of gastric contents around the tube, and for these reasons the procedure should only be performed by trained physicians, familiarized with the management of these events. The goal of this review is to illustrate the reader about the indications, contral indications, complications and general considerations in the patients who will have a percutaneous endoscopic gastrostomy.

  7. Orthopedic surgical analyzer for percutaneous vertebroplasty

    Science.gov (United States)

    Tack, Gye Rae; Choi, Hyung Guen; Lim, Do H.; Lee, Sung J.

    2001-05-01

    Since the spine is one of the most complex joint structures in the human body, its surgical treatment requires careful planning and high degree of precision to avoid any unwanted neurological compromises. In addition, comprehensive biomechanical analysis can be very helpful because the spine is subject to a variety of load. In case for the osteoporotic spine in which the structural integrity has been compromised, it brings out the double challenges for a surgeon both clinically and biomechanically. Thus, we have been developing an integrated medical image system that is capable of doing the both. This system is called orthopedic surgical analyzer and it combines the clinical results from image-guided examination and the biomechanical data from finite element analysis. In order to demonstrate its feasibility, this system was applied to percutaneous vertebroplasty. Percutaneous vertebroplasty is a surgical procedure that has been recently introduced for the treatment of compression fracture of the osteoporotic vertebrae. It involves puncturing vertebrae and filling with polymethylmethacrylate (PMMA). Recent studies have shown that the procedure could provide structural reinforcement for the osteoporotic vertebrae while being minimally invasive and safe with immediate pain relief. However, treatment failures due to excessive PMMA volume injection have been reported as one of complications. It is believed that control of PMMA volume is one of the most critical factors that can reduce the incidence of complications. Since the degree of the osteoporosis can influence the porosity of the cancellous bone in the vertebral body, the injection volume can be different from patient to patient. In this study, the optimal volume of PMMA injection for vertebroplasty was predicted based on the image analysis of a given patient. In addition, biomechanical effects due to the changes in PMMA volume and bone mineral density (BMD) level were investigated by constructing clinically

  8. Alignment and focus of mirrored facets of a heliosat

    Science.gov (United States)

    Yellowhair, Julius E; Ho, Clifford Kuofei; Diver, Richard B; Moss, Timothy A

    2013-11-12

    Various technologies pertaining to aligning and focusing mirrored facets of a heliostat are described herein. Updating alignment and/or focus of mirrored facets is undertaken through generation of a theoretical image, wherein the theoretical image is indicative of a reflection of the target via the mirrored facets when the mirrored facets are properly aligned. This theoretical image includes reference points that are overlaid on an image of the target as reflected by the mirrored facets of the heliostat. A technician adjusts alignment/focus of a mirrored facet by causing reflected reference markings to become aligned with the reference points in the theoretical image.

  9. Complications of Percutaneous Nephrolithotomy and their Management

    Directory of Open Access Journals (Sweden)

    Neeraj Thapa

    2016-11-01

    Full Text Available Introduction: Increasing global prevalence of nephrolithiasis has resulted in the development of new minimally invasive techniques and has also led to the resurgence of established methods such as percutaneous nephrolithotomy (PCNL. This procedure is now recommended as the first option for the treatment of single large or multiple renal stones and those in the inferior calyx. This study was done to assess the complications of PCNL and their management, in our centre. Methods: Medical records of 144 patients who underwent PCNL at Lumbini Medical College Teaching Hospital, during the last one year were reviewed. The demographic data, size, tract number and location of the calculi, and intraoperative and postoperative complications were evaluated. The various parameters of the calculi were evaluated. Descriptive analysis with frequencies was done. Results: Complications occurred in 13 (9.02% patients. Post operative bleeding occurred in seven (4.8% patients, out of which one patient developed pseudoaneurysms and the other developed arteriovenous fistula. One patient developed hypovolemic shock immediately after surgery. Frequent blockage of urine, excessive drainage of urine from the drain site, hemothorax and colonic perforation was seen in one  patient each. One patient had mortality due to post operative bleeding. Complications increased with the number and size of stones and number and site of the tracts. Conclusion: Percutaneous nephrolithotomy has low complication rate in experienced hands and complications depend upon stone size, history of open stone surgery, tract number, and tract location.

  10. [Ultrasound guided percutaneous nephrolithotripsy].

    Science.gov (United States)

    Guliev, B G

    2014-01-01

    The study was aimed to the evaluation of the effectiveness and results of ultrasound guided percutaneous nephrolithotripsy (PNL) for the treatment of patients with large stones in renal pelvis. The results of PNL in 138 patients who underwent surgery for kidney stones from 2011 to 2013 were analyzed. Seventy patients (Group 1) underwent surgery with combined ultrasound and radiological guidance, and 68 patients (Group 2)--only with ultrasound guidance. The study included patients with large renal pelvic stones larger than 2.2 cm, requiring the formation of a single laparoscopic approach. Using the comparative analysis, the timing of surgery, the number of intra- and postoperative complications, blood loss and length of stay were evaluated. Percutaneous access was successfully performed in all patients. Postoperative complications (exacerbation of chronic pyelonephritis, gross hematuria) were observed in 14.3% of patients in Group 1 and in 14.7% of patients in Group 2. Bleeding requiring blood transfusion, and injuries of adjacent organs were not registered. Efficacy of PNL in the Group 1 was 95.7%; 3 (4.3%) patients required additional interventions. In Group 2, the effectiveness of PNL was 94.1%, 4 (5.9%) patients additionally underwent extracorporeal lithotripsy. There were no significant differences in the effectiveness of PNL, the volume of blood loss and duration of hospitalization. Ultrasound guided PNL can be performed in large pelvic stones and sufficient expansion of renal cavities, thus reducing radiation exposure of patients and medical staff.

  11. Synthesis of ZnWO{sub 4} Electrode with tailored facets: Deactivating the Microorganisms through Photoelectrocatalytic methods

    Energy Technology Data Exchange (ETDEWEB)

    Zhan, Su [Department of Materials Science and Engineering, Dalian Maritime University, Dalian 116026 (China); Zhou, Feng, E-mail: zhoufeng99@mails.tsinghua.edu.cn [Department of Materials Science and Engineering, Dalian Maritime University, Dalian 116026 (China); Huang, Naibao; Liu, Yujun; He, Qiuchen; Tian, Yu; Yang, Yifan [Department of Materials Science and Engineering, Dalian Maritime University, Dalian 116026 (China); Ye, Fei [Department of Materials Science and Engineering, Dalian University of Technology, Dalian 116026 (China)

    2017-01-01

    Highlights: • ZnWO{sub 4} with different exposed facets was synthesized by the hydrothermal method. • The reactive facets were tailored by varying the solution pH. • The photoelectrocatalysis was more efficient in deactivating the microorganism. - Abstract: The exotic invasive species from the ballast water in the ship will bring about serious damages to ecosystem. Photocatalyst films have been widely studied for sterilization. In this study, ZnWO{sub 4} with different exposed facets was synthesized by hydrothermal method, and ZnWO{sub 4} film electrodes have been applied in ballast water treatment through the electro-assisted photocatalytic system. Then the samples were investigated by X-ray diffraction (XRD), X-ray photo-electron spectroscopy (XPS), Field emission on scanning electron microcopy (FE-SEM), Transmission electron microscopy (TEM), UV–vis diffuse reflectance spectroscopy (DRS), BET specific surface area analysis, Fourier transform infrared (FT-IR) and Electrochemical impedance spectra (EIS). ZnWO{sub 4} with an appropriate exposure of (0 1 1) facets ratio exhibited the best photocatalytic and photoelectrocatalytic activities. The microorganisms deactivated completely in 10 min by ZnWO{sub 4} films with 3 V bias. The mechanisms of (0 1 1) facets enhanced the photocatalytic and photoelectrocatalytic activities which were deduced based on the calculated result from the first principles. Simultaneously, appropriate exposed facets and applied bias could reduce the recombination of the photogenerated electron-hole pairs, and improve the photocatalytic activities of ZnWO{sub 4}.

  12. Percutaneous tibial nerve stimulation for fecal incontinence: a video demonstration.

    Science.gov (United States)

    Hotouras, Alexander; Allison, Marion; Currie, Ann; Knowles, Charles H; Chan, Christopher L; Thaha, Mohamed A

    2012-06-01

    Fecal incontinence is an increasingly common condition with significant negative impact on quality on life and health care resources. It frequently presents a therapeutic challenge to clinicians. Emerging evidence suggests that percutaneous tibial nerve stimulation is an effective treatment for fecal incontinence with the added benefit of being minimally invasive and cost effective. Pursuant to the preliminary report of our early experience of percutaneous tibial nerve stimulation in patients with fecal incontinence published in this journal in 2010, in this dynamic article, we now describe and demonstrate the actual technique that can be performed in a nurse-led clinic or outpatient or community setting. Percutaneous tibial nerve stimulation is a technically simple procedure that can potentially be performed in an outpatient or community setting. The overall early success rate of 68% following its use reported by our unit compares favorably with the success rate following other forms of neuromodulation, including sacral nerve stimulation. When completed, our long-term outcome data will provide further information on the efficacy of tibial nerve stimulation in a larger cohort of patients (n > 100). Future studies, including our currently planned randomized controlled trial of percutaneous tibial nerve stimulation vs sham stimulation, will provide controlled efficacy data and may provide information on its exact mechanism of action.

  13. Percutaneous cementoplasty of lytic metastasis in left acetabulum.

    Science.gov (United States)

    Harris, K; Pugash, R; David, E; Yee, A; Sinclair, E; Myers, J; Chow, E

    2007-02-01

    Minimally invasive procedures such as percutaneous cementoplasty can provide immediate pain relief and can restore mechanical stability for patients with bone metastases who are not candidates for surgery or who show resistance to radiotherapy or analgesic treatment. Here, we examine a case of percutaneous cementoplasty to treat a lytic lesion of the acetabulum from breast cancer. Good filling was observed, and no complications occurred. A research assistant recorded the patient's scores on the Karnofsky Performance Scale, Townsend Functional Assessment Scale, and Brief Pain Inventory before surgery and at days 1, 2, and 4 and weeks 1, 2, and 4 post-procedure. Improvement in pain and walking ability was demonstrated within the first 48 hours of treatment, and that improvement remained constant throughout follow-up. These findings echo the literature, in that percutaneous cementoplasty provides immediate and long-term pain relief with few complications. We recommend that percutaneous cementoplasty be used as an additional tool for palliative treatment of patients with bone metastases.

  14. Percutaneous Plating of Weber B Fibular Fractures.

    Science.gov (United States)

    Saxena, Amol; Yun, Andrew

    The purpose of the present study was to describe a minimally invasive percutaneous technique for plating Weber B distal fibular fractures and to evaluate its efficacy by measuring patient outcomes and hardware removal rates. The data from 17 patients undergoing percutaneous plating of a distal fibular (Weber B) fracture were prospectively studied. A 4- to 6-hole semitubular plate with 3 screws was used for percutaneously plating. The Roles and Maudsley score was used to assess the patients' activity level. All fibular fractures had healed clinically and radiographically by 8 weeks after surgery. The postoperative Roles and Maudsley scores had improved significantly. The time required to return to activity was 4.3 ± 2.0 months. Hardware removal was required in 3 patients during the study period, which had an average of almost 4 years postoperatively. The results of the present study have demonstrated that percutaneous plating is an effective surgical option for treating Weber B distal fibular fractures. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  15. Faceting of curved surfaces using the curvature coordinate system

    DEFF Research Database (Denmark)

    Almegaard, Henrik

    2008-01-01

    In many situations, a curved surface has to be approximated by a facetted surface, i.e., as a network with planar meshes. Most often this is done by triangulation of the surface. Points are chosen on the surface and the points are connected by straight lines so that these lines make a network...... this is by tangent faceting. Tangent points are chosen on the surface and the tangent planes at these points are connected along lines of intersection so that these lines make a network with planar meshes and so that no normal to the curved surface intersect more than one facet. The result is a faceted surface...... of triangular meshes and so that no normal to the curved surface intersect more than one mesh/facet. The result is a faceted surface, with vertices, edges and triangular facets. But faceting a curved surface can also be done using planes as the basic geometrical element instead of points. One way of doing...

  16. Vacuum facet phenomenon: a computed tomographic sign of degenerative spondylolisthesis

    Energy Technology Data Exchange (ETDEWEB)

    Lefkowitz, D.M.; Quencer, D.M.

    1982-08-01

    A vacuum facet phenomenon, seen on computed tomography as a lens-shaped lucency within a lumbar facet joint, was observed as a consequence of degenerative spondylolisthesis. The significance of this finding is discussed.

  17. Results from Plasma Wakefield Experiments at FACET

    Energy Technology Data Exchange (ETDEWEB)

    Li, S.Z.; Clarke, C.I.; England, R.J.; Frederico, J.; Gessner, S.J.; Hogan, M.J.; Jobe, R.K.; Litos, M.D.; Walz, D.R.; /SLAC; Muggli, P.; /Munich, Max Planck Inst.; An, W.; Clayton, C.E.; Joshi, C.; Lu, W.; Marsh, K.A.; Mori, W.; Tochitsky, S.; /UCLA; Adli, E.; /U. Oslo

    2011-12-13

    We report initial results of the Plasma Wakefield Acceleration (PWFA) Experiments performed at FACET - Facility for Advanced aCcelertor Experimental Tests at SLAC National Accelerator Laboratory. At FACET a 23 GeV electron beam with 1.8 x 10{sup 10} electrons is compressed to 20 {mu}m longitudinally and focused down to 10 {mu}m x 10 {mu}m transverse spot size for user driven experiments. Construction of the FACET facility completed in May 2011 with a first run of user assisted commissioning throughout the summer. The first PWFA experiments will use single electron bunches combined with a high density lithium plasma to produce accelerating gradients > 10 GeV/m benchmarking the FACET beam and the newly installed experimental hardware. Future plans for further study of plasma wakefield acceleration will be reviewed. The experimental hardware and operation of the plasma heat-pipe oven have been successfully commissioned. Plasma wakefield acceleration was not observed because the electron bunch density was insufficient to ionize the lithium vapor. The remaining commissioning time in summer 2011 will be dedicated to delivering the FACET design parameters for the experimental programs which will begin in early 2012. PWFA experiments require the shorter bunches and smaller transverse sizes to create the plasma and drive large amplitude wakefields. Low emittance and high energy will minimize head erosion which was found to be a limiting factor in acceleration distance and energy gain. We will run the PWFA experiments with the design single bunch conditions in early 2012. Future PWFA experiments at FACET are discussed in [5][6] and include drive and witness bunch production for high energy beam manipulation, ramped bunch to optimize tranformer ratio, field-ionized cesium plasma, preionized plasmas, positron acceleration, etc.. We will install a notch collimator for two-bunch operation as well as new beam diagnostics such as the X-band TCAV [7] to resolve the two bunches

  18. Synthesis of ZnWO4 Electrode with tailored facets: Deactivating the Microorganisms through Photoelectrocatalytic methods

    Science.gov (United States)

    Zhan, Su; Zhou, Feng; Huang, Naibao; Liu, Yujun; He, Qiuchen; Tian, Yu; Yang, Yifan; Ye, Fei

    2017-01-01

    The exotic invasive species from the ballast water in the ship will bring about serious damages to ecosystem. Photocatalyst films have been widely studied for sterilization. In this study, ZnWO4 with different exposed facets was synthesized by hydrothermal method, and ZnWO4 film electrodes have been applied in ballast water treatment through the electro-assisted photocatalytic system. Then the samples were investigated by X-ray diffraction (XRD), X-ray photo-electron spectroscopy (XPS), Field emission on scanning electron microcopy (FE-SEM), Transmission electron microscopy (TEM), UV-vis diffuse reflectance spectroscopy (DRS), BET specific surface area analysis, Fourier transform infrared (FT-IR) and Electrochemical impedance spectra (EIS). ZnWO4 with an appropriate exposure of (0 1 1) facets ratio exhibited the best photocatalytic and photoelectrocatalytic activities. The microorganisms deactivated completely in 10 min by ZnWO4 films with 3 V bias. The mechanisms of (0 1 1) facets enhanced the photocatalytic and photoelectrocatalytic activities which were deduced based on the calculated result from the first principles. Simultaneously, appropriate exposed facets and applied bias could reduce the recombination of the photogenerated electron-hole pairs, and improve the photocatalytic activities of ZnWO4.

  19. /facet: A browser for heterogeneous semantic web repositories

    NARCIS (Netherlands)

    M. Hildebrand (Michiel); J.R. van Ossenbruggen (Jacco); L. Hardman (Lynda)

    2006-01-01

    textabstractFacet browsing has become popular as a user friendly interface to data repositories. We extend facet browsing of Semantic Web data in four ways. First, users are able to select and navigate through facets of resources of any type and to make selections based on properties of other,

  20. Percutaneous Method of Management of Simple Bone Cyst

    Directory of Open Access Journals (Sweden)

    O. P. Lakhwani

    2013-01-01

    Full Text Available Introduction. Simple bone cyst or unicameral bone cysts are benign osteolytic lesions seen in metadiaphysis of long bones in growing children. Various treatment modalities with variable outcomes have been described in the literature. The case report illustrates the surgical technique of minimally invasive method of treatment. Case Study. A 14-year-old boy was diagnosed as active simple bone cyst proximal humerus with pathological fracture. The patient was treated by minimally invasive percutaneous curettage with titanium elastic nail (TENS and allogenic bone grafting mixed with bone marrow under image intensifier guidance. Results. Pathological fracture was healed and allograft filled in the cavity was well taken up. The patient achieved full range of motion with successful outcome. Conclusion. Minimally invasive percutaneous method using elastic intramedullary nail gives benefit of curettage cyst decompression and stabilization of fracture. Allogenic bone graft fills the cavity and healing of lesion by osteointegration. This method may be considered with advantage of minimally invasive technique in treatment of benign cystic lesions of bone, and the level of evidence was therapeutic level V.

  1. Percutaneous transpedicular management of discitis.

    Science.gov (United States)

    Arya, S; Crow, W N; Hadjipaviou, A G; Nauta, H J; Borowski, A M; Vierra, L A; Walser, E

    1996-01-01

    To present the technique of percutaneous transpedicular biopsy and debridement of discs in diagnosis and management of discitis. Fifteen patients underwent disc biopsy through a transpedicular approach with local anesthesia and fluoroscopic guidance. An attempt was made to debride the disc as much as possible. A surgical vacuum drain was deployed through the transpedicular tract when there was persistent drainage. Fifteen patients underwent percutaneous transpedicular disc biopsy and debridement of disc for suspected discitis. Three patients underwent biopsy only and 12 underwent percutaneous discectomy. Six patients had at least one positive culture. Eight patients who underwent discectomy had immediate improvement of pain or neurologic symptoms, obviating emergency surgical debridement of the disc. Four patients did not improve and underwent surgical debridement and fusion. Transpedicular biopsy of the disc is an effective technique for adequate tissue retrieval and diagnosis of discitis. Adequate debridement in selected patients with antibiotic therapy may be definitive. Epidural extension of discitis and massive vertebral destruction precludes percutaneous treatment.

  2. Percutaneously inserted central catheter - infants

    Science.gov (United States)

    PICC - infants; PQC - infants; Pic line - infants; Per-Q cath - infants ... A percutaneously inserted central catheter (PICC) is a long, very thin, soft plastic tube that is put into a small blood vessel. This article addresses PICCs in ...

  3. Percutaneous Nephrolithotomy in Children

    Directory of Open Access Journals (Sweden)

    Romano T. DeMarco

    2011-01-01

    Full Text Available The surgical management of pediatric stone disease has evolved significantly over the last three decades. Prior to the introduction of shockwave lithotripsy (SWL in the 1980s, open lithotomy was the lone therapy for children with upper tract calculi. Since then, SWL has been the procedure of choice in most pediatric centers for children with large renal calculi. While other therapies such as percutaneous nephrolithotomy (PNL were also being advanced around the same time, PNL was generally seen as a suitable therapy in adults because of the concerns for damage in the developing kidney. However, recent advances in endoscopic instrumentation and renal access techniques have led to an increase in its use in the pediatric population, particularly in those children with large upper tract stones. This paper is a review of the literature focusing on the indications, techniques, results, and complications of PNL in children with renal calculi.

  4. Percutaneous bone tumor management.

    Science.gov (United States)

    Gangi, Afshin; Buy, Xavier

    2010-06-01

    Interventional radiology plays a major role in the management of bone tumors. Many different percutaneous techniques are available. Some aim to treat pain and consolidate a pathological bone (cementoplasty); others aim to ablate tumor or reduce its volume (sclerotherapy, thermal ablation). In this article, image-guided techniques of primary and secondary bone tumors with vertebroplasty, ethanol injection, radiofrequency ablation, laser photocoagulation, cryoablation, and radiofrequency ionization (coblation) will be reviewed. For each modality, the principles, the indications, and the results will be presented. The technical choice depends on the therapeutic intent-curative or palliative-and the need for consolidation, but also on the general status of the patient and the other therapeutic options. For the most complex cases, combined treatments can be required. However, the less disabling technique should always be considered first.

  5. Nonradiative Step Facets in Semiconductor Nanowires.

    Science.gov (United States)

    Sanchez, Ana M; Zhang, Yunyan; Tait, Edward W; Hine, Nicholas D M; Liu, Huiyun; Beanland, Richard

    2017-04-12

    One of the main advantages of nanowires for functional applications is their high perfection, which results from surface image forces that act on line defects such as dislocations, rendering them unstable and driving them out of the crystal. Here we show that there is a class of step facets that are stable in nanowires, with no long-range strain field or dislocation character. In zinc-blende semiconductors, they take the form of Σ3 (112) facets with heights constrained to be a multiple of three {111} monolayers. Density functional theory calculations show that they act as nonradiative recombination centers and have deleterious effects on nanowire properties. We present experimental observations of these defects on twin boundaries and twins that terminate inside GaAsP nanowires and find that they are indeed always multiples of three monolayers in height. Strategies to use the three-monolayer rule during growth to prevent their formation are discussed.

  6. Outcome of Percutaneous Nephrolithotomy

    International Nuclear Information System (INIS)

    Ali, S.; Kumar, N.; Baloch, U.

    2014-01-01

    Objective: To assess the implementation of Percutaneous Nephrolithotomy (PCNL) in renal stone management and evaluate the factors for efficacy and safety of PCNL. Study Design: Case series. Place and Duration of Study: Department of Urology at Jinnah Postgraduate Medical Centre, Karachi, from January 2008 to December 2011. Methodology: Patients aged above 12 years of age, irrespective of gender with normal renal function, mean stone size > 2 cm, lower pole stones > 1 cm, and ESWL failure were selected. After the procedure, on the first postoperative day, a plain abdominal radiograph was obtained to verify stone clearance. A nephrostomy tube was clamped overnight and subsequently removed when no residual stone which needs second sitting was seen. Results: In 175 patients, 62.86% (n=110) were male and the mean age was 35 A +- 9.56 years. One hundred and seventeen (66.85%) patients were primarily stone free and 13.71% (n=24) patients needed a second look procedure, thus, a total of 80.57% (n=141) patients were stone free in the same admission. Complications included failure in 4.0% (n=7) patients, bleeding in 8.57% (n=15) patients, a small residual stone in 15.43% (n=27) patients; and puncture site pain almost in every patient. Transient fever occurred in 55.43% (n=97) patients, urinary leakage in 8.57% (n=15) patients, urinary tract infections in 5.14% (n=9) patients, ureteric colic in 3.43% (n=6) patients, colonic injury in 0.57% (n=1) patient; and nephrectomy was required in 0.57% (n=1) patient due to severe bleeding. One patient (0.57%) expired due to anaesthesia complications. Conclusion: Percutaneous nephrolithotomy (PCNL) has a good success rate. There is minimal blood loss, and few major complications. (author)

  7. Results of percutaneous abscess drainage

    International Nuclear Information System (INIS)

    Daehnert, W.; Guenther, R.; Klose, K.; Gamstaetter, G.

    1983-01-01

    Between 1978 and 1983 fifty-two abdominal abscesses in 44 patients were drained percutaneously, 79% of the abscesses occurred as postoperative complications. The overall success rate was 60%, whereas only 42% of left subphrenic abscesses were cured. Complications were encountered in 4.5%. Reasons for drainage failures were: liver sequestration, loculation, fistulae and recurrences. Percutaneous abscess drainage in an alternative, and valuable addition, to surgery. (orig.) [de

  8. Rhetorical facets of imagination in contemporary poetry

    OpenAIRE

    Hassan Delbari; Fariba Mehri

    2015-01-01

    Abstract The present article deals with the trend of literary imaginative descriptions in the purview of poetical imaginations which have been regarded greatly in the discourse of rhetoricâs. The different facets of imagination of these imageries are also introduced in this article. Throughout this study poetical demonstrations are dealt with on the basis of their indications, functions and profundity. Meanwhile overcoming superficial and intermediate layers of imagination towards inner and ...

  9. Studying the various facets of emotional aging

    OpenAIRE

    Ebner, Natalie C.; Fischer, Håkan

    2014-01-01

    To study emotional aging is to study a very multi-faceted concept. In particular, the study of emotion and aging covers a wide range of topics. Taking a closer look, domains of functioning can be differentiated such as pertaining to the experiential nature of emotion or its regulation, as well as social-cognitive processes associated with the perception of emotion in others or emotion-related attention and memory retrieval. Importantly, evidence over the last two decades suggests that not all...

  10. Plasma wakefield acceleration experiments at FACET II

    Science.gov (United States)

    Joshi, C.; Adli, E.; An, W.; Clayton, C. E.; Corde, S.; Gessner, S.; Hogan, M. J.; Litos, M.; Lu, W.; Marsh, K. A.; Mori, W. B.; Vafaei-Najafabadi, N.; O'shea, B.; Xu, Xinlu; White, G.; Yakimenko, V.

    2018-03-01

    During the past two decades of research, the ultra-relativistic beam-driven plasma wakefield accelerator (PWFA) concept has achieved many significant milestones. These include the demonstration of ultra-high gradient acceleration of electrons over meter-scale plasma accelerator structures, efficient acceleration of a narrow energy spread electron bunch at high-gradients, positron acceleration using wakes in uniform plasmas and in hollow plasma channels, and demonstrating that highly nonlinear wakes in the ‘blow-out regime’ have the electric field structure necessary for preserving the emittance of the accelerating bunch. A new 10 GeV electron beam facility, Facilities for Accelerator Science and Experimental Test (FACET) II, is currently under construction at SLAC National Accelerator Laboratory for the next generation of PWFA research and development. The FACET II beams will enable the simultaneous demonstration of substantial energy gain of a small emittance electron bunch while demonstrating an efficient transfer of energy from the drive to the trailing bunch. In this paper we first describe the capabilities of the FACET II facility. We then describe a series of PWFA experiments supported by numerical and particle-in-cell simulations designed to demonstrate plasma wake generation where the drive beam is nearly depleted of its energy, high efficiency acceleration of the trailing bunch while doubling its energy and ultimately, quantifying the emittance growth in a single stage of a PWFA that has optimally designed matching sections. We then briefly discuss other FACET II plasma-based experiments including in situ positron generation and acceleration, and several schemes that are promising for generating sub-micron emittance bunches that will ultimately be needed for both an early application of a PWFA and for a plasma-based future linear collider.

  11. Multiple needle-pass percutaneous testicular sperm aspiration as first-line treatment in azoospermic men

    DEFF Research Database (Denmark)

    Jensen, C F S; Ohl, D A; Hiner, M R

    2016-01-01

    Percutaneous testicular sperm aspiration (TESA) has been known for decades as a simple, minimally invasive approach to sperm retrieval in azoospermic men. Because of lower reported sperm retrieval rates (SRR) when compared with microdissection testicular sperm extraction (mTESE), many centers now...

  12. An update on percutaneous nephrolithotomy: lessons learned from the CROES PCNL Global Study

    NARCIS (Netherlands)

    Tefekli, A.; Cordeiro, E.; de la Rosette, J. J. M. C. H.

    2013-01-01

    Since its introduction in late 1970's, percutaneous nephrolithotomy (PNL) has undergone an evolution in both equipment and technique. This evolution still continues today in the era of minimally invasive treatment options, and is evidenced by the numerous publications. PNL is generally advantageous

  13. Treatment of displaced intra-articular calcaneal fractures with closed reduction and percutaneous screw fixation

    NARCIS (Netherlands)

    Tomesen, T.; Biert, J.; Frolke, J.P.M.

    2011-01-01

    BACKGROUND: Surgical treatment of displaced intra-articular fractures of the calcaneus is a standard procedure in many institutions. To avoid soft-tissue complications, several minimally invasive procedures have recently been introduced. The aim of this study was to assess the percutaneous treatment

  14. Subcutaneous Transitional Cell Cancer After Percutaneous Nephrolithotomy: A Case Report

    Directory of Open Access Journals (Sweden)

    Lokman Ižrkilata

    2013-10-01

    Full Text Available Transitional cell carcinomas of the upper urinary tract are rare but, highly predisposing to tumoral seeding. Percutaneous lithotripsy (PNL recently has expanded the therapeutic choices for patients with kidney stones and gained popularity by urologic surgeons. Although unusual, renal collecting system tumours may be encountered during PNL. We present and discuss the clinical course of a 48 years old male patient who underwent PNL surgery for kidney stone in whom transitional cell carcinoma in the renal collecting system obscured by stone left undiagnosed. Three months later following PNL he admitted with a bulge on lumbar region. Excisional biopsy revealed carcinoma and therefore, he was directed to chemoradiotherapy and died 21 months later. Renal collecting system tumors undiagnosed during surgery may progress and demonstrate local invasion in a short period of time. Therefore, we recommend to take more caution during any percutaneous access and to exclude the possible existence of tumor.

  15. Renal pelvic stones: choosing shock wave lithotripsy or percutaneous nephrolithotomy

    Directory of Open Access Journals (Sweden)

    Robert Marcovich

    2003-06-01

    Full Text Available Introduction of minimally invasive techniques has revolutionized the surgical management of renal calculi. Extracorporeal shock wave lithotripsy and percutaneous nephrolithotomy are now both well-established procedures. Each modality has advantages and disadvantages, and the application of each should be based on well-defined factors. These variables include stone factors such as number, size, and composition; factors related to the stone's environment, including the stone's location, spatial anatomy of the renal collecting system, presence of hydronephrosis, and other anatomic variables, such as the presence of calyceal diverticula and renal anomalies; and clinical or patient factors like morbid obesity, the presence of a solitary kidney, and renal insufficiency. The morbidity of each procedure in relation to its efficacy should be taken in to account. This article will review current knowledge and suggest an algorithm for the rational management of renal calculi with shock wave lithotripsy and percutaneous nephrolithotomy.

  16. MR-guided percutaneous cryotherapy of liver metastases

    International Nuclear Information System (INIS)

    Haage, P.; Tacke, J.

    2001-01-01

    The prognosis for patients with liver metastases depends on the therapeutic options regarding the treatment of the primary tumor, co-existing extrahepatic metastases and the extent and treatment possibilities of the hepatic metastases themselves. Numerous curative or palliative oncological therapeutic concepts have been introduced in case of non-resectable liver metastases to prolong survival while maintaining a highest possible quality of life. Cryotherapy, which can be performed percutaneously and under magnetic resonance guidance, is one of these manifold therapeutic modalities, combining the inherent advantages of MRI with minimal invasiveness. Excellent visualization of the frozen liver tissue, precise tumor ablation, as well as an almost painless intervention due to the analgetic effect of the ice are implicating percutaneous cryotherapy as an attractive alternative to other ablation techniques. First clinical results are promising. However, meticulous and extensive long-term evaluation on a broad clinical scale is required. (orig.) [de

  17. Facet-to-facet Linking of Shape-anisotropic Colloidal Cadmium Chalcogenide Nanostructures.

    Science.gov (United States)

    Ong, Xuanwei; Gupta, Shashank; Wu, Wen-Ya; Chakrabortty, Sabyasachi; Chan, Yinthai

    2017-08-10

    Here, we describe a protocol that allows for shape-anisotropic cadmium chalcogenide nanocrystals (NCs), such as nanorods (NRs) and tetrapods (TPs), to be covalently and site-specifically linked via their end facets, resulting in polymer-like linear or branched chains. The linking procedure begins with a cation-exchange process in which the end facets of the cadmium chalcogenide NCs are first converted to silver chalcogenide. This is followed by the selective removal of ligands at their surface. This results in cadmium chalcogenide NCs with highly reactive silver chalcogenide end facets that spontaneously fuse upon contact with each other, thereby establishing an interparticle facet-to-facet attachment. Through the judicious choice of precursor concentrations, an extensive network of linked NCs can be produced. Structural characterization of the linked NCs is carried out via low- and high-resolution transmission electron microscopy (TEM), as well as energy-dispersive X-ray spectroscopy, which confirm the presence of silver chalcogenide domains between chains of cadmium chalcogenide NCs.

  18. Improving personality facet scores with multidimensional computer adaptive testing

    DEFF Research Database (Denmark)

    Makransky, Guido; Mortensen, Erik Lykke; Glas, Cees A W

    2013-01-01

    Narrowly defined personality facet scores are commonly reported and used for making decisions in clinical and organizational settings. Although these facets are typically related, scoring is usually carried out for a single facet at a time. This method can be ineffective and time consuming when...... personality tests contain many highly correlated facets. This article investigates the possibility of increasing the precision of the NEO PI-R facet scores by scoring items with multidimensional item response theory and by efficiently administering and scoring items with multidimensional computer adaptive...... testing (MCAT). The increase in the precision of personality facet scores is obtained from exploiting the correlations between the facets. Results indicate that the NEO PI-R could be substantially shorter without attenuating precision when the MCAT methodology is used. Furthermore, the study shows...

  19. Percutaneous endoscopic lumbar discectomy: Results of first 100 cases

    Directory of Open Access Journals (Sweden)

    Kanthila Mahesha

    2017-01-01

    Full Text Available Background: Lumbar disc herniation is a major cause of back pain and sciatica. The surgical management of lumbar disc prolapse has evolved from exploratory laminectomy to percutaneous endoscopic discectomy. Percutaneous endoscopic discectomy is the least invasive procedure for lumbar disc prolapse. The aim of this study was to analyze the clinical outcome, quality of life, neurologic function, and complications. Materials and Methods: One hundred patients with lumbar disc prolapse who were treated with percutaneous endoscopic discectomy from May 2012 to January 2014 were included in this retrospective study. Clinical followup was done at 1 month, 3 months, 6 months, 1 year, and at yearly interval thereafter. The outcome was assessed using modified Macnab′s criteria, visual analog scale, and Oswestry Disability Index. Results: The mean followup period was 2 years (range 18 months - 3 years. Transforaminal approach was used in 84 patients, interlaminar approach in seven patients, and combined approach in nine patients. An excellent outcome was noted in ninety patients, good outcome in six patients, fair result in two patients, and poor result in two patients. Minor complications were seen in three patients, and two patients had recurrent disc prolapse. Mean hospital stay was 1.6 days. Conclusions: Percutaneous endoscopic lumbar discectomy is a safe and effective procedure in lumbar disc prolapse. It has the advantage that it can be performed on a day care basis under local anesthesia with shorter length of hospitalization and early return to work thus improving the quality of life earlier. The low complication rate makes it the future of disc surgery. Transforaminal approach alone is sufficient in majority of cases, although 16% of cases required either percutaneous interlaminar approach or combined approach. The procedure definitely has a learning curve, but it is acceptable with adequate preparations.

  20. Percutaneous umbilical cord blood sampling - slideshow

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/presentations/100196.htm Percutaneous umbilical cord blood sampling - series—Normal anatomy To use the ... or blood disorder, your doctor may recommend percutaneous umbilical cord blood sampling (PUBS), which is performed at 18 ...

  1. Ultrasound guided percutaneous fine needle aspiration biopsy ...

    African Journals Online (AJOL)

    2011-06-15

    )-guided percutaneous fine needle aspiration biopsy (PFNAB)/US-guided percutaneous needle core biopsy (PNCB) of abdominal lesions is efficacious in diagnosis, is helpful in treatment choice, to evaluate whether various ...

  2. Ultrasound guided percutaneous fine needle aspiration biopsy ...

    African Journals Online (AJOL)

    )-guided percutaneous fine needle aspiration biopsy (PFNAB)/US-guided percutaneous needle core biopsy (PNCB) of abdominal lesions is efficacious in diagnosis, is helpful in treatment choice, to evaluate whether various other investigations ...

  3. Duodenal perforation during percutaneous nephrolithotomy (PCNL ...

    African Journals Online (AJOL)

    A. Bansal

    2016-06-03

    Jun 3, 2016 ... Calculus;. Duodenum;. Injury;. Paediatric;. Percutaneous nephrolithotomy. Abstract. Introduction: Colonic perforations are known complications of percutaneous nephrolithotomy (PCNL). However, to the best of our knowledge, small bowel perforation has rarely been reported.. Observation: We report the ...

  4. Height of a faceted macrostep for sticky steps in a step-faceting zone

    Science.gov (United States)

    Akutsu, Noriko

    2018-02-01

    The driving force dependence of the surface velocity and the average height of faceted merged steps, the terrace-surface slope, and the elementary step velocity are studied using the Monte Carlo method in the nonequilibrium steady state. The Monte Carlo study is based on a lattice model, the restricted solid-on-solid model with point-contact-type step-step attraction (p-RSOS model). The main focus of this paper is a change of the "kink density" on the vicinal surface. The temperature is selected to be in the step-faceting zone [N. Akutsu, AIP Adv. 6, 035301 (2016), 10.1063/1.4943400] where the vicinal surface is surrounded by the (001) terrace and the (111) faceted step at equilibrium. Long time simulations are performed at this temperature to obtain steady states for the different driving forces that influence the growth/recession of the surface. A Wulff figure of the p-RSOS model is produced through the anomalous surface tension calculated using the density-matrix renormalization group method. The characteristics of the faceted macrostep profile at equilibrium are classified with respect to the connectivity of the surface tension. This surface tension connectivity also leads to a faceting diagram, where the separated areas are, respectively, classified as a Gruber-Mullins-Pokrovsky-Talapov zone, step droplet zone, and step-faceting zone. Although the p-RSOS model is a simplified model, the model shows a wide variety of dynamics in the step-faceting zone. There are four characteristic driving forces: Δ μy,Δ μf,Δ μc o , and Δ μR . For the absolute value of the driving force, |Δ μ | is smaller than Max[ Δ μy,Δ μf] , the step attachment-detachments are inhibited, and the vicinal surface consists of (001) terraces and the (111) side surfaces of the faceted macrosteps. For Max[ Δ μy,Δ μf]effects were also determined to be distinctive near equilibrium.

  5. The biomechanical impact of facet tropism on the intervertebral disc and facet joints in the cervical spine.

    Science.gov (United States)

    Rong, Xin; Wang, Beiyu; Ding, Chen; Deng, Yuxiao; Chen, Hua; Meng, Yang; Yan, Weijie; Liu, Hao

    2017-12-01

    Facet tropism is defined as the angular difference between the left and the right facet orientation. Facet tropism was suggested to be associated with the disc degeneration and facet degeneration in the lumbar spine. However, little is known about the relationship between facet tropism and pathologic changes in the cervical spine and the mechanism behind. This study was conducted to investigate the biomechanical impact of facet tropism on the intervertebral disc and facet joints. A finite element analysis study. The computed tomography (CT) scans of a 28-year-old male volunteer was used to construct the finite element model. First, a symmetrical cervical model from C2 to C7 was constructed. The facet orientations at each level were simulated using the data from our previously published study. Second, the facet orientations at the C5-C6 level were altered to simulate facet tropism with respect to the sagittal plane. The angular difference of the moderate facet tropism model was set to be 7 degrees, whereas the severe facet tropism model was set to be 14 degrees. The inferior of the C7 vertebra was fixed. A 75 N follower loading was applied to simulate the weight of the head. A 1.0 N⋅m moments was applied on the odontoid process of the C2 to simulate flexion, extension, lateral bending, and axial rotation. The intradiscal pressure (IDP) at the C5-C6 level of the severe facet tropism model increased by 49.02%, 57.14%, 39.06%, and 30.67%, under flexion, extension, lateral bending, and axial rotation moments, in comparison with the symmetrical model. The contact force of the severe facet tropism model increased by 35.64%, 31.74%, 79.26%, and 59.47% from the symmetrical model under flexion, extension, lateral bending, and axial rotation, respectively. Facet tropism with respect to the sagittal plane at the C5-C6 level increased the IDP and facet contact force under flexion, extension, lateral bending, and axial rotation. The results suggested that facet tropism might

  6. Percutaneous transbiliary biopsy.

    Science.gov (United States)

    Andrade, Gustavo Vieira; Santos, Miguel Arcanjo; Meira, Marconi Roberto; Meira, Mateus Duarte

    2017-01-01

    Percutaneous drainage of the bile ducts is an established procedure for malignant obstructions, in which a histological diagnosis is often not obtained. We describe the biopsy technique of obstructive lesions through biliary drainage access, using a 7F endoscopic biopsy forceps, widely available; some are even reusable. This technique applies to lesions of the hepatic ducts, of the common hepatic duct and of all extension of the common bile duct. RESUMO A drenagem percutânea das vias biliares é um procedimento estabelecido para obstruções malignas, nos quais, muitas vezes, não se consegue um diagnóstico histológico. Descrevemos a técnica de biópsia da lesão obstrutiva através do acesso de drenagem biliar, utilizando um fórcipe de biópsia endoscópica 7F, amplamente disponível e alguns reutilizáveis. Esta técnica aplica-se a lesões dos ductos hepáticos, do hepático comum e de toda extensão do colédoco.

  7. Control to Facet for Polynomial Systems

    DEFF Research Database (Denmark)

    Sloth, Christoffer; Wisniewski, Rafael

    2014-01-01

    This paper presents a solution to the control to facet problem for arbitrary polynomial vector fields defined on simplices. The novelty of the work is to use Bernstein coefficients of polynomials for determining certificates of positivity. Specifically, the constraints that are set up...... for the controller design are solved by searching for polynomials in Bernstein form. This allows the controller design problem to be formulated as a linear programming problem. Examples are provided that demonstrate the efficiency of the method for designing controls for polynomial systems....

  8. Multiquark hadrons. A new facet of QCD

    International Nuclear Information System (INIS)

    Ali, Ahmed

    2016-05-01

    I review some selected aspects of the phenomenology of multiquark states discovered in high energy experiments. They have four valence quarks (called tetraquarks) and two of them are found to have five valence quarks (called pentaquarks), extending the conventional hadron spectrum which consists of quark-antiquark (q anti q) mesons and qqq baryons. Multiquark states represent a new facet of QCD and their dynamics is both challenging and currently poorly understood. I discuss various approaches put forward to accommodate them, with emphasis on the diquark model.

  9. Facet Joints of the Spine: Structure-Function Relationships, Problems and Treatments, and the Potential for Regeneration.

    Science.gov (United States)

    O'Leary, Siobhan A; Paschos, Nikolaos K; Link, Jarrett M; Klineberg, Eric O; Hu, Jerry C; Athanasiou, Kyriacos A

    2018-03-01

    The zygapophyseal joint, a diarthrodial joint commonly referred to as the facet joint, plays a pivotal role in back pain, a condition that has been a leading cause of global disability since 1990. Along with the intervertebral disc, the facet joint supports spinal motion and aids in spinal stability. Highly susceptible to early development of osteoarthritis, the facet is responsible for a significant amount of pain in the low-back, mid-back, and neck regions. Current noninvasive treatments cannot offer long-term pain relief, while invasive treatments can relieve pain but fail to preserve joint functionality. This review presents an overview of the facet in terms of its anatomy, functional properties, problems, and current management strategies. Furthermore, this review introduces the potential for regeneration of the facet and particular engineering strategies that could be employed as a long-term treatment. Expected final online publication date for the Annual Review of Biomedical Engineering Volume 20 is June 4, 2018. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

  10. Percutaneous treatment of benign bile duct strictures

    Energy Technology Data Exchange (ETDEWEB)

    Koecher, Martin [Department of Radiology, University Hospital, I.P.Pavlova 6, 775 20 Olomouc (Czech Republic)]. E-mail: martin.kocher@seznam.cz; Cerna, Marie [Department of Radiology, University Hospital, I.P.Pavlova 6, 775 20 Olomouc (Czech Republic); Havlik, Roman [Department of Surgery, University Hospital, I.P.Pavlova 6, 775 20 Olomouc (Czech Republic); Kral, Vladimir [Department of Surgery, University Hospital, I.P.Pavlova 6, 775 20 Olomouc (Czech Republic); Gryga, Adolf [Department of Surgery, University Hospital, I.P.Pavlova 6, 775 20 Olomouc (Czech Republic); Duda, Miloslav [Department of Surgery, University Hospital, I.P.Pavlova 6, 775 20 Olomouc (Czech Republic)

    2007-05-15

    Purpose: To evaluate long-term results of treatment of benign bile duct strictures. Materials and methods: From February 1994 to November 2005, 21 patients (9 men, 12 women) with median age of 50.6 years (range 27-77 years) were indicated to percutaneous treatment of benign bile duct stricture. Stricture of hepatic ducts junction resulting from thermic injury during laparoscopic cholecystectomy was indication for treatment in one patient, stricture of hepaticojejunostomy was indication for treatment in all other patients. Clinical symptoms (obstructive jaundice, anicteric cholestasis, cholangitis or biliary cirrhosis) have appeared from 3 months to 12 years after surgery. Results: Initial internal/external biliary drainage was successful in 20 patients out of 21. These 20 patients after successful initial drainage were treated by balloon dilatation and long-term internal/external drainage. Sixteen patients were symptoms free during the follow-up. The relapse of clinical symptoms has appeared in four patients 9, 12, 14 and 24 months after treatment. One year primary clinical success rate of treatment for benign bile duct stricture was 94%. Additional two patients are symptoms free after redilatation (15 and 45 months). One patient is still in treatment, one patient died during secondary treatment period without interrelation with biliary intervention. The secondary clinical success rate is 100%. Conclusion: Benign bile duct strictures of hepatic ducts junction or biliary-enteric anastomosis are difficult to treat surgically and endoscopically inaccessible. Percutaneous treatment by balloon dilatation and long-term internal/external drainage is feasible in the majority of these patients. It is minimally invasive, safe and effective.

  11. Percutaneous thermal ablation of renal neoplasms

    International Nuclear Information System (INIS)

    Tacke, J.; Mahnken, A.H.; Guenther, R.W.

    2005-01-01

    Due to modern examination techniques such as multidetector computed tomography and high-field magnetic resonance imaging, the detection rate of renal neoplasms is continually increasing. Even though tumors exceeding 4 cm in diameter rarely metastasize, all renal lesions that are possible neoplasms should be treated. Traditional treatment techniques include radical nephrectomy or nephron-sparing resection, which are increasingly performed laparoscopically. Modern thermal ablation techniques such as hyperthermal techniques like radiofrequency ablation RFA, laser induced thermal ablation LITT, focused ultrasound FUS and microwave therapy MW, as well as hypothermal techniques (cryotherapy) may be a useful treatment option for patients who are unfit for or refuse surgical resection. Cryotherapy is the oldest and best known thermal ablation technique and can be performed laparoscopically or percutaneously. Since subzero temperatures have no antistyptic effect, additional maneuvers must be performed to control bleeding. Percutaneous cryotherapy of renal tumors is a new and interesting method, but experience with it is still limited. Radiofrequency ablation is the most frequently used method. Modern probe design allows volumes between 2 and 5 cm in diameter to be ablated. Due to hyperthermal tract ablation, the procedure is deemed to be safe and has a low complication rate. Although there are no randomized comparative studies to open resection, the preliminary results for renal RFA are promising and show RFA to be superior to other thermal ablation techniques. Clinical success rates are over 90% for both, cryo- and radiofrequency ablation. Whereas laser induced thermal therapy is established in hepatic ablation, experience is minimal with respect to renal application. For lesions of more than 2 cm in diameter, additional cooling catheters are required. MR thermometry offers temperature control during ablation. Microwave ablation is characterized by small ablation volumes

  12. Percutaneous treatment of benign bile duct strictures

    International Nuclear Information System (INIS)

    Koecher, Martin; Cerna, Marie; Havlik, Roman; Kral, Vladimir; Gryga, Adolf; Duda, Miloslav

    2007-01-01

    Purpose: To evaluate long-term results of treatment of benign bile duct strictures. Materials and methods: From February 1994 to November 2005, 21 patients (9 men, 12 women) with median age of 50.6 years (range 27-77 years) were indicated to percutaneous treatment of benign bile duct stricture. Stricture of hepatic ducts junction resulting from thermic injury during laparoscopic cholecystectomy was indication for treatment in one patient, stricture of hepaticojejunostomy was indication for treatment in all other patients. Clinical symptoms (obstructive jaundice, anicteric cholestasis, cholangitis or biliary cirrhosis) have appeared from 3 months to 12 years after surgery. Results: Initial internal/external biliary drainage was successful in 20 patients out of 21. These 20 patients after successful initial drainage were treated by balloon dilatation and long-term internal/external drainage. Sixteen patients were symptoms free during the follow-up. The relapse of clinical symptoms has appeared in four patients 9, 12, 14 and 24 months after treatment. One year primary clinical success rate of treatment for benign bile duct stricture was 94%. Additional two patients are symptoms free after redilatation (15 and 45 months). One patient is still in treatment, one patient died during secondary treatment period without interrelation with biliary intervention. The secondary clinical success rate is 100%. Conclusion: Benign bile duct strictures of hepatic ducts junction or biliary-enteric anastomosis are difficult to treat surgically and endoscopically inaccessible. Percutaneous treatment by balloon dilatation and long-term internal/external drainage is feasible in the majority of these patients. It is minimally invasive, safe and effective

  13. Bipolar Radiofrequency Facet Ablation of the Lumbar Facet Capsule: An Adjunct to Conventional Radiofrequency Ablation for Pain Management.

    Science.gov (United States)

    Jacobson, Robert E; Palea, Ovidiu; Granville, Michelle

    2017-09-01

    Radiofrequency facet ablation (RFA) has been performed using the same technique for over 50 years. Except for variations in electrode size, tip shape, and change in radiofrequency (RF) stimulation parameters, using standard, pulsed, and cooled RF wavelengths, the target points have remained absolutely unchanged from the original work describing RFA for lumbar pain control. Degenerative changes in the facet joint and capsule are the primary location for the majority of lumbar segmental pathology and pain. Multiple studies show that the degenerated facet joint is richly innervated as a result of the inflammatory overgrowth of the synovium. The primary provocative clinical test to justify an RFA is to perform an injection with local anesthetic into the facet joint and the posterior capsule and confirm pain relief. However, after a positive response, the radiofrequency lesion is made not to the facet joint but to the more proximal fine nerve branches that innervate the joint. The accepted target points for the recurrent sensory branch ignore the characteristic rich innervation of the pathologic lumbar facet capsule and assume that lesioning of these recurrent branches is sufficient to denervate the painful pathologic facet joint. This report describes the additional targets and technical steps for further coagulation points along the posterior capsule of the lumbar facet joint and the physiologic studies of the advantage of the bipolar radiofrequency current in this location. Bipolar RF to the facet capsule is a simple, extra step that easily creates a large thermo-coagulated lesion in this capsule region of the pathologic facet joint. Early studies demonstrate bipolar RF to the facet capsule can provide long-term pain relief when used alone for specific localized facet joint pain, to coagulate lumbar facet cysts to prevent recurrence, and to get more extensive pain control by combining it with traditional lumbar RFA, especially when RFA is repeated.

  14. Morphometric analysis of the cervical facets and the feasibility, safety, and effectiveness of Goel inter-facet spacer distraction technique.

    Science.gov (United States)

    Shah, Abhidha

    2014-01-01

    Quantitative anatomy of the facets of the sub-axial cervical spine was performed. The purpose of the evaluation was to determine the feasibility of insertion of Goel inter-facetal articular spacers in the sub-axial cervical spine. Only few studies detailing the morphometry of the facets are available in the literature. Ten cervical vertebrae from C3 to C7 with a total of 20 facets were evaluated by the author. The anatomic parameters studied were the height, width, thickness, shape, orientation, and inclination of each of the superior and inferior facets. The alterations in a number of intervertebral segmental distances were measured before and after spacer insertion. The distance of the inferior facet from the foramen tranversarium, spinal canal, and neural foramina was measured to assess safety of spacer insertion with respect to the vertebral artery and neural structures. The height, width and thickness of the superior facets from C3 to C7 ranged from 6 to 12 mm, 8 to 12 mm, and 2.5 to 6 mm, respectively. The inferior facets had an average height of 10.5 mm, average width of 11.2 mm and average thickness of 3.5 mm. The inclination of the superior facets with respect to the transverse plane ranged from 22° to 45° and that of the inferior facets ranged from 29° to 53°. The distance of the anterior margin of the inferior facet from the posterior border of the foramen transversium ranged from 5 to 7 mm. This distance was maximum at C3 level, then decreased at C4 and remained constant from C5 to C7. This anatomic evaluation aided in understanding the morphology of the cervical facets and the suitability of the cervical facetal articular cavity for insertion of spacers.

  15. The Effects of Orientation of Lumbar Facet Joints on the Facet Joint Contact Forces: An In Vitro Biomechanical Study.

    Science.gov (United States)

    Liu, Xiang; Huang, Zhiping; Zhou, Ruozhou; Zhu, Qingan; Ji, Wei; Long, Yaowu; Wang, Jixing

    2018-02-15

    A biomechanical human cadaveric study. The aim of this study was to measure L2-L3 facet joint contact forces in a flexibility test using thin film electroresistive sensors, and facet joint orientation on computed tomographic (CT) scan images, to examine the effects of orientation of lumbar facet joint on the facet joint contact forces. Biomechanically, the bilateral facet joints play a critical role in maintaining stability of the lumbar spine. The effect of orientation of lumbar facet joints on the contact forces remains unknown. Eight human cadaveric lumbar spine specimens (L2-L3) were tested by applying a pure moment of ±7.5 Nm in three directions of loading (flexion-extension, lateral bending, and axial rotation) with and without a follower preload of 300 N. The orientation of the lumbar facet joints at the L2-L3 was measured on axial CT scans. Bilateral facet contact forces were measured during flexibility tests using thin film electroresistive sensors (Tekscan 6900). The average total peak facet loads was 66 N in axial rotation, 27 N in extension, and 20 N in lateral bending under a pure moment. Under a pure moment with a follower preload of 300 N, the average total peak facet loads was 53 N in axial rotation, 43 N in extension, and 24 N in lateral bending. The facet joint forces were correlated positively and significantly with the orientation in all directions with and without a compressive follower preload (P forces at neutral position with a follower preload were correlated positively with the orientation (rs = 0.759, P = 0.001). This study identified that the greater coronal orientation of lumbar facet joints is, the higher the facet joint contact forces are. 3.

  16. Morphometric analysis of the cervical facets and the feasibility, safety, and effectiveness of Goel inter-facet spacer distraction technique

    Directory of Open Access Journals (Sweden)

    Abhidha Shah

    2014-01-01

    Full Text Available Aim: Quantitative anatomy of the facets of the sub-axial cervical spine was performed. The purpose of the evaluation was to determine the feasibility of insertion of Goel inter-facetal articular spacers in the sub-axial cervical spine. Only few studies detailing the morphometry of the facets are available in the literature. Materials and Methods: Ten cervical vertebrae from C3 to C7 with a total of 20 facets were evaluated by the author. The anatomic parameters studied were the height, width, thickness, shape, orientation, and inclination of each of the superior and inferior facets. The alterations in a number of intervertebral segmental distances were measured before and after spacer insertion. The distance of the inferior facet from the foramen tranversarium, spinal canal, and neural foramina was measured to assess safety of spacer insertion with respect to the vertebral artery and neural structures. Results: The height, width and thickness of the superior facets from C3 to C7 ranged from 6 to 12 mm, 8 to 12 mm, and 2.5 to 6 mm, respectively. The inferior facets had an average height of 10.5 mm, average width of 11.2 mm and average thickness of 3.5 mm. The inclination of the superior facets with respect to the transverse plane ranged from 22° to 45° and that of the inferior facets ranged from 29° to 53°. The distance of the anterior margin of the inferior facet from the posterior border of the foramen transversium ranged from 5 to 7 mm. This distance was maximum at C3 level, then decreased at C4 and remained constant from C5 to C7. Conclusion: This anatomic evaluation aided in understanding the morphology of the cervical facets and the suitability of the cervical facetal articular cavity for insertion of spacers.

  17. Facets of Dispositional Mindfulness and Health Among College Students.

    Science.gov (United States)

    Bodenlos, Jamie S; Wells, Stephanie Y; Noonan, Marleah; Mayrsohn, Aubreyanne

    2015-10-01

    The purpose of the current study was to examine the relationship between the facets of trait mindfulness with psychological and physical health while controlling for health behaviors in college students. 310 students from a small, private college in the Northeastern United States. Students completed self-report measures, including the Perceived Stress Scale (PSS-14), the Five Facet Mindfulness Questionnaire (FFMQ), Medical Outcomes Short-Form Health Survey (SF-36), and the Rutgers Alcohol Problems Index (RAPI). After controlling for other health behaviors, the observation facet of mindfulness was negatively associated with physical health. Both acting with awareness and nonjudging facets were positively associated with emotional well-being. For social functioning, nonjudging was a significant positive facet for this domain of health. Tailoring mindfulness-based interventions to enhance these facets may be beneficial to young adults.

  18. PTED study : design of a non-inferiority, randomised controlled trial to compare the effectiveness and cost-effectiveness of percutaneous transforaminal endoscopic discectomy (PTED) versus open microdiscectomy for patients with a symptomatic lumbar disc herniation

    NARCIS (Netherlands)

    Seiger, Ankie; Gadjradj, Pravesh S; Harhangi, Biswadjiet S; van Susante, Job Lc; Peul, Wilco C; van Tulder, Maurits W; de Boer, Michiel R; Rubinstein, Sidney M

    2017-01-01

    INTRODUCTION: Lumbosacral radicular syndrome is often caused by a disc herniation. The standard surgical technique to remove a disc herniation is open microdiscectomy. An alternative technique is percutaneous transforaminal endoscopic discectomy (PTED), which is less invasive. In the Netherlands,

  19. Modeling Reusable and Interoperable Faceted Browsing Systems with Category Theory

    OpenAIRE

    Harris, Daniel R.

    2015-01-01

    Faceted browsing has become ubiquitous with modern digital libraries and online search engines, yet the process is still difficult to abstractly model in a manner that supports the development of interoperable and reusable interfaces. We propose category theory as a theoretical foundation for faceted browsing and demonstrate how the interactive process can be mathematically abstracted. Existing efforts in facet modeling are based upon set theory, formal concept analysis, and lightweight ontol...

  20. Foundations of reusable and interoperable facet models using category theory

    OpenAIRE

    Harris, Daniel R.

    2016-01-01

    Faceted browsing has become ubiquitous with modern digital libraries and online search engines, yet the process is still difficult to abstractly model in a manner that supports the development of interoperable and reusable interfaces. We propose category theory as a theoretical foundation for faceted browsing and demonstrate how the interactive process can be mathematically abstracted. Existing efforts in facet modeling are based upon set theory, formal concept analysis, and light-weight onto...

  1. Preliminary design of large reflectors with flat facets

    Science.gov (United States)

    Agrawal, P. K.; Anderson, M. S.; Card, M. F.

    1981-01-01

    A concept for approximating curved antenna surfaces using flat facets is discussed. A preliminary design technique for determining the size of the reflector surface facets necessary to meet antenna surface accuracy requirements is presented. A proposed large microwave radiometer satellite (MRS) is selected as an application, and the far-field electromagnetic response of a faceted reflector surface is compared with that from a spherical reflector surface.

  2. Faceted ceramic fibers, tapes or ribbons and epitaxial devices therefrom

    Science.gov (United States)

    Goyal, Amit [Knoxville, TN

    2012-07-24

    A crystalline article includes a single-crystal ceramic fiber, tape or ribbon. The fiber, tape or ribbon has at least one crystallographic facet along its length, which is generally at least one meter long. In the case of sapphire, the facets are R-plane, M-plane, C-plane or A-plane facets. Epitaxial articles, including superconducting articles, can be formed on the fiber, tape or ribbon.

  3. A folk-psychological ranking of personality facets

    Directory of Open Access Journals (Sweden)

    Eka Roivainen

    2016-10-01

    Full Text Available Background Which personality facets should a general personality test measure? No consensus exists on the facet structure of personality, the nature of facets, or the correct method of identifying the most significant facets. However, it can be hypothesized (the lexical hypothesis that high frequency personality describing words more likely represent important personality facets and rarely used words refer to less significant aspects of personality. Participants and procedure A ranking of personality facets was performed by studying the frequency of the use of popular personality adjectives in causal clauses (because he is a kind person on the Internet and in books as attributes of the word person (kind person. Results In Study 1, the 40 most frequently used adjectives had a cumulative usage frequency equal to that of the rest of the 295 terms studied. When terms with a higher-ranking dictionary synonym or antonym were eliminated, 23 terms remained, which represent 23 different facets. In Study 2, clusters of synonymous terms were examined. Within the top 30 clusters, personality terms were used 855 times compared to 240 for the 70 lower-ranking clusters. Conclusions It is hypothesized that personality facets represented by the top-ranking terms and clusters of terms are important and impactful independent of their correlation with abstract underlying personality factors (five/six factor models. Compared to hierarchical personality models, lists of important facets probably better cover those aspects of personality that are situated between the five or six major domains.

  4. Zero-Flow Pressure Measured Immediately After Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction Provides the Best Invasive Index for Predicting the Extent of Myocardial Infarction at 6 Months: An OxAMI Study (Oxford Acute Myocardial Infarction).

    Science.gov (United States)

    Patel, Niket; Petraco, Ricardo; Dall'Armellina, Erica; Kassimis, George; De Maria, Giovanni Luigi; Dawkins, Sam; Lee, Regent; Prendergast, Bernard D; Choudhury, Robin P; Forfar, John C; Channon, Keith M; Davies, Justin; Banning, Adrian P; Kharbanda, Rajesh K

    2015-09-01

    The aim of this study was to define which measure of microvascular best predicts the extent of left ventricular (LV) infarction. Microvascular injury after ST-segment elevation myocardial infarction (STEMI) is an important determinant of outcome. Several invasive measures of the microcirculation at primary percutaneous coronary intervention (PPCI) have been described. One such measure is zero-flow pressure (Pzf), the calculated pressure at which coronary flow would cease. In 34 STEMI patients, Pzf, hyperemic microvascular resistance (hMR), and index of microcirculatory resistance (IMR) were derived using thermodilution flow/pressure and Doppler flow/pressure wire assessment of the infarct-related artery following PPCI. The extent of infarction was determined by blinded late gadolinium enhancement on cardiac magnetic resonance at 6 months post-PPCI. Infarction of ≥24% total LV mass was used as a categorical cutoff in receiver-operating characteristic curve analysis. Pzf was superior to both hMR and IMR for predicting ≥24% infarction area under the curve: 0.94 for Pzf versus 0.74 for hMR (p = 0.04) and 0.54 for IMR (p = 0.003). Pzf ≥42 mm Hg was the optimal cutoff value, offering 100% sensitivity and 73% specificity. Patients with Pzf ≥42 mm Hg also had a lower salvage index (61.3 ± 8.1 vs. 44.4 ± 16.8, p = 0.006) and 6-month ejection fraction (62.4 ± 3.6 vs. 49.9 ± 9.6, p = 0.002). In addition, there were significant direct relationships between Pzf and troponin area under the curve (rho = 0.55, p = 0.002), final infarct mass (rho = 0.75, p infarction and percent transmurality of infarction (rho = 0.77 and 0.74, respectively, p myocardial salvage index (rho = -0.53, p = 0.01) and 6-month ejection fraction (rho = -0.73, p = 0.0001). Pzf measured at the time of PPCI is a better predictor of the extent of myocardial infarction than hMR or IMR. Pzf may provide important prognostic information at the time of PPCI and merits further

  5. Percutaneous treatment of cervical and lumbar herniated disc.

    Science.gov (United States)

    Kelekis, A; Filippiadis, D K

    2015-05-01

    Therapeutic armamentarium for symptomatic intervertebral disc herniation includes conservative therapy, epidural infiltrations (interlaminar or trans-foraminal), percutaneous therapeutic techniques and surgical options. Percutaneous, therapeutic techniques are imaging-guided, minimally invasive treatments for intervertebral disc herniation which can be performed as outpatient procedures. They can be classified in 4 main categories: mechanical, thermal, chemical decompression and biomaterials implantation. Strict sterility measures are a prerequisite and should include extensive local sterility and antibiotic prophylaxis. Indications include the presence of a symptomatic, small to medium sized contained intervertebral disc herniation non-responding to a 4-6 weeks course of conservative therapy. Contraindications include sequestration, infection, segmental instability (spondylolisthesis), uncorrected coagulopathy or a patient unwilling to provide informed consent. Decompression techniques are feasible and reproducible, efficient (75-94% success rate) and safe (>0.5% mean complications rate) therapies for the treatment of symptomatic intervertebral disc herniation. Percutaneous, imaging guided, intervertebral disc therapeutic techniques can be proposed either as an initial treatment or as an attractive alternative prior to surgery for the therapy of symptomatic herniation in both cervical and lumbar spine. This article will describe the mechanism of action for different therapeutic techniques applied to intervertebral discs of cervical and lumbar spine, summarize the data concerning safety and effectiveness of these treatments, and provide a rational approach for the therapy of symptomatic intervertebral disc herniation in cervical and lumbar spine. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  6. Percutaneous treatment of cervical and lumbar herniated disc

    Energy Technology Data Exchange (ETDEWEB)

    Kelekis, A., E-mail: akelekis@med.uoa.gr; Filippiadis, D.K., E-mail: dfilippiadis@yahoo.gr

    2015-05-15

    Therapeutic armamentarium for symptomatic intervertebral disc herniation includes conservative therapy, epidural infiltrations (interlaminar or trans-foraminal), percutaneous therapeutic techniques and surgical options. Percutaneous, therapeutic techniques are imaging-guided, minimally invasive treatments for intervertebral disc herniation which can be performed as outpatient procedures. They can be classified in 4 main categories: mechanical, thermal, chemical decompression and biomaterials implantation. Strict sterility measures are a prerequisite and should include extensive local sterility and antibiotic prophylaxis. Indications include the presence of a symptomatic, small to medium sized contained intervertebral disc herniation non-responding to a 4–6 weeks course of conservative therapy. Contraindications include sequestration, infection, segmental instability (spondylolisthesis), uncorrected coagulopathy or a patient unwilling to provide informed consent. Decompression techniques are feasible and reproducible, efficient (75–94% success rate) and safe (>0.5% mean complications rate) therapies for the treatment of symptomatic intervertebral disc herniation. Percutaneous, imaging guided, intervertebral disc therapeutic techniques can be proposed either as an initial treatment or as an attractive alternative prior to surgery for the therapy of symptomatic herniation in both cervical and lumbar spine. This article will describe the mechanism of action for different therapeutic techniques applied to intervertebral discs of cervical and lumbar spine, summarize the data concerning safety and effectiveness of these treatments, and provide a rational approach for the therapy of symptomatic intervertebral disc herniation in cervical and lumbar spine.

  7. [INVITED] Surface plasmon cavities on optical fiber end-facets for biomolecule and ultrasound detection

    Science.gov (United States)

    Yang, Tian; He, Xiaolong; Zhou, Xin; Lei, Zeyu; Wang, Yalin; Yang, Jie; Cai, De; Chen, Sung-Liang; Wang, Xueding

    2018-05-01

    Integrating surface plasmon resonance (SPR) devices upon single-mode fiber (SMF) end facets renders label-free sensing systems that have a simple dip-and-read configuration, a small form factor, high compatibility with fiber-optic techniques, and invasive testing capability. Such devices are not only low cost replacement of current equipments in centralized laboratories, but also highly desirable for opening paths to new applications of label-free optical sensing technologies, such as point-of-care immunological tests and intravascular ultrasound imaging. In this paper, we explain the requirements and challenges for such devices from the perspectives of biomolecule and ultrasound detection applications. In such a context, we review our recent work on SMF end-facet SPR cavities. This include a glue-and-strip fabrication method to transfer a nano-patterned thin gold film to the SMF end-facet with high yield, high quality and high alignment precision, the designs of distributed Bragg reflector (DBR) and distributed feedback (DFB) SPR cavities that couple efficiently with the SMF guided mode and reach quality factors of over 100, and the preliminary results for biomolecule interaction sensing and ultrasound detection. The particular advantages and potential values of these devices have been discussed, in terms of sensitivity, data reliability, reproducibility, bandwidth, etc.

  8. Optimized cervical spine bone SPET for detection of facet joint injury after whiplash injury

    International Nuclear Information System (INIS)

    Cardaci, G.T.; Bower, G.D.; Taylor, J.

    1999-01-01

    Full text: The most frequent origin for chronic cervical pain in patients with a remote history of whiplash injury is the cervical facet joints. Exact localization of facet joint injury is difficult and currently advocated methods include multiple invasive diagnostic injections. Optimization of 99 Tc m -HDP cervical SPET (CSPET) to accurately localize facet joint pathology was attempted and the results correlated with clinical localization relying on focal joint tenderness and passive movement methods. Imaging was performed on a dual-headed gamma camera system using an elliptical orbit over 360 deg. The patient's neck was flexed to eliminate the cervical lordosis. Reconstructed CSPET images were reorientated into the long axis of the vertebral bodies. CSPET studies were independently scored by two observers blinded to the clinical and other imaging information and correlated with clinical localization and response to radiofrequency ablation. 54 patients have been studied using this technique in a prospective study. Early patient follow-up data will be presented. CSPET was felt to be clinically useful by pain therapists in targeting treatment

  9. [Talar Neck Fractures Treated Using Percutaneous Screw Fixation].

    Science.gov (United States)

    Veselý, R; Kelbl, M; Kacián, J; Hulka, V; Kočiš, J; Kunovský, R

    2017-01-01

    PURPOSE OF THE STUDY Closed reduction and percutaneous fixation of nondisplaced talar neck fractures have been applied by some authors. The aim of this paper is to assess the results and complications of this minimally invasive technique. MATERIAL AND METHODS In the period from 2009 to 2014, twenty-one patients with a talar neck fracture were observed after closed reduction and percutaneous screw fixation in the Traumatological Hospital in Brno. The mean age of the patients was 38 years (range 18-56 years). The mechanism of injury was a motor vehicle accident in 11 cases, a fall from height in six cases, a sports injury in 3 cases, and a fall from stairs in one case. Injuries were classified according to the Hawkins classification. Conventional preoperative 3-dimensional CT scans of the fractures were analysed. Under the guidance of C-arm fluoroscopy, Kirscher wires were used for closed reduction and temporary percutaneous fixation. Subsequently, 3.5 and 4.5 mm diameter cannulated screws were inserted. The outcome was evaluated on the American Orthopaedic Foot and Ankle Society (AOFAS) scoring scale. RESULTS The average follow-up was 32 months (21-42 months). The average healing time was 15.5 weeks (13-19 weeks). The average AOFAS score was 82.3 points (69-96 points). 75% of patients with type I injury achieved excellent results and 72% of patients with type II injury achieved excellent or good results. None of the patients developed wound complications. Two patients developed partial avascular necrosis and three patients subtalar traumatic arthritis after surgery. DISCUSSION Talar neck fractures are relatively uncommon fractures. Most of the published studies are small. Tenuous blood supply and displaced talar neck fracture predispose to avascular necrosis of the talus. Closed reduction and percutaneous fixation can reduce the soft tissue damage and disturbance to the blood supply. CONCLUSIONS Preoperative 3D CT scans, early surgery, anatomic articular surface

  10. Percutaneous nephrolithotomy and its legacy

    NARCIS (Netherlands)

    Skolarikos, A.; Alivizatos, G.; de la Rosette, J. J. M. C. H.

    2005-01-01

    Objective: We review the indications of Percutaneous Nephrolithotomy (PNL), its safety and efficacy when applied to various patient groups as well as the different points of technique, giving emphasis on new tips and ongoing debates. Methods: A literature search was performed using MEDLINE database

  11. Robotics in percutaneous cardiovascular interventions.

    Science.gov (United States)

    Pourdjabbar, Ali; Ang, Lawrence; Behnamfar, Omid; Patel, Mitul P; Reeves, Ryan R; Campbell, Paul T; Madder, Ryan D; Mahmud, Ehtisham

    2017-11-01

    The fundamental technique of performing percutaneous cardiovascular (CV) interventions has remained unchanged and requires operators to wear heavy lead aprons to minimize exposure to ionizing radiation. Robotic technology is now being utilized in interventional cardiology partially as a direct result of the increasing appreciation of the long-term occupational hazards of the field. This review was undertaken to report the clinical outcomes of percutaneous robotic coronary and peripheral vascular interventions. Areas covered: A systematic literature review of percutaneous robotic CV interventions was undertaken. The safety and feasibility of percutaneous robotically-assisted CV interventions has been validated in simple to complex coronary disease, and iliofemoral disease. Studies have shown that robotically-assisted PCI significantly reduces operator exposure to harmful ionizing radiation without compromising procedural success or clinical efficacy. In addition to the operator benefits, robotically-assisted intervention has the potential for patient advantages by allowing more accurate lesion length measurement, precise stent placement and lower patient radiation exposure. However, further investigation is required to fully elucidate these potential benefits. Expert commentary: Incremental improvement in robotic technology and telecommunications would enable treatment of an even broader patient population, and potentially provide remote robotic PCI.

  12. Weak layer fracture: facets and depth hoar

    Directory of Open Access Journals (Sweden)

    I. Reiweger

    2013-09-01

    Full Text Available Understanding failure initiation within weak snow layers is essential for modeling and predicting dry-snow slab avalanches. We therefore performed laboratory experiments with snow samples containing a weak layer consisting of either faceted crystals or depth hoar. During these experiments the samples were loaded with different loading rates and at various tilt angles until fracture. The strength of the samples decreased with increasing loading rate and increasing tilt angle. Additionally, we took pictures of the side of four samples with a high-speed video camera and calculated the displacement using a particle image velocimetry (PIV algorithm. The fracture process within the weak layer could thus be observed in detail. Catastrophic failure started due to a shear fracture just above the interface between the depth hoar layer and the underlying crust.

  13. Invasive Species

    Science.gov (United States)

    Invasive species have significantly changed the Great Lakes ecosystem. An invasive species is a plant or animal that is not native to an ecosystem, and whose introduction is likely to cause economic, human health, or environmental damage.

  14. Early mediastinal seroma secondary to modified Blalock-Taussig shunts - successful management by percutaneous drainage

    International Nuclear Information System (INIS)

    Connolly, Bairbre L.; Temple, Michael J.; Chait, Peter G.; Restrepo, Ricardo; Adatia, Ian

    2003-01-01

    Large symptomatic mediastinal seroma following modified-BT shunts, traditionally required revisional thoracotomy. We describe percutaneous image-guided pigtail catheter drainage in the successful treatment of early mediastinal seroma secondary to PTFE Blalock-Taussig shunt, avoiding thoracotomy. A retrospective review of all relevant clinical and imaging records in five patients was performed. All five presented with intermittent stridor, respiratory distress and/or episodic desaturation within 6 weeks of their surgery. In four of five infants, percutaneous drainage was effective and reoperation was avoided. In one of five, rather than urgent surgical evacuation and BT shunt revision, we were able to perform an elective stage-II bidirectional Glenn SVC-RA anastamosis in a stable infant. There were no complications. Percutaneous image-guided drainage of mediastinal seroma secondary to PTFE-BT shunt is a safe, minimally invasive, and effective treatment. This may avoid BT shunt revision. (orig.)

  15. Utilization of a Technique of Percutaneous S2 Alar-Iliac Fixation in Immunocompromised Patients with Spondylodiscitis.

    Science.gov (United States)

    Funao, Haruki; Kebaish, Khaled M; Isogai, Norihiro; Koyanagi, Takahiro; Matsumoto, Morio; Ishii, Ken

    2017-01-01

    Spondylodiscitis still remains a serious problem, especially in immunocompromised patients. Surgery is necessary when nonsurgical treatment is unsuccessful. Although minimally invasive spine stabilization (MISt) with percutaneous pedicle screws is less invasive, percutaneous sacropelvic fixation techniques are not common practice. Here, we describe 2 cases in which spondylodiscitis in the lumbosacral spine was treated with percutaneous stabilization using an S2 alar-iliac (S2AI) screw technique. Case 1 is a 77-year-old man who presented with low back pain and high fever. He was diagnosed with spondylodiscitis at L4-5. He had a history of lung cancer, which was complicated by the recurrence. Because nonsurgical treatment failed, MISt with percutaneous S2AI screws was performed. The patient's low back pain subsided markedly 1 week after surgery, and there was no screw/rod breakage or recurrence of infection during the follow-up period. Case 2 is a 71-year-old man who presented with hemiparesis because of a stroke. He also developed high fever and was diagnosed with spondylodiscitis at L5-S1. Because nonsurgical treatment failed, the patient was treated by MISt with percutaneous S2AI screws while being maintained on anticoagulants for stroke. Although his clinical symptoms had markedly improved, a postoperative lumbar computed tomography scan demonstrated a bone defect at L5-S1. An anterior spinal fusion with an iliac bone graft at L5-S1 was performed when a temporary cessation of anticoagulants was permitted. Both patients tolerated the procedures well and had no major perioperative complications. MISt with percutaneous S2AI screws was less invasive and efficacious for lumbosacral spondylodiscitis in providing rigid percutaneous sacropelvic fixation. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. A note on clique-web facets for multicut polytopes

    DEFF Research Database (Denmark)

    Sørensen, Michael Malmros

    2002-01-01

    In this note we provide a previously undiscovered necessary condition for the facet-defining property of clique-web inequalities for the multicut polytope. This condition imposes a minimum cardinality requirement on the node set of the clique, thus implying, in general, that clique-web inequalities...... associated with relatively small cliques are not facet-defining for multicut polytopes....

  17. A Note on Clique-Web Facets for Multicut Polytopes

    DEFF Research Database (Denmark)

    Sørensen, Michael Malmros

    2002-01-01

    In this note we provide a previously undiscovered necessary condition for the facet defining property of clique-web inequalities for the multicut polytope. This condition imposes a minimum cardinality requirement on the node set of the clique, thus implying that clique-web inequalities associated...... with relatively small cliques are not facet defining in general for multicut polytopes....

  18. /facet: A Browser for Heterogeneous Semantic Web Repositories

    NARCIS (Netherlands)

    M. Hildebrand (Michiel); J.R. van Ossenbruggen (Jacco); L. Hardman (Lynda)

    2006-01-01

    textabstractFacet browsing has become popular as a user friendly interface to data repositories. The Semantic Web raises new challenges due to the heterogeneous character of the data. First, users should be able to select and navigate through facets of resources of any type and to make selections

  19. Proximal attrition facets: morphometric, demographic, and aging characteristics.

    Science.gov (United States)

    Sarig, Rachel; Hershkovitz, Israel; Shvalb, Nir; Sella-Tunis, Tatiana; May, Hila; Vardimon, Alexander D

    2014-08-01

    Although interproximal attrition is considered to be limited in modern populations, it has important clinical implications. However, in contrast to occlusal attrition, proximal attrition receives limited scientific attention. The main purpose of the current study was to fill this void. Seven-hundred and sixty-five teeth were collected from 255 skulls of subjects 18-75 yr of age. For each individual, three mandibular teeth (the first and second premolars and the first molar) were examined for proximal attrition facets (PAFs). The results provide detailed information on the size, shape, and location of the facets according to age cohort, gender, and ethnicity. The validity of the method used to measure the facets was also examined. The major findings were as follows: PAFs are usually located on the upper half of the crown proximal aspect; in each tooth, the mesial facet is more lingually positioned and the distal facet is more buccally positioned; the majority of the facets are subrectangular in shape; the size of the facets tends to increase in an anteroposterior direction (from premolars to molars); and facet size and location are age- and sex-dependent and ethnicity-independent. It is our recommendation that dentists bear in mind that interproximal attrition is a dynamic, long-term process and needs to be considered in many clinical scenarios. © 2014 Eur J Oral Sci.

  20. [Treatment of spondyloarthrosis and lumbar discopathy by combined minimally invasive techniques].

    Science.gov (United States)

    Zakirov, A A; Dreval', O N; Chagava, D A; Rynkov, I P; Kuznetsov, A V

    2012-01-01

    The study was performed to develop differentiated indications and determination of effectiveness of percutaneous cold plasma nucleoplasty (PCPN) of intervertebral discs combined with percutaneous radiofrequency facet denervation (PRFD) in vertebrogenic pain syndromes. 139 patients surgically treated between 2007 and 2010 were included in this study. In 46 cases PRFD was performed, PCPN in 44 and PCPN of lumbar spine combined with PRFD in 49 cases. Surgical results were assessed on 2--3rd day after surgery and after 6-12 months. Achieved results confirmed that combined technique using PCPN and PRFD in most complicated cases with arthrogenic and discogenic lumbar pain is effective.

  1. New facets of the STS polytope generated from known facets of the ATS polytope.

    Energy Technology Data Exchange (ETDEWEB)

    Simonetti, Neil (Bryn Athyn College of the New Church, Bryn Athyn, PA); Fischetti, Matteo (University of Padova, Padova, Italy); Balas, Egon (Carnegie Mellon University, Pittsburgh, PA); Carr, Robert D.

    2005-05-01

    While it had been known for a long time how to transform an asymmetric traveling salesman (ATS) problem on the complete graph with n vertices into a symmetric traveling salesman (STS) problem on an incomplete graph with 2n vertices, no method was available for using this correspondence to derive facets of the symmetric polytope from facets of the asymmetric polytope until the work of E. Balas and M. Fischetti in [Lifted cycle inequalities for the asymmetric traveling salesman problem, Mathematics of Operations Research 24 (2) (1999) 273-292] suggested an approach. The original Balas-Fischetti method uses a standard sequential lifting procedure for the computation of the coefficient of the edges that are missing in the incomplete STS graph, which is a difficult task when addressing classes of (as opposed to single) inequalities. In this paper we introduce a systematic procedure for accomplishing the lifting task. The procedure exploits the structure of the tight STS tours and organizes them into a suitable tree structure. The potential of the method is illustrated by deriving large new classes of facet-defining STS inequalities.

  2. Investigation of stresses in facetted glass shell structures

    DEFF Research Database (Denmark)

    Bagger, Anne; Jönsson, Jeppe; Wester, Ture

    2007-01-01

    system, while the glass merely serves as a separation of the inside environment from the outside. In this paper facetted glass shell structures with three way vertices, i.e. with three adjoining edges in each vertex are considered, since the load carrying ability of such a structure is achieved primarily......The typical use of triangular and quadrangular facets in doubly curved facetted shells requires the use of triangulated truss systems or quadrangular truss framing with diagonals or cross tension cabling. In such a structure, the load carrying ability is based on concentrated forces in the framing...... by in-plane forces in the facets and the transfer of distributed in-plane forces across the joints. It is described how these facets work structurally, specifically how bending moments develop and cause possible stress concentrations in the corners, which are subjected to uplift. Apart from local...

  3. Concurrent, parallel, multiphysics coupling in the FACETS project

    Energy Technology Data Exchange (ETDEWEB)

    Cary, J R; Carlsson, J A; Hakim, A H; Kruger, S E; Miah, M; Pletzer, A; Shasharina, S [Tech-X Corporation, 5621 Arapahoe Avenue, Suite A, Boulder, CO 80303 (United States); Candy, J; Groebner, R J [General Atomics (United States); Cobb, J; Fahey, M R [Oak Ridge National Laboratory (United States); Cohen, R H; Epperly, T [Lawrence Livermore National Laboratory (United States); Estep, D J [Colorado State University (United States); Krasheninnikov, S [University of California at San Diego (United States); Malony, A D [ParaTools, Inc (United States); McCune, D C [Princeton Plasma Physics Laboratory (United States); McInnes, L; Balay, S [Argonne National Laboratory (United States); Pankin, A, E-mail: cary@txcorp.co [Lehigh University (United States)

    2009-07-01

    FACETS (Framework Application for Core-Edge Transport Simulations), is now in its third year. The FACETS team has developed a framework for concurrent coupling of parallel computational physics for use on Leadership Class Facilities (LCFs). In the course of the last year, FACETS has tackled many of the difficult problems of moving to parallel, integrated modeling by developing algorithms for coupled systems, extracting legacy applications as components, modifying them to run on LCFs, and improving the performance of all components. The development of FACETS abides by rigorous engineering standards, including cross platform build and test systems, with the latter covering regression, performance, and visualization. In addition, FACETS has demonstrated the ability to incorporate full turbulence computations for the highest fidelity transport computations. Early indications are that the framework, using such computations, scales to multiple tens of thousands of processors. These accomplishments were a result of an interdisciplinary collaboration among computational physics, computer scientists and applied mathematicians on the team.

  4. Percutaneous Sacroplasty for Non-neoplastic Osteoporotic Sacral Insufficiency Fractures.

    Science.gov (United States)

    Heo, Dong-Hwa; Park, Choon-Keun

    2017-02-01

    Osteoporosis is an important problem in those of advanced age. Osteoporosis can induce sacral insufficiency fractures (SIFs). As average life expectancy increases, the number of patients with osteoporotic SIFs also increases. Osteoporotic SIFs cause severe low back pain and immobilization. Treatment of SIFs varies from analgesia to surgery. To describe our experience and assess the safety and effectiveness of minimally invasive percutaneous sacroplasty in patients with osteoporotic SIFs. Retrospective evaluation. The spine and joint specialized hospital's research center. We reviewed cases of percutaneous sacroplasty performed since 2009. We used data only from patients with osteoporotic SIFs who were followed for more than 12 months after sacroplasty. Tumor-related SIFs were excluded from our analysis. The following clinical parameters were investigated: initial diagnosis, symptoms, visual analog scale (VAS) of pain, functional mobility scale (FDC) score, past history of illness, amount of bone cement infused, and complications related to sacroplasty. Also, the following radiological parameters were analyzed: the pattern of SIFs, T-score cement leakage, and concomitant fractures in other sites. Sixty-eight patients were enrolled in our study (4 men and 64 women). The mean age of the patients was 76.8 ± 6.2 years. All patients had severe osteoporosis (mean T score: -3.9 ± 0.5). Percutaneous sacroplasty was performed under fluoroscopic guidance. No major complications or procedure-related morbidity occurred. FDS and VAS scores significantly improved after sacroplasty, and the improvements lasted through the final follow-up period (P osteoporotic SIFs refractory to conservative management. The study patients experienced significant relief of pain and increased mobility.Key words: Sacrum, sacroplasty, insufficiency fractures, osteoporosis, minimally invasive surgery.

  5. Percutaneous Adductor Release in Nonambulant Children with Cerebral Palsy

    Directory of Open Access Journals (Sweden)

    Ramji Lal Sahu

    2014-03-01

    Full Text Available Introduction: Adductor spasticity at hips is the main barrier in functional activities and rehabilitation of spastic cerebral palsy patients. The aim of this study is to evaluate the results of percutaneous adductor release under general anesthesia. Methods: From July 2005 to July 2010, 64 hips in 32 patients (19 males and 13 females were recruited from outpatient department having adductor contracture at hips in cerebral palsy children. All children were operated under general anesthesia. All children were followed for twenty-four months. The clinical results were evaluated radiologically, including measurement of CE- angle, AC-index and femoral head coverage and in terms of activity level of children. Results: Of the thirty-two children, twenty-eight showed marked and immediate improvement. None of our children was functionally worse at follow-up. The CE-angle and femoral head coverage did not change significantly. The AC-index improved significantly (p = 0.01.The results were excellent in 12.5% children, good in 50%, fair in 25% and poor in 12.5%. Conclusions: Bilateral mini-invasive adductor release can be an effective treatment for children suffering from adductor contracture refractory to nonoperative management and early adductor release can prevent subluxation and possibly the need for future bony procedure on the proximal femur and pelvis. Keywords: Adductor contracture, Percutaneous, Cerebral palsy, Minimal invasive procedure.

  6. Lumbar facet anatomy changes in spondylolysis: a comparative skeletal study

    Science.gov (United States)

    Dar, Gali; Peleg, Smadar; Steinberg, Nili; Alperovitch-Najenson, Dvora; Salame, Khalil; Hershkovitz, Israel

    2007-01-01

    Opinions differ as to the exact mechanism responsible for spondylolysis (SP) and whether individuals with specific morphological characteristics of the lumbar vertebral neural arch are predisposed to SP. The aim of our study was to reveal the association between SP and the architecture of lumbar articular facets and the inter-facet region. Methods: Using a Microscribe three-dimensional apparatus (Immersion Co., San Jose, CA, USA), length, width and depth of all articular facets and all inter-facet distances in the lumbar spine (L1–L5) were measured. From the Hamann-Todd Human Osteological Collection (Cleveland Museum of Natural History, OH, USA) 120 normal male skeletons with lumbar spines in the control group and 115 with bilateral SP at L5 were selected. Analysis of variance was employed to examine the differences between spondylolytic and normal spines. Results: Three profound differences between SP and the norm appeared: (1) in individuals with SP, the size and shape of L4’s neural arch had significantly greater inter-facet widths, significantly shorter inter-facet heights and significantly shorter and narrower articular facets; (2) only in the L4 vertebra in individuals with SP was the inferior inter-facet width greater in size than the superior inter-facet width of the vertebra below (L5) (38.7 mm versus 40 mm); (3) in all lumbar vertebrae, the right inferior articular facets in individuals with SP were flatter compared to the control group. Conclusions: Individuals with L4 “SP” characteristics are at a greater risk of developing fatigue fractures in the form of spondylolysis at L5. PMID:17440753

  7. Minimizing radiation exposure during percutaneous nephrolithotomy.

    Science.gov (United States)

    Chen, T T; Preminger, G M; Lipkin, M E

    2015-12-01

    Given the recent trends in growing per capita radiation dose from medical sources, there have been increasing concerns over patient radiation exposure. Patients with kidney stones undergoing percutaneous nephrolithotomy (PNL) are at particular risk for high radiation exposure. There exist several risk factors for increased radiation exposure during PNL which include high Body Mass Index, multiple access tracts, and increased stone burden. We herein review recent trends in radiation exposure, radiation exposure during PNL to both patients and urologists, and various approaches to reduce radiation exposure. We discuss incorporating the principles of As Low As reasonably Achievable (ALARA) into clinical practice and review imaging techniques such as ultrasound and air contrast to guide PNL access. Alternative surgical techniques and approaches to reducing radiation exposure, including retrograde intra-renal surgery, retrograde nephrostomy, endoscopic-guided PNL, and minimally invasive PNL, are also highlighted. It is important for urologists to be aware of these concepts and techniques when treating stone patients with PNL. The discussions outlined will assist urologists in providing patient counseling and high quality of care.

  8. Percutaneous Nephrolithotomy for Paediatric Stone Disease

    Directory of Open Access Journals (Sweden)

    Hüseyin Çelik

    2015-06-01

    Full Text Available We evaluated the outcomes and complications occurring following percutaneous nephrolithotomy (PCNL procedures performed in paediatric patients. There were 291 paediatric patients (293 renal units included in the current study and who underwent PCNL in our clinic between March 1999 and December 2014. We evaluated stone burden, duration of surgery and complications, success (stone-free rate, residual fragments and auxilliary procedures, and follow-up details. The stone-free rate following PCNL was 88.3%. Early postoperative complications included excessive bleeding and transfusion in nine patients, and prolonged urinary extravasation following removal of the nephrostomy tube and requiring JJ stent placement in eight patients. The mean time to catheter removal was 2.8 days and the mean hospitalisation time was 3.5 days. The aim of kidney stone treatment is to achieve minimal kidney damage with the highest success rate. Therefore, minimally invasive procedures are important in the paediatric age group where life expectancy is high. PCNL is a safe and effective procedure for the treatment of kidney stones in children.

  9. Evaluation of percutaneous transhepatic gastroesophageal varices embolization

    International Nuclear Information System (INIS)

    Yao Hongxiang; Chen Gensheng; Sun Huiling; Zeng Yun; Yan Zhiping

    2008-01-01

    Objective: To evaluate the clinical application of percutaneous transheaptic gastroesophgeal varices embolization (PTVE) for treatment and prevention of acute upper gastrointestinal bleeding in patients with cirrhotic portal hypertension. Methods: 48 patients with cirrhotic portal hypertension and gastroesophageal varices were treated with PTVE for the prevention and control of upper gastrointestinal bleeding. Results: The technical success of PTVE was 97.9% and the rate of hemostasis was 100%. During the procedure, steel coil displacement occurred in 1 case, vagus nerve reflection with blood pressure degression and heart rate decline in 4 cases. After the procedure, 1 patients developed refractory ascites and 1 patients died of abdominal bleeding. 2 cases died of hepatic failure and 2 cases occurred rehaemorrhagia in fore 6 mon. after one year follow-up; 3 cases losed follow-up and 5 cases occurred rehaemorrhagia in the late 6 mon. Conclusion: PTVE is mini-invasive and efficient in treating acute upper gastrointestinal bleeding in patients with cirrhotic portal hypertension. Increase of technical success and decreases of morbidity can be achieved on the condition of' proper maneuver. (authors)

  10. Ultra-steep side facets in multi-faceted SiGe/Si(001 Stranski-Krastanow islands

    Directory of Open Access Journals (Sweden)

    Brehm Moritz

    2011-01-01

    Full Text Available Abstract For the prototypical Ge/Si(001 system, we show that at high growth temperature a new type of Stranski-Krastanow islands is formed with side facets steeper than {111} and high aspect ratio. Nano-goniometric analysis of the island shapes reveals the presence of six new facet groups in addition to those previously found for dome or barn-shaped islands. Due to the highly multi-faceted island shape and high aspect ratio, the new island types are named "cupola" islands and their steepest {12 5 3} side facet is inclined by 68°to the substrate surface. Assessing the relative stability of the new facets from surface area analysis, we find that their stability is similar to that of {113} and {15 3 23} facets of dome islands. The comparison of the different island shapes shows that they form a hierarchical class of geometrical structures, in which the lower aspect ratio islands of barns, domes and pyramids are directly derived from the cupola islands by successive truncation of the pedestal bases without facet rearrangements. The results underline the key role of surface faceting in the process of island formation, which is as crucial for understanding the island's growth evolution as it is important for device applications.

  11. Obstructive jaundice: a comparative study of forceps and brush biopsy under percutaneous transhepatic cholangiography

    International Nuclear Information System (INIS)

    Li Yongdong; Han Xinwei; Wu Gang; Ma Bo; Xing Gusheng

    2004-01-01

    Objective: To compare the sensitivity between forceps biopsy and brushing, and to explore a feasible approach to pathological diagnosis of the obstructive jaundice. Methods: 92 consecutive patients with obstructive jaundice underwent transluminal forceps biopsy and brushing during percutaneous transhepatic cholangiography and percutaneous transhepatic cholangiodrainage. The technique was performed through a preexisting percutaneous transhepatic tract with multiple specimens obtained after passing the forceps biopsy or brush into a 8-French sheath. Finally the specimens were fixed with formalin for pathologic or cytologic diagnosis. Results: The histopathologic diagnosis was acquired in 81 out of 92 patients with forceps biopsy reaching the successful rate of 97.83%. Sensitivity of forceps biopsy in 92 patients was higher than that of brush in 84 patients (88.04% vs 76.19% χ 2 =4.251, P= <0.05). Conclusions: Percutaneous transhepatic cholangiobiopsy is a simple technique with minimal invasion, high sensitivity and worthy to be used spread extensively. Percutaneous transluminal brush cytology is also an useful method for establishing a diagnosis of cholangiocarcinoma. (authors)

  12. Percutaneous vertebroplasty for symptomatic osteoporotic vertebral compression fracture adjacent to lumbar instrumented circumferential fusion.

    Science.gov (United States)

    Yang, Shih-Chieh; Chen, Hung-Shu; Kao, Yu-Hsien; Ma, Ching-Hou; Tu, Yuan-Kun; Chung, Kao-Chi

    2012-07-01

    The purpose of this study was to evaluate the efficacy and safety of percutaneous vertebroplasty for patients with symptomatic osteoporotic vertebral compression fractures adjacent to lumbar instrumented circumferential fusion. Between January 2005 and June 2010, eighteen patients in the authors' institution with lumbar instrumented circumferential fusion had adjacent symptomatic osteoporotic vertebral compression fractures. The patients received percutaneous vertebroplasty using polymethylmethacrylate bone cement augmentation. Radiographs and magnetic resonance imaging were used. The visual analog pain scale and modified Brodsky's criteria were used to compare clinical outcomes pre- and postoperatively. Minimum follow-up was 18 months. Dual-energy x-ray absorptiometry scan confirmed osteoporosis in all patients. The average interval between fusion surgery and sustaining osteoporotic vertebral compression fractures was 24.8 months. The average interval between sustaining osteoporotic vertebral compression fractures and undergoing percutaneous vertebroplasty was 49.3 days. One-level percutaneous vertebroplasty was performed in 13 patients, and 2 levels were performed in 5 patients. The patients' visual analog pain scale scores improved by an average of 53 points postoperatively. Fifteen patients returned to preinjury activities of daily living. The average restoration of the fractured vertebral body height was 12.1%. No major surgery-related complications, occurred except asymptomatic cement leakage in 3 patients. Elderly patients undergoing lumbar instrumented fusion surgery should be aware of the possibility of adjacent vertebral compression fractures. Percutaneous vertebroplasty is a minimally invasive and effective procedure to treat such adjacent segment disease. Copyright 2012, SLACK Incorporated.

  13. Percutaneous Microwave Ablation in the Spleen for Treatment of Hypersplenism in Cirrhosis Patients.

    Science.gov (United States)

    Jiang, XiangWu; Gao, Fei; Ma, Yan; Feng, ShuFen; Liu, XueLian; Zhou, HongKe

    2016-01-01

    The aim of this study was to estimate the feasibility and therapeutic effectiveness of percutaneous microwave ablation in the treatment of hypersplenism in cirrhosis. Forty-one cirrhosis patients with hypersplenism were treated with ultrasonography-guided percutaneous microwave ablation between February 2007 and August 2011. Peripheral blood cell counts, portal vein diameter, splenic vein diameter, and blood flow of splenic vein were evaluated before and after the operation, and complications of the treatment were also investigated. All patients were followed up for 24 months. The levels of platelets and white blood cells were increased, while the splenic vein diameter narrowed gradually after the therapy and 24 months later. Moreover, patients received percutaneous microwave ablation had much lower splenic venous flow velocity. The portal vein diameter did not change significantly 6 months after the treatment, although it narrowed gradually within 3 months after the treatment. Furthermore, no complications such as uncontrollable bleeding, splenic abscess, spleen rupture, and damage in surrounding organ happened after the therapy. Graded percutaneous microwave ablation, as a minimally invasive therapy, could damage the spleen, increase the levels of platelets and white blood cells, and reduce portal hypertension effectively without serious complications. Percutaneous microwave ablation is an effective, safe, and feasible method for cirrhosis patients with hypersplenism.

  14. An overview of systems for CT- and MRI-guided percutaneous needle placement in the thorax and abdomen

    NARCIS (Netherlands)

    Arnolli, Maarten Menno; Hanumara, Nevan C.; Franken, Michel; Brouwer, Dannis Michel; Broeders, Ivo Adriaan Maria Johannes

    2015-01-01

    Background Minimally invasive biopsies, drainages and therapies in the soft tissue organs of the thorax and abdomen are typically performed through a needle, which is inserted percutaneously to reach the target area. The conventional workflow for needle placement employs an iterative freehand

  15. Percutaneous tracheostomy: a comprehensive review

    Science.gov (United States)

    Rashid, Ashraf O.

    2017-01-01

    Tracheostomy is a common procedure. It can be done surgically or percutaneously by dilating the stoma using Seldinger technique. Percutaneous tracheostomy (PT) is now routinely performed by surgeons and non-surgeons such as intensivists and anesthesiologists in the intensive care units (ICU) all over the world. Although obesity, emergent tracheostomy, coagulopathy, inability to extend the neck and high ventilator demand (HVD) were initially thought to be a relative contraindication, recent data suggest safety of PT in these patient population. Ultrasound can be helpful in limited cases to identify the neck structure especially in patients with a difficult anatomy. Bronchoscopy during PT can shorten the duration and avoid complications. PT has favorable complication rate, lower infection rate, shorter procedural duration and is cost-effective. Experience with the technique and careful planning is needed to minimize any avoidable potential complication. PMID:29214070

  16. Percutaneous cryoablation for hepatocellular carcinoma

    Directory of Open Access Journals (Sweden)

    Kyoung Doo Song

    2016-12-01

    Full Text Available Local ablation therapy is considered as a conventional treatment option for patients with early stage hepatocellular carcinoma (HCC. Although radiofrequency (RF ablation is widely used for HCC, the use of cryoablation has been increasing as newer and safer cryoablation systems have developed. The thermodynamic mechanism of freezing and thawing used in cryoablation is the Joule-Thomson effect. Cryoablation destroys tissue via direct tissue destruction and vascular-related injury. A few recent comparative studies have shown that percutaneous cryoablation for HCCs is comparable to percutaneous RF ablation in terms of long term therapeutic outcomes and complications. Cryoablation has several advantages over RF ablation such as well visualization of iceball, no causation of severe pain, and lack of severe damage to great vessels and gallbladder. It is important to know the advantages and disadvantages of cryoablation compared with RF ablation for improvement of therapeutic efficacy and safety.

  17. Percutaneous Fixation of Displaced Calcaneal Fracture

    Directory of Open Access Journals (Sweden)

    Yeung Yip-Kan

    2011-06-01

    Conclusion: Percutaneous fixation of displaced tongue-type calcaneal fractures is an effective treatment with acceptable clinical outcome, short hospital stay, minimal skin complications, and quick recovery.

  18. Nephrostomy in percutaneous nephrolithotomy (PCNL)

    DEFF Research Database (Denmark)

    Cormio, Luigi; Preminger, Glenn; Saussine, Christian

    2013-01-01

    PURPOSE: To explore the relationships between nephrostomy tube (NT) size and outcome of percutaneous nephrolithotomy (PCNL). METHODS: The Clinical Research Office of the Endourological Society (CROES) prospectively collected data from consecutive patients treated with PCNL over a 1-year period at......; nephrostomy size > 18 Fr) NT. RESULTS: Patients who received a LB NT had a significantly lower rate of hemoglobin reduction (3.0 vs. 4.3 g/dL; P ...

  19. The convergence and divergence of impulsivity facets in daily life.

    Science.gov (United States)

    Sperry, Sarah H; Lynam, Donald R; Kwapil, Thomas R

    2017-11-10

    Impulsivity appears to be best conceptualized as a multidimensional construct. For example, the UPPS-P model posits that there are five underlying facets of impulsivity. The present study examined the expression of the UPPS-P facets in daily life using experience sampling methodology. A specific goal of the study was to examine positive urgency, a facet added to the original UPPS model, and its convergence and divergence from the negative urgency facet. A large nonclinical sample of young adults (n = 294) completed the UPPS-P scale and was signaled to complete questionnaires assessing daily affect, cognitions, sense of self, and impulsive behaviors eight times a day for 7 days. Results indicated that the UPPS-P facets are associated with disruptions in affect, cognitions, and behavior in daily life. Furthermore, all of the UPPS-P facets were associated with impulsivity in daily life. Contrary to expectation, positive urgency was associated with negative affect rather than positive affect and had a profile indistinguishable from negative urgency. These results generally support a four-factor model of multidimensional impulsivity with a general overall urgency factor instead of separate positive and negative urgency facets. © 2017 Wiley Periodicals, Inc.

  20. Percutaneous transhepatic portacaval shunt (PTPS)

    International Nuclear Information System (INIS)

    Chu Jianguo; Sun Xiaoli; Lv Chunyan; Xu Xiaoming; Huang He; Yang Shuhui; Zhou Hua

    2005-01-01

    Objective: To present a latest procedures for portal hypertension with preliminary results and evaluate the technical feasibility and efficacy of the portacaval shunt creation through percutaneous transhepatic approach with its potential clinical significance. Methods: Nineteen patients with portal hypertension (17 men; mean age 57 years, range 32-73) were referred for PTPS procedure because of bleeding varices (n=16), intractable ascites (n=2), and hepatopulmonary syndrome (n=1). The severity of liver disease was Child's B in 4 and Child's C in 15. The PTPS was created by a percutaneous transhepatic puncture through left portal vein to the IVC and a polytetrafluoroethylene (PTFE) stent-grafts was placed through a transhepatic approach. Results: Technical and functional successes were achieved in all patients-arerage without any procedure-related complications. The postprocedural portal vein-IVC gradients decreased with a mean 13 cmH 2 O and with average 216 days of follow-up showing no recurrent variceal bleeding and refractory ascites. The primary patency ratefor 365 days was 94.8%, obviously higher than classical TIPS. Conclusions: Portacaval shunt creation using the percutaneous transhepatic technique is secure and feasible with favorable primary patency due to the a straight line shunt construction and provide a good alternative to the standard portosystemic shunt in difficult or impossible circumstances. (authors)

  1. Pain reduction after percutaneous vertebroplasty for myeloma-associated vertebral fractures

    DEFF Research Database (Denmark)

    Simony, Ane; Hansen, Emil Jesper; Gaurilcikas, Marius

    2014-01-01

    INTRODUCTION: Percutaneous vertebroplasty (PVP) is a minimally invasive procedure with cement augmentation of vertebral fractures. It was introduced in 1987 as a treatment for painful haemangiomas and is today mostly used for painful osteoporotic fractures of the spine. Two randomised, double-bli....... The procedure can be repeated for several levels, and the pain relieving effect seems to be permanent. FUNDING: not relevant. TRIAL REGISTRATION: not relevant.......INTRODUCTION: Percutaneous vertebroplasty (PVP) is a minimally invasive procedure with cement augmentation of vertebral fractures. It was introduced in 1987 as a treatment for painful haemangiomas and is today mostly used for painful osteoporotic fractures of the spine. Two randomised, double....... The median VAS pain score decreased to 3.2 at the three-month follow-up. The results are statistically significant. No complications were observed either during or after the treatment. We observed cement leakage in 12.5% of the patients, but no patients with cement leakage had clinical symptoms. CONCLUSION...

  2. Association of facet tropism and progressive facet arthrosis after lumbar total disc replacement using ProDisc-L.

    Science.gov (United States)

    Shin, Myung-Hoon; Ryu, Kyeong-Sik; Hur, Jung-Woo; Kim, Jin-Sung; Park, Chun-Kun

    2013-08-01

    The purpose of this retrospective study was to examine the association of facet tropism and progressive facet arthrosis (PFA) after lumbar total disc replacement (TDR) surgery using ProDisc-L. A total of 51 segments of 42 patients who had undergone lumbar TDR using ProDisc-L between October 2003 and July 2007 and completed minimum 36-month follow-up period were retrospectively reviewed. The changes of facet arthrosis were categorized as non-PFA and PFA group. Comparison between non-PFA and PFA group was made according to age, sex, mean follow-up duration, grade of preoperative facet arthrosis, coronal and sagittal prosthetic position and degree of facet tropism. Multiple logistic regression analysis was also performed to analyze the effect of facet tropism on the progression of facet arthrosis. The mean age at the surgery was 44.43 ± 11.09 years and there were 16 males and 26 females. The mean follow-up period was 53.18 ± 15.79 months. Non-PFA group was composed of 19 levels and PFA group was composed of 32 levels. Age at surgery, sex proportion, mean follow-up period, level of implant, grade of preoperative facet arthrosis and coronal and sagittal prosthetic position were not significantly different between two groups (p = 0.264, 0.433, 0.527, 0.232, 0.926, 0.849 and 0.369, respectively). However, PFA group showed significantly higher degree of facet tropism (7.37 ± 6.46°) than that of non-PFA group (3.51 ± 3.53°) and p value was 0.008. After adjustment for age, sex and coronal and sagittal prosthetic position, multiple logistic regression analysis revealed that facet tropism of more than 5° was the only significant independent predictor of progression of facet arthrosis (odds ratio 5.39, 95 % confidence interval 1.251-19.343, p = 0.023). The data demonstrate that significant higher degree of facet tropism was seen in PFA group compared with non-PFA group and facet tropism of more than 5° had a significant association with PFA after TDR using ProDisc-L.

  3. Ultrasound guided, painful electrical stimulation of lumbar facet joint structures

    DEFF Research Database (Denmark)

    O'Neill, Søren; Graven-Nielsen, Thomas; Manniche, Claus

    2009-01-01

    placed either side of a lumbar facet joint (right L3-4) and used to induce experimental low back pain for 10 min with continuous stimulation. Thresholds, stimulus-response relationships, distribution and quality of the electrically induced pain were recorded. Electrical facet joint stimulation induced...... low back pain and pain referral into the anterior leg, ipsilaterally, proximal to the knee, similar to what is observed clinically. Pressure pain thresholds did not change significantly before, during and after facet joint stimulation. In conclusion, we describe a novel model of acute experimental low...

  4. Impact of Project Leadership Facets on Project Outcome

    Directory of Open Access Journals (Sweden)

    Arslan Ayub

    2015-08-01

    Full Text Available The study analyzes the role of project leadership facets on effective project outcome. Numerous such initiatives have already been taken on project outcome/performance in the context of apposite leadership styles or project management. However, the current study is unique in the milieu of project outcome that it introduces a new leadership approach, which throws light on the significance of variant leadership facets on project outcome. The study uses explanatory approach; primary data is collected from project management professionals working in different project organizations. The study uses structural equation model (SEM technique to test the hypothesis. The study found a positive relationship between project leadership facets and project outcome.

  5. Successful endovascular treatment of a hemodialysis graft pseudoaneurysm by covered stent and direct percutaneous thrombin injection.

    LENUS (Irish Health Repository)

    Keeling, Aoife N

    2011-07-25

    Vascular access for hemodialysis remains a challenge for nephrologists, vascular surgeons, and interventional radiologists alike. Arteriovenous fistula and synthetic grafts remain the access of choice for long-term hemodialysis; however, they are subject to complications from infection and repeated needle cannulation. Pseudoaneurysms are an increasingly recognized adverse event. At present, there are many minimally invasive methods to repair these wall defects. We present a graft pseudoaneurysm, which required a combination of endovascular stent graft placement and percutaneous thrombin injection for successful occlusion.

  6. Non-intubated recovery from refractory cardiogenic shock on percutaneous VA-extracorporeal membrane oxygenation

    OpenAIRE

    van Houte, J; Donker, D W; Wagenaar, L J; Slootweg, A P; Kirkels, J H; van Dijk, D

    2015-01-01

    We report on the use of percutaneous femoral veno-arterial extracorporeal membrane oxygenation (VA-ECMO) in a fully awake, non-intubated and spontaneously breathing patient suffering from acute, severe and refractory cardiogenic shock due to a (sub)acute anterior myocardial infarction. Intensified heart failure therapy was closely monitored with a pulmonary artery catheter and allowed gradual weaning off the ECMO support without additional invasive measures, notably without mechanical ventila...

  7. Percutaneous Disc Coagulation Therapy (PDCT) comparing with Automated Percutaneous Lumbar Discectomy (APLD) in Patients of Herniated Lumbar Disc Disease: Preliminary Report.

    Science.gov (United States)

    Park, Cheon Wook; Lee, Joo Yong; Choi, Woo Jin; Chang, Sang Keun

    2012-09-01

    Percutaneous techniques are rapidly replacing traditional open surgery. This is a randomized controlled trial study of clinical outcomes of Percutaneous Plasma Disc Coagulation Therapy (PDCT) in patients with HLD(herniated lumbar disc) as a new percutaneous access in comparison with Automated Percutaneous Lumbar Discectomy (APLD) in its clinical application and usefulness as a reliable alternative method. The authors analyzed 25 patients who underwent PDCT randomized 1:1 to 25 who underwent APLD between June, 2010 and October, 2011. All patients had herniated lumbar disc diseases. The clinical outcomes were evaluated using Visual Analog Scales (VAS) score and MacNab's criteria. The age of the patients who underwent PDCT ranged from 29 to 88 years with a mean age of 51.8 years. The age of the APLD undergone patients' population ranged from 30 to 66 with a mean age of 46.0 years. The average preoperative VAS score in PDCT was 7.60 and 1.94 at 7months post-operatively, and in APLD was 7.32, and 3.53 at 7 months post-operatively (pherniated lumbar disc. PDCT showed to be more effective than APLD in this study, allowing stable decompression and safe minimally invasive operation to an area desired by the operator in lumbar disc herniation patients, although further long term clinical evaluations are still necessary.

  8. Percutaneous transhepatic recanalization of malignant hilarobstruction: A possible rescue for early failure of endoscopic y-stenting

    International Nuclear Information System (INIS)

    Kwon, Hoon; Kim, Chang Won; Lee, Tae Hong; Kim, Dong Uk; Jeon, Ung Bae; Kang, Dae Hwan

    2013-01-01

    Endoscopic biliary stenting is well known as an optimal method of management of malignant hilar obstruction, but sometimes the result is not satisfactory, with early stent failure. Percutaneous transhepatic biliary drainage (PTBD) has a distinct advantage over endoscopic retrograde cholangiopancreatoscopy in that with ultrasound guidance one or more appropriate segments for drainage can be chosen. We evaluated the effectiveness of percutaneous transhepatic stenting as a rescue of early failure of endoscopic stenting. Ten patients (4 men, 6 women; age range, 52-78 years; mean age, 69 years) with inoperable biliary obstruction (2 patients with gall bladder cancer and hilar invasion, and 8 patients with Klatskin tumor) and with early endoscopic stent failure were included in our study. All of the patients underwent PTBD and percutaneous transhepatic biliary stenting. Metallic stents were placed in all patients for internal drainage. Percutaneous rescue stenting was successful in all the patients technically and clinically. Mean time for the development of biliary obstruction was 13.5 days after endoscopic stenting. The mean patency of the rescue stenting was 122 days. The mean survival time for percutaneous transhepatic rescue stenting was 226.3 days. In early failure of endoscopic biliary stenting, percutaneous transhepatic recanalization can be a possible solution.

  9. MR guided percutaneous laser lumbar disk hernia ablation

    Energy Technology Data Exchange (ETDEWEB)

    Hashimoto, Takuo; Terao, Tohru; Ishibashi, Toshihiro; Yuhki, Ichiro; Harada, Junta; Tashima, Michiko [Jikei Univ., Chiba (Japan). Kashiwa Hospital; Abe, Toshiaki

    1998-03-01

    An MRI unit for interventional procedure is very useful for minimally invasive surgery of the brain and spine. Percutaneous laser disc decompression (PLDD) utilizing X-ray fluoroscopy is a relatively new less invasive procedure for treatment of lumbar disc herniation. MR guided laser surgery is applied to patients with disc herniation at our department. Approaching the target of the disc protrusion was easily conducted and vaporizing the disc hernia directly using a laser was possible under MR fluoroscopy. The purpose of the present study is to evaluate the usefulness of MR guided percutaneous laser disc hernia ablation (MR-guided PLDHA). As subjects, 36 patients with lumbar disc herniation, including 23 cases with L4/5 involvement and 13 cases with L5/S1 involvement were studied. Among these, 26 were males and 10 were females, age ranging from 24 to 62. We used an open type MR system (Hitachi, Airis 0.3T), a permanent, open configuration MR system. A YAG laser (LaserScope, USA) was used for PLDHA. An MR compatible 18G titanium needle 15 cm in length was used to puncture the herniated discs. The MR compatible needle was clearly visualized, and used to safely and accurately puncture the target herniated disc in each case with multidimensional guidance. Application of the laser was performed with MR guidance. The energy dose from the laser ranged from 800 to 2100 joules. In most cases, signs and symptoms improved in the patients immediately after disc vaporization. The overall success rate was 88.9%. The complication rate was 2.8%, including one case of discitis after PLDHA. MR fluoroscopy sequence permits near real time imaging and provides an easy approach to the therapeutic target of disc herniation. MR guided PLDHA is a minimally invasive procedure and is very useful for the treatment of lumbar disc protrusion. (author)

  10. MR guided percutaneous laser lumbar disk hernia ablation

    International Nuclear Information System (INIS)

    Hashimoto, Takuo; Terao, Tohru; Ishibashi, Toshihiro; Yuhki, Ichiro; Harada, Junta; Tashima, Michiko; Abe, Toshiaki.

    1998-01-01

    An MRI unit for interventional procedure is very useful for minimally invasive surgery of the brain and spine. Percutaneous laser disc decompression (PLDD) utilizing X-ray fluoroscopy is a relatively new less invasive procedure for treatment of lumbar disc herniation. MR guided laser surgery is applied to patients with disc herniation at our department. Approaching the target of the disc protrusion was easily conducted and vaporizing the disc hernia directly using a laser was possible under MR fluoroscopy. The purpose of the present study is to evaluate the usefulness of MR guided percutaneous laser disc hernia ablation (MR-guided PLDHA). As subjects, 36 patients with lumbar disc herniation, including 23 cases with L4/5 involvement and 13 cases with L5/S1 involvement were studied. Among these, 26 were males and 10 were females, age ranging from 24 to 62. We used an open type MR system (Hitachi, Airis 0.3T), a permanent, open configuration MR system. A YAG laser (LaserScope, USA) was used for PLDHA. An MR compatible 18G titanium needle 15 cm in length was used to puncture the herniated discs. The MR compatible needle was clearly visualized, and used to safely and accurately puncture the target herniated disc in each case with multidimensional guidance. Application of the laser was performed with MR guidance. The energy dose from the laser ranged from 800 to 2100 joules. In most cases, signs and symptoms improved in the patients immediately after disc vaporization. The overall success rate was 88.9%. The complication rate was 2.8%, including one case of discitis after PLDHA. MR fluoroscopy sequence permits near real time imaging and provides an easy approach to the therapeutic target of disc herniation. MR guided PLDHA is a minimally invasive procedure and is very useful for the treatment of lumbar disc protrusion. (author)

  11. Percutaneous versus traditional and paraspinal posterior open approaches for treatment of thoracolumbar fractures without neurologic deficit: a meta-analysis.

    Science.gov (United States)

    Sun, Xiang-Yao; Zhang, Xi-Nuo; Hai, Yong

    2017-05-01

    This study evaluated differences in outcome variables between percutaneous, traditional, and paraspinal posterior open approaches for traumatic thoracolumbar fractures without neurologic deficit. A systematic review of PubMed, Cochrane, and Embase was performed. In this meta-analysis, we conducted online searches of PubMed, Cochrane, Embase using the search terms "thoracolumbar fractures", "lumbar fractures", ''percutaneous'', "minimally invasive", ''open", "traditional", "posterior", "conventional", "pedicle screw", "sextant", and "clinical trial". The analysis was performed on individual patient data from all the studies that met the selection criteria. Clinical outcomes were expressed as risk difference for dichotomous outcomes and mean difference for continuous outcomes with 95 % confidence interval. Heterogeneity was assessed using the χ 2 test and I 2 statistics. There were 4 randomized controlled trials and 14 observational articles included in this analysis. Percutaneous approach was associated with better ODI score, less Cobb angle correction, less Cobb angle correction loss, less postoperative VBA correction, and lower infection rate compared with open approach. Percutaneous approach was also associated with shorter operative duration, longer intraoperative fluoroscopy, less postoperative VAS, and postoperative VBH% in comparison with traditional open approach. No significant difference was found in Cobb angle correction, postoperative VBA, VBA correction loss, Postoperative VBH%, VBH correction loss, and pedicle screw misplacement between percutaneous approach and open approach. There was no significant difference in operative duration, intraoperative fluoroscopy, postoperative VAS, and postoperative VBH% between percutaneous approach and paraspianl approach. The functional and the radiological outcome of percutaneous approach would be better than open approach in the long term. Although trans-muscular spatium approach belonged to open fixation methods

  12. Percutaneous treatment of osteoid osteoma by CT-guided drilling resection in pediatric patients

    Energy Technology Data Exchange (ETDEWEB)

    Sierre, Sergio; Lipsich, Jose; Questa, Horacio; Moguillansky, Silvia [Hospital Nacional de Pediatria, Department of Interventional Radiology, Buenos Aires (Argentina); Innocenti, Sergio; Lanfranchi, Lucas [Hospital Nacional de Pediatria, Department of Orthopedics, Buenos Aires (Argentina)

    2006-02-01

    Osteoid osteoma is a painful, benign, small osteogenic bone tumor. For a long time, surgery was the only treatment for these lesions. Different minimally invasive therapeutic techniques have been proposed. We report our experience in the treatment of osteoid osteoma by CT-guided drilling resection in pediatric patients. To evaluate the efficacy of CT-guided percutaneous drilling resection as a minimally invasive therapy for osteoid osteoma in children. Over a 5-year period, 18 patients (age range 6-17 years, mean age 11.6 years) with osteoid osteomas (femur, n=10; tibia, n=5; humerus, n=2; vertebral body, n=1) were treated with this technique. All procedures were performed under general anesthesia. All procedures were technically successful. Clinical success was achieved in 94.5% of patients (17/18). Only one patient had recurrence of symptoms 8 months after percutaneous resection and was surgically retreated. There were no complications. CT-guided percutaneous drilling resection is a safe, simple and effective minimally invasive technique for the treatment of osteoid osteoma in pediatric patients. (orig.)

  13. Clarifying associations between psychopathy facets and personality disorders among offenders

    NARCIS (Netherlands)

    Klipfel, Kristen M.; Garofalo, C.; Kosson, D.S.

    2017-01-01

    Purpose This study examined bivariate, unique, and multivariate associations between psychopathy facets and other Personality Disorders (PDs). Method 76 incarcerated males were assessed with clinical interviews measuring psychopathy and DSM-5 PDs. Canonical Correlation Analysis (CCA) was used to

  14. Facets of Subjective Health From Early Adulthood to Old Age

    DEFF Research Database (Denmark)

    Franz, Carol E; Finkel, Deborah; Panizzon, Matthew S

    2017-01-01

    OBJECTIVE: Subjective health is a complex indicator predicting longevity independent of objective health. Few studies examine genetic and environmental mechanisms underlying different facets of subjective health across the life course. METHOD: Three subjective health measures were examined in 12,...

  15. The clinical aspects of the acute facet syndrome

    DEFF Research Database (Denmark)

    Hestbaek, Lise; Kongsted, Alice; Jensen, Tue Secher

    2009-01-01

    to agree on the number, frequency and duration of chiropractic treatment. RESULTS: Thirty-four chiropractors from nine European countries participated. They described the characteristics of an acute, uncomplicated facet syndrome as follows: local, ipsilateral pain, occasionally extending into the thigh...... that there would be no signs of neurologic involvement or antalgic posture and no aggravation of pain from sitting, flexion or coughing/sneezing. CONCLUSION: The chiropractors attending the workshop described the characteristics of an acute, uncomplicated lumbar facet syndrome in much the same way as chronic pain......ABSTRACT: BACKGROUND: The term 'acute facet syndrome' is widely used and accepted amongst chiropractors, but poorly described in the literature, as most of the present literature relates to chronic facet joint pain. Therefore, research into the degree of consensus on the subject amongst a large...

  16. Hypertrophic Synovitis of the Facet Joint Causing Root Pain

    Directory of Open Access Journals (Sweden)

    Koichi Iwatsuki M.D.

    2008-01-01

    Full Text Available Osteoarthritic changes in the facet joints are common in the presence of degenerative disc disease. Changes in the joint capsule accompany changes in the articular surfaces. Intraspinal synovial cysts that cause radicular pain, cauda equina syndrome, and myelopathy have been reported; however, there have been few reports in orthopedic or neurosurgical literature regarding hypertrophic synovitis of the facet joint presenting as an incidental para-articular mass. Here, we report a case of hypertrophic synovitis causing root pain. We describe the case of a 65-year-old man suffering from right sciatica and right leg pain in the L5 nerve-root dermatome for 1 year; magnetic resonance imaging (MRI revealed an enhanced mass around the L4–5 facet joint. We investigated this mass pathologically. After right medial facetectomy, the symptoms resolved. Pathological investigation revealed this mass was hypertrophic synovitis. Hypertrophic synovitis of the facet joint might cause root pain.

  17. Percutaneous balloon dilatation for benign hepaticojejunostomy strictures

    NARCIS (Netherlands)

    Vos, P. M.; van Beek, E. J.; Smits, N. J.; Rauws, E. A.; Gouma, D. J.; Reeders, J. W.

    2000-01-01

    BACKGROUND: Percutaneous balloon dilatation of biliary tract strictures is generally accepted as a safe and inexpensive procedure. The effectiveness in selected groups of patients remains under discussion. The purpose of this study was to evaluate the results of percutaneous balloon dilatation in

  18. PRIS at TREC 2010 Blog Track: Faceted Blog Distillation

    Science.gov (United States)

    2010-11-01

    faceted blog distillation system is presented. Finally in Section 4, conclusions and comments on the future work are given. 2 The Faceted Blog... VSM ) to score the blogs [9]. (p(t1|post), p(t2|post), p(t3|post) …p(ti|post)) and (personal(t1), personal(t2), personal(t3) …personal(ti)) can

  19. Framework Application for Core Edge Transport Simulation (FACETS)

    Energy Technology Data Exchange (ETDEWEB)

    Malony, Allen D; Shende, Sameer S; Huck, Kevin A; Mr. Alan Morris, and Mr. Wyatt Spear

    2012-03-14

    The goal of the FACETS project (Framework Application for Core-Edge Transport Simulations) was to provide a multiphysics, parallel framework application (FACETS) that will enable whole-device modeling for the U.S. fusion program, to provide the modeling infrastructure needed for ITER, the next step fusion confinement device. Through use of modern computational methods, including component technology and object oriented design, FACETS is able to switch from one model to another for a given aspect of the physics in a flexible manner. This enables use of simplified models for rapid turnaround or high-fidelity models that can take advantage of the largest supercomputer hardware. FACETS does so in a heterogeneous parallel context, where different parts of the application execute in parallel by utilizing task farming, domain decomposition, and/or pipelining as needed and applicable. ParaTools, Inc. was tasked with supporting the performance analysis and tuning of the FACETS components and framework in order to achieve the parallel scaling goals of the project. The TAU Performance System® was used for instrumentation, measurement, archiving, and profile / tracing analysis. ParaTools, Inc. also assisted in FACETS performance engineering efforts. Through the use of the TAU Performance System, ParaTools provided instrumentation, measurement, analysis and archival support for the FACETS project. Performance optimization of key components has yielded significant performance speedups. TAU was integrated into the FACETS build for both the full coupled application and the UEDGE component. The performance database provided archival storage of the performance regression testing data generated by the project, and helped to track improvements in the software development.

  20. Unilateral spondylolysis and the presence of facet joint tropism.

    Science.gov (United States)

    Rankine, James J; Dickson, Robert A

    2010-10-01

    Retrospective review of the CT scans performed in a group of patients examined for a possible spondylolysis. To investigate whether there is an association between unilateral spondylolysis and facet joint tropism. Spondylolysis is a fatigue fracture of the pars interarticularis of great importance in sports injury. The demonstration of a unilateral spondylolysis is important because there is a potential for full healing if the athletic activity is modified, whereas bilateral spondylolysis frequently leads to established nonunion. Coronally orientated facet joints are known to predispose to spondylolysis by increasing the point loading of the pars interarticularis. The importance of this finding has not been investigated in unilateral spondylolysis. A review of patients with low back pain and a possible diagnosis of spondylolysis who were investigated with multislice CT was performed. The coronal orientation of the facet joints at L4/5 and L5/S1 was measured and comparison was done between those with and without a spondylolysis. The coronal angle of 140 facet joints in 35 patients was recorded. Of 35 patients, 23 had a spondylolysis which was unilateral in 12 patients. The facet joint angle was significantly more coronally orientated in the presence of a spondylolysis when compared with an intact pars (means, 53° and 43°, respectively; P spondylolysis, the facet joint was significantly more coronally orientated on the side of the spondylolysis (means, 52° and 45°, respectively; P spondylolysis. Asymmetric facet joints do increase the force through one side of the spine, with a unilateral spondylolysis occurring on the side of the more coronally orientated facet joint.

  1. Proposal plan of classification faceted for federal universities

    Directory of Open Access Journals (Sweden)

    Renata Santos Brandão

    2017-09-01

    Full Text Available This study aims to present a faceted classification plan for the archival management of documents in the federal universities of Brazil. For this, was done a literature review on the archival management in Brazil, the types of classification plans and the theory of the Ranganathan faceted classification, through searches in databases in the areas of Librarianship and Archivology. It was identified the classification plan used in the Federal Institutions of Higher Education to represent the functional facet and created the structural classification plan to represent the structural facet. The two classification plans were inserted into a digital repository management system to give rise to the faceted classification plan. The system used was Tainacan, free software wordpress-based used in digital document management. The developed faceted classification plan allows the user to choose and even combine the way to look for the information that guarantees agreater efficiency in the information retrieval.

  2. Percutaneous vertebroplasty (pv): indications, contraindications, and technique

    International Nuclear Information System (INIS)

    Hoffmann, R.T.; Jakobs, T.F.; Wallnoefer, A.; Reiser, M.F.; Helmberger, T.K.

    2003-01-01

    Percutaneous vertebroplasty (pv) is a worldwide increasingly performed interventional therapeutic procedure. This article addresses indications, patient preparation, technical requirements and approach as well as possible complications of percutaneous vertebroplasty. Percutaneous vertebroplasty is a technique consisting in an injection of bone cement into a vertebral body under imaging guidance. This procedure is performed to relief pain and support the mechanical stability in partially collapsed vertebral bodies. In the management of spinal compression fractures secondary to osteoporosis, myeloma, osteolytic metastases and aggressive hemangiomas, percutaneous vertebroplasty yields analgesic effect, and provides additional fortification in weakened segments of the vertebral column. Contraindications include major bleeding disorders, radicular pain and pain caused by compression of the myelon. Percutaneous vertebroplasty results in prompt pain relief and rapid rehabilitation. In experienced hands, using correct technique, pv is a safe and effective procedure for treating pain, caused either by osteoporotic or malignant vertebral compression fractures. (orig.) [de

  3. A Rare Incidence of Breakage of tip of Micropituitary Forceps during Percutaneous Discectomy - How to Remove it: A Case Report

    Directory of Open Access Journals (Sweden)

    Sureisen M

    2015-11-01

    Full Text Available Breakage of the tip of the micropituitary forceps during spine surgery is a rare occurrence. Retrieval of the broken tip could be a challenge in minimally invasive surgeries due to limitation of access and retrieval instruments. We describe our experience in handling such a situation during percutaneous radiofrequency discectomy. The removal was attempted, without converting into open surgery, by utilising percutaneous endoscopic lumbar discectomy working cannula and guided by image intensifier. We were able to remove the fragment without any significant morbidity to the patient. This technique for removal has not been reported previously in the literature.

  4. [The percutaneous absorption of diclofenac].

    Science.gov (United States)

    Riess, W; Schmid, K; Botta, L; Kobayashi, K; Moppert, J; Schneider, W; Sioufi, A; Strusberg, A; Tomasi, M

    1986-07-01

    The percutaneous absorption of diclofenac diethylammonium 1.16% (w/w) in a combination of emulsion cream and gel (Voltaren Emulgel) and of diclofenac sodium 1% (w/w) in a cream formulation (Voltaren cream) was investigated in guinea-pig, rabbit and man. The percutaneous absorption of diclofenac sodium in guinea-pig was 3 to 6% of the dose when the cream formulation in doses of 320, 100 or 40 mg was applied on 10 cm2 of occluded skin and left in place for 6 h. The transdermal delivery of 14C-labelled diclofenac yielded plateau plasma concentrations of radiotracer from 1.5 h after application until removal of the residual cream. Subsequently the steady state drug depots in the skin and muscle tissue were depleted promptly. During daily administration the steady state levels in the muscle tissue in proximity to the application site were about 3 times higher than in distant muscle tissue. By topical application on knee joints of rabbits diclofenac penetrated into the patellar ligament, the adipose corpus and the synovial fluid. In man the percutaneous absorption was 6% of the dose when the Emulgel formulation was spread by 5 mg/cm2 and left for 12 h on non-occluded skin. The pattern of metabolites of diclofenac in human urine was the same after topical and oral administration. In man, upon daily topical administration of 3 times 2.5 g cream formulation (10 mg/cm2) the diclofenac steady state plasma levels were 20 to 40 nmol/l.(ABSTRACT TRUNCATED AT 250 WORDS)

  5. Publication Ethics: Many Facets, Collaboration Required

    Directory of Open Access Journals (Sweden)

    Viroj Wiwanitkit

    2013-05-01

    Full Text Available Sir, the recent publication on “Publication Ethics” is very interesting (1. The article by Fazly Bazzaz and Sadeghi demonstrated many interesting cases                   of misconducts. Indeed, the misconducts can be seen  in many ways. As mentioned in the present publication, both author and editor can perform publication misconducts. Nevertheless, the problem has many more facets. Sometimes, the misconducts                      are generated by the third parties. For example, the publisher can perform publication misconduct.                  In fact, the editor takes the role in control of                   the materials to be published in the journal. However, the publisher sometimes interferes with the process. Some unethical publication can be seen in some “predator” online publisher. “Pay then publish” without control of its quality can be seen                      (see also http://www.nature.com/news/predatory-publishers-are-corrupting-open-access-1.11385 and scholarlyoa.com/2012/12/06/bealls-list-of-edatory-publishers-2013. In the present era of rapidly increased number of open access journal, this problem is expected to increase. Another example is the criminal case of “one disguising to be the other person” to perform misconduct aiming at discrediting or destroying others. An interesting case was previously published in Hepatitis Monthly; an author performed plagiarized articles behind the name of another person and finally was charged by the IT investigation (2. Finally, the institute sometimes also performs misconduct. This can be supporting of their members who perform scientific misconduct by acts which do not correspond to the problem (this problem is usually seen in the problematic case generated by senior faculties or administrators, dealing with publisher to “buy” supplementary volume for publication of the works

  6. Clinical review: Percutaneous dilatational tracheostomy

    Science.gov (United States)

    Al-Ansari, Mariam A; Hijazi, Mohammed H

    2006-01-01

    As the number of critically ill patients requiring tracheotomy for prolonged ventilation has increased, the demand for a procedural alternative to the surgical tracheostomy (ST) has also emerged. Since its introduction, percutaneous dilatational tracheostomies (PDT) have gained increasing popularity. The most commonly cited advantages are the ease of the familiar technique and the ability to perform the procedure at the bedside. It is now considered a viable alternative to (ST) in the intensive care unit. Evaluation of PDT procedural modifications will require evaluation in randomized clinical trials. Regardless of the PDT technique, meticulous preoperative and postoperative management are necessary to maintain the excellent safety record of PDT. PMID:16356203

  7. Recent Advances in Percutaneous Nephrolithotomy

    Directory of Open Access Journals (Sweden)

    Erem Kaan Basok

    2014-05-01

    Full Text Available The continuous innovations in technology, instrumentations, and techniques allow urologists to perform percutaneous nephrolithotomy (PCNL with increasing efficacy. Although recent advances have facilitated the procedure, some steps are still challenging. A thorough review of the recent urologic literature was performed to identify these improvements in PCNL technique. The newer developments mainly focused on multimodal imaging techniques, miniaturisation of instruments, tracking and navigation systems during access to the stone, and robotic systems. Further studies are necessary to better define the benefits of these new fruitful developments which remain an active research field.

  8. Percutaneous drainage of lung abscesses

    International Nuclear Information System (INIS)

    van Sonnenberg, E.; D'Agostino, H.; Casola, G.; Vatney, R.R.; Wittich, G.R.; Harker, C.

    1989-01-01

    The authors performed percutaneous drainage of lung abscesses in 12 patients. Indications for drainage were septicemia and persistence or worsening of radiographic findings. These lung abscesses were refractory to intravenous antibiotics and to bronchial toilet. Etiology of the abscesses included pneumonia (most frequently), trauma, postoperative development, infected necrotic neoplasm, and infected sequestration. Guidelines for drainage included passage of the catheter through contiguously abnormal lung and pleura, inability of the patient to cough, and/or bronchial obstruction precluding bronchial drainage. Cure was achieved in 11 of 12 patients. Catheters were removed on an average of 16 days after insertion. Antibiotics were administered an average of 18 days before drainage. No major complications occurred

  9. A faceted eye on intellectual giftedness: Examining the personality of gifted students using FFM domains and facets

    Directory of Open Access Journals (Sweden)

    Altaras-Dimitrijević Ana

    2012-01-01

    Full Text Available The study examines the personality profile of gifted vs. average-ability students from the perspective of the FFM. The issue was approached by (1 reviewing the literature for well-established personality characteristics of the gifted, (2 establishing correspondences between these traits and FFM domains/facets, and (3 formulating a domain and a facet-level model which were hypothesized to discriminate significantly between gifted and nongifted students. The domain-level model consisted of Openness and Agreeableness. The facet-level model included 14 traits: Anxiety, Impulsiveness, Gregariousness, Assertiveness, Fantasy, Feelings, Aesthetics, Ideas, Compliance, Modesty, Tendermindedness, Order, Achievement, and Deliberation. The models were tested on three samples (N1=515 high-school students, 155 gifted; N2=132 psychology students, 28 gifted; N3=443 psychology students, 91 gifted. Results indicate that the domain-level model does not discriminate significantly between gifted and nongifted students in each sample, whereas the proposed 14-facet model yields a significant discrimination across all samples. The latter model may be further adjusted by removing facets which proved inconsistent or unsubstantial in distinguishing between the two groups. This yields a 7-facet discriminant function, which is also significant across samples, indicating that gifted students are consistently distinguished by a combination of high Ideas, Fantasy, Aesthetics, and Assertiveness, but low Gregariuosness, Modesty, and Tendermindeness. Educational implications and limitations are discussed. [Projekat Ministarstva nauke Republike Srbije, br. 179018

  10. Empirical relationships among triangular facet slope, facet height and slip rates along active normal faults from ASTER DEM data

    Science.gov (United States)

    Tsimi, Christina; Ganas, Athanassios

    2015-04-01

    ASTER DEM data (30-m pixel size) are used to derive empirical relationships between triangular facet attributes and slip rates along active normal faults. We sampled 232 triangular facets along 10 normal faults in Greece and Bulgaria that slip with rates from 0.1 mm/yr up to 1.3 mm/yr. The studied normal faults accumulate Quaternary tectonic strain in well-known extensional provinces, such as central Greece, Crete and SW Bulgaria. The normal fault footwalls analysed herein have been developed under similar long-term climatic conditions. It is suggested that two key geometrical features of the youngest generation of triangular facets (slope angle and height) can provide useful metrics to assess rates of deformation when seismological and geodetic data are lacking or not found in sufficient quantity to make reasonable assessments. Our derived empirical relation between slip rate and facet slope angle is: Y=0.057•X-1 where Y is fault slip rate (mm/yr) and X is facet slope angle (degrees), with an R² = 0.728. It is envisaged that our analysis may be helpful in assessing seismic hazard along normal faults with similar facet characteristics in other extensional settings. Note: This research was funded by The Rapid Analysis and Spatialisation Of Risk (RASOR) project http://www.rasor-project.eu/

  11. Beyond Text Queries and Ranked Lists: Faceted Search in Library Catalogs

    Science.gov (United States)

    Niu, Xi

    2012-01-01

    Since the adoption of faceted search in a small number of academic libraries in 2006, faceted library catalogs have gained popularity in many academic and public libraries. This dissertation seeks to understand whether faceted search improves the interactions between searchers and library catalogs and to understand ways that facets are used in…

  12. Eye Tracking the Use of a Collapsible Facets Panel in a Search Interface

    NARCIS (Netherlands)

    M.J. Kemman (Max); M. Kleppe (Martijn); J. Maarseveen (Jim)

    2013-01-01

    textabstractAbstract. Facets can provide an interesting functionality in digital libraries. However, while some research shows facets are important, other research found facets are only moderately used. Therefore, in this exploratory study we compare two search interfaces; one where the facets

  13. Percutaneous dilatational tracheostomy for ICU patients with severe brain injury

    Directory of Open Access Journals (Sweden)

    Guo Dongyuan

    2014-12-01

    Full Text Available 【Abstract】Objective: To sum up our experience in percutaneous dilatational tracheostomy (PDT in ICU patient with severe brain injury. Methods: Between November 2011 and April 2014, PDTs were performed on 32 severe brain injury patients in ICU by a team of physicians and intensivists. The success rate, effi cacy, safety, and complications including stomal infection and bleeding, paratracheal insertion, pneumothorax, pneumomediastinum, tracheal laceration, as well as clinically significant tracheal stenosis were carefully monitored and recorded respectively. Results: The operations took 4-15 minutes (mean 9.1 minutes±4.2 minutes. Totally 4 cases suffered from complications in the operations: 3 cases of stomal bleeding, and 1 case of intratracheal bloody secretion, but none required intervention. Paratracheal insertion, pneumothorax, pneumomediastinum, tracheal laceration, or clinically signifi cant tracheal stenosis were not found in PDT patients. There was no procedure-related death occurring during or after PDT. Conclusion: Our study demonstrats that PDT is a safe, highly effective, and minimally invasive procedure. The appropriate sedation and airway management perioperatively help to reduce complication rates. PDT should be performed or supervised by a team of physicians with extensive experience in this procedure, and also an intensivist with experience in diffi cult airway management. Key words: Brain injuries; Percutaneous dilatational tracheostomy; ICU

  14. Weaknesses in regional primary coronary angioplasty programs: is there still a role for a pharmaco-invasive approach?

    Science.gov (United States)

    Danchin, Nicolas; Dos Santos Teixeira, Nelson; Puymirat, Etienne

    2014-08-01

    All guidelines recommend primary percutaneous coronary intervention as the default strategy for achieving reperfusion in ST-segment elevation myocardial infarction patients. These recommendations are based upon randomized trials which compared primary percutaneous coronary intervention with stand-alone intravenous fibrinolysis. Since the time these trials were performed, however, it has been shown in further trials that use of rescue percutaneous coronary intervention in patients without signs of reperfusion after lysis, and routine coronary angiography within 24 h of the administration of lysis for all other patients, substantially improved the results of intravenous fibrinolytic treatment. This has led to proposing the pharmaco-invasive strategy as an alternative to primary percutaneous coronary intervention. Actually, it is not uncommon that circumstances prevent performing primary percutaneous coronary intervention within the recommended time limits set by the guidelines. In such cases, using a pharmaco-invasive strategy may constitute a valid alternative. Both the STREAM randomized trial and real-world experience, in particular the long-term results from the FAST-MI registry, suggest that the pharmaco-invasive strategy, when used in an appropriate population, compares favorably with primary percutaneous coronary intervention. Therefore, implementing a pharmaco-invasive strategy protocol may be an important complement to compensate for potential weaknesses in ST-segment elevation myocardial infarction networks. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  15. The marvel of percutaneous cardiovascular devices in the elderly.

    Science.gov (United States)

    Guidoin, Robert; Douville, Yvan; Clavel, Marie-Annick; Zhang, Ze; Nutley, Mark; Pîbarot, Philippe; Dionne, Guy

    2010-06-01

    Thanks to minimally invasive procedures, frail and elderly patients can also benefit from innovative technologies. More than 14 million implanted pacemakers deliver impulses to the heart muscle to regulate the heart rate (treating bradycardias and blocks). The first human implantation of defibrillators was performed in early 2000. The defibrillator detects cardiac arrhythmias and corrects them by delivering electric shocks. The ongoing development of minimally invasive technologies has also broadened the scope of treatment for elderly patients with vascular stenosis and aneurysmal disease as well as other complex vascular pathologies. The nonsurgical cardiac valve replacement represents one of the most recent and exciting developments, demonstrating the feasibility of replacing a heart valve by way of placement through an intra-arterial or trans-ventricular sheath. Percutaneous devices are particularly well suited for the elderly as the surgical risks of minimally invasive surgery are considerably less as compared to open surgery, leading to a shorter hospital stay, a faster recovery, and improved quality of life.

  16. [Percutaneous Nephrolithotripsy for Renal Transplant Lithiasis: A Case Report].

    Science.gov (United States)

    Oida, Takeshi; Kanemitsu, Toshiyuki; Hayashi, Tetsuya; Fujimoto, Nobumasa; Koide, Takuo

    2016-02-01

    A 54-year-old man was introduced to our hospital for follow-up examinations after renal transplantation. At the initial visit, a 25 mm renal transplant stone was noted, which had enlarged to 32 mm at an examination 1 year later. We first attempted transurethral lithotripsy (TUL), but failed due to ureteral stricture. However, we could completely remove the stone in 2 sessions of percutaneous nephrolithotripsy (PNL). The incidence of urinary lithiasis after renal transplantation ranges from 0.17-1.8%, for which PNL and TUL are frequently used. Although considered to be accompanied with risks of bleeding, bowel injury, and renal dysfunction, PNL is effective for urinary lithiasis after renal transplantation. TUL is less invasive, but access may be difficult when the ureter has an unusual course or ureteral stricture exists, as in our patient.

  17. Percutaneous vertebroplasty and kyphoplasty; Perkutane Vertebroplastie und Kyphoplastie

    Energy Technology Data Exchange (ETDEWEB)

    Wetzel, S.G. [Basel Univ. (Switzerland). Abt. fuer Neuroradiologie; Wilhelm, K.E. [Radiologische Universitaetsklinik Bonn (Germany)

    2006-09-15

    With percutaneous vertebroplasty, a minimal invasive method, bone cement is injected under radiological control into a vertebra. The technique was first applied for treatment of aggressive hemangiomas. Today, osteoporotic compression fractures and other vertebral pathologies that cause pain - foremost metastasis - are the main indications for PVP. Kyphoplasty (KP) is closely related to PVP; with this technique expandable balloons are introduced into a vertebra and the cavity is then filled with bone cement. Apart from pain treatment and stabilisation of the vertebra, the aim of the method is to restore and correct a local kyphosis. In this article the indications for both PVP and KP are discussed and the value of an interdisciplinary discussion that takes alternative therapeutic methods into account is stressed. Additionally, the technical aspects and the potential complications of the methods are explained. Finally, the therapeutic results of PVP and KP are reviewed in light of published results and our own experiences. (orig.)

  18. Percutaneous transcatheter sclerotherapy of oophoritic cysts

    International Nuclear Information System (INIS)

    Huang Youhua; Xu Qiang; Sun Jun; Shen Tao; Shi Hongjian; Tang Qingfang; Chen Qiying; Zhou Mingxia; Li Hongyao

    2005-01-01

    Objective: To evaluate the clinical value of percutaneous transcatheter sclerotherapy in oophoritic cysts. Methods: Seventy six oophoritic cysts incluoling 48 simple and 28 chocolate cysts of 64 patients were treated with percutaneous transcatheter sclerotherapy under CT guidance. 4F multisideholes pigtail catheter was introduced into cyst using absolute alcohol as sclerosing agents. Results: The successful rate of percutaneous oophoritc cyst puncture was 100% in all 64 patients. Among them 58 were cured (90.6%), 6 improved significantly (9.4%). The total effective rate reached 100% with no serious complications. Conclusions: Catheterization sclerotherapy for oophoritic cyst is a simple, complete, safe and effective method. (authors)

  19. Evaluation of the therapeutic efficacy of percutaneous nephropyelostomy for hydronephrosis after renal transplantation

    International Nuclear Information System (INIS)

    Ren Jianzhuang; Liang Huimin; Wu Hanping; Zheng Chuansheng; Zhou Guofeng; Xia Xiangwen

    2008-01-01

    Objective: To explore the method of percutaneous nephrostomy and the cause with prevention and treatment of the complication. Methods: 16 patients with nephrohydrosis after kidney transplantation in right iliac fossa were taken percutaneous nerphrostomy with coaxial puncture technique under ultrasound and fluoroscopic guidance; and by different operation methods according to the patient's condition. The color and volume of urine were observed, urine routine and renal function were rechecked after the operation. Results: The pyelography showed that all 16 patients had different degree nephrohydrosis and ureteral obstruction; including 7 ureteral complete obstructions and 9 ureteral incomplete obstructions. 3 cases received percutaneous pelvic external drainage and 13 others received percutaneous antegrade endolumina] balloon dilation of ureterostenosis and drainage. The average levels of serum urea nitrogen and creatinine decreased from 28.3 mmol/L and 537.7 μmol/L before operation to 9.7 mmol/L and 148.6 μmol/L one week after the operation respectively. Nephrohydrosis disappeared under ultrasonic inspection after the operation and no nephrohydrosis occurred in all patients during follow up of 4 to 48 months except one of double J catheter inadequate drainage two months postoperatively and in turn received external drainage. Conclusions: Characterized with simple manipulation, less invasion and complications, interventional therapy is a reliable and effective for renal transplanted patients with nephrohydrosis. (authors)

  20. Uncovertebral joint injury in cervical facet dislocation: the headphones sign

    Energy Technology Data Exchange (ETDEWEB)

    Palmieri, Francesco; Cassar-Pullicino, Victor N.; Dell' Atti, Claudia; Lalam, Radhesh K.; Tins, Bernhard J.; Tyrrell, Prudencia N.M.; McCall, Iain W. [Robert Jones and Agnes Hunt Orthopaedic and District Hospital, Department of Radiology, Oswestry, England (United Kingdom)

    2006-06-15

    The purpose of our study is to demonstrate the uncovertebral mal-alignment as a reliable indirect sign of cervical facet joint dislocation. We examined the uncovertebral axial plane alignment of 12 patients with unilateral and bilateral cervical facet joint dislocation (UCFJD and BCFJD, respectively), comparing its frequency to the reverse hamburger bun sign on CT and MR axial images. Of the seven cases with BCFJD, five clearly demonstrated the diagnostic reverse facet joint hamburger bun sign on CT and MR images, but in two cases this sign was not detectable. In the five cases with UCFJD, four demonstrated the reverse hamburger bun sign on both CT and MRI. In one case the reverse hamburger bun sign was not seen adequately with either image modality, but the facet dislocation was identified on sagittal imaging. The uncovertebral mal-alignment was detected in all 12 cases. Normally, the two components of the uncovertebral joint enjoy a concentric relationship that in the axial plane is reminiscent of the relationship of headphones with the wearer's head. We name this appearance the 'headphones' sign. Radiologists should be aware of the headphones sign as a reliable indicator of facet joint dislocation on axial imaging used in the assessment of cervical spine injuries. (orig.)

  1. Noble-Metal Nanocrystals with Controlled Facets for Electrocatalysis.

    Science.gov (United States)

    Hong, Jong Wook; Kim, Yena; Kwon, Yongmin; Han, Sang Woo

    2016-08-19

    Noble-metal nanocrystals (NCs) show excellent catalytic performance for many important electrocatalysis reactions. The crystallographic properties of the facets by which the NCs are bound, closely associated with the shape of the NCs, have a profound influence on the electrocatalytic function of the NCs. To develop an efficient strategy for the synthesis of NCs with controlled facets as well as compositions, understanding of the growth mechanism of the NCs and their interaction with the chemical species involved in NC synthesis is quite important. Furthermore, understanding the facet-dependent catalytic properties of noble-metal NCs and the corresponding mechanisms for various electrocatalysis reactions will allow for the rational design of robust electrocatalysts. In this review, we summarize recently developed synthesis strategies for the preparation of mono- and bimetallic noble-metal NCs by classifying them by the type of facets through which they are enclosed and discuss the electrocatalytic applications of noble-metal NCs with controlled facets, especially for reactions associated with fuel-cell applications, such as the oxygen reduction reaction and fuel (methanol, ethanol, and formic acid) oxidation reactions. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  2. Contribution of computed tomography guided percutaneous drainage of tuberculous cold abscesses adjunctive to pharmaceutical anti-tubercular treatment

    International Nuclear Information System (INIS)

    Tsagouli, Paraskevi; Sotiropoulou, Evagelia; Filippousis, Petros; Sidiropoulou, Nektaria; Georgiadi, Vithleem; Thanos, Loukas

    2012-01-01

    Purpose: To determine the efficiency and safety of the percutaneous aspiration and drainage of rare touberculous cold abscesses under CT guidance. Materials and methods: We retrospectively studied 63 cases of 44 patients, treated in our hospital during the last two years. They suffered from tuberculous infection complicated with tuberculous cold abscesses variously located. All these patients underwent percutaneous aspiration and drainage under CT imaging, following the trocar puncture technique. The catheter remained in place for about a week. A follow up CT scan was performed in all cases before the catheter removal. Some of the patients were under anti tuberculosis medication. Results: All the patients had a successful recovery from the abscesses. There were no major or minor complications observed. No recurrence occurred until today. Conclusion: CT guided percutaneous aspiration and drainage of tuberculous cold abscesses is a safe, minimal invasive and effective method of treatment. Drainage and specific antituberculosis therapy leads to a satisfactory conclusion.

  3. Percutaneous augmentation of the superior pubic ramus with polymethyl methacrylate: treatment of acute traumatic and chronic insufficiency fractures

    Energy Technology Data Exchange (ETDEWEB)

    Beall, Douglas P. [University of Oklahoma, Clinical Radiology of Oklahoma, Oklahoma City, OK (United States); D' Souza, Sharon L. [University of Oklahoma, Oklahoma City, OK (United States); Costello, Richard F.; Stapp, Annette M. [Clinical Radiology of Oklahoma, Edmond, OK (United States); Prater, Scott D. [University of Oklahoma College of Medicine, Edmond, OK (United States); Van Zandt, Bryan L. [University of Oklahoma College of Medicine, Oklahoma City, OK (United States); Martin, Hal D. [Oklahoma Sports Science and Orthopaedics, Oklahoma City, OK (United States)

    2007-10-15

    The injection of polymethylmethacrylate (PMMA) is a minimally invasive image-guided procedure that is typically used to treat vertebral body fractures due to osteoporosis or neoplastic involvement. The injection of PMMA into various other locations including the sacrum, acetabulum, pedicles, femur and tibia has been reported previously, and these procedures have, overall, been highly effective at alleviating pain and discomfort. Although the injection of PMMA into the vertebral body is a very common procedure that has been performed for over 2 decades for the percutaneous treatment of vertebral body fractures, the percutaneous injection of PMMA has not been reported in the English literature as treatment for superior pubic ramus fractures. We report the percutaneous treatment of an acute superior pubic ramus fracture and of a chronic insufficiency fracture of the superior pubic ramus using a parasymphyseal approach to access the region of injury. (orig.)

  4. Minimally invasive management of hepatic cysts: indications and complications.

    Science.gov (United States)

    Vardakostas, D; Damaskos, C; Garmpis, N; Antoniou, E A; Kontzoglou, K; Kouraklis, G; Dimitroulis, D

    2018-03-01

    Liver cysts are divided into congenital and acquired. Congenital cystic lesions include polycystic liver disease, simple cysts, duct related and ciliated hepatic foregut cysts. Acquired cystic lesions are divided into infectious and non-infectious. The infectious cysts are the hydatid cyst, the amoebic abscess, and the pyogenic abscess, whereas the non-infectious cysts are neoplastic cysts and false cysts. While modern medicine provides a lot of minimally invasive therapeutic modalities, there has emerged a pressing need for understanding the various types of liver cysts, the possible minimal therapeutic options along with their indications and complications. We aim is to clarify the role of minimally invasive techniques in the management of hepatic cysts. A literature review was performed using the MEDLINE database. The search terms were: liver cyst, minimally invasive, laparoscopic, percutaneous, drainage and fenestration. We reviewed 82 English language publications articles, published until October 2017. Minimally invasive management of liver LC is an emerging field including many therapeutic modalities ranging from the percutaneous aspiration of pyogenic abscesses to laparoscopic hepatectomy for hepatic cystadenomas. The most used techniques are percutaneous drainage, laparoscopic fenestration, and laparoscopic hepatectomy. The application of the various minimally invasive approaches, as well as their indication and complications, depend on the type of the cystic lesion, its size and its position in the liver. Percutaneous drainage is mostly used in simple cysts, hydatid cysts, pyogenic abscesses and bilomas. Laparoscopic fenestration is mostly used in simple cysts and polycystic liver disease. Finally, laparoscopic hepatectomy is mostly used in polycystic liver disease, hydatid cysts, and cystadenomas.

  5. Rhetorical facets of imagination in contemporary poetry

    Directory of Open Access Journals (Sweden)

    Hassan Delbari

    2015-03-01

    Full Text Available Abstract The present article deals with the trend of literary imaginative descriptions in the purview of poetical imaginations which have been regarded greatly in the discourse of rhetoric’s. The different facets of imagination of these imageries are also introduced in this article. Throughout this study poetical demonstrations are dealt with on the basis of their indications, functions and profundity. Meanwhile overcoming superficial and intermediate layers of imagination towards inner and profound thoughts would represent the domination of the poets in depiction of imagery. For this purpose, an introduction of numerous imagery layers with their deep and superficial, positive and subsidiary nature is presented through some examples. The result suggests that the extent of imagery complexity among many poets has a direct relation to their subjectivity in such a way that different levels of imageries are internalized as a unique stylistic feature of any individual poet. He endeavors to ornament his poem through imagery devices. Yousefi says: “any poem in which there is not imagery cannot be regarded as a poem. “The attractiveness of such imagination and the success or failure of the poet in conveying this imagery is a matter of poet’s tendency in using imagery devices. Through this article the contemporary poems are analyzed from the view point of objectivity and subjectivity. Furthermore, the poems are studied on their functions. The analysis has been carried out from two perspectives idiosyncratic features of the poet and the characteristics of the era in which he has lived. The examples presented in this article are selected from among the poets with different linguistic backgrounds and unique ideologies. The reason behind this specific consideration is an indication of a generalizability rather than a representativeness of few poets with their idiosyncratic styles. Therefore, the results indicate the style characteristics

  6. Rhetorical facets of imagination in contemporary poetry

    Directory of Open Access Journals (Sweden)

    Hassan Delbari

    2015-04-01

    Full Text Available Abstract The present article deals with the trend of literary imaginative descriptions in the purview of poetical imaginations which have been regarded greatly in the discourse of rhetoric’s. The different facets of imagination of these imageries are also introduced in this article. Throughout this study poetical demonstrations are dealt with on the basis of their indications, functions and profundity. Meanwhile overcoming superficial and intermediate layers of imagination towards inner and profound thoughts would represent the domination of the poets in depiction of imagery. For this purpose, an introduction of numerous imagery layers with their deep and superficial, positive and subsidiary nature is presented through some examples. The result suggests that the extent of imagery complexity among many poets has a direct relation to their subjectivity in such a way that different levels of imageries are internalized as a unique stylistic feature of any individual poet. He endeavors to ornament his poem through imagery devices. Yousefi says: “any poem in which there is not imagery cannot be regarded as a poem. “The attractiveness of such imagination and the success or failure of the poet in conveying this imagery is a matter of poet’s tendency in using imagery devices. Through this article the contemporary poems are analyzed from the view point of objectivity and subjectivity. Furthermore, the poems are studied on their functions. The analysis has been carried out from two perspectives idiosyncratic features of the poet and the characteristics of the era in which he has lived. The examples presented in this article are selected from among the poets with different linguistic backgrounds and unique ideologies. The reason behind this specific consideration is an indication of a generalizability rather than a representativeness of few poets with their idiosyncratic styles. Therefore, the results indicate the style characteristics of poet

  7. Large conservation gains possible for global biodiversity facets.

    Science.gov (United States)

    Pollock, Laura J; Thuiller, Wilfried; Jetz, Walter

    2017-06-01

    Different facets of biodiversity other than species numbers are increasingly appreciated as critical for maintaining the function of ecosystems and their services to humans. While new international policy and assessment processes such as the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services (IPBES) recognize the importance of an increasingly global, quantitative and comprehensive approach to biodiversity protection, most insights are still focused on a single facet of biodiversity-species. Here we broaden the focus and provide an evaluation of how much of the world's species, functional and phylogenetic diversity of birds and mammals is currently protected and the scope for improvement. We show that the large existing gaps in the coverage for each facet of diversity could be remedied by a slight expansion of protected areas: an additional 5% of the land has the potential to more than triple the protected range of species or phylogenetic or functional units. Further, the same areas are often priorities for multiple diversity facets and for both taxa. However, we find that the choice of conservation strategy has a fundamental effect on outcomes. It is more difficult (that is, requires more land) to maximize basic representation of the global biodiversity pool than to maximize local diversity. Overall, species and phylogenetic priorities are more similar to each other than they are to functional priorities, and priorities for the different bird biodiversity facets are more similar than those of mammals. Our work shows that large gains in biodiversity protection are possible, while also highlighting the need to explicitly link desired conservation objectives and biodiversity metrics. We provide a framework and quantitative tools to advance these goals for multi-faceted biodiversity conservation.

  8. Mapping mindfulness facets onto dimensions of anxiety and depression.

    Science.gov (United States)

    Desrosiers, Alethea; Klemanski, David H; Nolen-Hoeksema, Susan

    2013-09-01

    Mindfulness has been associated with anxiety and depression, but the ways in which specific facets of mindfulness relate to symptoms of anxiety and depression remains unclear. The purpose of the current study was to investigate associations between specific facets of mindfulness (e.g., observing, describing, nonjudging, acting with awareness, and nonreactivity) and dimensions of anxiety and depression symptoms (e.g., anxious arousal, general distress-anxiety, general distress-depression, and anhedonic depression) while controlling for shared variance among variables. Participants were 187 treatment-seeking adults. Mindfulness was measured using the Five Facet Mindfulness Questionnaire and symptoms of depression and anxiety were measured using the Mood and Anxiety Symptom Questionnaire. Bivariate correlations showed that all facets of mindfulness were significantly related to all dimensions of anxiety and depression, with two exceptions: describing was unrelated to general distress-anxiety, and observing was unrelated to all symptom clusters. Path analysis was used to simultaneously examine associations between mindfulness facets and depression and anxiety symptoms. Significant and marginally significant pathways were retained to construct a more parsimonious model and model fit indices were examined. The parsimonious model indicated that nonreactivity was significantly inversely associated with general distress anxiety symptoms. Describing was significantly inversely associated with anxious arousal, while observing was significantly positively associated with it. Nonjudging and nonreactivity were significantly inversely related to general distress-depression and anhedonic depression symptomatology. Acting with awareness was not significantly associated with any dimensions of anxiety or depression. Findings support associations between specific facets of mindfulness and dimensions of anxiety and depression and highlight the potential utility of targeting these

  9. Large conservation gains possible for global biodiversity facets

    Science.gov (United States)

    Pollock, Laura J.; Thuiller, Wilfried; Jetz, Walter

    2017-06-01

    Different facets of biodiversity other than species numbers are increasingly appreciated as critical for maintaining the function of ecosystems and their services to humans. While new international policy and assessment processes such as the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services (IPBES) recognize the importance of an increasingly global, quantitative and comprehensive approach to biodiversity protection, most insights are still focused on a single facet of biodiversity—species. Here we broaden the focus and provide an evaluation of how much of the world’s species, functional and phylogenetic diversity of birds and mammals is currently protected and the scope for improvement. We show that the large existing gaps in the coverage for each facet of diversity could be remedied by a slight expansion of protected areas: an additional 5% of the land has the potential to more than triple the protected range of species or phylogenetic or functional units. Further, the same areas are often priorities for multiple diversity facets and for both taxa. However, we find that the choice of conservation strategy has a fundamental effect on outcomes. It is more difficult (that is, requires more land) to maximize basic representation of the global biodiversity pool than to maximize local diversity. Overall, species and phylogenetic priorities are more similar to each other than they are to functional priorities, and priorities for the different bird biodiversity facets are more similar than those of mammals. Our work shows that large gains in biodiversity protection are possible, while also highlighting the need to explicitly link desired conservation objectives and biodiversity metrics. We provide a framework and quantitative tools to advance these goals for multi-faceted biodiversity conservation.

  10. Percutaneous penetration studies for risk assessment

    DEFF Research Database (Denmark)

    Sartorelli, Vittorio; Andersen, Helle Raun; Angerer, Jürgen

    2000-01-01

    . In order to predict the systemic risk of dermally absorbed chemicals and to enable agencies to set safety standards, data is needed on the rates of percutaneous penetration of important chemicals. Standardization of in vitro tests and comparison of their results with the in vivo data could produce...... internationally accepted penetration rates and/or absorption percentages very useful for regulatory toxicology. The work of the Percutaneous Penetration Subgroup of EC Dermal Exposure Network has been focussed on the standardization and validation of in vitro experiments, necessary to obtain internationally...... accepted penetration rates for regulatory purposes. The members of the Subgroup analyzed the guidelines on percutaneous penetration in vitro studies presented by various organizations and suggested a standardization of in vitro models for percutaneous penetration taking into account their individual...

  11. Percutaneous treatment of liver hydatid cysts

    Energy Technology Data Exchange (ETDEWEB)

    Akhan, Okan; Oezmen, Mustafa N

    1999-10-01

    Hydatic disease caused by Echinococcus granulosus is an endemic disease and an important public health problem in some countries of the world. The results of surgical treatment are associated with a high rate of mortality, morbidity, postoperative recurrence and a long period of hospital stay and the medical treatment results are still controversial. Although the percutaneous aspiration and treatment of liver hydatid cysts were considered to be contraindicated due to risks of anaphylactic shock and dissemination of clear-crystal fluid into the abdomen, several reports of successful percutaneous treatment of liver hydatid cysts have been published in the literature. Today, percutaneous treatment of liver hydatid cysts is the most effective and reliable treatment procedure in the selected cases. In this review, indications, contraindications, method and techniques, healing criteria, complications, results and importance of the percutaneous treatment of liver hydatid cysts are discussed.

  12. Percutaneous ablation of the gallbladder

    International Nuclear Information System (INIS)

    Saini, S.; Mueller, P.R.; Girard, M.; Lee, M.J.; Goldberg, M.; Brink, J.A.; Flotte, T.J.; Ribiero, R.; Ferrucci, J.T.

    1990-01-01

    This paper examines the feasibility of using Holmium: yttrium-aluminum-garnet (YAG) laser to permanently obliterate the cystic duct and then using chemical sclerosants to ablate the gallbladder mucosa. Percutaneous cholecystostomy was performed in 30 domestic pigs. The cystic duct was cannulated and while the laser fiber was withdrawn at a rate of 0.5 cm/sec, pulsed laser energy (10 Hz) was delivered. Animals were sacrificed immediately (n = 7), at 72 hours (n = 4), and 6 weeks (n = 19). In the 6-week group, gallbladder sclerosis (95% alcohol plus sodium tetradecyl sulfate) was performed in 13 animals immediately after occluding the cystic duct. Control animals were included in each group

  13. Left main percutaneous coronary intervention.

    Science.gov (United States)

    Teirstein, Paul S; Price, Matthew J

    2012-10-23

    The introduction of drug-eluting stents and advances in catheter techniques have led to increasing acceptance of percutaneous coronary intervention (PCI) as a viable alternative to coronary artery bypass graft (CABG) for unprotected left main disease. Current guidelines state that it is reasonable to consider unprotected left main PCI in patients with low to intermediate anatomic complexity who are at increased surgical risk. Data from randomized trials involving patients who are candidates for either treatment strategy provide novel insight into the relative safety and efficacy of PCI for this lesion subset. Herein, we review the current data comparing PCI with CABG for left main disease, summarize recent guideline recommendations, and provide an update on technical considerations that may optimize clinical outcomes in left main PCI. Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  14. Percutaneous drainage of tuberculous abscesses

    International Nuclear Information System (INIS)

    Puri, S.K.; Panicker, H.; Narang, P.; Kumar, N.; Dhall, A.; Gupta, S.B.

    2001-01-01

    To assess the role of percutaneous catheter drainage (PCD) in the management of tuberculous ilio-psoas abscesses, twenty-two patients with 26 tuberculous ilio-psoas abscesses were subjected to PCD under real time US guidance taking help of a pre-procedure CT for planning the route of catheter insertion. Complete cure of the ilio-psoas abscesses could be achieved in 22 of 26 abscesses (84.6%). Average duration of drainage was 10 days. US/ CT follow-up ranged from 3-24 months. PCD was a failure in four abscesses (15.4%). Two patients, one with bilateral abscesses, had recurrent abscesses while one patient had an abscess associated with extensive spondylo-discitis. No significant complication was encountered in the study. PCD is a simple, safe and very effective (success rate 84.6%) alternative to surgical drainage in the management of tuberculous ilio-psoas abscesses. (author)

  15. [Percutanous dilation tracheotomy: our experience].

    Science.gov (United States)

    Domènech, I; Mateu, T; Cisa, E; Juan, A; Gil, E; Palau, M; Dicenta, M

    2004-01-01

    Percutaneous dilation Tracheotomy (PDT) is becoming a popular alternative to surgical tracheotomy. In our hospital, we recently adopted the use of the PDT in intensive care unit patients. The objective [corrected] of this investigation is to characterize and quantify the rate of complications for PDT. A prospective study of 60 PDT performed at different intesive care units, betweem September 2002 to July 2003. The intraoperative time for PDT was 8 minutes. Complications included 6 cases of mild intraoperative hemorrhage, 1 case of moderate intraoperative hemorrhage, 4 cases of mild postoperative hemorrhage and 1 case of subcutaneous emphysema. PDT is a good alternative to surgical tracheotomy and should be added to the otolaryngologists armamentarium of surgical airway procedures.

  16. Percutaneous ablation of pancreatic cancer

    Science.gov (United States)

    D’Onofrio, Mirko; Ciaravino, Valentina; De Robertis, Riccardo; Barbi, Emilio; Salvia, Roberto; Girelli, Roberto; Paiella, Salvatore; Gasparini, Camilla; Cardobi, Nicolò; Bassi, Claudio

    2016-01-01

    Pancreatic ductal adenocarcinoma is a highly aggressive tumor with an overall 5-year survival rate of less than 5%. Prognosis and treatment depend on whether the tumor is resectable or not, which mostly depends on how quickly the diagnosis is made. Chemotherapy and radiotherapy can be both used in cases of non-resectable pancreatic cancer. In cases of pancreatic neoplasm that is locally advanced, non-resectable, but non-metastatic, it is possible to apply percutaneous treatments that are able to induce tumor cytoreduction. The aim of this article will be to describe the multiple currently available treatment techniques (radiofrequency ablation, microwave ablation, cryoablation, and irreversible electroporation), their results, and their possible complications, with the aid of a literature review. PMID:27956791

  17. Percutaneous transluminal angioplasty in arteriosclerosis

    International Nuclear Information System (INIS)

    Chung, Soo Young; Cha, In Ho

    1984-01-01

    Percutaneous transluminal angioplasty (PTA) is a non-operative therapeutic procedure to the dilation of stenosis or to the recanalization of occlusion in atherosclerotic arteries using of dilatation catheters. PTA was performed 37 times in 34 patients with arteriosclerotic for 1 year and 4 months from March, 1982 to June, 1983 at department of radiology, Klinikum Barmen/west Germany. The results were as follows; 1. The male to female ratio was 2 : 1 and peak age range was from 61 to 70. 2. The most common indication was clinical stage II b with 19 cases (51.3%). 3. PTA was performed most commonly in superficial femora artery in 25 cases (67.5%). 4. Acute major complication occurred in 2 cases (5.4%). PTA is a alternative or complementary therapeutic procedure to vascular surgery.

  18. Optical fiber end-facet polymer suspended-mirror devices

    Science.gov (United States)

    Yao, Mian; Wu, Jushuai; Zhang, A. Ping; Tam, Hwa-Yaw; Wai, P. K. A.

    2017-04-01

    This paper presents a novel optical fiber device based on a polymer suspended mirror on the end facet of an optical fiber. With an own-developed optical 3D micro-printing technology, SU-8 suspended-mirror devices (SMDs) were successfully fabricated on the top of a standard single-mode optical fiber. Optical reflection spectra of the fabricated SU- 8 SMDs were measured and compared with theoretical analysis. The proposed technology paves a way towards 3D microengineering of the small end-facet of optical fibers to develop novel fiber-optic sensors.

  19. b-tree facets for the simple graph partitioning polytope

    DEFF Research Database (Denmark)

    Sørensen, Michael Malmros

    2004-01-01

    The simple graph partitioning problem is to partition an edge-weighted graph into mutually disjoint subgraphs, each consisting of no more than b nodes, such that the sum of the weights of all edges in the subgraphs is maximal. In this paper we introduce a large class of facet defining inequalities...... for the simple graph partitioning polytopes P_n(b), b >= 3, associated with the complete graph on n nodes. These inequalities are induced by a graph configuration which is built upon trees of cardinality b. We provide a closed-form theorem that states all necessary and sufficient conditions for the facet...

  20. b-Tree Facets for the Simple Graph Partitioning Polytope

    DEFF Research Database (Denmark)

    Sørensen, Michael Malmros

    2000-01-01

    The simple graph partitioning problem is to partition an edge-weighted graph into mutually disjoint subgraphs, each consisting of no more than b nodes, such that the sum of the weights of all edges in the subgraphs is maximal. In this paper we introduce a large class of facet defining inequalities...... for the simple graph partitioning polytopes P_n(b), b >= 3, associated with the complete graph on n nodes. These inequalities are induced by a graph configuration which is built upon trees of cardinality b. We provide a closed-form theorem that states all necessary and sufficient conditions for the facet...

  1. 2016 FACET-II Science Workshop Summary Report

    Energy Technology Data Exchange (ETDEWEB)

    Hogan, Mark J., ed.

    2017-07-19

    The second in a series of FACET-II Science Workshops was held at SLAC National Accelerator Laboratory on October 17-19, 2016 [1]. The workshop drew thirty-five participants from eighteen different institutions including CERN, DESY, Ecole Polytechnique, FNAL, JAI, LBNL, LLNL, Radiabeam, Radiasoft, SLAC, Stony Brook, Strathclyde, Tech-X, Tsinghua, UC Boulder, UCLA and UT Austin. The 2015 workshop [2, 3] helped prioritize research directions for FACET-II. The 2016 workshop was focused on understanding what improvements are needed at the facility to support the next generation of experiments. All presentations are linked to the workshop website as a permanent record.

  2. Bivalirudin in percutaneous coronary intervention

    Directory of Open Access Journals (Sweden)

    Sam J Lehman

    2006-12-01

    Full Text Available Sam J Lehman, Derek P ChewDepartment of Medicine, Flinders University, South Australia, AustraliaAbstract: Bivalirudin is a member of the direct thrombin inhibitor group of anticoagulants. It has been evaluated as an alternative to unfractionated and low-molecular-weight heparins in the settings of percutaneous coronary intervention (PCI and acute coronary syndrome (ACS. Results of clinical trials to date suggest bivalirudin is a viable alternative to the use of a heparin combined with a glycoprotein (GP IIb/IIIa inhibitor in these settings. Thrombin has a central role in coagulation and platelet activation in ACS and during PCI. Its direct inhibition is an attractive target for therapy in these settings. Bivalirudin is a 20 amino acid polypeptide hirudin analog. It displays bivalent and reversible binding to the thrombin molecule, inhibiting its action. Direct inhibition of thrombin with bivalirudin has theoretical pharmacokinetic and pharmacodynamic advantages over the indirect anticoagulants. A reduction in rates of bleeding without loss of anti-thrombotic efficacy has been a consistent finding across multiple clinical trials. There may be economic benefits to the use of bivalirudin if it permits a lower rate of use of the GP IIb/IIIa inhibitors. This article reviews the pharmacology of bivalirudin and clinical trial evidence to date. There are now data from multiple clinical trials and meta-analyses in the setting of ACS and PCI. Early results from the acute catheterization and urgent intervention strategy (ACUITY trial are discussed. Keywords: bivalirudin, direct thrombin inhibitor, acute coronary syndrome, percutaneous coronary intervention

  3. Infective endocarditis following percutaneous pulmonary valve replacement

    DEFF Research Database (Denmark)

    Cheung, Gary; Vejlstrup, Niels; Ihlemann, Nikolaj

    2013-01-01

    Infective endocarditis (IE) following percutaneous pulmonary valve replacement (PPVR) with the Melody valve is rarely reported. Furthermore, there are challenges in this diagnosis; especially echocardiographic evidence of vegetation within the prosthesis may be difficult.......Infective endocarditis (IE) following percutaneous pulmonary valve replacement (PPVR) with the Melody valve is rarely reported. Furthermore, there are challenges in this diagnosis; especially echocardiographic evidence of vegetation within the prosthesis may be difficult....

  4. Percutaneous laser disc decompression versus conventional microdiscectomy for patients with sciatica: Two-year results of a randomised controlled trial.

    Science.gov (United States)

    Brouwer, Patrick A; Brand, Ronald; van den Akker-van Marle, M Elske; Jacobs, Wilco Ch; Schenk, Barry; van den Berg-Huijsmans, Annette A; Koes, Bart W; Arts, Mark A; van Buchem, M A; Peul, Wilco C

    2017-06-01

    Background Percutaneous laser disc decompression is a minimally invasive treatment, for lumbar disc herniation and might serve as an alternative to surgical management of sciatica. In a randomised trial with two-year follow-up we assessed the clinical effectiveness of percutaneous laser disc decompression compared to conventional surgery. Materials and methods This multicentre randomised prospective trial with a non-inferiority design, was carried out according to an intent-to-treat protocol with full institutional review board approval. One hundred and fifteen eligible surgical candidates, with sciatica from a disc herniation smaller than one-third of the spinal canal, were randomly allocated to percutaneous laser disc decompression ( n = 55) or conventional surgery ( n = 57). The main outcome measures for this trial were the Roland-Morris Disability Questionnaire for sciatica, visual analogue scores for back and leg pain and the patient's report of perceived recovery. Results The primary outcome measures showed no significant difference or clinically relevant difference between the two groups at two-year follow-up. The re-operation rate was 21% in the surgery group, which is relatively high, and with an even higher 52% in the percutaneous laser disc decompression group. Conclusion At two-year follow-up, a strategy of percutaneous laser disc decompression, followed by surgery if needed, resulted in non-inferior outcomes compared to a strategy of microdiscectomy. Although the rate of reoperation in the percutaneous laser disc decompression group was higher than expected, surgery could be avoided in 48% of those patients that were originally candidates for surgery. Percutaneous laser disc decompression, as a non-surgical method, could have a place in the treatment arsenal of sciatica caused by contained herniated discs.

  5. Uncharismatic Invasives

    Directory of Open Access Journals (Sweden)

    Clark, Jonathan L.

    2015-05-01

    Full Text Available Although philosophers have examined the ethics of invasive species management, there has been little research approaching this topic from a descriptive, ethnographic perspective. In this article I examine how invasive species managers think about the moral status of the animals they seek to manage. I do so through a case study of Oregon’s efforts to manage the invasive species that are rafting across the Pacific attached to tsunami debris in the wake of the Japanese tsunami of 2011. Focusing on the state’s response to a dock that washed ashore on Agate Beach with various marine invertebrates attached to it, I argue that these animals’ position on two intersecting scales of moral worth—the sociozoologic scale and the phylogenetic scale—rendered them unworthy of moral consideration.

  6. Cervical endplate and facet arthrosis: an anatomic study of cadaveric specimens.

    Science.gov (United States)

    Master, Daniel L; Toy, Jason O; Eubanks, Jason D; Ahn, Nicholas U

    2012-10-01

    An anatomic, epidemiologic study of cervical endplate and facet arthrosis in cadaveric spines. To determine the prevalence of cervical endplate and facet arthrosis and the relationship between these 2 entities in a large population sample. Cervical endplate and facet arthrosis are common radiographic findings, which have both been linked to pain. However, the prevalence and relationship between cervical endplate and facet arthrosis has not been clearly defined. The cervical vertebrae from 234 cadaveric spines were examined by a single investigator for evidence of endplate and facet arthrosis. Arthrosis at each endplate and facet was graded on a continuum from 0 to IV. Race, age at death, and sex of each specimen were also recorded. Stepwise multiple linear regression was used to analyze any association between race, age, sex, endplate arthrosis, and facet arthrosis. Factors with P values arthrosis severity scores among patients within the same decades of life. Concurrent cervical endplate and facet arthrosis was present in 77% of the study population. Stepwise multiple linear regression revealed significant (Parthrosis and between age and facet arthrosis. Race and sex did not correlate with facet arthrosis. In addition, patients in age groups 30 to 39, 40 to 49, 50 to 59, 60 to 69, 70 to 79, and 80 to 89 demonstrated more severe (Parthrosis in comparison with facet arthrosis. Concurrent cervical endplate and facet arthrosis is a common condition. Cervical endplate arthrosis and advancing age are associated with cervical facet arthrosis independent of race and sex. Cervical endplate arthrosis precedes facet arthrosis.

  7. Structural models of faceted-faceted eutectic system vanillin-acenaphthene

    International Nuclear Information System (INIS)

    Sharma, B.L.

    2003-01-01

    Thermodynamic model for the eutectic system vanillin-acenaphthene has been developed by analysing the excess functions computed from its experimentally determined solidus-liquidus equilibrium data. Spontaneous nucleation model has been explored from the maximum limit of undercooling of the system and verified by the experimental evidences of dislocation mechanism governing the anisotropic velocity of crystallisation determined at different undercoolings. Viscosity measurements of eutectic and non-eutectic melts at different temperatures revealed the essence of peculiar structural changes and specific energy interactions in the eutectic melt in the temperature range near its melting temperature. The rheological activation energy, E vis for eutectic and non-eutectic melts is found to be a function of temperature. Crystalline faceted structure of the system has been furnished with morphological evidences obtained from microscopic studies at different growth rates, whereas whisker reinforced structural model has been accomplished with mechanical properties computed for both isotropic and anisotropic modes of growth. Of greater interest is the special reference of moderate anisotropic growth, since experimental confirmation was obtained for the theoretical shape of parabolic variation in the mechanical properties of eutectic composite material with growth velocity. Direct evidence of three- to four-fold increase in strength properties of the eutectic material at its moderate anisotropic growth velocity (3.11x10 -7 m 3 s -1 ) in comparison with its isotropic growth in an ice bath (∼273 K), confirms a complete composite microstructure with whiskers in equilibrium with the matrix, embedded parallel to the growth direction

  8. Interval biliary stent placement via percutaneous ultrasound guided cholecystostomy: another approach to palliative treatment in malignant biliary tract obstruction.

    Science.gov (United States)

    Harding, James; Mortimer, Alex; Kelly, Michael; Loveday, Eric

    2010-12-01

    Percutaneous cholecystostomy is a minimally invasive procedure for providing gallbladder decompression, often in critically ill patients. It can be used in malignant biliary obstruction following failed endoscopic retrograde cholangiopancreatography when the intrahepatic ducts are not dilated or when stent insertion is not possible via the bile ducts. In properly selected patients, percutaneous cholecystostomy in obstructive jaundice is a simple, safe, and rapid option for biliary decompression, thus avoiding the morbidity and mortality involved with percutaneous transhepatic biliary stenting. Subsequent use of a percutaneous cholecystostomy for definitive biliary stent placement is an attractive concept and leaves patients with no external drain. To the best of our knowledge, it has only been described on three previous occasions in the published literature, on each occasion forced by surgical or technical considerations. Traditionally, anatomic/technical considerations and the risk of bile leak have precluded such an approach, but improvements in catheter design and manufacture may now make it more feasible. We report a case of successful interval metal stent placement via percutaneous cholecystostomy which was preplanned and achieved excellent palliation for the patient. The pros and cons of the procedure and approach are discussed.

  9. Interval Biliary Stent Placement Via Percutaneous Ultrasound Guided Cholecystostomy: Another Approach to Palliative Treatment in Malignant Biliary Tract Obstruction

    International Nuclear Information System (INIS)

    Harding, James; Mortimer, Alex; Kelly, Michael; Loveday, Eric

    2010-01-01

    Percutaneous cholecystostomy is a minimally invasive procedure for providing gallbladder decompression, often in critically ill patients. It can be used in malignant biliary obstruction following failed endoscopic retrograde cholangiopancreatography when the intrahepatic ducts are not dilated or when stent insertion is not possible via the bile ducts. In properly selected patients, percutaneous cholecystostomy in obstructive jaundice is a simple, safe, and rapid option for biliary decompression, thus avoiding the morbidity and mortality involved with percutaneous transhepatic biliary stenting. Subsequent use of a percutaneous cholecystostomy for definitive biliary stent placement is an attractive concept and leaves patients with no external drain. To the best of our knowledge, it has only been described on three previous occasions in the published literature, on each occasion forced by surgical or technical considerations. Traditionally, anatomic/technical considerations and the risk of bile leak have precluded such an approach, but improvements in catheter design and manufacture may now make it more feasible. We report a case of successful interval metal stent placement via percutaneous cholecystostomy which was preplanned and achieved excellent palliation for the patient. The pros and cons of the procedure and approach are discussed.

  10. Effectiveness of percutaneous tibial nerve stimulation in the treatment of overactive bladder syndrome

    Directory of Open Access Journals (Sweden)

    de Wall LL

    2017-08-01

    Full Text Available Liesbeth L de Wall, John PFA Heesakkers Department of Urology, Radboud University Medical Centre, Nijmegen, The NetherlandsAbstract: Overactive bladder syndrome (OAB is a common condition affecting adults and children worldwide, resulting in a substantial economic and psychological burden. Percutaneous tibial nerve stimulation (PTNS is derived from acupuncture used in Chinese traditional medicine and was first described in the early 1980s. It is a neuromodulation technique used to modulate bladder function and facilitate storage. Being a minimally invasive, easily applicable, but time-consuming treatment, future developments with implantable devices might be the solution for the logistical problems and economic burden associated with PTNS on the long term. This nonsystematic review provides a current overview on PTNS and its effectiveness in the treatment of OAB for both adults and children. Keywords: overactive bladder, percutaneous tibial nerve stimulation, neuromodulation, electrical stimulation 

  11. Ultrasound-Guided Percutaneous Drainage of Neonatal Pyometrocolpos Under Local Anesthesia

    International Nuclear Information System (INIS)

    Algin, Oktay; Erdogan, Cuneyt; Kilic, Nizamettin

    2011-01-01

    Hydrometrocolpos is an uncommon congenital disorder with cystic dilatation of the vagina and uterus that occurs as a result of accumulated secretions from the reproductive tract due to distal genital tract obstruction. Secondary infection may also occur, resulting in pyometrocolpos, a potentially lethal disease. Immediate drainage of the cystic mass in patients determined to have pyometrocolpos is required to prevent or treat uropathy and septicemia until definitive corrective surgery can be performed. We report an unusual cause of obstructive uropathy in three infants: pyometrocolpos due to lower genital tract atresia. Ultrasound-guided percutaneous drainage of the pyometrocolpos resulted in dramatically improved clinical and laboratory findings in these patients. Ultrasound-guided percutaneous drainage under local anesthesia is a simple, minimally invasive, safe, and effective procedure that facilitates later successful corrective surgery and avoids the need for more complex drainage procedures.

  12. Percutaneous targeted argon-helium cryoablation for renal carcinoma under CT guidance

    International Nuclear Information System (INIS)

    Xu Jian; Cao Jianmin; Lu Guangming; Shi Donghong; Kong Weidong; Gao Dazhi

    2008-01-01

    Objective: To establish initially the technique and evaluate the principle, safety and short term efficacy of argon-helium superconductor operation system (or Ar-He knife) targeted cryotherapy for renal carcinoma. Methods: Seven patients with renal carcinoma were treated with CT-guided percutaneous Ar-He knife targeted cryotherapy. Results: After cryotherapy, no serious complications, such as bleeding, skin cold injury, infection, implantation metastasis inside the puncture path occurred, and one month later, CT scans showed low-density local necrosis in all tumors of the 7 cases, but the tumor reduction in size was found only in 2 cases. Conclusion: CT guiding percutaneous Ar-He knife targeted cryoablation for renal carcinoma is a safe, effective and minimally invasive therapeutic method, particularly for inoperable cases. (authors)

  13. Value of 18F-FDG PET/MRI for the outcome of CT-guided facet block therapy in cervical facet syndrome: initial results

    International Nuclear Information System (INIS)

    Sawixki, Lino M.; Schaarscjmidt, Benedikt M.; Heusch, Philipp; Buchbender, Christian; Antoch, Gerald; Rosenbaum-Krumme, Sandra; Bockisch, Andreas; Umutlu, Lale; Eicker, Sven O.; Floeth, Frank W.

    2017-01-01

    The aim of this study was to evaluate the ability of 18 F-fluorodeoxyglucose positron emission tomography/magnetic resonance imaging ( 18 F-FDG PET/MRI) to detect PET-positive cervical facet arthropathy and identify patients who benefit from facet block therapy. Ten patients with cervical facet syndrome (mean age: 65 ± 12 years) underwent 18 F-FDG PET/MRI of the neck. Focal 18 F-FDG uptake in PET-positive facet joints served as target for computed tomography (CT)-guided facet blocks. In PET-negative patients, the target joint for facet block therapy was selected by current clinical standards considering the level of maximum facet arthrosis and pain. Neck pain was measured on visual analogue scale (VAS) before and after therapy. Bone marrow signal intensity (SI) ratio on turbo inversion recovery magnitude (TIRM) images and maximum standard uptake values (SUVmax) was calculated for each facet joint. Pearson's correlation coefficient (r) was calculated between bone marrow SI ratios on TIRM and SUVmax. 18 F-FDG PET/MRI detected PET-positive facet arthropathy in six patients. Patients with PET-positive facet arthropathy had significantly less pain compared with the pretreatment pain 3 h (P = 0.002), 4 weeks (P = 0.002) and 3 months (P = 0.026) after facet block therapy. Pain did not change significantly in patients with PET-negative facet arthropathy. TIRM SI ratio was higher in PET-positive facet arthropathy than in PET-negative facet arthropathy (P < 0.001). Correlation was strong between bone marrow SI ratio on TIRM images and SUVmax (r = 0.7; P < 0.001).

  14. Comparison of computed tomography and magnetic resonance imaging in the evaluation of facet tropism and facet arthrosis in degenerative cervical spondylolisthesis.

    Science.gov (United States)

    Xu, C; Ding, Z H; Xu, Y K

    2014-05-30

    The aim of this study was to determine the reliability of magnetic resonance imaging (MRI) in the assessment of facet tropism and facet arthrosis of spondylolisthesis levels in degenerative cervical spondylolisthesis as compared to computed tomography (CT). The discrepancies in the interpretation of CT and MRI data in the evaluation of facet tropism and arthrosis have given rise to questions regarding the reliability of comparisons of the two techniques. Using a 4-point scale, 3 blinded readers independently graded the severity of facet tropism and facet arthrosis of 79 cervical facet joints on axial T2-weighted and sagittal T1 and T2-weighted turbo spin echo images as well as the corresponding axial CT scans. All results were subjected to the kappa coefficient statistic for strength of agreement. In the assessment of the severity of facet arthrosis, intermethod agreement (weighted κ) between CT scanning with a moderate inter-rater reliability (range κ = 0.43-0.57) and MRI with fair inter-rater reliability (range κ = 0.23-0.38) was 0.76 and 0.43 for the severity of facet tropism and facet arthrosis, respectively. Intra-rater reliability for the severity of facet arthrosis was moderate to substantial for CT and was moderate for MRI scans. Intra-rater reliability for the severity of facet tropism was substantial to very good for CT and substantial for MRI scans. MRI can reliably determine the presence or degree of facet tropism but not facet arthrosis. Therefore, for a comprehensive assessment of cervical facet joint degeneration, both a CT and an MRI scan should be performed.

  15. PORCINE VENA CAVA AS AN ALTERNATIVE TO BOVINE PERICARDIUM IN BIOPROSTHETIC PERCUTANEOUS HEART VALVES

    Science.gov (United States)

    Munnelly, Amy; Cochrane, Leonard; Leong, Joshua; Vyavahare, Naren

    2011-01-01

    Percutaneous heart valves are revolutionizing valve replacement surgery by offering a less invasive treatment option for high-risk patient populations who have previously been denied the traditional open chest procedure. Percutaneous valves need to be crimped to accommodate a small-diameter catheter during deployment, and they must then open to the size of heart valve. Thus the material used must be strong and possess elastic recoil for this application. Most percutaneous valves utilize bovine pericardium as a material of choice. One possible method to reduce the device delivery diameter is to utilize a thin, highly elastic tissue. Here we investigated porcine vena cava as an alternative to bovine pericardium for percutaneous valve application. We compared the structural, mechanical, and in vivo properties of porcine vena cava to those of bovine pericardium. While the extracellular matrix fibers of pericardium are randomly oriented, the vena cava contains highly aligned collagen and elastin fibers that impart strength to the vessel in the circumferential direction and elasticity in the longitudinal direction. Moreover, the vena cava contains a greater proportion of elastin, whereas the pericardium matrix is mainly composed of collagen. Due to its high elastin content, the vena cava is significantly less stiff than the pericardium, even after crosslinking with glutaraldehyde. Furthermore, the vena cava’s mechanical compliance is preserved after compression under forces similar to those exerted by a stent, whereas pericardium is significantly stiffened by this process. Bovine pericardium also showed surface cracks observed by scanning electron microscopy after crimping that were not seen in vena cava tissue. Additionally, the vena cava exhibited reduced calcification (46.64 ± 8.15 μg Ca/mg tissue) as compared to the pericardium (86.79 ± 10.34 μg/mg). These results suggest that the vena cava may enhance leaflet flexibility, tissue resilience, and tissue

  16. Percutaneous vertebroplasty (pv): indications, contraindications, and technique; Perkutane Vertebroplastie: Indikationen, Kontraindikationen und Technik

    Energy Technology Data Exchange (ETDEWEB)

    Hoffmann, R.T.; Jakobs, T.F.; Wallnoefer, A.; Reiser, M.F.; Helmberger, T.K. [Institut fuer Klinische Radiologie, Klinikum der Universitaet Muenchen-Grosshadern (Germany)

    2003-09-01

    Percutaneous vertebroplasty (pv) is a worldwide increasingly performed interventional therapeutic procedure. This article addresses indications, patient preparation, technical requirements and approach as well as possible complications of percutaneous vertebroplasty. Percutaneous vertebroplasty is a technique consisting in an injection of bone cement into a vertebral body under imaging guidance. This procedure is performed to relief pain and support the mechanical stability in partially collapsed vertebral bodies. In the management of spinal compression fractures secondary to osteoporosis, myeloma, osteolytic metastases and aggressive hemangiomas, percutaneous vertebroplasty yields analgesic effect, and provides additional fortification in weakened segments of the vertebral column. Contraindications include major bleeding disorders, radicular pain and pain caused by compression of the myelon. Percutaneous vertebroplasty results in prompt pain relief and rapid rehabilitation. In experienced hands, using correct technique, pv is a safe and effective procedure for treating pain, caused either by osteoporotic or malignant vertebral compression fractures. (orig.) [German] In den letzten Jahren gewinnt die perkutane Vertebroplastie (PV) weltweit zunehmend an Bedeutung. In diesem Beitrag werden die korrekte Indikationsstellung, die Vorbereitung der Patienten, geeignete Materialien sowie das technische Vorgehen bei dieser Behandlungsmethode dargestellt. Die PV ist ein minimal-invasives Verfahren, bei dem - unter radiologischer Kontrolle - Knochenzement ueber eine Hohlnadel in einen Wirbelkoerper injiziert wird und damit Schmerzen behandelt werden, die durch einen knoechernen Stabilitaetsverlust der Wirbelkoerper hervorgerufen werden. Indikationen zur Durchfuehrung der Vertebroplastie sind nichtradikulaere, konservativ nicht behandelbare Schmerzen, die durch Kompressionsfrakturen von Wirbelkoerpern aufgrund einer Osteoporose, benignen (aggressiven Haemangiomen) oder

  17. Facet-defining inequalities for the simple graph partitioning polytope

    DEFF Research Database (Denmark)

    Sørensen, Michael Malmros

    2007-01-01

    The simple graph partitioning problem is to partition an edge-weighted graph into mutually node-disjoint subgraphs, each containing at most b nodes, such that the sum of the weights of all edges in the subgraphs is maximal. In this paper we provide several classes of facet-defining inequalities...

  18. Personality Facets and RIASEC Interests: An Integrated Model

    Science.gov (United States)

    Armstrong, Patrick Ian; Anthoney, Sarah Fetter

    2009-01-01

    Research examining links between personality and interest have typically focused on links between measures of the five factor model and Holland's RIASEC types. However, the five factor model of personality can be divided in to a larger set of narrow domain personality scales measuring facets of the "big five" traits. Research in a number of fields…

  19. Empirical Identification of the Major Facets of Conscientiousness

    Science.gov (United States)

    MacCann, Carolyn; Duckworth, Angela Lee; Roberts, Richard D.

    2009-01-01

    Conscientiousness is often found to predict academic outcomes, but is defined differently by different models of personality. High school students (N = 291) completed a large number of Conscientiousness items from different models and the Big Five Inventory (BFI). Exploratory and confirmatory factor analysis of the items uncovered eight facets:…

  20. Hydrothermal synthesis of magnetite particles with uncommon crystal facets

    Directory of Open Access Journals (Sweden)

    Junki Sato

    2014-09-01

    Full Text Available Hydrothermal synthesis of Fe3O4 (magnetite particles was carried out using organic compounds as morphology control agents to obtain magnetite crystals with uncommon facets. It was established that the morphology of Fe3O4 crystals obtained by hydrothermal treatment of an aqueous solution containing Fe2+ and organic compounds depended on the organic compound used. The shape of the Fe3O4 particles obtained when no additives were used was quasi-octahedral. In contrast, the addition of picolinic acid, citric acid or pyridine resulted in the formation of polyhedral crystals, indicating the presence of not only {1 1 1}, {1 0 0} and {1 1 0} facets but also high-index facets including at least {3 1 1} and {3 3 1}. When citric acid was used as an additive, octahedral crystals with {1 1 1} facets also appeared, and their size decreased as the amount of citric acid was increased. Thus, control of Fe3O4 particle morphology was achieved by a simple hydrothermal treatment using additives.

  1. A multi-faceted approach to research development (II): Supporting ...

    African Journals Online (AJOL)

    A multi-faceted approach to research development (II): Supporting communities of practice. IM Christiansen, L Slammert. Abstract. In South Africa, dominant discourses on research development are characterised by a technical-rational approach combined with a focus on the individual. Working from the notion that research ...

  2. Posterior longitudinal ligament status in cervical spine bilateral facet dislocations

    Energy Technology Data Exchange (ETDEWEB)

    Carrino, John A. [Brigham and Women' s Hospital, Harvard Medical School, Department of Radiology, Boston, MA (United States); Manton, Geoffrey L.; Morrison, William B.; Flanders, Adam E. [Thomas Jefferson University Hospital, Department of Radiology, Philadelphia, PA (United States); Vaccaro, Alex R. [Thomas Jefferson University Hospital, Department of Orthopedic Surgery, The Rothman Institute, Philadelphia, PA (United States); Schweitzer, Mark E. [New York University, Hospital for Joint Diseases, Department of Radiology, New York, NY (United States)

    2006-07-15

    It is generally accepted that cervical spine bilateral facet dislocation results in complete disruption of the posterior longitudinal ligament. The goal of this study was to evaluate the integrity of numerous spine-stabilizing structures by MRI, and to determine if any associations between injury patterns exist with respect to the posterior longitudinal ligament status. Retrospective case series. A retrospective review was performed of 30 cervical spine injury subjects with bilateral facet dislocation. Assessment of 1.5T MRI images was carried out for: intervertebral disc disruption, facet fracture, and ligamentous disruption. Statistical analyses were performed to evaluate for associations between various injury patterns and posterior longitudinal ligament status. The frequency of MRI abnormalities was: anterior longitudinal ligament disruption (26.7%), disc herniation or disruption (90%), posterior longitudinal ligament disruption (40%), facet fracture (63.3%) and disruption of the posterior column ligament complex (97%). There were no significant associations between injury to the posterior longitudinal ligament and other structures. Compared to surgical reports, MRI was accurate for determining the status for 24 of 26 ligaments (three of three anterior longitudinal ligament, seven of nine posterior longitudinal ligament, and 14 of 14 posterior column ligament complex) but generated false negatives in two instances (in both MRI showed an intact posterior longitudinal ligament that was torn at surgery). (orig.)

  3. Conceptualizing Educational Leadership: Does Exploring Macro-Level Facets Matters?

    Science.gov (United States)

    Sinha, Chetan

    2013-01-01

    The present review attempts to examine the present status of educational leadership highlighting the role of macro-level facets in Asian Pacific context. The conceptualization of educational leadership among researchers so far had been found to vary according to different contexts and situations. Theoretical perspectives associated with…

  4. Facet-Dependent Photoreduction on Single ZnO Crystals

    Science.gov (United States)

    2016-01-01

    Photocatalytic reactions occur at the crystal–solution interface, and hence specific crystal facet expression and surface defects can play an important role. Here we investigate the structure-related photoreduction at zinc oxide (ZnO) microparticles via integrated light and electron microscopy in combination with silver metal photodeposition. This enables a direct visualization of the photoreduction activity at specific crystallographic features. It is found that silver nanoparticle photodeposition on dumbbell-shaped crystals mainly takes place at the edges of O-terminated (0001̅) polar facets. In contrast, on ZnO microrods photodeposition is more homogeneously distributed with an increased activity at {101̅1̅} facets. Additional time-resolved measurements reveal a direct spatial link between the enhanced photoactivity and increased charge carrier lifetimes. These findings contradict previous observations based on indirect, bulk-scale experiments, assigning the highest photocatalytic activity to polar facets. The presented research demonstrates the need for advanced microscopy techniques to directly probe the location of photocatalytic activity. PMID:28001412

  5. The usability issues of faceted navigation in digital libraries

    Directory of Open Access Journals (Sweden)

    Eliane Blumer

    2014-05-01

    For more than five years, the project ACCEPT, a subproject of a Swiss national project called e-lib.ch, analyzes the usability and usefulness of digital libraries, by using user oriented methods. Experience has shown that filters provided through faceted navigation are considered as positive and very useful by end users. Nevertheless, based on different test results, several returning mistakes have been detected and it turns out that there are some ‘unwritten standards’ concerning e.g. position, labelling or ranking which should be respected to fulfil the aim of a good usability which users do expect of such web services. In this poster we will first give an introduction to faceted navigation, actual design issues and their use in digital libraries and then present testing methods, which can be easily applied in a digital library context. Together with a list of best practices concerning faceted navigation drawn out of different test experiences, the paper should give the reader all important information to evaluate its current faceted navigation and see where improvements could be made.

  6. [Surgical treatment of calcaneus fracture involving posterior subtalar articular facet].

    Science.gov (United States)

    Xu, Peng-Wu; Qiao, Lin; Zhang, Shu-Ming; Liu, Chun-Sheng; Zhang, Wei; Xu, Qing-Lei

    2010-06-01

    To investigate the methods of reduction and stable fixation for the treatment of calcaneus fracture involving posterior subtalar articular facet. From September 2004 to September 2008, 31 cases(38 feet) of calcaneus fracture involving posterior subtalar articular facet were treated with open reduction and plate fixation through L incision. There were 24 males and 7 females, with an average age of 39.6 years ranging from 20 to 65 years. All patients underwent systematic CT-scan with coronal and horizontal images and sagittal reconstruction. The classification of the fractures by the Sanders scale showed that there were 22 of type II,14 of type III, 2 of type IV. All cases were followed up for from 12 to 36 months with an average of 25 months, and all the fractures healed without skin flap necrosis. According to the Maryland foot scoring, the total score was (96.2 +/- 8.8) on average, the results were excellent in 32 feet, good in 4 feet, fair in 2 feet. The replacement of the posterior articular facet by X-ray control of Broden and open reduction and internal fixation with calcaneus plate and Schanz-Screw during the operation can keep stable of articular facet, and promote early rehabilitation of calcaneus fracture affected with subtalar joint.

  7. [Multi-facetted clinical presentation of thrombotic thrombocytopenic purpura

    DEFF Research Database (Denmark)

    Niemann, C.U.; Jurlander, J.; Daugaard, G.

    2009-01-01

    smears. Determination of the ADAMTS13-activity is now becoming available as a routine analysis. We present two cases that illustrate the multi-facetted clinical presentation under which TTP occurs. The importance of access to ADAMTS13 measurements is stressed Udgivelsesdato: 2009/1/26...

  8. Terahertz Light Source and User Area at FACET

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Z.; Li, S.Z.; Litos, M.; Fisher, A.D.; Hogan, M.J.; /SLAC

    2011-11-08

    FACET at SLAC provides high charge, high peak current, low emittance electron beam that is bunched at THz wavelength scale during its normal operation. A THz light source based coherent transition radiation (CTR) from this beam would potentially be the brightest short-pulse THz source ever constructed. Efforts have been put into building this photon source together with a user area, to provide a platform to utilize this unique THz radiation for novel nonlinear and ultrafast phenomena researches and experiments. Being a long-time underutilized portion of the electromagnetic spectrum, terahertz (100 GHz {approx} 10 THz) spectral range is experiencing a renaissance in recent years, with broad interests from chemical and biological imaging, material science, telecommunication, semiconductor and superconductor research, etc. Nevertheless, the paucity of THz sources especially strong THz radiation hinders both its commercial applications and nonlinear processes research. FACET - Facilities for Accelerator science and Experimental Test beams at SLAC - provides 23 GeV electron beam with peak currents of {approx} 20 kA that can be focused down to 100 {mu}m{sup 2} transversely. Such an intense electron beam, when compressed to sub-picosecond longitudinal bunch length, coherently radiates high intensity EM fields well within THz frequency range that are orders of magnitude stronger than those available from laboratory tabletop THz sources, which will enable a wide variety of THz related research opportunities. Together with a description of the FACET beamline and electron beam parameters, this paper will report FACET THz radiation generation via coherent transition radiation and calculated photon yield and power spectrum. A user table is being set up along the THz radiation extraction sites, and equipped with various signal diagnostics including THz power detector, Michelson interferometer, sample stages, and sets of motorized optical components. This setup will also be

  9. Lordosis manoeuvre in the diagnosis of lumbar facet syndrome.

    Science.gov (United States)

    Díez-Ulloa, M A; Almira Suárez, E L; Otero Fernández, M; Leborans Eiras, S; Collado Arce, G

    2016-01-01

    In lumbar pain patients an aetiopathogenic diagnosis leads to a better management. When there are alarm signs, they should be classified on an anatomical basis through anamnesis and physical examination. A significant group is of facet origin (lumbar facet syndrome [LFS]), but the precise clinical diagnosis remains cumbersome and time-consuming. In clinical practice it is observed that patients with an advanced degenerative disease do not perform extension or rotation of their lumbar spine when prompted to extend it, but rather knee flexion, making the manoeuvre meaningless. For this reason, a new simple and quick clinical test was developed for the diagnosis of lumbar facet syndrome, with a facet block-test as a confirmation. The new test is better than a classic one in the diagnosis of facet syndrome, and probably even better than imaging studies A prospective study was conducted on a series of 68 patients (01/01/2012-30/06/2013). A comparison in between: classic manoeuvre (CM), imaging diagnostics (ID), and the new lordosis manoeuvre (LM) test. Examination and block test by one author, and evaluation of results by another one. Deformity and instability. using a physical. To determine the effectiveness of a new clinical test (LM) for the diagnosis of LFS (as confirmed by a positive block-test of medial branch of dorsal ramus of the lumbar root, RMRDRL). R package software. The LM was most effective (pdiagnosis of LFS is presented that is reliable, quick, and simple. Clinical examination is more reliable than imaging test for the diagnosis of LFS. Copyright © 2016 SECOT. Published by Elsevier Espana. All rights reserved.

  10. Percutaneous radiofrequency thermal lumbar sympathectomy and its clinical use

    NARCIS (Netherlands)

    J. Pernak (Jamina)

    1988-01-01

    textabstractPercutaneous radiofrequency thermolesion techniques are commonly used in the treatment of chronic pain in different pain syndromes. There are many reports describing techniques of percutaneous radiofrequency thermolesion for denervation of central & spinal nerves (Mullan 1963), 1965,

  11. The efficacy of a percutaneous expandable titanium device in anatomical reduction of vertebral compression fractures of the thoracolumbar spine

    OpenAIRE

    Baeesa, Saleh S.; Krueger, Antonio; Arag?n, Francisco A.; Noriega, David C.

    2015-01-01

    Objectives: To evaluate the feasibility of a minimally invasive technique using a titanium expandable device to achieve anatomical restoration of vertebral compression fractures (VCF) of the thoracolumbar spine. Methods: This prospective study included 27 patients diagnosed with VCF (Magerl classification A.1.2, A.1.3, and A.3.1) of the thoracolumbar spine treated with percutaneous cement augmentation using the SpineJack? device. The study was conducted in Valladolid University Hospital, Vall...

  12. La ténorraphie percutanée dans les ruptures fraîches du tendon ...

    African Journals Online (AJOL)

    La rupture du tendon calcanéen est une des lésions les plus fréquentes en pathologie du sport, les deux options thérapeutiques classiques sont le traitement orthopédique et la chirurgie à ciel ouvert. Dans le but de minimiser ces complications, des techniques mini-invasives de ténorraphie percutanée ont été proposées ...

  13. Drainage percutané de l'abcès du psoas: Notre expérience et revue ...

    African Journals Online (AJOL)

    Introduction: L'abcès du muscle psoas, infection rétropéritonéale rare et de diagnostic difficile, affecte, des sujets débilités. Le but de notre étude était de rapporter notre expérience du drainage percutané, peu invasive, dans le traitement de cette affection. Patients et méthodes: Nous rapportons, de fac¸on rétrospective une ...

  14. Benign Fibroepithelial Polyp of Renal Pelvis in a Patient with Familial Adenomatous Polyposis: A Successful Percutaneous Nephroscopic Management Strategy

    Directory of Open Access Journals (Sweden)

    Nikhil Vasdev

    2009-01-01

    Full Text Available We present a rare case of a benign fibroepithelial polyp of the renal pelvis in a patient with familial adenomatous polyposis. In our paper we describe a new minimally invasive technique developed in our unit using an amplatz goose neck snare via a percutaneous nephroscope sheath in the management of the benign fibroepithelial polyp of the renal pelvis and present a current review of management strategies in literature.

  15. Quantitative morphometric analysis of the lumbar vertebral facets and evaluation of feasibility of lumbar spinal nerve root and spinal canal decompression using the Goel intraarticular facetal spacer distraction technique: A lumbar/cervical facet comparison.

    Science.gov (United States)

    Satoskar, Savni R; Goel, Aimee A; Mehta, Pooja H; Goel, Atul

    2014-10-01

    The authors evaluate the anatomic subtleties of lumbar facets and assess the feasibility and effectiveness of use of 'Goel facet spacer' in the treatment of degenerative spinal canal stenosis. Twenty-five lumbar vertebral cadaveric dried bones were used for the purpose. A number of morphometric parameters were evaluated both before and after the introduction of Goel facet spacers within the confines of the facet joint. The spacers achieved distraction of facets that was more pronounced in the vertical perspective. Introduction of spacers on both sides resulted in an increase in the intervertebral foraminal height and a circumferential increase in the spinal canal dimensions. Additionally, there was an increase in the disc space or intervertebral body height. The lumbar facets are more vertically and anteroposteriorly oriented when compared to cervical facets that are obliquely and transversely oriented. Understanding the anatomical peculiarities of the lumbar and cervical facets can lead to an optimum utilization of the potential of Goel facet distraction arthrodesis technique in the treatment of spinal degenerative canal stenosis.

  16. [Minimally invasive surgery for Chance fractures: Three case studies].

    Science.gov (United States)

    Blondel, B; Fuentes, S; Rambolarimanana, T; Metellus, P; Dufour, H

    2010-02-01

    Chance fractures are quite rare injuries that require surgical treatment in cases of spinal instability. Development of percutaneous and minimally invasive procedures can alter the management of such lesions, resulting in fewer related soft tissue lesions and morbidities. We present our experience with three patients who underwent percutaneous posterior osteosynthesis associated with a minimally invasive anterior graft for discal lesion. The first two cases presented fracture through the disc and osteosynthesis was done on a single mobile level. In the third case with a bony Chance fracture, we performed a short-segment fixation one level above and below the fractured vertebra. In all three cases, operative blood loss was minimal and clinical outcomes were favorable, with tolerable postoperative pain. Fusion and consolidation were visible for all the patients without loss of correction or implant failure. Percutaneous osteosynthesis and minimally invasive surgery can be an advantageous alternative for the management of Chance fractures. They allow early mobilization of the patient with less soft tissue trauma and morbidities associated with open procedures. Copyright 2009 Elsevier Masson SAS. All rights reserved.

  17. Percutaneous endoscopic gastrostomy in children.

    Science.gov (United States)

    Park, Jye Hae; Rhie, Seonkyeong; Jeong, Su Jin

    2011-01-01

    Percutaneous endoscopic gastrostomy (PEG) can improve nutritional status and reduce the amount of time needed to feed neurologically impaired children. We evaluated the characteristics, complications, and outcomes of neurologically impaired children treated with PEG. We retrospectively reviewed the records of 32 neurologically impaired children who underwent PEG between March 2002 and August 2008 at our medical center. Forty-two PEG procedures comprising 32 PEG insertions and 10 PEG exchanges, were performed. The mean follow-up time was 12.2 (6.6) months. Mean patient age was 9.4 (4.5) years. The main indications for PEG insertion were swallowing difficulty with GI bleeding due to nasogastric tube placement and/or the presence of gastroesophageal reflux disease (GERD). The overall rate of complications was 47%, with early complications evident in 25% of patients and late complications in 22%. The late complications included one gastro-colic fistula, two cases of aggravated GERD, and four instances of wound infection. Among the 15 patients with histological evidence of GERD before PEG, 13 (87%) had less severe GERD, experienced no new aspiration events, and showed increased body weight after PEG treatment. PEG is a safe, effective, and relatively simple technique affording long-term enteral nutritional support in neurologically impaired children. Following PEG treatment, the body weight of most patients increased and the levels of vomiting, GI bleeding, and aspiration fell. We suggest that PEG with post-procedural observation be considered for enteral nutritional support of neurologically impaired children.

  18. Imaging in percutaneous musculoskeletal interventions

    International Nuclear Information System (INIS)

    Gangi, Afshin; Guth, Stephane; Guermazi, Ali

    2009-01-01

    This is one of the first books to deal specifically with imaging in percutaneous musculoskeletal interventions. The use of different imaging modalities during these procedures is well described. In the first chapter, the basic procedures and different guidance techniques are presented and discussed. The ensuing chapters describe in exhaustive detail the abilities and uses of imaging in guiding procedures ranging from biopsy and joint injection to management of pain and tumors. These procedures are extensively documented in adults as well as in the pediatric population. The third part of the book describes the different indications for vascular interventions in musculoskeletal lesions. The final chapter focuses on ultrasound-guided interventions, as they are more common and tend to be fashionable. The book is well illustrated with carefully chosen and technically excellent images. Each of the 18 chapters is written by an expert of international repute, making this book the most current and complete treatment of the subject available. It should be of great interest to interventional radiologists and also musculoskeletal and general radiologists. (orig.)

  19. Modeling Integration and Reuse of Heterogeneous Terminologies in Faceted Browsing Systems

    OpenAIRE

    Harris, Daniel R.

    2016-01-01

    We integrate heterogeneous terminologies into our category-theoretic model of faceted browsing and show that existing terminologies and vocabularies can be reused as facets in a cohesive, interactive system. Commonly found in online search engines and digital libraries, faceted browsing systems depend upon one or more taxonomies which outline the structure and content of the facets available for user interaction. Controlled vocabularies or terminologies are often externally curated and are av...

  20. Minimally Invasive Surgical Approach to Distal Fibula Fractures: A Technique Tip

    Directory of Open Access Journals (Sweden)

    Tyler A. Gonzalez

    2017-01-01

    Full Text Available Wound complications following ankle fracture surgery are a major concern. Through the use of minimally invasive surgical techniques some of these complications can be mitigated. Recent investigations have reported on percutaneous fixation of distal fibula fractures demonstrating similar radiographic and functional outcomes to traditional open approaches. The purpose of this manuscript is to describe in detail the minimally invasive surgical approach for distal fibula fractures.

  1. Minimally invasive surgery for Achilles tendon pathologies

    Directory of Open Access Journals (Sweden)

    Nicola Maffulli

    2010-07-01

    Full Text Available Nicola Maffulli1, Umile Giuseppe Longo2, Filippo Spiezia2, Vincenzo Denaro21Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, London, England; 2Department of Orthopedic and Trauma Surgery, Campus Bio-Medico University, Rome, ItalyAbstract: Minimally invasive trauma and orthopedic surgery is increasingly common, though technically demanding. Its use for pathologies of the Achilles tendon (AT hold the promise to allow faster recovery times, shorter hospital stays, and improved functional outcomes when compared to traditional open procedures, which can lead to difficulty with wound healing because of the tenuous blood supply and increased chance of wound breakdown and infection. We present the recent advances in the field of minimally invasive AT surgery for tendinopathy, acute ruptures, chronic tears, and chronic avulsions of the AT. In our hands, minimally invasive surgery has provided similar results to those obtained with open surgery, with decreased perioperative morbidity, decreased duration of hospital stay, and reduced costs. So far, the studies on minimally invasive orthopedic techniques are of moderate scientific quality with short follow-up periods. Multicenter studies with longer follow-up are needed to justify the long-term advantages of these techniques over traditional ones.Keywords: tendinopathy, rupture, percutanous repair, less invasive

  2. Percutaneous endoscopic lumbar discectomy for L5-S1 disc herniation: transforaminal versus interlaminar approach.

    Science.gov (United States)

    Choi, Kyung Chul; Kim, Jin-Sung; Ryu, Kyeong-Sik; Kang, Byung Uk; Ahn, Yong; Lee, Sang-Ho

    2013-01-01

    Percutaneous endoscopic lumbar discectomy (PELD) is a minimally invasive spinal technique. The unique anatomic features of the L5-S1 space include a large facet joint, narrow foramen, small disc space, and a wide interlaminar space. PELD can be performed via 2 routes, transforaminal (TF-PELD) or interlaminar (IL-PELD). However, it is questionable that the decision of the endoscopic route for L5-S1 discs only depends on the surgeon's preference and anatomic relation between iliac bone and disc space. Thus far, no study has compared TF-PELD with IL-PELD for L5-S1 disc herniation. The goal of this study was to compare the radiologic features and results of TF-PELD and IL-PELD. We have clarified the patient selection for the PELD route for L5-S1 disc herniation. Retrospective evaluation. Thirty consecutive patients each were treated with TF-PELD and IL-PELD for L5-S1 disc herniation in 2 institutes, respectively. Radiological assessments were performed pre- and postoperatively. The disc type, disc size, location, migration, disc height, foraminal height, iliolumbar angle, iliac height, and interlaminar space were analyzed. Clinical data were compared with a 2-year follow-up period. Pre- and postoperative pain was measured using a visual analog scale (VAS; 0 - 10) and functional status was assessed using the Oswestry Disability Index (ODI; 0 - 100%) and the time to return to work. In the 2 groups, the mean VAS scores for back and leg pain, as well as the ODI, were significantly improved. The mean time to return to work was 4.9 weeks with TF-PELD and 4.4 weeks with IL-PELD. Incomplete removal, resulting in the need for subsequent open surgery, occurred in one case (3.3%) of TF-PELD and in 2 cases (6.6%) of IL-PELD. Postoperative dysesthesia developed in 2 patients (6.7%) after IL-PELD; however, there was no dysesthesia after TF-PELD. Recurrence occurred in 3.3% with TF-PELD and in 6.7% with IL-PELD during the 2-year follow-up. A significant difference between groups was

  3. Dioptrics of the facet lenses in the dorsal rim area of the cricket Gryllus bimaculatus

    NARCIS (Netherlands)

    Ukhanov, KY; Leertouwer, HL; Gribakin, FG; Stavenga, DG

    1996-01-01

    1. The optics of the corneal facet lenses from the dorsal rim area (DRA) and from the dorso-lateral areas (DA) of the compound eye of the cricket Gryllus bimaculatus were studied. 2. The DRA of the cricket eye contains quite normally shaped facet lenses. The diameter of the facet lens in the DA is

  4. Percutaneous thermal ablation of renal neoplasms; Perkutane Thermoablation von Nierentumoren

    Energy Technology Data Exchange (ETDEWEB)

    Tacke, J. [Inst. fuer Diagnostische und Interventionelle Radiologie/Neuroradiologie, Klinikum Passau (Germany); Mahnken, A.H.; Guenther, R.W. [Klinik fuer Radiologische Diagnostik, Universitaetsklinikum Aachen (Germany)

    2005-12-15

    Due to modern examination techniques such as multidetector computed tomography and high-field magnetic resonance imaging, the detection rate of renal neoplasms is continually increasing. Even though tumors exceeding 4 cm in diameter rarely metastasize, all renal lesions that are possible neoplasms should be treated. Traditional treatment techniques include radical nephrectomy or nephron-sparing resection, which are increasingly performed laparoscopically. Modern thermal ablation techniques such as hyperthermal techniques like radiofrequency ablation RFA, laser induced thermal ablation LITT, focused ultrasound FUS and microwave therapy MW, as well as hypothermal techniques (cryotherapy) may be a useful treatment option for patients who are unfit for or refuse surgical resection. Cryotherapy is the oldest and best known thermal ablation technique and can be performed laparoscopically or percutaneously. Since subzero temperatures have no antistyptic effect, additional maneuvers must be performed to control bleeding. Percutaneous cryotherapy of renal tumors is a new and interesting method, but experience with it is still limited. Radiofrequency ablation is the most frequently used method. Modern probe design allows volumes between 2 and 5 cm in diameter to be ablated. Due to hyperthermal tract ablation, the procedure is deemed to be safe and has a low complication rate. Although there are no randomized comparative studies to open resection, the preliminary results for renal RFA are promising and show RFA to be superior to other thermal ablation techniques. Clinical success rates are over 90% for both, cryo- and radiofrequency ablation. Whereas laser induced thermal therapy is established in hepatic ablation, experience is minimal with respect to renal application. For lesions of more than 2 cm in diameter, additional cooling catheters are required. MR thermometry offers temperature control during ablation. Microwave ablation is characterized by small ablation volumes

  5. Current Considerations in Direct Percutaneous Endoscopic Jejunostomy

    Directory of Open Access Journals (Sweden)

    Yanfei Zhu

    2012-01-01

    Full Text Available For patients who are unable to meet their nutritional needs orally, enteral feeding via a percutaneous approach has become the mainstay of therapy. However, traditional enteral feeding methods, such as percutaneous endoscopic gastrostomy, may not be viable options for patients with severe gastroparesis or gastric outlet obstruction. Direct percutaneous endoscopic jejunostomy (DPEJ is an enteral access method that was first described more than 20 years ago and has gained popularity among gastroenterologists. This review discusses the indications for and contraindications to DPEJ, the procedure, the application of DPEJ in specific subsets of patients with gastrointestinal disorders, and presents a brief tabular summary of complications and success rates of DPEJ in case series published since 2000.

  6. Biomechanical study of percutaneous lumbar diskectomy

    International Nuclear Information System (INIS)

    Li Yuan; Huang Xianglong; Shen Tianzhen; Hu Zhou; Hong Shuizong; Mei Haiying

    2003-01-01

    Objective: To investigate the stiffness of lumbar spine after the injury caused by percutaneous diskectomy and evaluate the efficiency of percutaneous lumbar diskectomy by biomechanical study. Methods: Four fresh lumbar specimens were used to analyse load-displacement curves in the intact lumbar spine and vertical disc-injured lumbar spine. The concepts of average flexibility coefficient (f) and standardized average flexibility coefficient (fs) were also introduced. Results: The load-displacement curves showed a good stabilization effect of the intact lumbar spine and disc-injured lumbar spine in flexion, extension, right and left bending. The decrease of anti-rotation also can be detected (P<0.05). Conclusion: In biomechanical study, percutaneous lumbar diskectomy is one of the efficiency methods to treat lumbar diac hernia

  7. Percutaneous management of staghorn renal calculi

    International Nuclear Information System (INIS)

    Lee, Won Jay

    1989-01-01

    During a four year period, ending May 1987, 154 cases of symptomatic staghorn calculi have been treated by percutaneous nephrolithotomy. Of these patients,86% were discharged completely stone free with the remainder having fragments less than 5 mm in greatest diameter. More than one operative procedure during the same hospitalizations was required in 24% of patients and multiple percutaneous tracts were established in excess of 73% of them. Significant complications occurred in 16% of patients and there was one death. Most complications can be generally by minimized by careful approach and manageable by interventional radiological means. The management of patients with staghorn calculi requires a comprehensive understanding of the renal anatomy, selection of appropriate percutaneous nephrostomy tract sites, and radiologic-urologic expertise needed to remove the large stone mass. The advent of extracorporeal shock wave lithotripsy will not abolish the need for nephrolithotomy, particularly complex stones such as staghorn calculi

  8. Percutaneous epidural drainage through a burr hole

    Directory of Open Access Journals (Sweden)

    Priscila M Falsarella

    2016-01-01

    Full Text Available Intracranial extradural collection may cause an increase in intracranial pressure, requiring rapid emergency treatment to reduce morbidity and mortality. We described an alternative CT-guided percutaneous access for extradural collection drainage. We report a case of a patient with previous craniectomy for meningioma ressection who presented to the Emergency Department with symptoms of intracranial hypertension. Brains CT showed a extradural collection with subfalcine herniation. After multidisciplinary discussion a CT-guided percutaneous drainage through previous burr hole was performed. The patient was discharged after 36 hours of admission, without further symptoms. We describe a safe and effective alternative percutaneous access for extradural collection drainage in patients with previous burr hole.

  9. An overview of complications associated with open and percutaneous tracheostomy procedures

    Science.gov (United States)

    Cipriano, Anthony; Mao, Melissa L; Hon, Heidi H; Vazquez, Daniel; Stawicki, Stanislaw P; Sharpe, Richard P; Evans, David C

    2015-01-01

    Tracheostomy, whether open or percutaneous, is a commonly performed procedure and is intended to provide long-term surgical airway for patients who are dependent on mechanical ventilatory support or require (for various reasons) an alternative airway conduit. Due to its invasive and physiologically critical nature, tracheostomy placement can be associated with significant morbidity and even mortality. This article provides a comprehensive overview of commonly encountered complications that may occur during and after the tracheal airway placement, including both short- and long-term postoperative morbidity. PMID:26557488

  10. Percutaneous septal ablation for left mid-ventricular obstructive hypertrophic cardiomyopathy: a case report

    Directory of Open Access Journals (Sweden)

    Alioglu Emin

    2006-04-01

    Full Text Available Abstract Background Mid-ventricular obstructive hypertrophic cardiomyopathy (MVOHC is a rare type of cardiomyopathy. The diagnosis is based on the hourglass appearance on the left ventriculogram and the presence of pressure gradient between apical and basal chamber of the ventriculum on the hemodynamic assessment. Case presentation The present case represents successful percutaneous treatment with septal ablation to patient with MVOHC associated with systolic anterior motion of the mitral valve and obstruction at both the mid-ventricular and outflow levels. Conclusion Alcohol septal ablation has been proposed as less invasive alternatives to surgery in patients with MVOHC.

  11. Transforaminal Percutaneous Endoscopic Discectomy using Transforaminal Endoscopic Spine System technique: Pitfalls that a beginner should avoid.

    Science.gov (United States)

    Kapetanakis, Stylianos; Gkasdaris, Grigorios; Angoules, Antonios G; Givissis, Panagiotis

    2017-12-18

    Transforaminal Percutaneous Endoscopic Discectomy (TPED) is a minimally invasive technique mainly used for the treatment of lumbar disc herniation from a lateral approach. Performed under local anesthesia, TPED has been proven to be a safe and effective technique which has been also associated with shorter rehabilitation period, reduced blood loss, trauma, and scar tissue compared to conventional procedures. However, the procedure should be performed by a spine surgeon experienced in the specific technique and capable of recognizing or avoiding various challenging conditions. In this review, pitfalls that a novice surgeon has to be mindful of, are reported and analyzed.

  12. MRI-guided focused ultrasound (MRgFUS) to treat facet joint osteoarthritis low back pain - case series of an innovative new technique

    International Nuclear Information System (INIS)

    Weeks, Evan M.; Platt, Michael W.; Gedroyc, Wladyslaw

    2012-01-01

    To evaluate the safety and efficacy of magnetic resonance-guided focused ultrasound (MRgFUS) to treat facet joint osteoarthritis pain. Patients with a positive response to facet joint interventions were recruited from Pain and Spinal Clinics. Treatments were performed at the levels of pain according to symptomatology, previous invasive treatment and MRI grading of facet joint osteoarthritis. Both safety and efficacy data were collected. Pain palliation was evaluated using a validated pain numerical rating scale (NRS), Oswestry disability questionnaire (ODQ), Brief Pain Inventory (BPI) and the EuroQol (EQ-5D) health state score Eighteen patients were treated. There were no major adverse events. At 6/12 we found a reduction in both the NRS (average/worst) pain scores (60.2 %/51.2 %). This was associated with 45.9 % improvement in the ODQ score and 61.9 % reduction in the BPI interference score. We observed an improvement in the EuroQol (EQ-5D) health state score based on UK coefficients of +0.379 (0.317 to 0.696). Our phase I observational pilot study has evaluated an innovative new technique that is both non-invasive and radiation free. It is the first description of this procedure in the literature. In all patients the technique was safe, free of complications, effective and well tolerated. (orig.)

  13. MRI-guided focused ultrasound (MRgFUS) to treat facet joint osteoarthritis low back pain - case series of an innovative new technique

    Energy Technology Data Exchange (ETDEWEB)

    Weeks, Evan M.; Platt, Michael W. [St Mary' s Hospital, Imperial College Healthcare NHS Trust, Department of Anaesthesia and Pain Medicine, London (United Kingdom); Gedroyc, Wladyslaw [St Mary' s Hospital, Imperial College Healthcare NHS Trust, Department of Radiology, London (United Kingdom)

    2012-12-15

    To evaluate the safety and efficacy of magnetic resonance-guided focused ultrasound (MRgFUS) to treat facet joint osteoarthritis pain. Patients with a positive response to facet joint interventions were recruited from Pain and Spinal Clinics. Treatments were performed at the levels of pain according to symptomatology, previous invasive treatment and MRI grading of facet joint osteoarthritis. Both safety and efficacy data were collected. Pain palliation was evaluated using a validated pain numerical rating scale (NRS), Oswestry disability questionnaire (ODQ), Brief Pain Inventory (BPI) and the EuroQol (EQ-5D) health state score Eighteen patients were treated. There were no major adverse events. At 6/12 we found a reduction in both the NRS (average/worst) pain scores (60.2 %/51.2 %). This was associated with 45.9 % improvement in the ODQ score and 61.9 % reduction in the BPI interference score. We observed an improvement in the EuroQol (EQ-5D) health state score based on UK coefficients of +0.379 (0.317 to 0.696). Our phase I observational pilot study has evaluated an innovative new technique that is both non-invasive and radiation free. It is the first description of this procedure in the literature. In all patients the technique was safe, free of complications, effective and well tolerated. (orig.)

  14. (100) faceted anion voids in electron irradiated fluorite

    International Nuclear Information System (INIS)

    Johnson, E.

    1979-01-01

    High fluence electron irradiation of fluorite crystals in the temperature range 150 to 320 K results in formation of a simple cubic anion void superlattice. Above 320 K the damage structure changes to a random distribution of large [001] faceted anion voids. This voidage behaviour, similar to that observed in a range of irradiated metals, is discussed in terms points defect rather than conventional colour centre terminology. (Auth.)

  15. Multidimensional Facets of Perceived Risk in Mobile Travel Booking

    OpenAIRE

    Park, Sangwon; Tussyadiah, Iis

    2016-01-01

    Despite the growing prevalence of smartphones in daily life and travel context, travellers still perceive an extent of risk associated with using their smartphone to book travel products. In order to alleviate or reduce perceived risk, it is important to better understand the dimensions of and the factors that contribute to perceived risk. This study analysed 411 responses from an online panel to examine perceived risk in mobile travel booking and identified the following facets: time risk, f...

  16. The differing effects of the extraversion facets on leadership behaviours

    OpenAIRE

    Karlsen, Håvard

    2016-01-01

    Several meta-analyses have shown extraversion to be an important predictor of leadership emergence, effectiveness, and behaviours. However, in recent years researchers have shown that introverts in some conditions are equal or even better leaders. There have also been several calls for researchers to focus on narrower personality traits, as these might be more valid predictors than broader traits. For that reason, the relationship between facets of extraversion and leadership behaviour was...

  17. Renal effects of percutaneous stone removal

    Energy Technology Data Exchange (ETDEWEB)

    Eshghi, M.; Schiff, R.G.; Smith, A.D.

    1989-02-01

    Preoperative and postoperative renography with 99mTechnetium-diethylene-triamine pentaacetic acid was performed on 33 patients who were free of renal scarring, infection, and obstruction and who underwent percutaneous renal stone removal. Although there was a transient decrease in renal function postoperatively in some patients, statistically significant reductions in renal function occurred only in 1 patient with an arteriovenous malformation that was embolized and in 1 patient who had a postoperative ureteropelvic junction stricture. The creation of more than one nephrostomy tract did not affect the results. In the absence of serious complications, percutaneous nephrostomy does not have a significant effect on renal function.

  18. Percutaneous Cryotherapy of Vascular Malformation: Initial Experience

    Energy Technology Data Exchange (ETDEWEB)

    Cornelis, F., E-mail: francoiscornelis@hotmail.com [Institut Bergonie, Department of Radiology (France); Neuville, A. [Institut Bergonie, Department of Pathology (France); Labreze, C. [Pellegrin Hospital, Department of Pediatric Dermatology (France); Kind, M. [Institut Bergonie, Department of Radiology (France); Bui, B. [Institut Bergonie, Department of Oncology (France); Midy, D. [Pellegrin Hospital, Department of Vascular Surgery (France); Palussiere, J. [Institut Bergonie, Department of Radiology (France); Grenier, N. [Pellegrin Hospital, Department of Radiology (France)

    2013-06-15

    The present report describes a case of percutaneous cryotherapy in a 36-year-old woman with a large and painful pectoral venous malformation. Cryoablation was performed in a single session for this 9-cm mass with 24 h hospitalisation. At 2- and 6-month follow-up, the pain had completely disappeared, and magnetic resonance imaging demonstrated a significant decrease in size. Percutaneous cryoablation shows promise as a feasible and apparently safe method for local control in patients with symptomatic venous vascular malformations.

  19. Percutaneous Cryotherapy of Vascular Malformation: Initial Experience

    International Nuclear Information System (INIS)

    Cornelis, F.; Neuville, A.; Labrèze, C.; Kind, M.; Bui, B.; Midy, D.; Palussière, J.; Grenier, N.

    2013-01-01

    The present report describes a case of percutaneous cryotherapy in a 36-year-old woman with a large and painful pectoral venous malformation. Cryoablation was performed in a single session for this 9-cm mass with 24 h hospitalisation. At 2- and 6-month follow-up, the pain had completely disappeared, and magnetic resonance imaging demonstrated a significant decrease in size. Percutaneous cryoablation shows promise as a feasible and apparently safe method for local control in patients with symptomatic venous vascular malformations.

  20. Duodenal damage complicating percutaneous access to kidney

    Directory of Open Access Journals (Sweden)

    Antonio Corrêa Lopes Neto

    2000-07-01

    Full Text Available CONTEXT: Since the first percutaneous nephrostomy performed by Goodwin in 1954, technical advances in accessing the kidneys via percutaneous puncture have increased the use of this procedure and thus the complications too. Among these complications, digestive tract damage is not common. DESIGN: Case report. CASE REPORT: We report a duodenal lesion that was corrected using surgical exploration and we touch on the therapeutic options, which may be conservative or interventionist. We chose conservative treatment, which has been approached in diverse manners in the literature.

  1. Exit strategies following percutaneous nephrolithotomy (PCNL)

    DEFF Research Database (Denmark)

    Cormio, Luigi; Gonzalez, Gaspar Ibarlucea; Tolley, David

    2013-01-01

    PURPOSE: To compare the characteristics and outcomes of exit strategies following percutaneous nephrolithotomy (PCNL) using the Clinical Research Office of the Endourological Society (CROES) PCNL Global Study database. MATERIALS AND METHODS: Two matched data sets were prepared in order to compare...... stent only versus NT only and TTL versus NT only. Patients were matched on the exit strategy using the following variables: case volume of the center where they underwent PCNL, stone burden, the presence of staghorn stone, size of sheath used at percutaneous access, the presence of bleeding during...

  2. Minimally Invasive Management of Acute Biliary Tract Disease during Pregnancy

    Directory of Open Access Journals (Sweden)

    Luis Tomás Chiappetta Porras

    2009-01-01

    Full Text Available Background. Acute biliary diseases during pregnancy have been classically managed conservatively. Advances in minimally invasive surgery and the high recurrence rate of symptoms observed changed this management. Methods. This is a prospective observational study. Initial management was medical. Unresponsive patients were treated with minimally invasive techniques including gallbladder percutaneous aspiration or cholecystostomy, endoscopic retrograde cholangiography, and laparoscopic cholecystectomy, depending on the pregnancy trimester and underlying diagnosis. Results. 122 patients were admitted. 69 (56.5% were unresponsive to medical treatment. Recurrent gallbladder colic was the most frequent indication for minimally invasive intervention, followed by acute cholecystitis, choledocholithiasis, and acute biliary pancreatitis. 8 patients were treated during the first trimester, 54 during the second, and 7 during the last trimester. There was no fetal morbidity or mortality. Maternal morbidity was minor with no mortality. Conclusion. Acute biliary tract diseases during pregnancy may be safely treated with minimally invasive procedures according to the underlying diagnosis and to the trimester of pregnancy.

  3. Ambulatory percutaneous nephrolithotomy: initial series.

    Science.gov (United States)

    Shahrour, Walid; Andonian, Sero

    2010-12-01

    To assess the safety and feasibility of ambulatory percutaneous nephrolithotomy (PCNL). PCNL is the gold standard for the management of large renal stones. Although tubeless PCNL has been previously described, no case series have been published of ambulatory PCNL. The criteria for ambulatory PCNL were: single tract, stone-free status documented by flexible nephroscopy, adequate pain control, and satisfactory postoperative hematocrit level and chest radiographic findings. Patient information, including operating room and fluoroscopy times, stone size and Hounsfield units, and number of needle punctures, were collected prospectively. The time spent in the recovery room, in addition to the amount of narcotics used in the recovery room and at home, was documented. Of 10 patients, 8 had nephrostomy tracts established intraoperatively by the urologist and 2 had preoperative nephrostomy tubes placed. The median operating and fluoroscopy time was 83.5 and 4.45 minutes, respectively. The median stone diameter was 20 mm (800 Hounsfield units) in addition to a patient with a staghorn calculus. The patients spent a median of 240 minutes in the recovery room and had received a median of 19.25 mg of morphine equivalents. Only 3 patients (30%) used narcotics at home. No intraoperative complications occurred, and none of the patients required transfusions. Two postoperative complications developed: a deep vein thrombosis requiring outpatient anticoagulation and multiresistant Escherichia coli infection requiring intravenous antibiotics. In highly selected patients, ambulatory PCNL is safe and feasible. More patients are needed to verify the criteria for patients undergoing the ambulatory approach. Copyright © 2010 Elsevier Inc. All rights reserved.

  4. Percutaneous endoscopic gastrostomy in children

    Directory of Open Access Journals (Sweden)

    Jye Hae Park

    2011-01-01

    Full Text Available Purpose: Percutaneous endoscopic gastrostomy (PEG can improve nutritional status and reduce the amount of time needed to feed neurologically impaired children. We evaluated the characteristics, complications, and outcomes of neurologically impaired children treated with PEG. Methods: We retrospectively reviewed the records of 32 neurologically impaired children who underwent PEG between March 2002 and August 2008 at our medical center. Forty-two PEG procedures comprising 32 PEG insertions and 10 PEG exchanges, were performed. The mean follow-up time was 12.2 (6.6 months. Results: Mean patient age was 9.4 (4.5 years. The main indications for PEG insertion were swallowing difficulty with GI bleeding due to nasogastric tube placement and/or the presence of gastroesophageal reflux disease (GERD. The overall rate of complications was 47%, with early complications evident in 25% of patients and late complications in 22%. The late complications included one gastro-colic fistula, two cases of aggravated GERD, and four instances of wound infection. Among the 15 patients with histological evidence of GERD before PEG, 13 (87% had less severe GERD, experienced no new aspiration events, and showed increased body weight after PEG treatment. Conclusion: PEG is a safe, effective, and relatively simple technique affording long-term enteral nutritional support in neurologically impaired children. Following PEG treatment, the body weight of most patients increased and the levels of vomiting, GI bleeding, and aspiration fell. We suggest that PEG with post-procedural observation be considered for enteral nutritional support of neurologically impaired children.

  5. The Chernyshenko Conscientiousness Scales: A New Facet Measure of Conscientiousness.

    Science.gov (United States)

    Green, Jessica A; O'Connor, Daryl B; Gartland, Nicola; Roberts, Brent W

    2016-06-01

    The current research sought to validate the Chernyshenko Conscientiousness Scales (CCS), a novel measure designed to assess six facets of conscientiousness. Data from 7,569 U.S. participants and 649 U.K. participants were analyzed to assess the internal reliability and factorial structure of the scales. Test-retest reliability, convergent and divergent validity, and criterion-related validity were also evaluated using a separate U.K. sample (n = 118; n = 80 for test-retest). The results showed that those items designed to measure industriousness, order, self-control, traditionalism, and virtue were best represented by a five-factor structure, broadly consistent with the five scales. However, the content and structure of the responsibility scale requires further investigation. Overall, the CCS has the potential to be a useful alternative to the faceted measures of conscientiousness that are currently available. However, future research is required to refine a number of problematic items and to clarify which facets can be better described as interstitial dimensions between conscientiousness and other Big Five domains. © The Author(s) 2015.

  6. Impact of Distributed Injection on Plasma Wakefield Acceleration at FACET

    Science.gov (United States)

    Vafaei-Najafabadi, Navid

    2017-10-01

    Impact of Distributed Injection on Plasma Wakefield Acceleration at FACET An electron-beam-driven plasma wakefield accelerator (PWFA) will sustain accelerating gradients of tens of GeV/m in a meter-scale plasma. If the transverse radius of the electron beam is not matched to the plasma, the envelope of this drive beam will execute betatron oscillations in the focusing force of the ion column. At its lowest radius in this oscillation cycle, the electric field of the beam can surpass the ionization threshold of elements, leading to ionization injection of these electrons in to the wake. Electrons from each cycle of this betatron oscillation then accumulate at the back of the wake and decrease the accelerating field. The experiments were carried out at FACET, where the drive electron beam had 3 nC of charge and an energy of 20.35 GeV. Two different plasma sources were used: a 30 cm self-ionized Rubidium (Rb) vapor confined by argon (Ar) gas at room-temperature and a partially pre-ionized hydrogen gas. The experimental and simulation evidence for the distributed injection of electrons and their impact on the PWFA at FACET will be presented in this talk. This work was supported by NSF Grant No. PHY-1415386 and DOE Grant No. DE-SC0010064. Work at SLAC was supported by DOE Contract No. DE-AC02-76SF00515.

  7. Fiber facet gratings for high power fiber lasers

    Science.gov (United States)

    Vanek, Martin; Vanis, Jan; Baravets, Yauhen; Todorov, Filip; Ctyroky, Jiri; Honzatko, Pavel

    2017-12-01

    We numerically investigated the properties of diffraction gratings designated for fabrication on the facet of an optical fiber. The gratings are intended to be used in high-power fiber lasers as mirrors either with a low or high reflectivity. The modal reflectance of low reflectivity polarizing grating has a value close to 3% for TE mode while it is significantly suppressed for TM mode. Such a grating can be fabricated on laser output fiber facet. The polarizing grating with high modal reflectance is designed as a leaky-mode resonant diffraction grating. The grating can be etched in a thin layer of high index dielectric which is sputtered on fiber facet. We used refractive index of Ta2O5 for such a layer. We found that modal reflectance can be close to 0.95 for TE polarization and polarization extinction ratio achieves 18 dB. Rigorous coupled wave analysis was used for fast optimization of grating parameters while aperiodic rigorous coupled wave analysis, Fourier modal method and finite difference time domain method were compared and used to compute modal reflectance of designed gratings.

  8. Framework Application for Core Edge Transport Simulation (FACETS)

    Energy Technology Data Exchange (ETDEWEB)

    Krasheninnikov, Sergei; Pigarov, Alexander

    2011-10-15

    The FACETS (Framework Application for Core-Edge Transport Simulations) project of Scientific Discovery through Advanced Computing (SciDAC) Program was aimed at providing a high-fidelity whole-tokamak modeling for the U.S. magnetic fusion energy program and ITER through coupling separate components for each of the core region, edge region, and wall, with realistic plasma particles and power sources and turbulent transport simulation. The project also aimed at developing advanced numerical algorithms, efficient implicit coupling methods, and software tools utilizing the leadership class computing facilities under Advanced Scientific Computing Research (ASCR). The FACETS project was conducted by a multi-discipline, multi-institutional teams, the Lead PI was J.R. Cary (Tech-X Corp.). In the FACETS project, the Applied Plasma Theory Group at the MAE Department of UCSD developed the Wall and Plasma-Surface Interaction (WALLPSI) module, performed its validation against experimental data, and integrated it into the developed framework. WALLPSI is a one-dimensional, coarse grained, reaction/advection/diffusion code applied to each material boundary cell in the common modeling domain for a tokamak. It incorporates an advanced model for plasma particle transport and retention in the solid matter of plasma facing components, simulation of plasma heat power load handling, calculation of erosion/deposition, and simulation of synergistic effects in strong plasma-wall coupling.

  9. Selective Facet Reactivity During Cation Exchange in Cadmium Sulfide Nanorods

    Energy Technology Data Exchange (ETDEWEB)

    Sadtler, Bryce; Demchenko, Denis; Zheng, Haimei; Hughes, Steven; Merkle, Maxwell; Dahmen, Ulrich; Wang, Lin-Wang; Alivisatos, A. Paul

    2008-12-18

    The partial transformation of ionic nanocrystals through cation exchange has been used to synthesize nanocrystal heterostructures. We demonstrate that the selectivity for cation exchange to take place at different facets of the nanocrystal plays an important role in determining the resulting morphology of the binary heterostructure. In the case of copper I (Cu+) cation exchange in cadmium sulfide (CdS) nanorods, the reaction starts preferentially at the ends of the nanorods such that copper sulfide (Cu2S) grows inwards from either end. The resulting morphology is very different from the striped pattern obtained in our previous studies of silver I (Ag+) exchange in CdS nanorods where non-selective nucleation of silver sulfide (Ag2S) occurs. From interface formation energies calculated for several models of epitaxialconnections between CdS and Cu2S or Ag2S, we infer the relative stability of each interface during the nucleation and growth of Cu2S or Ag2S within the CdS nanorods. The epitaxial connections of Cu2S to the end facets of CdS nanorods minimize the formation energy, making these interfaces stable throughout the exchange reaction. However, as the two end facets of wurtzite CdS nanorods are crystallographically nonequivalent, asymmetric heterostructures can be produced.

  10. Eye Tracking the Use of a Collapsible Facets Panel in a Search Interface (Poster)

    OpenAIRE

    Kemman, Max; Kleppe, Martijn; Maarseveen, Jim

    2013-01-01

    Facets can provide an interesting functionality in digital libraries. However, while some research shows facets are important, other research foundfacets are only moderately used. Therefore, in this exploratory study we compare two search interfaces; one where the facets panel is always visible and one where the facets panel is hidden by default. Our main research question is “Is folding the facets panel in a digital library search interface beneficial to academic users?” By performing an eye...

  11. Isolated Facet Joint Fracture as a Cause of Chronic Low Back Pain and Sciatica

    Directory of Open Access Journals (Sweden)

    Robert W Teasell

    1996-01-01

    Full Text Available A case of facet joint fracture following a rear-end motor vehicle accident who presented with chronic low back pain and sciatica is outlined. Diagnosis was made with 99Tc nuclear bone scan and was confirmed on computed tomographic scan after diagnosis with regular radiographs had failed. Facetectomy relieved pain but led to symptoms related to asymmetric load on the opposite facet joint. Symptoms were substantially relieved with a facet joint deinnervation procedure. Facet joint fracture was felt to occur as a consequence of compression forces on the facet joint at the time of impact.

  12. Ultrasound guided percutaneous removal of wooden foreign bodies in the extremities with hydro-dissection technique

    Energy Technology Data Exchange (ETDEWEB)

    Park, HeeJin; Lee, So Yeon; Chung, Eun Chul; Rho, Myung Ho [Dept. of Radiology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul (Korea, Republic of); Lee, Sung Moon; Son, Eun Seok [Dongsan Medical Center, Keimyung University School of Medicine, Daegu (Korea, Republic of); Lee, Sun Joo [Dept. of Radiology, Inje University College of Medicine, Busan Paik Hospital, Busan (Korea, Republic of)

    2015-12-15

    We described the technique of ultrasound (US)-guided percutaneous removal of the foreign bodies (FB) with hydro-dissection in the radiologic department and presented video files of several cases.Four patients referred to the radiology department for US evaluation and US-guided percutaneous removal of the FBs in the upper and lower extremities between November, 2006 and November, 2013 were included in this study. The procedures started with US evaluation for the exact location and shape of the FB. A 5 mm-sized skin incision was made at the site of the nearest point from the FB where no passing arteries or tendons were present. We adopted a hydro dissection technique to separate the FB from adjacent tissue using a 2% lidocaine solution. Injected anesthetics detached the FBs from surrounding tissue and thereby facilitated removal. After the tip of the mosquito forceps reached the FB, the wooden FBs were removed. The mean time required for the entire procedure was approximately 20 minutes. There were no significant complications during the US-guided removal or long-term complications after the procedure. All 4 FBs were successfully removed from the soft tissue under US guidance. Ultrasound-guided percutaneous removal of the FBs with hydro-dissection in the radiology department is a less invasive and safe method over surgical removal in the operating room. Additionally, the use of a guide wire and serial dilator may help minimize soft tissue injury and facilitate the introduction of forceps.

  13. Percutaneous Extraction of Cement Leakage After Vertebroplasty Under CT and Fluoroscopy Guidance: A New Technique

    International Nuclear Information System (INIS)

    Amoretti, Nicolas; Huwart, Laurent

    2012-01-01

    Purpose: We report a new minimally invasive technique of extraction of cement leakage following percutaneous vertebroplasty in adults. Methods: Seven adult patients (five women, two men; mean age: 81 years) treated for vertebral compression fractures by percutaneous vertebroplasty had cement leakage into perivertebral soft tissues along the needle route. Immediately after vertebroplasty, the procedure of extraction was performed under computed tomography (CT) and fluoroscopy guidance: a Chiba needle was first inserted using the same route as the vertebroplasty until contact was obtained with the cement fragment. This needle was then used as a guide for an 11-gauge Trocar t’am (Thiebaud, France). After needle withdrawal, a 13-gauge endoscopy clamp was inserted through the cannula to extract the cement fragments. The whole procedure was performed under local anesthesia. Results: In each patient, all cement fragments were withdrawn within 10 min, without complication. Conclusions: This report suggests that this CT- and fluoroscopy-guided percutaneous technique of extraction could reduce the rate of cement leakage-related complications.

  14. Percutaneous local ablation of unifocal subclinical breast cancer: clinical experience and preliminary results of cryotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Manenti, Guglielmo; Perretta, Tommaso; Gaspari, Eleonora; Pistolese, Chiara A.; Scarano, Lia; Cossu, Elsa; Simonetti, Giovanni; Masala, Salvatore [University Hospital ' ' Tor Vergata' ' , Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy, Rome (Italy); Bonanno, Elena [University Hospital ' ' Tor Vergata' ' , Department of Biopathology, Rome (Italy); Buonomo, Oreste C.; Petrella, Giuseppe [University Hospital ' ' Tor Vergata' ' , Department of General Surgery Division, Rome (Italy)

    2011-11-15

    To assess the ablative effectiveness, the oncological and cosmetic efficacy of image-guided percutaneous cryoablation in the treatment of single breast nodules with subclinical dimensions after identification with ultrasonography (US), mammography, magnetic resonance (MRI) and characterization by vacuum assisted biopsy. Fifteen women with a mean age of 73 {+-} 5 years (range 64-82 years) and lesion diameter of 8 {+-} 4 mm were undergoing cryotherapy technology with a single probe under US-guidance associated with intra-procedural lymph-node mapping and excision of the sentinel node. All the patients underwent surgical resection (lumpectomy) from 30 to 45 days after the percutaneous ablation. The iceball size generated by the cryoprobe during the procedure at minus 40 C was 16 x 41 mm. In 14 of the 15 patients was observed a complete necrosis of the cryo-ablated lesion both in post-procedural MRI follow-up and anatomo-pathological evaluation after surgical resection. In one case there was a residual disease in post-procedural MRI and postoperative histological examination, probably justified by an incorrect positioning of the probe. The percutaneous cryoablation as a ''minimally invasive'' technique can provide excellent oncological and cosmetic results on selected cases handled by experienced operators by using the tested devices. (orig.)

  15. Percutaneous local ablation of unifocal subclinical breast cancer: clinical experience and preliminary results of cryotherapy

    International Nuclear Information System (INIS)

    Manenti, Guglielmo; Perretta, Tommaso; Gaspari, Eleonora; Pistolese, Chiara A.; Scarano, Lia; Cossu, Elsa; Simonetti, Giovanni; Masala, Salvatore; Bonanno, Elena; Buonomo, Oreste C.; Petrella, Giuseppe

    2011-01-01

    To assess the ablative effectiveness, the oncological and cosmetic efficacy of image-guided percutaneous cryoablation in the treatment of single breast nodules with subclinical dimensions after identification with ultrasonography (US), mammography, magnetic resonance (MRI) and characterization by vacuum assisted biopsy. Fifteen women with a mean age of 73 ± 5 years (range 64-82 years) and lesion diameter of 8 ± 4 mm were undergoing cryotherapy technology with a single probe under US-guidance associated with intra-procedural lymph-node mapping and excision of the sentinel node. All the patients underwent surgical resection (lumpectomy) from 30 to 45 days after the percutaneous ablation. The iceball size generated by the cryoprobe during the procedure at minus 40 C was 16 x 41 mm. In 14 of the 15 patients was observed a complete necrosis of the cryo-ablated lesion both in post-procedural MRI follow-up and anatomo-pathological evaluation after surgical resection. In one case there was a residual disease in post-procedural MRI and postoperative histological examination, probably justified by an incorrect positioning of the probe. The percutaneous cryoablation as a ''minimally invasive'' technique can provide excellent oncological and cosmetic results on selected cases handled by experienced operators by using the tested devices. (orig.)

  16. Percutaneous hallux valgus surgery: strengths and weakness in our clinical experience.

    Science.gov (United States)

    Pichierri, P; Sicchiero, P; Fioruzzi, A; Maniscalco, P

    2014-11-10

    The Reverdin-Isham percutaneous osteotomy is indicated in the treatment of mild to moderate hallux valgus deformity. The aim of the work is the evaluation of the technique itself as a possible future landmark in the hallux valgus treatment. Between January 2010 and January 2011 we have performed 138 percutaneous osteotomies. The patients were assessed with a clinical and radiological control after a median five months follow up. The score proposed by the American Orthopaedic Foot and Ankle Society was used for the clinical evaluation. The average score has improved from a preoperative median of 45 points to a postoperative median of 91 points. The technique has been largely accepted by the patients because of the speed of the procedure itself, the minimal invasiveness, the short pain and the immediate functional recovery. The results we have obtained with the Reverdin-Isham procedure have confirmed that this technique is a valid alternative to other percutaneous techniques and open surgical procedures. However the technique is not simple, it needs the strict indications observance and it needs a steep learning curve, those are features that impose further future studies.

  17. Injury to the anterior tibial system during percutaneous plating of a proximal tibial fracture.

    Science.gov (United States)

    Gary, Joshua L; Sciadini, Marcus F

    2012-07-01

    Minimally invasive osteosynthesis of proximal tibial fractures has grown in popularity in recent years. This article describes a patient with a Schatzker type VI proximal tibial fracture (AO/OTA type 41.C3) and previous compartment syndrome treated with definitive fixation 8 weeks after initial injury with a precontoured proximal tibial plate and a distal targeting device. Brisk bleeding occurred during percutaneous insertion of a cortical screw at the midshaft of the tibia. Surgical exploration revealed sidewall tearing of the anterior tibial artery and vein, which were clipped at the screw insertion site. After the bleeding was controlled, the patient had a strong palpable posterior tibial pulse with no palpable dorsalis pedis pulse, and the foot remained well perfused. Function of the deep peroneal nerve was normal postoperatively. Previous concerns regarding the percutaneous treatment of proximal tibial fractures have focused on the risks of damage to the superficial peroneal nerve from distal screws. Based on cadaveric studies, percutaneously and laterally based screw placement in the distal tibial metaphysis threatens injury to the anterior tibial system. However, with alterations to the normal anatomy caused by severe trauma, previously described safe zones may be changed and neurovascular structures may be exposed to risk in locations that were previously thought safe. Copyright 2012, SLACK Incorporated.

  18. POTENTIAL OF ULTRASOUND-GUIDED LUMBAR FACET RADIOFREQUENCY DENERVATION

    Directory of Open Access Journals (Sweden)

    I. V. Volkov

    2017-01-01

    Full Text Available The aim of the study was to evaluate the possibility of US navigation for Radiofrequency denervation (RFD of the lumbar facets.Material and methods. The authors performed a prospective controlled cohort study which included 50 patients with chronic pain syndrome who underwent RFD LIII-SI facets on both sides. The main group (US included 25 patients, who underwent US guided navigation with FScontrol of the correct placement of the cannula prior to ablation. In the control group (FS the RFD was performed only under FS control. Patients were selected after preliminary test block of medial branch with 50% pain reduction from the baseline. Patients with overweight, spinal deformity, pronounced degenerative changes, spinal stenosis and developmental anomalies were not included in the study. For the evaluation of outcomes, the numeric pain scale NRS-11 and the Oswestry index (ODI were used, the accuracy of the cannula position was assessed and factors determining the accuracy were searched.Results. As a result of the intervention, there was a significant decrease of NRS-11 and ODI criteria in both groups (p<0.001, a positive outcome was achieved in 18 (72% of US patients and 16 (64% of FS patients, p = 0.564. Of the 200 attempts to position the cannula under the ultrasound control, 169 (84.5% were successful, in most cases (187 out of 200, 93.5% at least 3 attempts were required to reposition the cannula. The average time for performing the procedure under the ultrasound control was 47.3±1.13 minutes. The facet angle and procedure level were defined as predictors of the cannula positioning accuracy, odds ratio 0.93 (95% CI 0.894–0.963 and 0.51 (95% CI 0.32–0.805, respectively.Conclusion. RFD of lumbar facet under ultrasound navigation allows to achieve a relatively high accuracy of the cannula position into the zone of passage of the articular branch. The navigation capabilities are reduced at the level of LV and SI vertebrae due to structural

  19. Results of arthrospine assisted percutaneous technique for lumbar discectomy

    Directory of Open Access Journals (Sweden)

    Mohinder Kaushal

    2016-01-01

    Full Text Available Background: Avaialable minimal invasive arthro/endoscopic techniques are not compatible with 30 degree arthroscope which orthopedic surgeons uses in knee and shoulder arthroscopy. Minimally invasive “Arthrospine assisted percutaneous technique for lumbar discectomy” is an attempt to allow standard familiar microsurgical discectomy and decompression to be performed using 30° arthroscope used in knee and shoulder arthroscopy with conventional micro discectomy instruments. Materials and Methods: 150 patients suffering from lumbar disc herniations were operated between January 2004 and December 2012 by indiginously designed Arthrospine system and were evaluated retrospectively. In lumbar discectomy group, there were 85 males and 65 females aged between 18 and 72 years (mean, 38.4 years. The delay between onset of symptoms to surgery was between 3 months to 7 years. Levels operated upon included L1-L2 (n = 3, L2-L3 (n = 2, L3-L4 (n = 8, L4-L5 (n = 90, and L5-S1 (n = 47. Ninety patients had radiculopathy on right side and 60 on left side. There were 22 central, 88 paracentral, 12 contained, 3 extraforaminal, and 25 sequestrated herniations. Standard protocol of preoperative blood tests, x-ray LS Spine and pre operative MRI and pre anaesthetic evaluation for anaesthesia was done in all cases. Technique comprised localization of symptomatic level followed by percutaneous dilatation and insertion of a newly devised arthrospine system devise over a dilator through a 15 mm skin and fascial incision. Arthro/endoscopic discectomy was then carried out by 30° arthroscope and conventional disc surgery instruments. Results: Based on modified Macnab's criteria, of 150 patients operated for lumbar discectomy, 136 (90% patients had excellent to good, 12 (8% had fair, and 2 patients (1.3% had poor results. The complications observed were discitis in 3 patients (2%, dural tear in 4 patients (2.6%, and nerve root injury in 2 patients (1.3%. About 90% patients

  20. Percutaneous Tracheostomy in the Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Fatma Yıldırım

    2015-12-01

    Full Text Available Percutaneous tracheostomy (PT has become an oftenly used procedure in critically ill patients requiring prolonged mechanical ventilation in recent years. The ideal timing and techniques of PT have been topics of considerable debate. In this review, we address general issues regarding PT (indications, contraindications, timing, preparation, techniques, complications and specifically review the literatures regarding the comparison of techniques.

  1. New developments in percutaneous stone surgery

    African Journals Online (AJOL)

    S. Derisavifard

    2016-08-01

    Aug 1, 2016 ... toxin content in renal calculi. J Urol 2003;169:1813–4. [20] Larson J, Roth E, Desai A, editor. Comparative analysis of stone com- position and stone culture after percutaneous nephrolithotomy. Podium session presented at: The 2014 Meeting of the American Urological. Association; May 20, 2014. Orlando ...

  2. Percutaneous Placement of Peritoneal Dialysis Catheters in ...

    African Journals Online (AJOL)

    Background: The percutaneous placement of peritoneal dialysis (PD) catheters using conscious sedation with ultrasound and fluoroscopic guidance is underutilised and hasseveral advantages over the open surgical and laparoscopic placement methods, especially in the resource-limited developing world. Objectives: To ...

  3. Percutaneous Nephrolithotomy: Update, Trends, and Future Directions

    NARCIS (Netherlands)

    Ghani, Khurshid R.; Andonian, Sero; Bultitude, Matthew; Desai, Mihir; Giusti, Guido; Okhunov, Zhamshid; Preminger, Glenn M.; de la Rosette, Jean

    2016-01-01

    Percutaneous nephrolithotomy (PCNL) is the surgical standard for treating large or complex renal stones. Since its inception, the technique of PCNL has undergone many modifications. To perform a collaborative review on the latest evidence related to outcomes and innovations in the practice of PCNL

  4. Percutaneous transvenous mitral commissurotomy in juvenile mitral ...

    African Journals Online (AJOL)

    Patients: Forty five consecutive patients aged less than 21 years with severe pure mitral stenosis and suitable mitral valve apparatus (leaflets, chordae and papillary muscles) for successful commissurotomy. Intervention: Percutaneous transvenous mitral commissurotomy under local anaesthesia. Standard left and right ...

  5. Percutaneous transvenous mitral commissurotomy in juvenile mitral ...

    African Journals Online (AJOL)

    Objective: To determine the efficacy and safety of percutaneous transvenous mitral commissurotomy(PTMC), using multi-track double balloon technique in juvenile mitral stenosis. Design: Open non-randomised intervention. Setting: Cardiac catheterisation laboratories of The Mater Hospital, The Nairobi Hospital and ...

  6. Percutaneous vertebroplasty in osteoporotic vertebral compression fractures

    NARCIS (Netherlands)

    Voormolen, Maurits Hendrik Joannes

    2006-01-01

    Percutaneous vertebroplasty (PV) literary means augmentation of the vertebral body through the skin. The main goal is partial or complete pain relief. Nowadays, the most frequent indication for treatment is a painful invalidating osteoporotic vertebral compression fracture (VCF), not responding to

  7. Percutaneous Injuries in Nigerian Dentists | Utomi | Nigerian ...

    African Journals Online (AJOL)

    Objective: The purpose of this study is to assess the frequency of percutaneous injuries among Nigerian dentists and to describe the factors associated with the injuries. Materials and Methods: A questionnaire survey of 160 practicing dentists in Lagos, Ibadan, Ife and Benin. Result: A total of 208 injuries were reported by ...

  8. Percutaneous tension band wiring for patellar fractures.

    Science.gov (United States)

    Rathi, Akhilesh; Swamy, M K S; Prasantha, I; Consul, Ashu; Bansal, Abhishek; Bahl, Vibhu

    2012-08-01

    To evaluate outcome of percutaneous tension band wiring for transverse fractures of the patella. 16 men and 7 women aged 27 to 65 (mean, 40) years underwent percutaneous tension band wiring for transverse fractures of the patella with a displacement of >3 mm. Pain, operating time, mobility, functional score, and complications were evaluated. 20 patients underwent successful percutaneous tension band wiring. The remaining 3 patients in whom closed reduction failed underwent open reduction and tension band wiring. The mean operating time was 46 (range, 28-62) minutes. The mean follow-up period was 20 (range, 15-30) months. At the latest follow-up, all patients had regained full extension. The objective score was excellent in 20 patients and good in 3, whereas the subjective score was excellent in 17, good in 5, and fair in one. All patients had radiological union at week 8. One patient had patellofemoral arthritis (secondary to a postoperative articular step). Two patients developed superficial infections, which resolved after antibiotic therapy. Mean thigh muscle wasting was 0.7 (range, 0.4-1) cm. Three patients encountered hardware problems (impingement/irritation of the skin over the knee) necessitating implant removal. Percutaneous tension band wiring is a viable option for transverse fractures of the patella.

  9. Ultrasound Guided Percutaneous Nephrostomy: Experience at ...

    African Journals Online (AJOL)

    2018-01-30

    Jan 30, 2018 ... Background: Obstructive uropathy is a common problem in urologic practice; temporary relief of obstruction in the upper tract poses a significant challenge. Ultrasound‑guided percutaneous nephrostomy (PCN) is an option for upper tract drainage; compared to fluoroscopic guidance, it is readily available, ...

  10. Ultrasound Guided Percutaneous Nephrostomy: Experience at ...

    African Journals Online (AJOL)

    Background: Obstructive uropathy is a common problem in urologic practice; temporary relief of obstruction in the upper tract poses a significant challenge. Ultrasound‑guided percutaneous nephrostomy (PCN) is an option for upper tract drainage; compared to fluoroscopic guidance, it is readily available, affordable, and not ...

  11. State-of-the-art transforaminal percutaneous endoscopic lumbar surgery under local anesthesia: Discectomy, foraminoplasty, and ventral facetectomy.

    Science.gov (United States)

    Sairyo, Koichi; Chikawa, Takashi; Nagamachi, Akihiro

    2018-03-01

    Transforaminal (TF) percutaneous endoscopic surgery for the lumbar spine under the local anesthesia was initiated in 2003 in Japan. Since it requires only an 8-mm skin incision and damage of the paravertebral muscles would be minimum, it would be the least invasive spinal surgery at present. At the beginning, the technique was used for discectomy; thus, the procedure was called PELD (percutaneous endoscopic lumbar discectomy). TF approach can be done under the local anesthesia, there are great benefits. During the surgery patients would be in awake and aware condition; thus, severe nerve root damage can be avoided. Furthermore, the procedure is possible for the elderly patients with poor general condition, which does not allow the general anesthesia. Historically, the technique was first applied for the herniated nucleus pulposus. Then, foraminoplasty, which is the enlargement surgery of the narrow foramen, became possible thanks to the development of the high speed drill. It was called the percutaneous endoscopic lumbar foraminoplasty (PELF). More recently, this technique was applied to decompress the lateral recess stenosis, and the technique was named percutaneous endoscopic ventral facetectomy (PEVF). In this review article, we explain in detail the development of the surgical technique of with time with showing our typical cases. Copyright © 2017 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

  12. Treatment of Metastatic Spinal Tumors by Percutaneous Vertebroplasty versus Percutaneous Vertebroplasty Combined with Interstitial Implantation of 125I Seeds

    Energy Technology Data Exchange (ETDEWEB)

    Zuozhang Yang; Lin Xie; Yunchao Huang; Hongpu Sun; Pengjie Liu; Zhongxiong Wu (Dept. of Orthopedics, Tumor Hospital of Yunnan Province, Third Affiliated Hospital of Kunming Medical College, Kunming, Yunnan (China)). e-mail. yangzuozhang@163.com; Dakuan Yang (Second Affiliated Hospital of Kunming Medical College, Kunming Yunnan (China)); Yuqing Sun (Dept. of Orthopedic Oncology, Beijing Jishuitan Hospital, Beijing (China))

    2009-12-15

    Background: As the most frequent bone metastasis, spinal metastases cause severe pain and damage to vertebral bodies such as spinal osteolytic destruction and compression fractures. To avoid the trauma and complications of open surgery, a minimally invasive procedure, percutaneous vertebroplasty (PVP), has recently been developed to treat metastatic spinal tumors. Purpose: To analyze the treatment outcomes of metastatic spinal tumors by percutaneous vertebroplasty (PVP) alone or PVP combined with interstitial implantation of 125I seeds. Material and Methods: 80 patients with metastatic spinal tumors were randomized to receive PVP alone (40 cases) or PVP combined with 125I seed implantation (40 cases). Digital subtraction angiography (DSA)-guided vertebroplasty was performed under local anesthesia, and acrylic bone cement was injected into the vertebra through a bone trocar to the center of the lesion, with or without simultaneous interstitial implantation of 125I seeds. Results: At 6-month follow-up, PVP combined with 125I seed implantation resulted in zero cases with complete relief (CR), 36 with partial relief (PR), four with no changes (NC), and zero with progression of disease (PD), while PVP alone without seed implantation resulted in 0 CR, 31 PR, 7 NC, and 2 PD. While the combined-treatment group and the single-PVP group showed overall clinical benefit rates without significant difference (100% and 95.0%, respectively), their visual analogue pain scales (VAS; 2.26+-1.05 and 5.41+-0.94, respectively) and Karnofsky performance scores (KPS; 92.5+-7.1 and 87.7+-7.3, respectively) were significantly different after treatment (P = 0.028 and P = 0.009, respectively). Patients in both groups had 1-year follow-up, and the mean time to tumor progression (TTP) was 9.0 and 8.9 months, respectively (not significant). Conclusion: PVP is a minimally invasive procedure with small wounds and minor complications. It is effective in the alleviation of pain in metastatic spinal

  13. Factors affecting results of fluoroscopy-guided facet joint injection: Probable differences in the outcome of treatment between pure facet joint hypertrophy and concomitant diseases

    Directory of Open Access Journals (Sweden)

    Akif Albayrak

    2016-01-01

    Full Text Available Study Design: Retrospective cohort study. Purpose: Facet joints are considered a common source of chronic low-back pain. To determine whether pathogens related to the facet joint arthritis have any effect on treatment failure. Materials and Methods: Facet joint injection was applied to 94 patients treated at our hospital between 2011 and 2012 (mean age 59.5 years; 80 women and 14 men. For the purpose of analysis, the patients were divided into two groups. Patients who only had facet hypertrophy were placed in group A (47 patients, 41 women and 6 men, mean age 55.3 years and patients who had any additional major pathology to facet hypertrophy were placed in group B (47 patients, 39 women and 8 men, mean age 58.9 years. Injections were applied around the facet joint under surgical conditions utilizing fluoroscopy device guidance. A mixture of methylprednisolone and lidocaine was used as the injection ingredient. Results: In terms of Oswestry Disability Index (ODI and visual analog scale (VAS scores, no significant difference was found between preinjection and immediate postinjection values in both groups, and the scores of group A patients were significantly lower (P < 0.005 compared with that of group B patients at the end of the third, sixth, and twelfth month. Conclusion: For low-back pain caused by facet hypertrophy, steroid injection around the facet joint is an effective treatment, but if there is an existing major pathology, it is not as effective.

  14. Graft Loss Due to Percutaneous Sclerotherapy of a Lymphocele Using Acetic Acid After Renal Transplantation

    International Nuclear Information System (INIS)

    Adani, Gian Luigi; Baccarani, Umberto; Bresadola, Vittorio; Lorenzin, Dario; Montanaro, Domenico; Risaliti, Andrea; Terrosu, Giovanni; Sponza, Massimo; Bresadola, Fabrizio

    2005-01-01

    Development of lymphoceles after renal transplantation is a well-described complication that occurs in up to 40% of recipients. The gold standard approach for the treatment of symptomatic cases is not well defined yet. Management options include simple aspiration, marsupialization by a laparotomy or laparoscopy, and percutaneous sclerotherapy using different chemical agents. Those approaches can be associated, and they depend on type, dimension, and localization of the lymphocele. Percutaneous sclerotherapy is considered to be less invasive than the surgical approach; it can be used safely and effectively, with low morbidity, in huge, rapidly accumulating lymphoceles. Moreover, this approach is highly successful, and the complication rate is acceptable; the major drawback is a recurrence rate close to 20%. We herewith report a renal transplant case in which the patient developed a symptomatic lymphocele that was initially treated by ultrasound-guided percutaneous sclerotherapy with ethanol and thereafter using acetic acid for early recurrence. A few hours after injection of acetic acid in the lymphatic cavity, the patient started to complain of acute pain localized to the renal graft and fever. An ultrasound of the abdomen revealed thrombosis of the renal vein and artery. The patient was immediately taken to the operating room, where the diagnosis of vascular thrombosis was confirmed and the graft was urgently explanted. In conclusion, we strongly suggest avoiding the use of acetic acid as a slerosating agent for the percutaneous treatment of post-renal transplant lymphocele because, based on our experience, it could be complicated by vascular thrombosis of the kidney, ending in graft loss

  15. Management of closed tibial plateau fractures with percutaneous cancellous screw fixation

    Directory of Open Access Journals (Sweden)

    Tushar Agarwal

    2013-01-01

    Full Text Available Background: Tibial plateau fractures, intra-articular in nature and caused by high-velocity trauma, constitute approximately 1% of all fractures. Primary goal in the management of proximal tibial articular fracture aims for a stable, congruous, pain-free, mobile joint. Objective: To study the technique, results, and complications of percutaneous cancellous screw fixation for tibial plateau fractures. Materials and Methods: Twenty-three men and seven women aged 18-65 years (mean = 36.8 years underwent closed reduction and percutaneous screw fixation for closed tibial plateau fractures with <5 mm depression. According to the Schatzker classification, patients were grouped as type I (n = 18, type II (n = 4, type III (n = 0, type IV (n = 8, type V (n = 2, and type VI (n = 1. Closed reduction was achieved by manual ligamentotaxis technique under image intensifier control and fixed percutaneously with two cancellous screws (6.5 mm with or without washers in a parallel fashion. Results: Functional outcome was evaluated using the Mason Hohl evaluation system. A total score of 19-24 was considered as excellent, 13-18 as good, 7-12 as fair, and <6 as poor. Outcomes were excellent in 10 patients, good in 15, fair in 4, and poor in 1 patient. Patients were allowed partial weight bearing with walker after 1 month and full weight bearing after radiological union in approximately 3-4 months. The mean period of hospital stay was 5 (range 2-15 days. All the fractures united radiologically after a mean of 3 (range 2.5- 5 months. Patients were evaluated at a mean of 3 years after injury. No patient had any complication like infection, wound dehiscence, or hardware problem. Conclusion: Percutaneous cancellous screw fixation for closed tibial plateau fractures is minimally invasive. It reduces hospital stay and cost, enables early mobilization with minimal instrumentation, and achieves satisfactory outcomes.

  16. Percutaneous endoscopy to diagnose malignancy in gastric outlet obstruction of excluded stomach after gastric bypass.

    Science.gov (United States)

    Ahmad, Waseem; Rubin, Joshua; Kwong, Wilson

    2017-01-01

    Gastric cancer in the excluded stomach after Roux-en-Y gastric bypass is a rare finding and most reported diagnoses are made via surgery. Endoscopic access to the excluded stomach is difficult, even with balloon-assisted enteroscopy. We present the case of a 74-year-old woman with malignant gastric outlet obstruction of the excluded stomach, 41 years after Roux-en-Y gastric bypass. Minimally invasive access to the excluded stomach was obtained by placement of a percutaneous gastrostomy tube, followed by insertion of a pediatric gastroscope through the gastrostomy tube tract. This novel approach provides minimally invasive access to the excluded stomach in patients with high suspicion of pathology in the excluded stomach, when balloon-assisted enteroscopy is not technically feasible or available.

  17. Percutaneous Isolated Hepatic Perfusion for the Treatment of Unresectable Liver Malignancies

    Energy Technology Data Exchange (ETDEWEB)

    Burgmans, Mark C., E-mail: m.c.burgmans@lumc.nl [Leiden University Medical Centre, Department of Radiology (Netherlands); Leede, Eleonora M. de, E-mail: e.m.de-leede@lumc.nl [Leiden University Medical Centre, Department of Surgery (Netherlands); Martini, Christian H., E-mail: c.h.martini@lumc.nl [Leiden University Medical Centre, Department of Anesthesiology (Netherlands); Kapiteijn, Ellen, E-mail: h.w.kapiteijn@lumc.nl [Leiden University Medical Centre, Department of Medical Oncology (Netherlands); Vahrmeijer, Alexander L., E-mail: a.l.vahrmeijer@lumc.nl [Leiden University Medical Centre, Department of Surgery (Netherlands); Erkel, Arian R. van, E-mail: a.r.van-erkel@lumc.nl [Leiden University Medical Centre, Department of Radiology (Netherlands)

    2016-06-15

    Liver malignancies are a major burden of disease worldwide. The long-term prognosis for patients with unresectable tumors remains poor, despite advances in systemic chemotherapy, targeted agents, and minimally invasive therapies such as ablation, chemoembolization, and radioembolization. Thus, the demand for new and better treatments for malignant liver tumors remains high. Surgical isolated hepatic perfusion (IHP) has been shown to be effective in patients with various hepatic malignancies, but is complex, associated with high complication rates and not repeatable. Percutaneous isolated liver perfusion (PHP) is a novel minimally invasive, repeatable, and safer alternative to IHP. PHP is rapidly gaining interest and the number of procedures performed in Europe now exceeds 200. This review discusses the indications, technique and patient management of PHP and provides an overview of the available data.

  18. Percutaneous Isolated Hepatic Perfusion for the Treatment of Unresectable Liver Malignancies

    International Nuclear Information System (INIS)

    Burgmans, Mark C.; Leede, Eleonora M. de; Martini, Christian H.; Kapiteijn, Ellen; Vahrmeijer, Alexander L.; Erkel, Arian R. van

    2016-01-01

    Liver malignancies are a major burden of disease worldwide. The long-term prognosis for patients with unresectable tumors remains poor, despite advances in systemic chemotherapy, targeted agents, and minimally invasive therapies such as ablation, chemoembolization, and radioembolization. Thus, the demand for new and better treatments for malignant liver tumors remains high. Surgical isolated hepatic perfusion (IHP) has been shown to be effective in patients with various hepatic malignancies, but is complex, associated with high complication rates and not repeatable. Percutaneous isolated liver perfusion (PHP) is a novel minimally invasive, repeatable, and safer alternative to IHP. PHP is rapidly gaining interest and the number of procedures performed in Europe now exceeds 200. This review discusses the indications, technique and patient management of PHP and provides an overview of the available data.

  19. Pneumonia and mortality after percutaneous endoscopic gastrostomy insertion.

    Science.gov (United States)

    Azzopardi, Neville; Ellul, Pierre

    2013-01-01

    Percutaneous endoscopic gastrostomy feeding provides enteral nutrition to patients with neurological dysphagia. Thirty-day mortality rates of 4-26% have been reported, with pneumonia being the common cause post-percutaneous endoscopic gastrostomy insertion. This retrospective analysis of percutaneous endoscopic gastrostomy tube insertions in Malta (January 2008 - June 2010) compares the incidence of pneumonia in patients fed through a nasogastric tube versus in those fed via a percutaneous endoscopic gastrostomy tube. We analyzed the indications, poor prognostic factors and mortality for percutaneous endoscopic gastrostomy insertion. Ninety-seven patients underwent percutaneous endoscopic gastrostomy insertion. Fifty-four patients received nasogastric feeds before percutaneous endoscopic gastrostomy feeds. Patients on nasogastric feeds developed 32 episodes of pneumonia over a total of 7884 days of feeds (1 every 246 days). Patients with percutaneous endoscopic gastrostomy feeds after a period of nasogastric feeds developed 48 pneumonia episodes over 36,238 days (1 every 755 days). Patients with percutaneous endoscopic gastrostomy feeds without previous nasogastric feeds developed 28 pneumonia episodes over 23,983 days (1 every 856 days), and this was statistically significant (χ 2 test p value nasogastric feeds. However, pneumonia is still the major cause of death among percutaneous endoscopic gastrostomy patients.

  20. Light-induced spatial separation of charges toward different crystal facets of square-like WO3.

    Science.gov (United States)

    Gong, Huihua; Ma, Ruirui; Mao, Fang; Liu, Kewei; Cao, Hongmei; Yan, Hongjian

    2016-09-29

    Light-induced preferential migration of electrons and holes to the minor (200) and (020) facets and the dominant (002) facets of square-like WO 3 , respectively, resulted in the square-like WO 3 nanoplates with Pt loaded mainly on dominant (002) facets shows higher photocatalytic activity than that Pt loaded on the minor facets.

  1. Association between facet joint osteoarthritis and the Oswestry Disability Index.

    Science.gov (United States)

    Maataoui, Adel; Vogl, Thomas J; Middendorp, Marcus; Kafchitsas, Konstantinos; Khan, M Fawad

    2014-11-28

    To investigate the correlation of facet joint osteoarthritis (FJOA) at lumbar levels L4/L5 and L5/S1 and the Oswestry Disability Index (ODI). The study involved lumbar MRIs of 591 patients with a mean age of 47.3 years. The MRIs of the lumbar spine were performed on a 1.5 Tesla scanner (Magnetom(®) Avanto, Siemens AG, Erlangen, Germany) using a dedicated receive only spine coil. After initial blinding, each dataset was evaluated by 2 board certified radiologist with more than 5 years experience in musculoskeletal imaging. In total 2364 facet joints were graded. Degenerative changes of the facet joints were evaluated according to the 4-point scale as proposed by Weishaupt et al Functional status was assessed using the ODI. The index is scored from 0 to 100 and interpreted as follows: 0%-20%, minimal disability; 20%-40%, moderate disability; 40%-60%, severe disability; 60%-80%, crippled; 80%-100%, patients are bedbound. Spearman's coefficient of rank correlation was used for statistical analysis, with significance set at P disability had a minimum of 0% and a maximum of 91.11% with an arithmetic mean of 32.77% ± 17.02%. The majority of patients (48.39%) had moderate functional disability (21%-40%). There was no significant correlation between FJOA and ODI on both sides of lumbar level L4/5 and on the left side of lumbar level L5/S1. A weak positive correlation was evaluated between ODI and FJOA on the right side of lumbar level L5/S1. The missing correlation of FJOA and ODI confirms our clinical experience that imaging alone is an insufficient approach explaining low back pain. Clinical correlation is imperative for an adequate diagnostic advance in patients with low back pain.

  2. Association of facet tropism and orientation with lumbar disc herniation in young patients.

    Science.gov (United States)

    Zhou, Qiang; Teng, Donghui; Zhang, Tao; Lei, Xinwei; Jiang, Wenxue

    2018-02-15

    Facet tropism and orientation are thought to be associated with lumbar disc herniation (LDH), but the relationship is not well established. Moreover, the effect of facet joint on LDH has not been outlined in young patients. The objective of this study was to investigate the associations of facet joint tropism and orientation with LDH in young patients (18-35 years) by computed tomography (CT). Fifty-three patients with LDH and 129 with neither LDH nor low back pain (18-35 years) were included in this study. The facet joint angles were measured for each facet joint by CT as per the method described by Noren et al. We defined facet tropism as a bilateral angle difference > 5°. Young cases with neither LDH nor low back pain were used as the control group. The results showed that LDH was significantly associated with more coronal facet joint orientation at L1-2 (p = 0.009), L2-3 (p = 0.004), and L3-4 (p = 0.004). No association was established between facet tropism and LDH. This study revealed that facet joint orientation was associated with LDH in young patients (18-35 years); they were more of coronal facing at upper levels. Also, the facet tropism was not associated with LDH.

  3. Facet Defining Inequalities for the Simple Graph Partioning Polytope

    DEFF Research Database (Denmark)

    Sørensen, Michael Malmros

    2000-01-01

    The simple graph partitioning problem is to partition an edge-weighted graph into mutually disjoint subgraphs, each containing at most b nodes, such that the sum of the weights of all edges in the subgraphs is maximal. In this paper we investigate the facial structure of the simple graph partitio...... partitioning polytopes P(b), b = 3,...,n, associated with the complete graph on n nodes. In particular we introduce two new classes af facet defining inequalities that are induced by cliques and multistars....

  4. Lumbar facet septic arthritis. Report of two cases

    Directory of Open Access Journals (Sweden)

    Juan Manuel Velasco

    2017-02-01

    Full Text Available We report two cases with isolated septic arthritis of a lumbar facet after a non articular infection, and sepsis. Being a rarity, it is a condition that goes frequently unnoticed, unless taken into account directly. If it is not treated on time, it can leave serious sequelae. The treatment may vary, according to the time of diagnosis. It might have a good response to antibiotic therapy alone, or it may be necessary to associate surgical drainage.

  5. An Enhanced Facet Determination Scheme in 3D

    Science.gov (United States)

    Reivinen, M.; Salonen, E.-M.; Todoshchenko, I.; Vaskelainen, V. P.

    2017-01-01

    An enhanced scheme for the determination of equilibrium crystal shapes is introduced. The emphasis of the present study is put on the proper detection of the facets appearing on the crystal surface. The original formulation presented in [1] employs the principle of the virtual work, and the enhanced scheme additionally makes use of a penalty formulation approach. The derivation of the penalty terms is discussed in detail. Finally, the corresponding discrete method is applied to a certain problematic example case presented in [1] resulting now in the correct crystal shape.

  6. Optimization of spherical facets for parabolic solar concentrators

    Science.gov (United States)

    White, J. E.; Erikson, R. J.; Sturgis, J. D.; Elfe, T. B.

    1986-01-01

    Solar concentrator designs which employ deployable hexagonal panels are being developed for space power systems. An offset optical configuration has been developed which offers significant system level advantages over previously proposed collector designs for space applications. Optical analyses have been performed which show offset reflector intercept factors to be only slightly lower than those for symmetric reflectors with the same slope error. Fluxes on the receiver walls are asymmetric but manageable by varying the tilt angle of the receiver. Greater producibility is achieved by subdividing the hexagonal panels into triangular mirror facets of spherical contour. Optical analysis has been performed upon these to yield near-optimum sizes and radii.

  7. Severe renal bleeding caused by a ruptured renal sheath: case report of a rare complication of percutaneous nephrolithotomy

    Directory of Open Access Journals (Sweden)

    Gunes Ali

    2002-09-01

    Full Text Available Abstract Background Percutaneous nephrolithotomy is a minimally invasive intervention for renal stone disease. Complications, which are rare and usually presented as case reports, are diversified as the utilization of the procedure is expanded. The procedure causes less blood loss and less morbidity when compared to open surgical procedures. Yet, there are some reports involving severe bleeding and relevant morbidity during surgery. These are usually related with the surgical technique or experience of the surgeon. Renal sheaths are designed to cause minimal trauma inside the kidney and, to our knowledge, there are no reports presenting the rupture of a sheath causing severe bleeding during the procedure. Case report We present an adult patient who had severe bleeding during percutaneous nephrolithotomy due to parenchymal injury caused by a ruptured renal sheath. During retrieval, due probably to rough handling of the equipment, a piece of stone with serrated edges ruptured the tip of the sheath, and this tip caused damage inside the kidney. The operation was terminated and measures were taken to control bleeding. The patient was transfused with a total of 1600 ml of blood, and the stones were cleared in a second look operation. Conclusion Although considered to be a minimally invasive procedure, some unexpected complications may arise during percutaneous nephrolithotomy. After being fragmanted, stone pieces may damage surgical equipment, causing acute and severe harm to the kidney. Surgeons must manipulate the equipment with fine and careful movements in order to prevent this situation.

  8. Ozone-augmented percutaneous discectomy: a novel treatment option for refractory discogenic sciatica.

    Science.gov (United States)

    Crockett, M T; Moynagh, M; Long, N; Kilcoyne, A; Dicker, P; Synnott, K; Eustace, S J

    2014-12-01

    To assess the short and medium-term efficacy and safety of a novel, minimally invasive therapeutic option combining automated percutaneous lumbar discectomy, intradiscal ozone injection, and caudal epidural: ozone-augmented percutaneous discectomy (OPLD). One hundred and forty-seven patients with a clinical and radiological diagnosis of discogenic sciatica who were refractory to initial therapy were included. Fifty patients underwent OPLD whilst 97 underwent a further caudal epidural. Outcomes were evaluated using McNab's score, improvement in visual analogue score (VAS) pain score, and requirement for further intervention. Follow-up occurred at 1 and 6 months, and comparison was made between groups. OPLD achieved successful outcomes in almost three-quarters of patients in the short and medium term. OPLD achieved superior outcomes at 1 and 6 months compared to caudal epidural. There was a reduced requirement for further intervention in the OPLD group. No significant complications occurred in either group. OPLD is a safe and effective treatment for patients with refractory discogenic sciatica in the short and medium term. OPLD has the potential to offer an alternative second-line minimally invasive treatment option that could reduce the requirement for surgery in this patient cohort. Copyright © 2014 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  9. Automated percutaneous lumbar discectomy: technique, indications and clinical follow-up in over 1000 patients

    Energy Technology Data Exchange (ETDEWEB)

    Bonaldi, G. [Department of Neuroradiology, Ospedali Riuniti, Bergamo (Italy)

    2003-10-01

    This paper summarises my experience, over 14 years, treating over 1350 patients suffering from lumbar disc pathology, using minimally invasive intradiscal decompressive percutaneous techniques. The vast majority underwent the method introduced by Onik in 1985, referred to as ''automated'' since it involves a mechanical probe, working by a ''suction and cutting'' action for removal of the nucleus pulposus. Postoperative follow-up of at least 6 months was available for 1047 patients aged 15-92 years, who underwent this procedure up to June 2002. Results, based on a patient satisfaction, have been good in 58% of patients at 2 months and in 67.5% at 6 months; they have been particularly favourable in some subgroups such as elderly people (79.5% of excellent or good results), patients previously operated upon (78%) and those with ''discogenic'' low back pain (79%). Complication rates have been extremely low (less than 1%) and all complications cleared up without sequelae. In comparison with other percutaneous disc treatments, Onik's achieves the best compromise between clinical efficacy, comfort for the patient and low invasiveness. (orig.)

  10. 4-year experience with percutaneous US-guided radiofrequency ablation of kidney tumors

    International Nuclear Information System (INIS)

    Salagierska-Barwinska, A.; Salagierski, M.; Salagierski, M.

    2007-01-01

    The past decades have significantly changed the diagnosis and management of kidney tumors. There is a growing trend for a less invasive therapeutic approach. The study seeks to present our experience with a number of patients who underwent percutaneous ultrasound (US)-guided radiofrequency ablation (RFA) of renal masses. From July 2002 to December 2006, RFA was carried out in 55 selected patients with an enhancing kidney tumor on computed tomography (CT). The procedure was performed under conscious sedation. The patients were at risk for surgery or had a remaining kidney. Monopolar Cool-tip Tyco or bipolar Celon Olympus RFA devices under US-guidance (convex 3.5 MHz) were used. Abdominal 3-phase multi-slice computed tomography (MSCT) was performed 3, 6 and 12 months post RFA and once yearly thereafter. At a mean follow up of 25 months (range, 6-53 months), 52 of the 55 tumors showed no contrast enhancement on CT. Three incompletely ablated tumors were successfully treated with the second RFA. There were no major complications in any procedure and intervention was well tolerated. So far we have observed one metastasis to a homolateral adrenal gland which was revealed on MSCT. Percutaneous RFA is a minimally invasive technique which appears to be a promising alternative for patients with small renal tumors. 3-phase MSCT improves the imaging of renal masses, enabling not only optimal treatment planning but also a reliable monitoring of tumor destruction after RFA. (author)

  11. Cholangitis and multiple liver abscesses after percutaneous ethanol injection (PEI for recurrent hepatocellular carcinoma (HCC Colangitis y abscesos hepáticos múltiples tras la inyección percutánea de etanol (IPE en el tratamiento del carcinoma hepatocelular recurrente

    Directory of Open Access Journals (Sweden)

    Fernando Macias-García

    2013-02-01

    Full Text Available Percutaneous ablation procedures are minimally invasive treatments for unresectable early stage hepatocellular carcinoma (HCC. These techniques are usually safe, but rare and even fatal complications have been described. We present a fatal result after percutaneous ethanol injection (PEI for the treatment of a recurrent HCC in a non-cirrhotic liver, with subsequent development of diffuse cholangitis and multiple liver abscesses. Although percutaneous drainage and intensive antibiotic treatment were employed, the patient finally died. We discuss about the etiology and the physiopathology of this rare complication in which the therapeutic options are limited and usually unsuccessful.

  12. [Percutaneous endoscopic gastrostomy in geriatrics : Indications, technique and complications].

    Science.gov (United States)

    Wirth, Rainer

    2018-02-01

    The technique of percutaneous endoscopic gastrostomy (PEG) was introduced in 1979 as a semi-invasive approach for children with the need for a gastric fistula in order to avoid an operative intervention. The suture pull-through method was rapidly established and is now omnipresent. Because scientific evidence is broadly missing, there is some uncertainty about the indications in geriatric medicine. Guidelines do not recommend the insertion of a PEG in patients with severe dementia and malnutrition. Tube feeding is mainly recommended as a temporary method for patients who cannot take oral nutrition for more than 3 days or for whom the energy intake for more than 10 days presumably covers less than 50% of their needs, assuming that the overall prognosis is reasonable. Insertion of a PEG is only recommended if artificial nutrition is expected to be necessary for more than 3-4 weeks or if a nasogastric tube is not tolerated.

  13. Emergency bypass post percutaneous atrial ablation: a case report.

    LENUS (Irish Health Repository)

    Hargrove, M

    2010-11-01

    A 34-year-old male undergoing percutaneous atrial ablation procedure for paroxysmal fibrillation required emergency sternotomy for cardiac tamponade. The patient had been anticoagulated and had received plavix and aspirin prior to and during the ablation procedure. Seven units of red cell concentrate had been transfused in the cardiac catherisation laboratory. On arrival in theatre, the patient was hypotensive, but was awake on induction of anaesthesia. No recordable blood pressure with non-invasive monitoring was observed. A sternotomy was immediately performed and, on evacuation of the pericardium, a bleeding site was not visible. The patient was commenced on cardiopulmonary bypass. Bleeding site was identified and the defect closed. The patient was weaned from cardiopulmonary bypass with minimal inotropic support and made an uneventful recovery. Bypass time was 38 minutes. A literature review showed a 1% incidence of post-ablation bleeding(1). The incidence of reverting to bypass for such an event has not been reported previously. During these procedures, it might be wise to have the cardiothoracic team notified while atrial ablation procedures are being performed in the cardiac catheterization laboratory.

  14. Novel design of honeybee-inspired needles for percutaneous procedure.

    Science.gov (United States)

    Sahlabadi, Mohammad; Hutapea, Parsaoran

    2018-04-18

    The focus of this paper is to present new designs of innovative bioinspired needles to be used during percutaneous procedures. Insect stingers have been known to easily penetrate soft tissues. Bioinspired needles mimicking the barbs in a honeybee stinger were developed for a smaller insertion force, which can provide a less invasive procedure. Decreasing the insertion force will decrease the tissue deformation, which is essential for more accurate targeting. In this study, some design parameters, in particular, barb shape and geometry (i.e. front angle, back angle, and height) were defined, and their effects on the insertion force were investigated. Three-dimensional printing technology was used to manufacture bioinspired needles. A specially-designed insertion test setup using tissue mimicking polyvinyl chloride (PVC) gels was developed to measure the insertion and extraction forces. The barb design parameters were then experimentally modified through detailed experimental procedures to further reduce the insertion force. Different scales of the barbed needles were designed and used to explore the size-scale effect on the insertion force. To further investigate the efficacy of the proposed needle design in real surgeries, preliminary ex vivo insertion tests into bovine liver tissue were performed. Our results show that the insertion force of the needles in different scales decreased by 21-35% in PVC gel insertion tests, and by 46% in bovine liver tissue insertion tests.

  15. Percutaneous Nephrolithotomy Using an Individual 3-Dimensionally Printed Surgical Guide.

    Science.gov (United States)

    Golab, Adam; Smektala, Tomasz; Krolikowski, Marcin; Slojewski, Marcin

    2016-05-13

    Percutaneous nephrolithotomy (PNL) is an endoscopic technique used for treating large stones, multiple stones, and staghorn calculi. Although minimally invasive, complication rate of PNL reaches 25%, and it is partially associated with needle puncture during nephrostomy tract preparation. Continuous improvement of armamentarium and imaging methods and the introduction of three-dimensional (3D) visualizations optimize the procedure; however, the rapid and precise establishment of the nephrostomy tract is still difficult. In the present short communication, we present the PNL procedure assisted by a personalized 3D-printed surgical guide (SG) to ensure fast and precise needle access to the renal collecting system. We also describe the workflow for SG preparation, which consists of CT image acquisition and data segmentation, planning a safe needle insertion path, SG designing, and guide manufacturing. With the growing market of low-cost 3D printers, the presented technique can shorten the PNL procedure time and decrease the complication rate associated with needle puncture in a cost-efficient manner. © 2016 S. Karger AG, Basel.

  16. Tumour seeding following percutaneous needle biopsy: The real story

    Energy Technology Data Exchange (ETDEWEB)

    Robertson, E.G. [Department of Radiology, Western Infirmary, Glasgow (United Kingdom); Baxter, G., E-mail: grant.baxter@ggc.scot.nhs.uk [Department of Radiology, Western Infirmary, Glasgow (United Kingdom)

    2011-11-15

    The demand for percutaneous needle biopsy is greater than ever before and with the majority of procedures requiring imaging guidance, radiologists have an increasingly important role in the diagnostic work-up of patients with suspected malignancy. All invasive procedures incur potential risks; therefore, clinicians should be aware of the most frequently encountered complications and have a realistic idea of their likelihood. Tumour seeding, whereby malignant cells are deposited along the tract of a biopsy needle, can have disastrous consequences particularly in patients who are organ transplant candidates or in those who would otherwise expect good long-term survival. Fortunately, tumour seeding is a rare occurrence, yet the issue invariably receives a high profile and is often regarded as a major contraindication to certain biopsy procedures. Although its existence is in no doubt, realistic insight into its likelihood across the spectrum of biopsy procedures and multiple anatomical sites is required to permit accurate patient counselling and risk stratification. This review provides a comprehensive overview of tumour seeding and examines the likelihood of this much feared complication across the range of commonly performed diagnostic biopsy procedures. Conclusions have been derived from an extensive analysis of the published literature, and a number of key recommendations should assist practitioners in their everyday practice.

  17. Invasive amebiasis.

    Science.gov (United States)

    Grecu, F; Bulgariu, Teodora; Blanaru, Oana; Dragomir, C; Lunca, Claudia; Stratan, I; Manciuc, Carmen; Luca, V

    2006-01-01

    Digestive amoebiasis with his invasive form is an unusual pathology encountered in the temperate zone. This could lead to a life threatening complication: systemic amoebiasis. A 55-year-old male was treated successfully of systemic amoebiasis in a third referral hospital. The diagnosis was established based on epidemiology data and microscopical identification of trophozoites of Entamoeba histolytica. The amoebicidal, antibiotic and supportive treatments was firstly administrated. The clinical picture of intestinal amoebiasis raised from dysenteric syndrome to necrotizing enteritis. The bowel perforation with localized peritonitis was followed by chronic enteric fistula. Amoebic liver abscess, as the most frequent extraintestinal complication, was concomitantly diagnosed and treated. Urinary amoebiasis was considered as complication in the context of systemic dissemination: any other location could become a site of an amoebic abscess. Multidisciplinary approach was the successful key in the management of the patient, including antiparasitic therapy and antibiotic prophylaxis, intensive care and multiple surgical approaches. The diagnosis of digestive amoebiasis and systemic complication may be delayed in nonendemic areas, leading to advanced and complicated stages of the disease. The surgical approach is most efficiently to treat a large liver amoebic abscess and intraperitoneal collections.

  18. ZnO powders as multi-facet single crystals.

    Science.gov (United States)

    Haque, Francia; Chenot, Stéphane; Viñes, Francesc; Illas, Francesc; Stankic, Slavica; Jupille, Jacques

    2017-04-19

    Oxides are most commonly found in divided forms with properties difficult to control since their crystallographic orientations usually escape analysis. To overcome this an appropriate model system can be provided by ZnO smoke which, obtained by combustion of Zn in air, exhibits nanoparticles with well-defined surface facets. The present work focuses on the interaction of water with ZnO smokes by combining density functional theory based simulations and infrared spectroscopy measurements with applied pressures from 10 -7 to 1 mbar. We demonstrate that the use of ultra-high vacuum allows the analysis of the very first stages of the adsorption, and report on water structures on ZnO(112[combining macron]0) for the first time. We further show that ZnO powders behave as multi-facet single crystals involving (101[combining macron]0), (112[combining macron]0), (0001), and (0001[combining macron]) surfaces with the polar orientations corresponding to 25% of the total surface area. A great deal of cross-agreements between experimental results and simulation provides a simple approach for the examination of hydroxylated/hydrated ZnO smokes and can be widely applied on other ZnO-related powders.

  19. Unknown facets of Well-Known Scientists Series - Part II

    Directory of Open Access Journals (Sweden)

    V S Dixit

    2016-01-01

    Full Text Available 1st in the series of articles on “Unknown Facets of well-known Scientists” was about Sir Frederick Grant Banting, co-discoverer of Insulin, who also researched in Aviation and Diving Medicines, results of which brought extraordinary benefits for Flight crew during the World War II. The article was published in the previous issue of the Journal Unknown facets could be celebrated attributes, talents or otherwise, but it is necessary that we get to know fully about the “great mind". THIS ARTICLE IS ABOUT DR WERNER THEODOR OTTO FORSSMANN, A CARDIOLOGIST, WHO BECAME A UROLOGIST! Does the name Dr Forssmann ring a bell? He shared the 1956 Nobel Prize in Physiology or Medicine with “Andre Cournand and Dickinson Richards". The trio was awarded for their “discoveries concerning heart catheterization and pathological changes in the circulatory system". Dr Forssmann was nominated for performing an experiment in which he introduced a catheter into a vein of his arm, further passing it onward into his heart It was risky. This was in the year 1929. Subject of this article is the self-experimentation he carried out and what happened later.

  20. Dynamics of faceted thin films formation during vapor deposition

    Science.gov (United States)

    Li, Kun-Dar; Huang, Po-Yu

    2018-01-01

    In this study, an anisotropic phase-field model was established to simulate the growth of crystalline thin films during vapor deposition. The formation and evolution of characteristic surface with faceted morphologies were demonstrated, in accordance with the regularly obtained microstructure in the actual experiments. In addition, the influences of deposition parameters, such as the deposition rate and the interfacial energy, on the formation mechanism of the characteristic morphology were also illustrated. While a relatively low surface energy of substrate was regarded, the faceted islands were formed, owing to the anisotropic interfacial energy of thin films. In the condition of a high surface energy of substrate, the layered structures of deposited films were produced, which was corresponding to the Frank–van der Merwe growth mode. As various deposition rates were utilized in the numerical simulations, diverse surface morphologies were developed on the basis of the dominant mechanisms, correlating with the adatom diffusion and the deposition kinetics. According to the calculation results, it was observed that a surface character with flattened morphology was generally driven by the adatom diffusion, while the factor of the deposition kinetics was inclined to roughen the surface of thin films. These numerical simulations enhanced the knowledge of thin film growth and facilitated the progress of the vapor deposition technology for advanced applications.

  1. MR imaging of lumbar facet joint synovial cysts

    Energy Technology Data Exchange (ETDEWEB)

    Apostolaki, E.; Davies, A.M.; Evans, N. [Royal Orthopaedic Hospital, Birmingham (United Kingdom). Dept. of Radiology; Cassar-Pullicino, V.N. [Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry (United Kingdom)

    2000-04-01

    The increasing application of magnetic resonance (MR) imaging of the spine has raised the awareness of lumbar facet synovial cysts (LFSC). This well recognised, yet uncommon condition, presents with low back pain and radiculopathy due to the presence of an extradural mass. The commonest affected level is L4/5 with a mild degenerative spondylolisthesis a frequent associated finding. MR imaging is the technique of choice to detect and diagnose a LFSC. This pictorial essay, drawing on experience of 43 cases seen in 40 patients, illustrates the spectrum of appearances that can be encountered and suggest differing causes for the variable signal characteristics exhibited. Computed tomography (CT) can be of value in some cases to aid interpretation of the MR images. In addition, CT facet arthrography by injection of air or iodinated non-ionic contrast medium may be used to confirm the diagnosis in doubtful cases as well as noting whether the patients presenting symptoms can be provoked. A comprehensive review of the existing literature is presented. (orig.)

  2. Percutaneous drainage of complicated abscesses and fluid collections

    International Nuclear Information System (INIS)

    Wittich, G.R.; Karnel, F.; Kumpan, W.; Herold, C.; Schurawitzki, H.; Van Sonnenberg, E.; Casola, G.; Jantsch, H.

    1987-01-01

    The original concept of percutaneous, radiological abscess drainage was confined to well circumscribed, solitary abscesses, that could be reached by a short access avoiding transgression of uninvolved organs or compartments. With increasing experience criteria for percutaneous abscess drainage have been expanded to radiological treatment of pancreatic, periappendiceal, diverticular, interloop and mediastinal abscesses and fluid collections. The authors present their experience with percutaneous treatment of such 'complicated' abscesses in 140 patients. (orig.) [de

  3. Residual Fragments after Percutaneous Nephrolithotomy

    Directory of Open Access Journals (Sweden)

    Kaan Özdedeli

    2012-09-01

    Full Text Available Clinically insignificant residual fragments (CIRFs are described as asymptomatic, noninfectious and nonobstructive stone fragments (≤4 mm remaining in the urinary system after the last session of any intervention (ESWL, URS or PCNL for urinary stones. Their insignificance is questionable since CIRFs could eventually become significant, as their presence may result in recurrent stone growth and they may cause pain and infection due to urinary obstruction. They may become the source of persistent infections and a significant portion of the patients will have a stone-related event, requiring auxilliary interventions. CT seems to be the ultimate choice of assessment. Although there is no concensus about the timing, recent data suggests that it may be performed one month after the procedure. However, imaging can be done in the immediate postoperative period, if there are no tubes blurring the assessment. There is some evidence indicating that selective medical therapy may have an impact on decreasing stone formation rates. Retrograde intrarenal surgery, with its minimally invasive nature, seems to be the best way to deal with residual fragments.

  4. Facet joint injuries in acute cervical spine trauma : evaluation with CT and MRI

    Energy Technology Data Exchange (ETDEWEB)

    Ha, Jeon Ju; Kim, Dong Hyun; Lee, Jeong Hwa; Lee, Keon; Kwon, Hyeok Po; Kwon, Jung Hyeok; Yun, Seong Mun [Dongkang General Hospital, Seoul (Korea, Republic of)

    1999-05-01

    To evaluate injury patterns of facet joints and associated soft tissue injuries in patients with acute traumatic cervical facet joint injuries. From among patients with cervical spine trauma, 27 with facet joint injuries, as seen on CT and MRI, were chosen for this study. CT scans were analyzed with regard to the location of facet joint injury, the presence or absence of facet dislocation or fracture, and other associated fractures. MR images were analyzed with regard to ligament injury, intervertebral disc injury, intervertebral disc herniation, and spinal cord injury. The most common location of facet joint injury was C6-7 level(n=10), followed by C5-6(n=8). Among these 27 patients with facet joint injuries, 12(44%) had bilateral injuries and 15(56%) unilateral injuries. Facet fractures were present in 17 cases(63%) and the fracture of inferior facet was more frequent than superior. Patterns of fracture were vertical, transverse, or comminuted, but vertical fracture was the most common. Various degrees of dislocation were observed in patients with facet fractures. Fractures other than facet included pillar(n=11), lamina(n=6), transverse process(n=14), body(n=13), and spinous process(n=3). On MR images, anterior longitudinal ligament injury was found in 8 patients(30%), posterior longitudinal ligament injury in 4(15%), and interspinous ligament injury in 20(74%). Twelve patients(44%) had spinal cord injuries including edema(n=8) and hemorrhage(n=4). Among patients with disc abnormalities, 11(41%) had intervertebral disc injuries, and traumatic disc herniations were found in nine. Traumatic cervical facet joint injuries were manifested as various patterns and frequently associated with other fractures or soft tissue injuries. Analysis of CT and MR findings of these injury patterns helped formulate a therapeutic plan and determine of prognosis.

  5. In vivo Structure/Function analysis of the Drosophila fat facets deubiquitinating enzyme gene.

    OpenAIRE

    Chen, X; Fischer, J A

    2000-01-01

    The Drosophila Fat facets protein is a deubiquitinating enzyme required for patterning the developing compound eye. Ubiquitin, a 76-amino-acid polypeptide, serves as a tag to direct proteins to the proteasome, a protein degradation complex. Deubiquitinating enzymes are a large group of proteins that cleave ubiquitin-protein bonds. Fat facets belongs to a class of deubiquitinating enzymes called Ubps that share a conserved catalytic domain. Fat facets is unique among them in its large size and...

  6. Comparing linkage designs based on land facets to linkage designs based on focal species.

    Science.gov (United States)

    Brost, Brian M; Beier, Paul

    2012-01-01

    Least-cost modeling for focal species is the most widely used method for designing conservation corridors and linkages. However, these designs depend on today's land covers, which will be altered by climate change. We recently proposed an alternative approach based on land facets (recurring landscape units of relatively uniform topography and soils). The rationale is that corridors with high continuity of individual land facets will facilitate movement of species associated with each facet today and in the future. Conservation practitioners might like to know whether a linkage design based on land facets is likely to provide continuity of modeled breeding habitat for species needing connectivity today, and whether a linkage for focal species provides continuity and interspersion of land facets. To address these questions, we compared linkages designed for focal species and land facets in three landscapes in Arizona, USA. We used two variables to measure linkage utility, namely distances between patches of modeled breeding habitat for 5-16 focal species in each linkage, and resistance profiles for focal species and land facets between patches connected by the linkage. Compared to focal species designs, linkage designs based on land facets provided as much or more modeled habitat connectivity for 25 of 28 species-landscape combinations, failing only for the three species with the most narrowly distributed habitat. Compared to land facets designs, focal species linkages provided lower connectivity for about half the land facets in two landscapes. In areas where a focal species approach to linkage design is not possible, our results suggest that conservation practitioners may be able to implement a land facets approach with some confidence that the linkage design would serve most potential focal species. In areas where focal species designs are possible, we recommend using the land facet approach to complement, rather than replace, focal species approaches.

  7. Facet joint injuries in acute cervical spine trauma : evaluation with CT and MRI

    International Nuclear Information System (INIS)

    Ha, Jeon Ju; Kim, Dong Hyun; Lee, Jeong Hwa; Lee, Keon; Kwon, Hyeok Po; Kwon, Jung Hyeok; Yun, Seong Mun

    1999-01-01

    To evaluate injury patterns of facet joints and associated soft tissue injuries in patients with acute traumatic cervical facet joint injuries. From among patients with cervical spine trauma, 27 with facet joint injuries, as seen on CT and MRI, were chosen for this study. CT scans were analyzed with regard to the location of facet joint injury, the presence or absence of facet dislocation or fracture, and other associated fractures. MR images were analyzed with regard to ligament injury, intervertebral disc injury, intervertebral disc herniation, and spinal cord injury. The most common location of facet joint injury was C6-7 level(n=10), followed by C5-6(n=8). Among these 27 patients with facet joint injuries, 12(44%) had bilateral injuries and 15(56%) unilateral injuries. Facet fractures were present in 17 cases(63%) and the fracture of inferior facet was more frequent than superior. Patterns of fracture were vertical, transverse, or comminuted, but vertical fracture was the most common. Various degrees of dislocation were observed in patients with facet fractures. Fractures other than facet included pillar(n=11), lamina(n=6), transverse process(n=14), body(n=13), and spinous process(n=3). On MR images, anterior longitudinal ligament injury was found in 8 patients(30%), posterior longitudinal ligament injury in 4(15%), and interspinous ligament injury in 20(74%). Twelve patients(44%) had spinal cord injuries including edema(n=8) and hemorrhage(n=4). Among patients with disc abnormalities, 11(41%) had intervertebral disc injuries, and traumatic disc herniations were found in nine. Traumatic cervical facet joint injuries were manifested as various patterns and frequently associated with other fractures or soft tissue injuries. Analysis of CT and MR findings of these injury patterns helped formulate a therapeutic plan and determine of prognosis

  8. Percutaneous Cementoplasty for Kienbock’s Disease

    Energy Technology Data Exchange (ETDEWEB)

    Vallejo, Eduardo Crespo, E-mail: dreduardocrespo@gmail.com [Hospital Príncipe de Asturias, Vascular and Interventional Radiology Unit (Spain); Martinez-Galdámez, Mario [Fundación Jimenez Diaz, Neurointerventional Radiology Unit (Spain); Martin, Ernesto Santos [Memorial Sloan-Kettering Center, Vascular and Interventional Radiology Unit (United States); Gregorio, Arturo Perera de [Hospital Príncipe de Asturias, Department of Orthopedic Surgery (Spain); Gallego, Miriam Gamo [Hospital Príncipe de Asturias, Vascular and Interventional Radiology Unit (Spain); Escobar, Angeles Ramirez [Hospital Príncipe de Asturias, Radiology Unit (Spain)

    2017-05-15

    Kienböck disease typically presents with wrist pain, swelling, restricted range of motion, and difficulty in performing activities of daily living. Because the etiology and evolution of disease remain unclear, broad ranges of treatments have been designed. Percutaneous cementoplasty is expanding its role for managing painful bone metastases outside the spine. We can draw a parallel between lytic tumoral lesions and Kienbock’s disease. Increasing the strength and rigidity of lunate with cementoplasty can prevent it from collapse, relieve the symptoms associated with the process of avascular necrosis, and increase the wrist range of motion. We report the case of 30-year-old man with a painful stage IIIA Kienböck disease who underwent percutaneous cementoplasty and experienced immediate effective pain relief and recovery of wrist mobility.

  9. [CAT-guided percutaneous drainage of abscesses].

    Science.gov (United States)

    Aguilera Manrique, F; Fernández Miranda, E; García Cáceres, E; Franciso Moriana Maldonado, J; Granero Molina, J; Aguilera Manrique, G

    2001-09-01

    Drainage of percutaneous abscesses guided by Computerized Axial Tomography (CAT) is a technique being employed more frequently all the time by Radiodiagnostic Services. Correctly put into practice by trained professionals, this procedure can prevent patients having to undergo another series of treatments which bear greater risks, to have a longer hospital stay, or even, depending on the case, to have to undergo an operation. Nurses in a radiological unit have an overwhelming role in every step of a percutaneous abscess drainage, a role which can not be carried out by any other personnel. To achieve being up to date in this technique and to perform our function as nurses in the use of this technique are the main objectives of this review.

  10. Percutaneous drainage of 100 subphrenic abscesses

    International Nuclear Information System (INIS)

    Casola, G.; Sonnenberg, E. van; D'Agostino, H.; Kothari, R.; May, S.; Taggart, S.

    1990-01-01

    PURPOSE: Percutaneous drainage of subphrenic abscesses is technically more difficult because lung and pleura may be transgressed during catheter insertion. The purpose of this paper is to determine the incidence of thoracic complications secondary to subphrenic abscess drainage and to determine factors that may alter this. The authors' series consists of 100 subphrenic abscesses that were drained percutaneously. Patients range in age from 14 to 75 years. Abscesses were secondary to surgery (splenectomy, pancreatectomy, partial hepatectomy, gastrectomy), pancreatitis, and trauma. Catheters ranged in size from 8 to 14 F and were inserted via trocar or Seldinger technique. Thoracic complications of pneumothorax or empyema were determined from follow-up chest radiographs or CT scans

  11. Percutaneous Cementoplasty for Kienbock’s Disease

    International Nuclear Information System (INIS)

    Vallejo, Eduardo Crespo; Martinez-Galdámez, Mario; Martin, Ernesto Santos; Gregorio, Arturo Perera de; Gallego, Miriam Gamo; Escobar, Angeles Ramirez

    2017-01-01

    Kienböck disease typically presents with wrist pain, swelling, restricted range of motion, and difficulty in performing activities of daily living. Because the etiology and evolution of disease remain unclear, broad ranges of treatments have been designed. Percutaneous cementoplasty is expanding its role for managing painful bone metastases outside the spine. We can draw a parallel between lytic tumoral lesions and Kienbock’s disease. Increasing the strength and rigidity of lunate with cementoplasty can prevent it from collapse, relieve the symptoms associated with the process of avascular necrosis, and increase the wrist range of motion. We report the case of 30-year-old man with a painful stage IIIA Kienböck disease who underwent percutaneous cementoplasty and experienced immediate effective pain relief and recovery of wrist mobility.

  12. Percutaneous penetration through slightly damaged skin

    DEFF Research Database (Denmark)

    Nielsen, Jesper B

    2005-01-01

    work. We have therefore evaluated an experimental model for percutaneous penetration through slightly damaged skin. The influence of a slight damage to the skin was evaluated using five pesticides covering a wide range of solubilities. We used an experimental model with static diffusion cells mounted......Guidelines for experimental studies of percutaneous penetration prescribe optimal barrier integrity of the skin. The barrier integrity of the skin exposed in occupational or household situations is, however, not always ideal, and skin problems are among the most dominant reasons for absence from...... with human skin. A slight damage to the barrier integrity was induced by pre-treatment of the skin with sodium lauryl sulphate (SLS) before pesticide exposure. The experimental model with 3 h pre-treatment with SLS (0.1% or 0.3%) assured a significant but controlled damage to the barrier integrity, a damage...

  13. Promising results after percutaneous mitral valve repair

    DEFF Research Database (Denmark)

    Ihlemann, Nikolaj; Franzen, Olaf; Jørgensen, Erik

    2011-01-01

    Mitral valve regurgitation (MR) is the secondmost frequent valve disease in Europe. Untreated MR causes considerable morbidity and mortality. In the elderly, as many as half of these patients are denied surgery because of an estimated high surgical risk. Percutaneous mitral valve repair with the ...... with the MitraClip system resembles the Alfieristitch where a clip is used to connect the tip of the mitral valve leaflets....

  14. CIRSE Guidelines on Percutaneous Vertebral Augmentation

    Energy Technology Data Exchange (ETDEWEB)

    Tsoumakidou, Georgia, E-mail: gtsoumakidou@yahoo.com; Too, Chow Wei, E-mail: spyder55@gmail.com; Koch, Guillaume, E-mail: guillaume.koch@gmail.com; Caudrelier, Jean, E-mail: jean.caudrelier@chru-strasbourg.fr; Cazzato, Roberto Luigi, E-mail: gigicazzato@hotmail.it; Garnon, Julien, E-mail: juliengarnon@gmail.com; Gangi, Afshin, E-mail: gangi@unistra.fr [Strasbourg University Hospital, Interventional Radiology Department (France)

    2017-03-15

    Vertebral compression fracture (VCF) is an important cause of severe debilitating back pain, adversely affecting quality of life, physical function, psychosocial performance, mental health and survival. Different vertebral augmentation procedures (VAPs) are used in order to consolidate the VCFs, relief pain,and whenever posible achieve vertebral body height restoration. In the present review we give the indications, contraindications, safety profile and outcomes of the existing percutaneous VAPs.

  15. Percutaneous hallux valgus treatment: Unilaterally or bilaterally.

    Science.gov (United States)

    Carvalho, Paulo; Viana, G; Flora, M; Emanuel, P; Diniz, P

    2016-12-01

    Currently there is no consensus regarding the use of bilateral simultaneous percutaneous surgery for Hallux valgus treatment. Although the technique described in M. Prado's book, recommends operating only one foot at a time there are no published studies confirming it. The aim of this study was to evaluate whether there is a difference between the results of patients that have been percutaneously operated on one foot and those operated on both feet at the same surgical time for mild to moderate Hallux valgus correction. We did a retrospective single centre evaluation of 93 feet (61 patients) with Hallux valgus operated percutaneously. 29 patients were operated unilaterally (group I) and 32 bilaterally simultaneously (group II) between 2005 and 2009. The Metatarsophalangeal angle (MPA), Intermetatarsal angle (IMA) and Distal metatarsal articular angle (DMAA) were evaluated pre- and postoperatively. The AOFAS score, the degree of patients' satisfaction and the complications were evaluated postoperatively. The mean follow-up was 24.0 months in group I, and 28.0 in group II. The average postoperative AOFAS score was 86.8, 82.9 in group I and 88.6 in group II (p>0.05). 90.6% were satisfied or very satisfied in group I, and 89.7% in group II (p>0.05). There was no statistically significant difference (p>0.05) in the average correction of MPA, DMAA, and IMA. The complications rate was similar in both groups. The similar results obtained in both groups suggest that the simultaneous bilateral percutaneous surgery gives equivalent results to the unilateral, which has an important socioeconomic impact since there is only one recovery time for both feet. Further research is needed. Copyright © 2015 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

  16. Plasmas, Dielectrics and the Ultrafast: First Science and Operational Experience at FACET

    Energy Technology Data Exchange (ETDEWEB)

    Clarke, C.I.; Adli, E.; Corde, S.; Decker, F.J.; England, R.J.; Erickson, R.; Fisher, A.; Gessner, S.; Hast, C.; Hogan, M.J.; Li, S.Z.; Lipkowitz, N.; Litos, M.; Nosochkov, Y.; Seeman, J.; Sheppard, J.C.; Tudosa, I.; White, G.; Wienands, U.; Woodley, M.; Wu, Z.; /SLAC /UCLA

    2012-09-14

    FACET (Facility for Advanced Accelerator and Experimental Tests) is an accelerator R&D test facility that has been recently constructed at SLAC National Accelerator Laboratory. The facility provides 20 GeV, 3 nC electron beams, short (20 {micro}m) bunches and small (20 {micro}m wide) spot sizes, producing uniquely high power beams. FACET supports studies from many fields but in particular those of Plasma Wakefield Acceleration and Dielectric Wakefield Acceleration. FACET is also a source of THz radiation for material studies. We present the FACET design, initial operating experience and first science from the facility.

  17. FACET: an object-oriented software framework for modeling complex social behavior patterns

    Energy Technology Data Exchange (ETDEWEB)

    Dolph, J. E.; Christiansen, J. H.; Sydelko, P. J.

    2000-06-30

    The Framework for Addressing Cooperative Extended Transactions (FACET) is a flexible, object-oriented architecture for implementing models of dynamic behavior of multiple individuals, or agents, in a simulation. These agents can be human (individuals or organizations) or animal and may exhibit any type of organized social behavior that can be logically articulated. FACET was developed by Argonne National Laboratory's (ANL) Decision and Information Sciences Division (DIS) out of the need to integrate societal processes into natural system simulations. The FACET architecture includes generic software components that provide the agents with various mechanisms for interaction, such as step sequencing and logic, resource management, conflict resolution, and preemptive event handling. FACET components provide a rich environment within which patterns of behavior can be captured in a highly expressive manner. Interactions among agents in FACET are represented by Course of Action (COA) object-based models. Each COA contains a directed graph of individual actions, which represents any known pattern of social behavior. The agents' behavior in a FACET COA, in turn, influences the natural landscape objects in a simulation (i.e., vegetation, soil, and habitat) by updating their states. The modular design of the FACET architecture provides the flexibility to create multiple and varied simulation scenarios by changing social behavior patterns, without disrupting the natural process models. This paper describes the FACET architecture and presents several examples of FACET models that have been developed to assess the effects of anthropogenic influences on the dynamics of the natural environment.

  18. Congenital absence of the lumbar facet joint associated with bilateral spondylolysis of the fifth lumbar vertebra.

    Science.gov (United States)

    Wang, Zhuo; Sakakibara, Toshihiko; Kasai, Yuichi

    2013-01-01

    A 14-year-old boy presented with a rare case of congenital absence of lumbar facet joint manifesting as low back pain. Physical examination showed no neurological or hematologic abnormalities. Radiography revealed absence of a facet joint on the right side of L4-5. Computed tomography and three-dimensional computed tomography revealed absence of the facet joint on the right side of L4-5 and spondylolysis on both sides of L5. Pain subsided after conservative treatment. This is an extremely rare case of congenital absence of lumbar facet joint associated with bilateral spondylolysis.

  19. Percutaneous Dilatational Tracheostomy via Griggs Technique.

    Science.gov (United States)

    Karimpour, Hasan Ali; Vafaii, Kamran; Chalechale, Maryam; Mohammadi, Saeed; Kaviannezhad, Rasool

    2017-01-01

    Tracheostomy is considered the airway management of choice for patients who need prolonged mechanical ventilation support. Percutaneous Dilatational Tracheotomy (PDT) is a technique that can be performed easily and rapidly at bedside and is particularly useful in the intensive care setting. The Griggs percutaneous tracheotomy is unique in its utilization of a guide wire dilator forceps. We aimed to describe the early perioperative and late postoperative complications of PDT using the Griggs technique in patients in the intensive care unit (ICU). This cross-sectional study was conducted on all patients who underwent tracheostomy in the ICU of the Imam Reza Hospital of Kermanshah, Iran, from June 2011 to June 2015. PDT was performed in 184 patients with the Griggs technique. Demographic variables, as well as perioperative and late postoperative complications were recorded. The mean age of patients was 57.3 ± 15.37 years. The most common primary causes of tracheostomy were hypoxic brain damage disorders (43.2%) and pneumonia (14.8%). Perioperative and early complications occurred in 16.7 % of procedures, of which 9.3% were bleedings (minor, significant and major). Furthermore, the incidence of late complications was 8.6%, including: stomal infection, difficult replace tracheostomy tube, tracheoesophageal fistula, tracheal stenosis, and tracheomalacia. PDT via Griggs technique is a safe, quick, and effective method. The low incidence of complications indicates that bedside percutaneous tracheostomy can be performed safely as a routine procedure for daily care implemented in the ICU.

  20. CT guidance of percutaneous hepatic abscess drainage

    International Nuclear Information System (INIS)

    Li Jiahua; Zhang Jiaxing; Cao Chuanwu; Li Maoquan; Lu Fuming; Zheng Manhua

    2008-01-01

    Objective: To discuss the method and effectiveness of percutaneous drainage for hepatic abscess under CT guidance. Methods: 20 patients were enrolled into this retrospective research, including 13 males and 7 females with age form 18 to 84 yrs. The diagnosis were made by clinical examination, laboratory test and CT imaging. Hepatic abscess focus involved right lobe in 9 cases, left lobe of 6 cases, both lobes with 5 cases. All patients received percutaneous abscess drainage subsequently. Results: There were 14 cases with solitary abscess, in which 9 disappeared completely after single procedure of aspiration under CT guidance, 1 disappeared after twice aspirations. Multiple or multi-lobular abscesses were found in six cases, which were treated by aspirating the larger one first or by splitting multi-aspiration. In all cases, drainage catheters were placed and lavage was done with a mean time of 19.2 days together with intravenous antibiotics. There was no recurrence until the end-piont of research. Conclusions: Percutaneous CT-guided aspiration and drainage is an effective way in the treatment of hepatic abscess. (authors)

  1. Combating photoaging with percutaneous collagen induction.

    Science.gov (United States)

    Fernandes, Desmond; Signorini, Massimo

    2008-01-01

    Medical clinicians are used to being consulted by patients who want to restore their youthful appearance. Although structural changes to the face and body may be achieved with surgery, for example, face lifts, the impression of youth also relies heavily on young-looking skin. It is desirable to have thicker and tighter skin to properly fulfill the desire for youth. Percutaneous collagen induction offers an antiaging effect to improve the appearance of old skin. It allows us to improve our patients' skin from the inside outward as well as from the surface. Experience has shown that percutaneous collagen induction works optimally when combined with a scientific skin care program to restore a youthful appearance. In addition, the same technique has proven to be very effective in minimizing acne scars and burn scars by removing scar collagen and replacing it with normal collagen. Consequently, scar contractures and depressed scars are improved. With the introduction of percutaneous collagen induction therapy in 1997, a simple and fast method was developed with regard to safely treating wrinkles and scars and producing lasting smoothness. As opposed to ablative laser treatments, the epidermis remains intact and is not damaged. For this reason, the operation can be safely repeated if needed, and it can be also applicable to regions where laser treatments or deep peelings cannot be done.

  2. Lumbar juxta-facet joint cysts in association with facet joint orientation, -tropism and -arthritis: A case-control study.

    Science.gov (United States)

    Ening, Genevieve; Kowoll, Annika; Stricker, Ingo; Schmieder, Kirsten; Brenke, Christopher

    2015-12-01

    To assess the association between juxta-facet-joint cysts (JFC) occurrence at the lumbar spine and Facet Joint (FJ) orientation, -tropism and -arthritis. Study group, 36 consecutive patients with JFC and the same number of controls, with degenerative diseases without JFC were match paired for demographics and spine segment. Parameter assessment was by T2-weighted axial MRI scans. JFC diagnosis was confirmed histopathologically. Group comparison was by Student's t-test for continuous variables and X(2) for categorical variables. Nineteen female and 17 male patients, aged between 45 and 85 years (mean 67.19 ± 10.3 years) had a mean JFC size of 9.26 ± 4.8mm occurring most frequently in the segment L4-L5 (75% n=25) and on the left side (61%). Mean FJ orientation of the study group was significantly more coronal compared to controls (left side 42° vs 36°, ptropism (ptropism. Copyright © 2015 Elsevier B.V. All rights reserved.

  3. Mechano-transduction effect of shockwaves in the treatment of lumbar facet joint pain: comparative effectiveness evaluation of shockwave therapy, steroid injections and radiofrequency medial branch neurotomy.

    Science.gov (United States)

    Nedelka, Tomas; Nedelka, Jiri; Schlenker, Jakub; Hankins, Christopher; Mazanec, Radim

    2014-01-01

    Lumbar facet joints (FJ) is a common source of low back pain and contributes approximmately on one third of chronic low back pain. Medial branch radiofrequency neurotomy is considered as a gold standard in the treatment of facet joint pain. Corticosteroid injections have also presented effect in FJ pain. As an interventional procedures, they carry not-negligible risk of possible complications including infection, damage to nerve root or medial branch structures. Shockwave therapy (SWT) is a non-invasive method for treatment of various musculoskeletal disorders. Its effect is based on transduction of mechanical energy, transferred to cascade of various biochemical processes in target tissue. Its efficacy was proved in the treatment of different painful conditions. The efficacy of SWT was not yet studied in FJ pain. Aim of our work was to compare the efficacy of SWT against interventional treatment procedures - radiofrequency neurotomy and corticosteroid FJ injections. A retrospective study was done on 62 selected patients with unilateral chronic lumbar facet pain. There were 32 women and 30 men, divided into SWT group, corticosteroid injections group radiofrequency group. Nociceptive and neuropathic pain intensity and severity of pain were measured. Shockwave therapy had shown better longterm results compared to FJ injections group and little inferior efficacy compared to RMBN. We did not observe any adverse effects and complications in SWT group. Moreover, in SWT and RMBN groups, significant longterm improvement in daily activities limitation, was observed. SWT appears to be a safe and perspective option in the treatment of FJ pain with negligible side effects.

  4. Percutaneous Tennis Elbow Release Under Local Anaesthesia

    Science.gov (United States)

    Nazar, MA; Lipscombe, S; Morapudi, S; Tuvo, G; Kebrle, R; Marlow, W; Waseem, M

    2012-01-01

    Introduction: When the non-operative treatment of tennis elbow fails to improve the symptoms a surgical procedure can be performed. Many different techniques are available. The percutaneous release of the common extensor origin was first presented by Loose at a meeting in 1962. Despite the simplicity of the operation and its effectiveness in relieving pain with minimal scarring this procedure is still not widely accepted. This study presents the long-term results of percutaneous tennis elbow release in patients when conservative measures including local steroid injections have failed to relieve the symptoms. Patients and Methods: Percutaneous release of the extensor origin was performed in 24 consecutive patients (seven male and seventeen female), providing 30 elbows for this study. The age of the patients ranged from 26 to 71 years with mean age of 55 years. The technique involved a day case procedure in the operating theatre using local anaesthesia without the need for a tourniquet. The lateral elbow was infiltrated with 5mls 1% lignocaine and 5mls 0.5% bupivicaine with 1:200,000 adrenaline. All operations were performed by the senior author. The patients were assessed post operatively by using DASH (disabilities of arm, shoulder and hand) score and Oxford elbow scores. The mean follow up period was 36 months (1-71months). Results: Twenty one patients returned the DASH and Oxford elbow questionnaires. Four patients were lost in the follow up. The post operative outcome was good to excellent in most patients. Eighty seven percent of patients had complete pain relief. The mean post-op DASH score was 8.47 (range 0 to 42.9) and the mean Oxford elbow score was 42.8 (range 16 to 48). There were no complications reported. All the patients returned to their normal jobs, hobbies such as gardening, horse riding and playing musical instruments. Conclusion: In our experience Percutaneous release of the epicondylar muscles for humeral epicondylitis has a high rate of success

  5. Percutaneous tenotomy: development of a novel, percutaneous, ultrasound-guided needle-cutting technique for division of tendons and other connective tissue structures

    International Nuclear Information System (INIS)

    Hopkins, James; Sampson, Matthew

    2014-01-01

    A variety of surgical procedures derive therapeutic benefit from the division of retinacular, ligamentous or tendinous structures. Examples include carpal tunnel release for median nerve impingement, annular pulley release for trigger finger and tendon division for spastic muscular contractures. Here, using an animal cadaveric model, we describe the first steps in determining the feasibility of a novel, percutaneous, ultrasound-guided needle-cutting technique to achieve the same ends. The technique we describe involves the creation of an effective needle tenotomy device via a simple modification to an 18G coaxial, beveled needle. The technique holds promise for the development of a minimally invasive alternative approach that utilises readily available technology and equipment with minimisation of morbidity and cost associated with open procedures.

  6. Management of intra-articular fracture of calcaneus by combined percutaneous and minimal internal fixation.

    Science.gov (United States)

    Lamichhane, A; Mahara, D

    2013-01-01

    Fractures of the calcaneus are among the most challenging for the orthopaedic surgeon. The treatment of the intra-articular calcaneum fracture remains controversial due to complications and complexity of surgical anatomy. Treatment of calcaneal fracture ranges from non-operative treatment to operative. We present intraarticular fracture of calcaneus treated by combined percutaneous and minimal internal fixation. All cases evaluated either by X-ray or CT scan. All fractures were sanders two or three type evaluated by CT scan and either joint depression or tongue type fracture by X-ray. Lateral approach was used, posterior facet was exposed, reduced and fixed with one 4 mm canulated cancellous screws and 2 axial pins percutaneously from tuberosity. Clinical evaluation of the outcomes was done by modified Rowe Score. Out of 22 patients, 14 were male and 8 cases were female. Average age of the patients was 30.5 yrs (15-63 yrs). Mode of the injury was RTA in 6 cases and fall from height in 16 cases. There was no soft tissue problem in any patient. All fractures united without secondary displacement in an average of 8 weeks. Average duration of follow up was 26 months (6-37 months). Average Modified Rowe Score was 80 (Range 55-95). Ten patients had excellent, 10 had good and 2 had satisfactory outcome. Intra-articular fracture of the calcaneus can be well managed by minimal opening at the fracture and fixation by single cancellous screw and 2 axial k-wires, so minimizes complications and results in comparable outcomes.

  7. Cervical facet oedema: prevalence, correlation to symptoms, and follow-up imaging

    International Nuclear Information System (INIS)

    Nevalainen, M.T.; Foran, P.J.; Roedl, J.B.; Zoga, A.C.; Morrison, W.B.

    2016-01-01

    Aim: To evaluate the prevalence of cervical facet oedema in patients referred for magnetic resonance imaging (MRI) to investigate neck pain and/or radiculopathy, and to investigate whether there is a correlation between the presence of oedema and patients' symptoms. Materials and methods: A retrospective report review of 1885 patients undergoing cervical spine MRI between July 2008 and June 2015 was performed. Exclusion criteria included acute trauma, surgery, neoplastic disease, or infection in the cervical spine. One hundred and seventy-three MRI studies with cervical facet oedema were evaluated by each of the two radiologists. In these patients, the grade of bone marrow oedema (BMO) and corresponding neuroforaminal narrowing at the cervical facets was assessed. Correlation with symptoms was performed based on pre-MRI questionnaire. Results: The prevalence of cervical facet oedema was 9%; the most commonly affected levels were C3–4, C4–5, and C2–3. A total of 202 cervical facets were evaluated: mild BMO was seen in 35%, moderate in 41%, and severe in 24% of cases. Surrounding soft-tissue oedema was observed in 36%, 69%, and 92% of the BMO grades, respectively. The correlations between unilateral radiculopathy and ipsilateral facet BMO grades were 79%, 83%, and 73% (chi-square, p<0.001), respectively. Furthermore, neuroforaminal narrowing on the corresponding level was found in 35%, 38%, and 11% of cases, respectively. At follow-up imaging, facet oedema was most likely to remain unchanged or to decrease. Conclusion: The prevalence of cervical facet oedema is 9%. Cervical facet oedema is associated with ipsilateral radiculopathy. Neuroforaminal narrowing, however, is not associated with facet oedema. - Highlights: • Association between the cervical facet oedema and cervical radiculopathy was studied. • Prevalence of the cervical facet oedema was 9%. • Facet oedema was associated with radiculopathy regardless of the degree of oedema.

  8. Examining student rating of teaching effectiveness using FACETS.

    Science.gov (United States)

    Mat Daud, Nuraihan; Abu Kassim, Noor Lide

    2011-01-01

    Students' evaluations of teaching staff can be considered high-stakes, as they are often used to determine promotion, reappointment, and merit pay to academics. Using Facets, the reliability and validity of one student rating questionnaire is analyzed. A total of 13,940 respondents of the Human Science Division of International Islamic University Malaysia were involved in the study. The analysis shows that the student rating questionnaire used was valid and reliable, and it allows identification of staff for the institution's prestigious teaching excellence awards, and those needing in-service training. It was found that there was no significant difference in terms of rank, age and gender of the staff. The study also shows that the majority of staff have problems keeping the class interested and getting students to participate in class activities. Faculty also hardly discussed common errors in assignments and tests.

  9. Assessment of wear facets produced by the ACTA wear machine

    DEFF Research Database (Denmark)

    Benetti, Ana R; Larsen, Liselotte; Dowling, Adam H

    2016-01-01

    the 2D profile technique ranks RBC materials in terms of in-vitro wear performance. CLINICAL SIGNIFICANCE: Confidence in the wear volume measurements can only be achieved if the wear facet is analysed with sufficient resolution using a 3D digital measurement technique. However, the employment of 2D....... The mean wear depth was measured using the traditionally employed 2D and compared with the 3D profilometric (digital) techniques. Data were submitted to analyses of variance, Tukey's post hoc tests and Independent Samples Student's t-tests (where appropriate) at p... for mean wear depth calculations were similar whether the 2D or 3D techniques were employed. However, the mean wear depth values obtained from the 3D digital technique were significantly increased for two of the five RBC materials compared with the 2D methodology. The total volumetric wear data provided...

  10. Synthesis and photocatalytic activity of mesoporous – (001) facets TiO{sub 2} single crystals

    Energy Technology Data Exchange (ETDEWEB)

    Dong, Yeshuo [School of Chemical Engineering and Technology, Tianjin University, Tianjin 300072 (China); Fei, Xuening, E-mail: xueningfei@126.com [School of Chemical Engineering and Technology, Tianjin University, Tianjin 300072 (China); School of Science, Tianjin Chengjian University, Tianjin 300384 (China); Zhou, Yongzhu [School of Science, Tianjin Chengjian University, Tianjin 300384 (China)

    2017-05-01

    Highlights: • The (001) facets of TiO{sub 2} single crystals with mesoporous structure. • The (010) and (100) facets of TiO{sub 2} single crystals were covered by the flower – shaped TiO{sub 2} crystals. • This special structure could promote charge separation and provide more active sites, which will lead to a substantial increase in photocatalytic activity. - Abstract: In this work, the mesoporous – (001) facets TiO{sub 2} single crystals have been successfully synthesized through a two-step solvothermal route without any template. Their structure and morphology were characterized by scanning electron microscopy (SEM), X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), ultraviolet-visible (UV–vis) diffuse reflectance spectroscopy and energy dispersive X-ray spectrometer (EDX). Based on the different characteristics and atomic arrangements on each facet of anatase TiO{sub 2} single crystals, we synthesized these mesoporous – (001) facets TiO{sub 2} single crystals by controlling the interaction characteristics of hydrofluoric acid (HF) and isopropanol (i-PrOH) on the crystal facets. It can been seen that the (001) facets of these as-synthesized TiO{sub 2} single crystals have a clear mesoporous structure through the SEM images and BET methods. Moreover, the other four facets were covered by the flower – shaped TiO{sub 2} crystals with the generation of the mesoporous – (001) facets. This special and interesting morphology could promote charge separation and provide more active sites, which will lead to a substantial increase in photocatalytic activity. Moreover, it is more intuitive to reflect that the different crystal facets possess the different properties due to their atomic arrangement. Besides, according to the different synthetic routes, we proposed and discussed a plausible synthesis mechanism of these mesoporous – (001) facets TiO{sub 2} single crystals.

  11. How the increase of the cervical disc space height affects the facet joint: an anatomy study.

    Science.gov (United States)

    Liu, Jiayong; Ebraheim, Nabil A; Haman, Steven P; Sanford, Chris G; Sairyo, Koichi; Faizan, Ahmad; Woldenberg, Lee; Goel, Vijay K

    2006-05-20

    In vitro study on the effect of increasing the height of the cervical disc space on the facet joint. To demonstrate how facet joint articulation is affected by increasing the cervical disc space height. A surgeon attempts to increase the disc space and inserts a larger artificial disc than normal in order to keep the intervertebral foramen open and the prosthesis stable. However, it is hypothesized by the current authors that this procedure could have an adverse effect on the facet joints. Computerized tomography images passing through the disc space and the center of the C4-C7 facet joints (sagittal plane) were obtained from 15 cadaveric cervical spine specimens. A 1-mm incremental increase to a total 5 mm in disc space height was performed to simulate the changes seen in disc replacement. The change in the facet joint articulation overlap and space in the sagittal plane at normal and each displacement was measured. Each 1-mm incremental increase in disc space at C4-C5 translated to a decrease in the facet joint articulation overlap in the sagittal plane by approximately 8%. The mean facet joint space increased approximately 0.8 mm. At the C5-C6 and the C6-C7 levels, the articulation overlap decreased by approximately 7% and the facet joint space increased approximately 0.8 mm. There is a significant decrease of the facet joint articulation overlap in the sagittal plane and an increase in the facet joint space following an increase in the cervical disc space. The inappropriate increase of the disc space height may result in facet joint subluxation and could lead to the accelerated failure of the artificial disc.

  12. Superior facet syndrome. Findings on metrizamide CT myelography

    Energy Technology Data Exchange (ETDEWEB)

    Kubo, Yoshichika; Igarashi, Seishi; Koyama, Tsunemaro

    1985-02-01

    Sciatica caused by root entrapment in the lateral recess was named superior facet syndrome by Epstein in 1972. Few reports on this subject based on large numbers of cases have been documented to date. Of the patients with sciatica, 32 patients were diagnosed to have root entrapment at the lateral recess L5 or/and S1 lumbar spine. Out of 32 patients, 20 patients were operated on and the lateral entrapment was recognized in all of surgical cases. Neuroradiological findings, especially of metrizamide CT (met. CT), were documented in detail. Thirty two patients were classified in three types according to radiological findings. They were congenital or developmental, degenerative, and combined type, respectively. Fourteen cases belonged to the congenital type, 13 to the degenerative and 5 to the combined type. Each group had the mean ages of 23.4, 53.8, and 36.8 years old, respectively. Of 32 cases the entrapment occured in 47 L5 roots and 11 S1 roots. There was no remarkable laterality. In operation the unroofing of the lateral recess were done and the sciatica subsided postoperatively in all of surgical cases. Met. CT revealed extreme medial protrusion of the superior articular joint in 18 of 24 cases(75%) and none filling of the root in the lateral recess in 21 of 24 cases (87.5%). In the degenerative type, met. CT showed some degenerative changes that were hypertrophy or deformity of the articular joints and spur formation of the vertebral body. In contrast to met. CT, metrizamide myelography revealed only slight changes, which were poor filling of the root before it turned out the pedicle of lateral compression of the root. In plain films or lumbar spine articular joints at Lsub(4/5) were formed in coronal plane in 69% of cases of the L5 root entrapment. Met. CT using ReView technique was of great diagnostic value in superior facet syndrome.

  13. Using the ASTER global DEM to derive empirical relationships among triangular facet slope, facet height and slip rates along active normal faults

    Science.gov (United States)

    Tsimi, Christina; Ganas, Athanassios

    2015-04-01

    The advent of global DEMs provided a uniform elevation dataset for studying geomorphic parameters in a variety of settings. In this paper ASTER DEM data (30-m pixel size) are used to derive empirical relationships between triangular facet attributes and slip rates along active normal faults. We sampled 232 triangular facets along 10 normal faults in Greece and Bulgaria that slip with rates from 0.1 mm/yr up to 1.3 mm/yr. The studied normal faults accumulate Quaternary tectonic strain in well-known extensional provinces, such as central Greece, Crete and SW Bulgaria. The normal fault footwalls analyzed herein have been developed under similar long-term climatic conditions. It is suggested that two key geometrical features of the youngest generation of triangular facets (slope angle and height) can provide useful metrics to assess rates of deformation when seismological and geodetic data are lacking or not found in sufficient quantity to make reasonable assessments. Our derived empirical relation between slip rate and facet slope angle is: Y = 0.057 × X - 1 where Y is the fault slip rate (mm/yr) and X is the facet slope angle (degrees), with an R2 = 0.728. It is envisaged that our analysis may be helpful in assessing seismic hazard along normal faults with similar facet characteristics in other extensional settings.

  14. Case Report Percutaneous Dilational Tracheostomy A bed side ...

    African Journals Online (AJOL)

    Introduction: Tracheostomy is one of the most commonly performed procedures in critically ill patients. Percutaneous dilatational tracheostomy (PDT), according to ciaglias technique described in 1985, has become the most popular technique for percutaneous tracheostomy and is demonstrably as safe as surgical.

  15. Percutaneous central venous catheterization in children, is it efficient ...

    African Journals Online (AJOL)

    Objective To evaluate the frequent use of percutaneous central venous catheters (CVCs) in pediatric agegroup. Methods Retrospectively we reviewed the records of all children that had percutaneous CVCs in the pediatric surgical ward and pediatric intensive care unit at King Hussein Medical Center between January

  16. Percutaneous management of tumoral biliary obstruction in children

    Energy Technology Data Exchange (ETDEWEB)

    Akinci, Devrim; Gumus, Burcak; Ozkan, Orhan S.; Ozmen, Mustafa N.; Akhan, Okan [Hacettepe School of Medicine, Department of Radiology, Sihhiye, Ankara (Turkey); Ekinci, Saniye [Hacettepe School of Medicine, Department of Paediatric Surgery, Sihhiye, Ankara (Turkey); Akcoren, Zuhal [Hacettepe School of Medicine, Department of Paediatric Pathology, Sihhiye, Ankara (Turkey); Kutluk, Tezer [Hacettepe School of Medicine, Department of Paediatric Oncology, Sihhiye, Ankara (Turkey)

    2007-10-15

    There is limited experience of percutaneous biliary interventions in children although they are safe and effective procedures. To evaluate the efficacy and safety of percutaneous management of tumoral biliary obstruction in children. Percutaneous biliary interventions were performed in eight children (six boys, two girls) with a mean age of 10.5 years (range 4-17 years). The interventions included percutaneous biliary drainage (five patients), percutaneous biliary drainage and placement of a self-expanding metallic stent (two patients), and percutaneous cholecystostomy (one patient). All patients had signs of obstructive jaundice and two had cholangitis. All procedures were successful. No procedure-related mortality was observed. Bilirubin levels returned to normal in four of the eight patients. Findings of cholangitis resolved in the two affected patients after the procedure and antibiotic treatment. Two patients underwent surgery after percutaneous biliary drainage procedures. A self-expanding metallic stent was placed in two patients with malignancy and the stents remained patent until death. Percutaneous biliary interventions can be performed safely for the management of tumoral biliary obstruction in children. (orig.)

  17. CT guided percutaneous needle biopsy of the chest: initial experience

    African Journals Online (AJOL)

    The objective of this article is to report our first experience of CT guided percutaneous thoracic biopsy and to demonstrate the accuracy and safety of this procedure. This was a retrospective study of 28 CT-Guided Percutaneous Needle Biopsies of the Chest performed on 24 patients between November 2014 and April 2015.

  18. Prevention and treatment of complications following percutaneous nephrolithotomy

    NARCIS (Netherlands)

    Skolarikos, Andreas; de la Rosette, Jean

    2008-01-01

    PURPOSE OF REVIEW: The aim of this article is to identify classification and grading systems of percutaneous nephrolithotomy-related complications and evidence for the prevention and treatment of these complications. RECENT FINDINGS: A total complication rate of up to 83% following percutaneous

  19. Percutaneous management of tumoral biliary obstruction in children

    International Nuclear Information System (INIS)

    Akinci, Devrim; Gumus, Burcak; Ozkan, Orhan S.; Ozmen, Mustafa N.; Akhan, Okan; Ekinci, Saniye; Akcoren, Zuhal; Kutluk, Tezer

    2007-01-01

    There is limited experience of percutaneous biliary interventions in children although they are safe and effective procedures. To evaluate the efficacy and safety of percutaneous management of tumoral biliary obstruction in children. Percutaneous biliary interventions were performed in eight children (six boys, two girls) with a mean age of 10.5 years (range 4-17 years). The interventions included percutaneous biliary drainage (five patients), percutaneous biliary drainage and placement of a self-expanding metallic stent (two patients), and percutaneous cholecystostomy (one patient). All patients had signs of obstructive jaundice and two had cholangitis. All procedures were successful. No procedure-related mortality was observed. Bilirubin levels returned to normal in four of the eight patients. Findings of cholangitis resolved in the two affected patients after the procedure and antibiotic treatment. Two patients underwent surgery after percutaneous biliary drainage procedures. A self-expanding metallic stent was placed in two patients with malignancy and the stents remained patent until death. Percutaneous biliary interventions can be performed safely for the management of tumoral biliary obstruction in children. (orig.)

  20. Prevalence and factors associated with percutaneous injuries and ...

    African Journals Online (AJOL)

    Higher rates of percutaneous injuries were observed among nurses (50%), during stitching (30%), and in obstetric and gynecologic department (22%). Health workers aged below 40 years were more likely to experience percutaneous injuries (OR= 3.7; 95% CI=1.08-9.13) while previous training in infection prevention was ...

  1. Long-Term Developmental Changes in Children's Lower-Order Big Five Personality Facets.

    Science.gov (United States)

    de Haan, Amaranta; De Pauw, Sarah; van den Akker, Alithe; Deković, Maja; Prinzie, Peter

    2017-10-01

    This study examined long-term developmental changes in mother-rated lower-order facets of children's Big Five dimensions. Two independent community samples covering early childhood (2-4.5 years; N = 365, 39% girls) and middle childhood to the end of middle adolescence (6-17 years; N = 579, 50% girls) were used. All children had the Belgian nationality. Developmental changes were examined using cohort-sequential latent growth modeling on the 18 facets of the Hierarchical Personality Inventory for Children. In early childhood, changes were mostly similar across child gender. Between 2 and 4.5 years, several facets showed mean-level stability; others changed in the direction of less Extraversion and Emotional Stability, and more Benevolence and Imagination. The lower-order facets of Conscientiousness showed opposite changes. Gender differences became more apparent from middle childhood onward for facets of all dimensions except Imagination, for which no gender differences were found. Between 6 and 17 years, same-dimension facets showed different shapes of growth. Facets that changed linearly changed mostly in the direction of less Extraversion, Benevolence, Conscientiousness, Emotional Stability, and Imagination. Changes in facets for which nonlinear growth was found generally moved in direction or magnitude during developmental transitions. This study provides comprehensive, fine-grained knowledge about personality development during the first two decades of life. © 2016 Wiley Periodicals, Inc.

  2. A Facet Theory Model for Integrating Contextual and Personal Experiences of International Students

    Science.gov (United States)

    Hackett, Paul M. W.

    2014-01-01

    The purpose of this article is to use a facet theory research approach to provide a clear, coherent, and integrated model of international students' experiences based upon the findings of psychological research into students when studying abroad. In research that employs a facet theory approach events are classified in terms of their constituent…

  3. Investigation on CO catalytic oxidation reaction kinetics of faceted perovskite nanostructures loaded with Pt

    KAUST Repository

    Yin, S. M.

    2017-01-18

    Perovskite lead titanate nanostructures with specific {111}, {100} and {001} facets exposed, have been employed as supports to investigate the crystal facet effect on the growth and CO catalytic activity of Pt nanoparticles. The size, distribution and surface chemical states of Pt on the perovskite supports have been significantly modified, leading to a tailored conversion temperature and catalytic kinetics towards CO catalytic oxidation.

  4. Contacting ZnO Individual Crystal Facets by Direct Write Lithography.

    Science.gov (United States)

    Petkov, Nikolay; Volk, János; Erdélyi, Róbert; Lukács, István Endre; Nagata, Takahiro; Sturm, Chris; Grundmann, M

    2016-09-14

    Many advanced electronic devices take advantage of properties developed at the surface facets of grown crystals with submicrometer dimensions. Electrical contacts to individual crystal facets can make possible the investigations of facet-dependent properties such as piezoelectricity in ZnO or III-nitride crystals having noncentrosymmetric structure. However, a lithography-based method for developing contacts to individual crystal facets with submicrometer size has not yet been demonstrated. In this report we study the use of electron beam-induced deposition (EBID), a direct write lithography method, for contacting individual facets of ZnO pillars within an electron microscope. Correlating structural and in situ deposition and electrical data, we examine proximity effects during the EBID and evaluate the process against obtaining electrically insulated contact lines on neighboring and diametrically opposite ZnO facets. Parameters such as incident beam energy geometry and size of the facets were investigated with the view of minimizing unwanted proximity broadening effects. Additionally, we show that the EBID direct write method has the required flexibility, resolution, and minimized proximity deposition for creating prototype devices. The devices were used to observe facet-dependent effects induced by mechanical stress on single ZnO pillar structures.

  5. Technical Design Report for the FACET-II Project at SLAC National Accelerator Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    2016-08-26

    Electrons can “surf” on waves of plasma – a hot gas of charged particles – gaining very high energies in very short distances. This approach, called plasma wakefield acceleration, has the potential to dramatically shrink the size and cost of particle accelerators. Research at the SLAC National Accelerator Laboratory has demonstrated that plasmas can provide 1,000 times the acceleration in a given distance compared with current technologies. Developing revolutionary and more efficient acceleration techniques that allow for an affordable high-energy collider has been the focus of FACET, a National User Facility at SLAC. FACET used part of SLAC’s two-mile-long linear accelerator to generate high-density beams of electrons and their antimatter counterparts, positrons. Research into plasma wakefield acceleration was the primary motivation for constructing FACET. In April 2016, FACET operations came to an end to make way for the second phase of SLAC’s x-ray laser, the LCLS-II, which will use part of the tunnel occupied by FACET. FACET-II is a new test facility to provide the unique capability to develop advanced acceleration and coherent radiation techniques with high-energy electron and positron beams. FACET-II represents a major upgrade over current FACET capabilities and the breadth of the potential research program makes it truly unique.

  6. Facile Synthesis of Gold Nanorice Enclosed by High- Index Facets and Its Application for CO Oxidation

    International Nuclear Information System (INIS)

    Zheng, Y.; Tao, J.; Liu, H.; Zeng, J.; Yu, T.; Ma, Y.; Moran, C.; Wu, L.; Zhu, Y.; Liu, J.; Xia, Y.

    2011-01-01

    A facile method for generating Au nanorice enclosed by high-index facets in high purity. The nanorice shows much higher catalytic activity for CO oxidation than multiply twinned particles of Au enclosed by {111} facets at temperatures below 300 C.

  7. Percutaneous pedicle screw reduction and axial presacral lumbar interbody fusion for treatment of lumbosacral spondylolisthesis: A case series

    Directory of Open Access Journals (Sweden)

    Miller Larry E

    2011-09-01

    Full Text Available Abstract Introduction Traditional surgical management of lumbosacral spondylolisthesis is technically challenging and is associated with significant complications. The advent of minimally invasive surgical techniques offers patients treatment alternatives with lower operative morbidity risk. The combination of percutaneous pedicle screw reduction and an axial presacral approach for lumbosacral discectomy and fusion offers an alternative procedure for the surgical management of low-grade lumbosacral spondylolisthesis. Case presentation Three patients who had L5-S1 grade 2 spondylolisthesis and who presented with axial pain and lumbar radiculopathy were treated with a minimally invasive surgical technique. The patients-a 51-year-old woman and two men (ages 46 and 50-were Caucasian. Under fluoroscopic guidance, spondylolisthesis was reduced with a percutaneous pedicle screw system, resulting in interspace distraction. Then, an axial presacral approach with the AxiaLIF System (TranS1, Inc., Wilmington, NC, USA was used to perform the discectomy and anterior fixation. Once the axial rod was engaged in the L5 vertebral body, further distraction of the spinal interspace was made possible by partially loosening the pedicle screw caps, advancing the AxiaLIF rod to its final position in the vertebrae, and retightening the screw caps. The operative time ranged from 173 to 323 minutes, and blood loss was minimal (50 mL. Indirect foraminal decompression and adequate fixation were achieved in all cases. All patients were ambulatory after surgery and reported relief from pain and resolution of radicular symptoms. No perioperative complications were reported, and patients were discharged in two to three days. Fusion was demonstrated radiographically in all patients at one-year follow-up. Conclusions Percutaneous pedicle screw reduction combined with axial presacral lumbar interbody fusion offers a promising and minimally invasive alternative for the management

  8. Exploring relations among mindfulness facets and various meditation practices: Do they work in different ways?

    Science.gov (United States)

    Cebolla, Ausiàs; Campos, Daniel; Galiana, Laura; Oliver, Amparo; Tomás, Jose Manuel; Feliu-Soler, Albert; Soler, Joaquim; García-Campayo, Javier; Demarzo, Marcelo; Baños, Rosa María

    2017-03-01

    Several meditation practices are associated with mindfulness-based interventions but little is known about their specific effects on the development of different mindfulness facets. This study aimed to assess the relations among different practice variables, types of meditation, and mindfulness facets. The final sample was composed of 185 participants who completed an on-line survey, including information on the frequency and duration of each meditation practice, lifetime practice, and the Five Facet Mindfulness Questionnaire. A Multiple Indicators Multiple Causes structural model was specified, estimated, and tested. Results showed that the Model's overall fit was adequate: χ 2 (1045)=1542.800 (pmindfulness facets were uniquely related to the different variables and types of meditation. Our findings showed the importance of specific practices in promoting mindfulness, compared to compassion and informal practices, and they pointed out which one fits each mindfulness facet better. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Measured and predicted root-mean-square errors in square and triangular antenna mesh facets

    Science.gov (United States)

    Fichter, W. B.

    1989-01-01

    Deflection shapes of square and equilateral triangular facets of two tricot-knit, gold plated molybdenum wire mesh antenna materials were measured and compared, on the basis of root mean square (rms) differences, with deflection shapes predicted by linear membrane theory, for several cases of biaxial mesh tension. The two mesh materials contained approximately 10 and 16 holes per linear inch, measured diagonally with respect to the course and wale directions. The deflection measurement system employed a non-contact eddy current proximity probe and an electromagnetic distance sensing probe in conjunction with a precision optical level. Despite experimental uncertainties, rms differences between measured and predicted deflection shapes suggest the following conclusions: that replacing flat antenna facets with facets conforming to parabolically curved structural members yields smaller rms surface error; that potential accuracy gains are greater for equilateral triangular facets than for square facets; and that linear membrane theory can be a useful tool in the design of tricot knit wire mesh antennas.

  10. Growth of Au@Ag core-shell pentatwinned nanorods: tuning the end facets.

    Science.gov (United States)

    Zhang, Weiqing; Goh, Hao Ying Johnny; Firdoz, Shaik; Lu, Xianmao

    2013-09-16

    Au@Ag core-shell nanorods with tunable end facets are obtained by coating Au bipyramids (BPs) with Ag. The resultant nanorods exhibit a pentatwinned crystal structure with tips terminated with either {110} or {111} facets. The control over the end facets is achieved by varying the capping agents and tuning the reduction rate of Ag. Specifically, when Ag is reduced slowly, Au@Ag nanorods with flat {110} end facets are formed with cetyltrimethylammonium bromide (CTAB) as the capping agent. If CTAB is replaced with cetyltrimethylammonium chloride (CTAC), Au@Ag nanorods with tips terminated with {111} facets are obtained. However, at a high Ag reduction rate, dumbbell-shaped Au@Ag nanorods are formed, with either CTAB or CTAC as the capping agent. The morphological evolution of the nanorods in each case is closely followed and a growth mechanism is proposed. Copyright © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  11. When Ligand Exchange Leads to Ion Exchange: Nanocrystal Facets Dictate the Outcome.

    Science.gov (United States)

    Hewavitharana, Indika K; Brock, Stephanie L

    2017-11-28

    This study demonstrates that ligand exchange of nanocrystals (NCs) is not always an innocuous process, but can lead to facile (room temperature) ion exchange, depending on the surface crystal faceting. Rock salt PbTe NCs prepared as cubes with neutral facets undergo room-temperature ligand exchange with sulfide ions, whereas cuboctahedron-shaped particles with neutral {100} and polar {111} facets are transformed to PbS, driven by ion exchange along the ⟨111⟩ direction. Likewise, cation exchange (with Ag + ) occurs rapidly for cuboctahedra, whereas cubes remain inert. This dramatic difference is attributed to the relative surface area of {111} facets that promote rapid ion exchange and shows how facet engineering is a powerful knob for the control of reaction pathways in nanoparticles.

  12. Synthesis of anatase TiO2with exposed (100) facets and enhanced electrorheological activity.

    Science.gov (United States)

    He, Kai; Wen, Qingkun; Wang, Chengwei; Wang, Baoxiang; Yu, Shoushan; Hao, Chuncheng; Chen, Kezheng

    2017-11-08

    Herein, a simple hydrothermal method is employed to synthesize anatase TiO 2 with dominant (100) facets, as a precursor, using titanate nanofibers derived from alkali treatment. Scanning electron microscopy (SEM), transmission electron microscopy (TEM) and X-ray diffraction (XRD) are carried out to confirm the surface morphology and phase structure of the TiO 2 product. The formation mechanism of TiO 2 enclosed by (100) and (101) facets is deduced to be the selective adsorption of OH - on the (100) facets of anatase TiO 2 . Electroheological (ER) experiments indicate that the tetragonal-facet-rod anatase TiO 2 with exposed (100) facets exhibits an excellent ER performance with a high ER efficiency of up to 52.5, which results from the anisotropy of its special morphology. In addition, the effect of shape on its dielectric property is investigated via broadband dielectric spectroscopy.

  13. On the spectrum of facet crystallization waves at the smooth 4He crystal surface

    International Nuclear Information System (INIS)

    Burmistrov, S.N.

    2011-01-01

    The wavelike processes of crystallization and melting or crystallization waves are well known to exist at the 4 He crystal surface in the rough state. Much less is known about crystallization waves for the 4 He crystal surface in the smooth well-faceted state below the roughening transition temperature. To meet the lack, we analyze here the spectrum of facet crystallization waves and its dependence upon the wavelength, perturbation amplitude, and the number of possible facet steps distributed somehow over the wavelength. All the distinctive features of facet crystallization waves from conventional waves at the rough surface result from a nonanalytic cusplike behavior in the angle dependence for the surface tension of smooth crystal facets.

  14. Polarity of prismatic facets delimiting WC grains in WC-Co alloys.

    Science.gov (United States)

    Lay, Sabine; Donnadieu, Patricia; Loubradou, Marc

    2010-07-01

    This study reports a determination of the polarity of WC facets in WC-Co alloys sintered at the liquid state. In these alloys, WC grains are delimited by basal facets and two sets of {10 10} prismatic facets, one set of facets being much more developed than the other. A variation of the shape is observed as a function of the composition of the alloy. High resolution transmission electron microscopy is used to investigate the polarity of the prismatic facets owing to the typical triangular patterns appearing on the images. The effect of the composition is investigated using two alloys with different carbon potentials and one containing VC and Cr(3)C(2) as grain growth inhibitors. The interpretation of the images shows that in all cases, the same set of prismatic planes is favoured. Copyright 2010 Elsevier Ltd. All rights reserved.

  15. Percutaneous vertebral augmentation for painful osteolytic vertebral metastasis: a case report

    Directory of Open Access Journals (Sweden)

    Anselmetti GC

    2012-03-01

    Full Text Available Giovanni C Anselmetti1, Sean M Tutton2, Francis R Facchini3, Larry E Miller4,5, Jon E Block51Institute for Cancer Research and Treatment, Turin, Italy; 2Medical College of Wisconsin in Milwaukee, Froedtert Memorial Lutheran Hospital, Milwaukee, WI, USA; 3Interventional Radiology, Interventional Oncology, VIR Chicago, Hinsdale, IL, USA; 4Miller Scientific Consulting, Inc, Arden, NC, USA; 5The Jon Block Group, San Francisco, CA, USAIntroduction: Vertebral metastases are associated with significant pain, disability, and morbidity. Open surgery for fracture stabilization is often inappropriate in this population due to a poor risk-benefit profile, particularly if life expectancy is short. Percutaneous vertebroplasty and kyphoplasty are appealing adjunctive procedures in patients with malignancy for alleviation of intractable pain. However, these patients have higher risk of serious complications, notably cement extravasation. Described in this report is a case of a painful osteolytic vertebral metastasis that was successfully treated by a novel percutaneous vertebral augmentation system.Case presentation: A 42-year-old Caucasian female presented with a history of metastatic lung cancer unresponsive to radiation and chemotherapy with symptoms inadequately controlled by opiates over the previous 6 months. Magnetic resonance imaging and spiral computed tomography with two-dimensional reconstruction showed an osteolytic vertebral metastasis with complete involvement of the T10 vertebral body, extending to the cortical vertebral wall anteriorly and posteriorly. The patient was treated with percutaneous vertebral augmentation (Kiva® VCF Treatment System, Benvenue Medical, Inc, Santa Clara, CA utilizing a novel coil-shaped polyetheretherketone implant designed to minimize the risk of cement extravasation. After the minimally invasive procedure, bone cement distribution within the vertebral body was ideal, with no observed cement extravasation. No

  16. Percutaneous CT-Guided Cryoablation as an Alternative Treatment for an Extensive Pelvic Bone Giant Cell Tumor

    Energy Technology Data Exchange (ETDEWEB)

    Panizza, Pedro Sergio Brito; Albuquerque Cavalcanti, Conrado Furtado de [Sírio Libânes Hospital, Radiology and Imaged Guided Intervention Service (Brazil); Yamaguchi, Nise Hitomi [Instituto Avanços em Medicina (Brazil); Leite, Claudia Costa; Cerri, Giovanni Guido; Menezes, Marcos Roberto de, E-mail: marcos.menezes@hc.fm.usp.br [Sírio Libânes Hospital, Radiology and Imaged Guided Intervention Service (Brazil)

    2016-02-15

    A giant cell tumor (GCT) is an intermediate grade, locally aggressive neoplasia. Despite advances in surgical and clinical treatments, cases located on the spine and pelvic bones remain a significant challenge. Failure of clinical treatment with denosumab and patient refusal of surgical procedures (hemipelvectomy) led to the use of cryoablation. We report the use of percutaneous CT-guided cryoablation as an alternative treatment, shown to be a minimally invasive, safe, and effective option for a GCT with extensive involvement of the pelvic bones and allowed structural and functional preservation of the involved bones.

  17. Percutaneous CT-Guided Cryoablation as an Alternative Treatment for an Extensive Pelvic Bone Giant Cell Tumor.

    Science.gov (United States)

    Panizza, Pedro Sergio Brito; de Albuquerque Cavalcanti, Conrado Furtado; Yamaguchi, Nise Hitomi; Leite, Claudia Costa; Cerri, Giovanni Guido; de Menezes, Marcos Roberto

    2016-02-01

    A giant cell tumor (GCT) is an intermediate grade, locally aggressive neoplasia. Despite advances in surgical and clinical treatments, cases located on the spine and pelvic bones remain a significant challenge. Failure of clinical treatment with denosumab and patient refusal of surgical procedures (hemipelvectomy) led to the use of cryoablation. We report the use of percutaneous CT-guided cryoablation as an alternative treatment, shown to be a minimally invasive, safe, and effective option for a GCT with extensive involvement of the pelvic bones and allowed structural and functional preservation of the involved bones.

  18. Percutaneous management of prosthetic valve thrombosis.

    Science.gov (United States)

    Hariram, Vuppaladadhiam

    2014-01-01

    Thrombosis of a prosthetic valve is a serious complication in patients with prosthetic heart valves. Thrombolysis is the initial choice of treatment. Patients who do not respond to thrombolysis are subjected to surgery which carries a high risk. We report a case series of 5 patients with prosthetic mitral valve thrombosis who did not respond to thrombolysis and were subjected to percutaneous manipulation of the prosthetic valves successfully and improved. Five patients who were diagnosed to have prosthetic mitral valve thrombosis and failed to respond to a minimum of 36 h of thrombolysis (persistent symptoms with increased gradients, abnormal findings on fluoroscopy),were subjected to percutaneous treatment after receiving proper consent. None of them had a visible thrombus on transthoracic echocardiogram. All patients underwent transseptal puncture following which a 6F JR4 guiding catheter was passed into the left atrium. The valve leaflets were repeatedly hit gently under fluoroscopic guidance till they regained their normal mobility. Mean age was 38.8 years. Average peak and mean gradients prior to the procedure were 38 and 25 and after the procedure were 12 and 6 mm of Hg respectively. All patients had successful recovery of valve motion on fluoroscopy with normalization of gradients and complete resolution of symptoms. None of the patients had any focal neurological deficits, embolic manifestations or bleeding complications. Percutaneous manipulation of prosthetic valves in selected patients with prosthetic valve thrombosis who do not respond to thrombolytic therapy is feasible and can be used as an alternative to surgery. Copyright © 2014 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

  19. Percutaneous distraction osteogenesis for treatment of brachymetatarsia.

    Science.gov (United States)

    Lamm, Bradley M

    2010-01-01

    Brachymetatarsia is not an unusual deformity and is often associated with functional and cosmetic issues that warrant surgical reconstruction. Lengthening of the affected metatarsal can be undertaken on an acute basis in a single operative procedure that involves the use of a bone graft or by means of gradual callus distraction. Because of the risk of metatarsophalangeal joint malalignment, it is important for the surgeon to take steps to stabilize the joint during the lengthening process. In this report, a percutaneous method of callus distraction for repair of brachymetatarsia and maintenance of metatarsophalangeal joint alignment is presented. Copyright 2010 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  20. Percutaneous treatment of lumbar disc herniation

    Energy Technology Data Exchange (ETDEWEB)

    Leonardi, M.; Resta, F.; Bettinelli, A. [Ospedale Maggiore di Milano (Italy); Lavaroni, A.; Fabris, G. [Ospedale Civile di Udine (Italy); Abelli, F. [Fondazione Clinica del Lavorno, Pavia (Italy)

    1994-12-31

    918 patients were subjected to percutaneous treatment of lumbar herniated disc. 733 of these were treated through enzymatic nucleolysis with chymopapain, for a total 883 levels. Chemonucleolysis was carried out on 733 patients (79.8%). Automated discectomy has been carried out in 185 cases (20.1%). Chemonucleolysis has led to the resolution of the symptoms in a high percentage of cases (82.2%). Nucleotomy has proved to be an effective method in 74.6% of cases. (author). 7 refs, 6 figs, 1 tab.

  1. Percutaneous catheter dilatation of carotid stenoses

    International Nuclear Information System (INIS)

    Mathias, K.; Mittermayer, C.; Ensinger, H.; Neff, W.

    1980-01-01

    Thirty-one carotid artery stenoses were produced in thirty dogs by three different techniques. Twenty-three of these could be cured by transfemoral percutaneous catheter dilatation. High grade tight stenoses may present resistance which cannot be overcome by the catheter. Histological examination of the dilated vessels showed circumscribed changes in the vessel wall, with destruction of elastic membranes. From our experience of catheter dilatation of pelvic and lower limb arteries and of renal arteries, we consider it feasible to use this technique in selected patients with carotid stenosis. (orig.) [de

  2. US and RTG guided percutaneous biliary drainage

    International Nuclear Information System (INIS)

    Bukowski, J.

    1994-01-01

    Under combined US and fluoroscopic guidance from anterior approach through left liver lobe a Seldinger technique was used for biliary drainage in 46 patients with nonresectable malignant biliary obstruction. In 9 cases of hilar tumor separating both hepatic ducts a second catheter was inserted through right liver lobe. In 11 cases an internal-external drainage was established. In 3 cases the externally drained bile was recycled by connecting the transhepatic catheter to a percutaneous gastrostomy also performed under US guidance. No severe complications were observed. A described drainage technique provides an effective palliative intervention for advanced biliary malignancies. (author)

  3. Percutaneous Cryoablation and Vertebroplasty: A Case Report

    International Nuclear Information System (INIS)

    Masala, Salvatore; Roselli, Mario; Manenti, Guglielmo; Mammucari, Matteo; Bartolucci, Dario Alberto; Simonetti, Giovanni

    2008-01-01

    A 70-year-old man with a painful vertebral metastasis was treated with combined percutaneous cryoablation and vertebroplasty therapy (CVT) in one session. The patient was suffering from diffuse visceral metastasized cholangiocarcinoma. After several weeks of back pain, magnetic resonance imaging documented a single L2 bone metastasis. In consultation with the oncologists, palliative combined CVT was administered with the aim of obtaining pain relief and bone stabilization. In our experience this combined treatment is safe and effective for immediate pain relief in painful bone metastases when other standard palliative treatments have failed

  4. Percutaneous biliary drainage in patients with cholangiocarcinoma

    International Nuclear Information System (INIS)

    Mehta, A.C.; Gobel, R.J.; Rose, S.C.; Hayes, J.K.; Miller, F.J.

    1990-01-01

    This paper determines whether radiation therapy (RT) is a risk factor for infectious complications (particularly hepatic abscess formation) related to percutaneous biliary drainage (PBD). The authors retrospectively reviewed the charts of 98 consecutive patients who had undergone PBD for obstruction. In 34 patients with benign obstruction, three infectious complications occurred, none of which were hepatic abscess or fatal sepsis. In 39 patients who had malignant obstruction but did not have cholangiocarcinoma, 13 infectious complications occurred, including two hepatic abscesses and three cases of fatal sepsis. Of the 25 patients with cholangiocarcinoma, 15 underwent RT; in these 15 patients, 14 infectious complications occurred, including six hepatic abscesses and two cases of fatal sepsis

  5. Is percutaneous microwave ablation of liver tumor safe for patients with renal dysfunction

    International Nuclear Information System (INIS)

    Liu Cun; Wang Yang; Yu Xiaoling; Dong Baowei; Zhou Pei; Ren He; Liang Ping

    2011-01-01

    Purpose: To determine the safety of percutaneous microwave ablation of primary and metastatic liver tumor for patients with renal dysfunction. Materials and methods: Fifty primary and metastatic liver tumors in 23 patients with renal dysfunction were retrospectively reviewed at our institution. Renal function was determined by measuring serum creatinine and serum urea before MWA as baseline, within 1 week and at last follow-up. The mean creatinine was 1.69 ± 0.32 mg/dL, 1.71 ± 0.33 mg/dL, and 1.71 ± 0.26 mg/dL respectively, there was not a statistically significant difference between baseline and at last follow-up (P = 0.26). The mean serum urea was 52.52 ± 6.48 mg/dL, 56.55 ± 14.72 mg/dL, and 57.90 ± 16.39 mg/dL respectively, there was not a statistically significant difference between baseline and within 1 week (P = 0.119), between within baseline and at last follow-up (P = 0.090). At the last follow-up examination, all patients had adequately functioning kidneys and did not require any form of renal replacement therapy. This is a small retrospectively study including highly selected patients treated. Therefore, further study should to determine the safety of percutaneous MWA for patients with renal dysfunction in the future. Conclusions: Percutaneous microwave ablation of primary and metastatic liver tumor is no adverse influence on renal function for patients with renal dysfunction in this preliminary series, which can be a minimally invasive alternative therapy.

  6. MR imaging-guided percutaneous cryotherapy for lung tumors: initial experience.

    Science.gov (United States)

    Liu, Shangang; Ren, Ruimei; Liu, Ming; Lv, Yubo; Li, Bin; Li, Chengli

    2014-09-01

    To evaluate prospectively the initial clinical experience of magnetic resonance (MR) imaging-guided percutaneous cryotherapy of lung tumors. MR imaging-guided percutaneous cryotherapy was performed in 21 patients with biopsy-proven lung tumors (12 men, 9 women; age range, 39-79 y). Follow-up consisted of contrast-enhanced chest computed tomography (CT) scan performed at 3-month intervals to assess tumor control; CT scanning was carried out for 12 months or until death. Cryotherapy procedures were successfully completed in all 21 patients. Pneumothorax occurred in 7 (33.3%) of 21 patients. Chest tube placement was required in one (4.8%) case. Hemoptysis was exhibited by 11 (52.4%) patients, and pleural effusion occurred in 6 (28.6%) patients. Other complications were observed in 14 (66.7%) patients. The mean follow-up period was 10.5 months (range, 9-12 mo) in patients who died. At month 12 of follow-up, 7 (33.3%) patients had a complete response to therapy, and 10 (47.6%) patients showed a partial response. In addition, two patients had stable disease, and two patients developed progressive disease; one patient developed a tumor in the liver, and the other developed a tumor in the brain. The 1-year local control rate was 81%, and 1-year survival rate was 90.5%. MR imaging-guided percutaneous cryotherapy appears feasible, effective, and minimally invasive for lung tumors. Copyright © 2014 SIR. Published by Elsevier Inc. All rights reserved.

  7. Long-Term Results of Percutaneous Bilioenteric Anastomotic Stricture Treatment in Liver-Transplanted Children

    International Nuclear Information System (INIS)

    Moreira, Airton Mota; Carnevale, Francisco Cesar; Tannuri, Uenis; Suzuki, Lisa; Gibelli, Nelson; Maksoud, Joao Gilberto; Cerri, Giovanni Guido

    2010-01-01

    The purpose of this study was to evaluate the mid- and long-term results of percutaneous transhepatic cholangiography (PTC) and biliary drainage in children with isolated bilioenteric anastomotic stenosis (BAS) after pediatric liver transplantation. Sixty-four children underwent PTC from March 1993 to May 2008. Nineteen cholangiograms were normal; 10 showed intrahepatic biliary stenosis and BAS, and 35 showed isolated BAS. Cadaveric grafts were used in 19 and living donor grafts in 16 patients. Four patients received a whole liver, and 31 patients received a left lobe or left lateral segment. Roux-en-Y hepaticojejunostomy was performed in all patients. Indication for PTC was based on clinical, laboratory, and histopathologic findings. In patients with isolated BAS, dilation and biliary catheter placement, with changes every 2 months, were performed. Patients were separated into 4 groups according to number of treatment sessions required. The drainage catheter was removed if cholangiogram showed no significant residual stenosis and normal biliary emptying time after a minimum of 6 months. The relationship between risk factors (recipient's weight 20 months, 4 patients (4 of 35; 11.4%) required 1 additional treatment session (group III), and 1 patient (1 of 35; 2.9%) had a catheter placed at the end of the study period (group IV). Drainage time in group I was significantly shorter than those in groups II, III, and IV (p 0.05). The majority of complications, such as catheter displacement and leakage, were classified as minor; however, 2 patients (5.7%) with hemobilia were noted. Complications increased according to the need for reintervention. In conclusion, balloon dilation and percutaneous drainage placement is safe and effective, and it has long-term patency for children with BAS after liver transplantation. Because of prolonged treatment time, reintervention may be necessary, thereby increasing the complication rate. Balloon dilation and percutaneous drainage

  8. Is percutaneous microwave ablation of liver tumor safe for patients with renal dysfunction

    Energy Technology Data Exchange (ETDEWEB)

    Liu Cun [Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853 (China); Department of Ultrasound, Jinan Central Hospital, Shandong University, 105 Jiefang Xi Road, Jinan, Shandong 250013 (China); Wang Yang; Yu Xiaoling; Dong Baowei; Zhou Pei; Ren He [Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853 (China); Liang Ping, E-mail: liangping301@hotmail.com [Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853 (China)

    2011-08-15

    Purpose: To determine the safety of percutaneous microwave ablation of primary and metastatic liver tumor for patients with renal dysfunction. Materials and methods: Fifty primary and metastatic liver tumors in 23 patients with renal dysfunction were retrospectively reviewed at our institution. Renal function was determined by measuring serum creatinine and serum urea before MWA as baseline, within 1 week and at last follow-up. The mean creatinine was 1.69 {+-} 0.32 mg/dL, 1.71 {+-} 0.33 mg/dL, and 1.71 {+-} 0.26 mg/dL respectively, there was not a statistically significant difference between baseline and at last follow-up (P = 0.26). The mean serum urea was 52.52 {+-} 6.48 mg/dL, 56.55 {+-} 14.72 mg/dL, and 57.90 {+-} 16.39 mg/dL respectively, there was not a statistically significant difference between baseline and within 1 week (P = 0.119), between within baseline and at last follow-up (P = 0.090). At the last follow-up examination, all patients had adequately functioning kidneys and did not require any form of renal replacement therapy. This is a small retrospectively study including highly selected patients treated. Therefore, further study should to determine the safety of percutaneous MWA for patients with renal dysfunction in the future. Conclusions: Percutaneous microwave ablation of primary and metastatic liver tumor is no adverse influence on renal function for patients with renal dysfunction in this preliminary series, which can be a minimally invasive alternative therapy.

  9. Percutaneous osteoid osteoma treatment with combination of radiofrequency and alcohol ablation

    International Nuclear Information System (INIS)

    Akhlaghpoor, S.; Tomasian, A.; Arjmand Shabestari, A.; Ebrahimi, M.; Alinaghizadeh, M.R.

    2007-01-01

    Aim: To assess the efficacy of percutaneous osteoid osteoma treatment using a combination of radiofrequency ablation (RFA) and alcohol ablation with regard to technical and long-term clinical success. Materials and methods: From December 2001 to November 2004, RFA and subsequent alcohol ablation was performed on 54 patients with osteoid osteoma, diagnosed clinically using radiography, computed tomography (CT) and symptoms. Under general anaesthesia, treatment was performed via percutaneous access under thin section (2 mm) spiral CT guidance in all cases with an 11 G radiofrequency-compatible coaxial needle and 2 mm coaxial drill system and 1.0 cm active tip 17 G non-cooled radiofrequency needle. RFA was performed at 90 o C for a period of 6 min. After needle removal, 0.5-1.0 ml absolute alcohol (99.8% concentration) was injected directly into the nidus using a 20 G needle. Patients were discharged within 24 h and followed up clinically (at 1 week, 1 month and every 3 months thereafter). Results: The technical success rate was 100%. Complications occurred in two patients consisting of local mild cellulitis in entry site and peripheral small zone paresthesia on the anterior part of leg. The follow-up period range was 13-48 months (mean ± SD, 28.2 ± 7.4 months). Prompt pain relief and return to normal activities were observed in 52 of 54 patients. Recurrent pain occurred in two patients after a 1 and 3 months period of being pain free, respectively; a second RFA and alcohol ablation was performed achieving successful results. Primary and secondary clinical success rates were 96.3% (52/54 patients) and 100% (2/2 patients), respectively. Conclusion: Percutaneous osteoid osteoma treatment with combination of radiofrequency and alcohol ablation is safe, effective and minimally invasive with high primary and secondary success rates. Persistent or recurrent lesions can be effectively re-treated

  10. Cervical degenerative spondylolisthesis: analysis of facet orientation and the severity of cervical spondylolisthesis.

    Science.gov (United States)

    Xu, Cong; Lin, Bingquan; Ding, Zihai; Xu, Yikai

    2016-01-01

    Previous studies have shown an association between the degree of cervical degenerative spondylolisthesis (DS) and spinal cord conditions of the cervical spine. However, there is no information available on the association between the severity of cervical DS and the orientation of the cervical facet joints. This study examined the association between the severity of cervical DS and facet tropism. This study aimed to retrospectively explore the relationship between facet tropism and cervical DS and the effect of facet tropism on cervical DS. A retrospective review of radiographic and magnetic resonance imaging (MRI) findings in patients with or without cervical DS was carried out. A total of 200 patients from a single institution who underwent both MRI and radiography were reviewed. The facet angles at the C3-C4, C4-C5, and C5-C6 levels based on axial MRI in the two groups and the slippage degree at C4-C5 based on neutral lateral radiographs in the experimental group were measured and calculated. One hundred patients with only C4-C5 level cervical DS who were treated in our hospital from January 2005 to August 2011 were selected as the experimental group. One hundred age- and sex-matched spinal disease-free patients were selected as the control group from patients who presented for physical examinations. Comparative analysis of the obtained parameters was performed to determine significant differences between the examined levels in the two groups and to investigate the association between cervical DS and facet tropism. Facet tropism at C4-C5 was significantly greater than that at C3-C4 and C5-C6 in the experimental group (C4-C5 vs. C3-C4, pspondylolisthesis patients was significantly greater than that in the severe spondylolisthesis patients (p=.036), but facet tropism severity did not vary with the degree of spondylolisthesis in the experimental group (p=.108). This study revealed that facet tropism is universally present at the C3-C4, C4-C5, and C5-C6 levels and

  11. Our initial experience with percutaneous nephrolithotomy in children

    Directory of Open Access Journals (Sweden)

    Mehmet Hanifi Okur

    2014-03-01

    Full Text Available Objective: To present our initial experience on percutaneous nephrolithotomy (PCNL in children between March 2012 and November 2013. Methods: 13 renal units of 12 patients underwent PCNL. Patients were evaluated in terms of age, preoperatively in terms of urine, blood count, urine culture, serum biochemical, and routine coagulation tests and radiological examinations, stone location, stone burden (according to plain radiograph, preoperative use of nephrostomy and average fluoroscopic manipulation time. To facilitate access, prior mechanical dilatation was performed nephrostomy access tract. After the PCNL procedure, we placed nephrostomy in all patients postoperatively. They were evaluated with regard to residual stone, complications (according to the Clavien classification and outcomes. Results: Average age was 11 years (6-15. There was no abnormality in Laboratory Screening. Location of 11 stones was renal pelvis and 2 stones was pelvis + calyx. The average stone size was 260 mm². Preoperative acces were provided in 3 patients, others were intraoperatively. Average fluoroscopic manipulation time was 4,8 minutes (2-11. At the first postoperative day, 11 (85 % patients achieved a completely stone-free state. Complications were seen in 3 patients; failure of renal access in one patient (Grade 3b, urine leakage was observed after surgery in one (Grade 3a, postoperative blood transfusion required in one patient (Grade 2. The hospital stay duration was 5,5 days (5-7 days. Conclusions: Pediatric PCNL is a minimal invasive procedure which provides high rate of stone free and good cosmetics. İf there is adequate facilities and equipment with experienced persons, this procedure can easily be used in pediatric surgery clinics.

  12. Percutaneous Ultrasound-Guided Hydrodissection of a Symptomatic Sural Neuroma.

    Science.gov (United States)

    Fader, Ryan R; Mitchell, Justin J; Chadayammuri, Vivek P; Hill, John; Wolcott, Michelle L

    2015-11-01

    Symptomatic neuromas of the sural nerve are a rare but significant cause of pain and debilitation in athletes. Presentation is usually in the form of chronic pain and dysesthesias or paresthesias of the lateral foot and ankle. Treatment traditionally ranges from conservative measures, such as removing all external compressive forces, to administration of nonsteroidal anti-inflammatory drugs, vitamin B6, tricyclic antidepressants, antiepileptics, or topical anesthetics. This article reports a case of sural nerve entrapment in a 34-year-old male triathlete with a history of recurrent training-induced right-sided gastrocnemius strains. The patient presented with numbness in the right lateral foot and ankle that had persisted for 3 months, after he was treated unsuccessfully with extensive nonoperative measures, including anti-inflammatory drugs, activity modification, and a dedicated physical therapy program of stretching and strengthening. Orthopedic assessment showed worsening pain with forced passive dorsiflexion and manual pressure applied over the distal aspect of the gastrocnemius. Plain radiographs showed normal findings, but in-office ultrasound imaging showed evidence of sural nerve entrapment with edema and neuromatous scar formation in the absence of gastrocnemius or soleus pathology. Percutaneous ultrasound-guided hydrodissection of the sural nerve at the area of symptomatic neuroma and neural edema was performed the same day. The patient had complete relief of symptoms and full return to the preinjury level of participation in competitive sports. This case report shows that hydrodissection, when performed by an experienced physician, can be an effective, minimally invasive technique for neurolysis in the setting of sural nerve entrapment, resulting in improvement in clinical symptoms. Copyright 2015, SLACK Incorporated.

  13. National invasive species program

    Science.gov (United States)

    Anna Rinick

    2007-01-01

    The structure and function of the National Invasive Species Council was presented below. The names and contact information for the USDA Invasive Species coordinators as of February 2006 were presented on the next page.

  14. Effectiveness and Complications of Percutaneous Needle Tenotomy with a Large Needle for Muscle Contractures: A Cadaver Study.

    Science.gov (United States)

    Chesnel, Camille; Genêt, François; Almangour, Waleed; Denormandie, Philippe; Parratte, Bernard; Schnitzler, Alexis

    2015-01-01

    Twenty-two percent of institutionalised elderly persons have muscle contractures. Contractures have important functional consequences, rendering hygiene and positioning in bed or in a chair difficult. Medical treatment (such as botulinum toxin injections, physiotherapy or positioning) is not very effective and surgery may be required. Surgery is carried out in the operating theatre, under local or general anaesthesia but is often not possible in fragile patients. Mini-invasive tenotomy could be a useful alternative as it can be carried out in ambulatory care, under local anaesthesia. To evaluate the effectiveness of percutaneous needle tenotomy and the risks of damage to adjacent structures in cadavers. Thirty two doctors who had never practiced the technique (physical medicine and rehabilitation specialists, geriatricians and orthopaedic surgeons) carried out 401 tenotomies on the upper and lower limbs of 8 fresh cadavers. A 16G needle was used percutaneous following location of the tendons. After each tenotomy, a neuro-orthopaedic surgeon and an anatomist dissected the area in order to evaluate the success of the tenotomy and any adjacent lesions which had occurred. Of the 401 tenotomies, 72% were complete, 24.9% partial and 2.7% failed. Eight adjacent lesions occurred (2%): 4 (1%) in tendons or muscles, 3 (0.7%) in nerves and 1 (0.2%) in a vessel. This percutaneous needle technique effectively ruptured the desired tendons, with few injuries to adjacent structures. Although this study was carried out on cadavers, the results suggest it is safe to carry out on patients.

  15. Detailed examination of the lower cervical spine facet joints in a road traffic crash fatality - a case study

    DEFF Research Database (Denmark)

    Uhrenholt, Lars; Nielsen, Edith; Vesterby, Annie

    2005-01-01

    The lower cervical spine facet joints of a road traffic crash fatality were examined using diagnostic imaging and histological techniques. No injuries to the cervical spine facet joints could be identified with diagnostic imaging including conventional radiology, CT and MRI. Examination of stained...... histological sections visualised the morphology and integrity of the facet joints in detail. Occult injuries to and in close proximity of the cervical spine facet joints were identified only on histological examination....

  16. Percutaneous Reduction and Screw Fixation of Displaced Intra-articular Fractures of the Calcaneus.

    Science.gov (United States)

    Tantavisut, Saran; Phisitkul, Phinit; Westerlind, Brian O; Gao, Yubo; Karam, Matthew D; Marsh, John L

    2017-04-01

    Extensile open approaches to reduce and fix intra-articular calcaneal fractures are associated with high levels of wound complications. To avoid these complications, a technique of percutaneous reduction and fixation with screws alone was developed. This study assessed the clinical outcomes, radiographs, and postoperative CT scans after operative treatment with this technique. 153 consecutive patients with 182 intra-articular calcaneal fractures were reviewed. All patients were assessed for early postoperative complications at 3 months from the injury. The clinical results were assessed for patients seen at a minimum of 1 year after surgery (mean follow-up of 2.6 years; 90 patients, 106 feet). In patients who had both preoperative and postoperative CT scans (50 patients, 60 feet), the articular reduction was quantitatively analyzed. At the 3-month follow-up, there were 1% superficial infections and 1% rate of screw irritation. The complications at a minimum of 1 year after injury included screw irritation 9.3%, subtalar osteoarthritis requiring subtalar fusion 5.5%, malunion 1.8%, and deep infection 0.9%. Bohler angle, calcaneal facet height, and width were significantly improved postoperatively ( P fractures using screws alone based on articular reduction and level of residual pain. Level IV, retrospective case series.

  17. The fullendoscopic anterior cervical fusion: a new horizon for selective percutaneous endoscopic cervical decompression.

    Science.gov (United States)

    Hellinger, S

    2011-01-01

    As a bridge between open and percutaneous therapy, endoscopy of the cervical spine started to be used at the beginning of the 1990s, following good experiences on the lumbar spine. The principle of microsurgery is combined with the minimally invasive principles by bringing the optical level to the forefront of pathology. Access morbidity has been significantly reduced by the percutaneous access technique. However, this procedure cannot be applied in patients with cervical disc herniation accompanied by segmental instability.In further developing these endoscopic techniques, in view of the experiences with the classical "Cloward procedure", the aim was to do a bony fusion of the intervertebral space of the cervical spine by endoscopic access. A female patient with postraumatic instability of the cervical segments C4/5 underwent a fullendoscopic bony fusion. The technique will be described. The fusional process has been documented by CT and clinical assessment over 3 months. Having preoperative pain of VAS 8, it diminished to VAS 1 after surgery. The Ct-controls demonstrated a good placement of the bony dowel through the endoscopic sheath in the intervertebral space. After 3 months a bony fusion was documented by CT and in bending X-ray. The result of this method displays that a fullendoscopic fusion of the cervical spine with a bone dowel is possible. The clinical result seems to be comparable to the classical Cloward procedure. To the best of my knowledge, this is the first report of a fullendoscopic osseous fusion on the cervical spine.

  18. [Image-guided bone consolidation in oncology: Cementoplasty and percutaneous screw fixation].

    Science.gov (United States)

    Buy, Xavier; Cazzato, Roberto Luigi; Catena, Vittorio; Roubaud, Guilhem; Kind, Michele; Palussiere, Jean

    2017-05-01

    Bone metastases are a common finding in oncology. They often induce pain but also fractures which impair quality of life, especially when involving weight-bearing bones. Percutaneous image-guided consolidation techniques play a major role for the management of bone metastases. Cementoplasty aims to stabilize bone and control pain by injecting acrylic cement into a weakened bone. This minimally invasive technique has proven its efficacy for bones submitted to compression forces: vertebra, acetabular roof, and condyles. However, long bone diaphysis should be treated with caution due to lower resistance of the cement subject to torsional forces. The recent improvements of navigation systems allow percutaneous image-guided screw fixation without requiring open surgery. This fast-track procedure avoids postponing introduction of systemic therapies. If needed, cementoplasty can be combined with screw insertion to ensure better anchoring in major osteolysis. Interventional radiology bone consolidation techniques increase the therapeutic field in oncology. A multidisciplinary approach remains mandatory to select the best indications. Copyright © 2017 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

  19. Percutaneous Ventricular Restoration with a Partitioning Device for Ischemic Heart Failure Treatment.

    Science.gov (United States)

    Dhakal, Bishnu P; Oliveira, Guilherme H

    2017-04-01

    Percutaneous ventricular restoration with a ventricular partitioning device (VPD) is a novel minimally invasive procedure designed to restore the left ventricular (LV) shape by isolating the infarcted and aneurysmal LV apex from remainder of the cavity in heart failure patients with severely reduced LV ejection fraction. In this review, we perform an in-depth analysis of the design and purpose of the VPD and review the available clinical data, with special attention to hemodynamics, outcomes, and complications. PARACHUTE trials have shown >90% procedural success rate of VPD implant. Heart failure patients had improvement in hemodynamics (reduction in LV volumes and increase in LV ejection fraction) and functional status (6-min walking distance and quality of life scores) after the VPD implant. Optimal implant position is necessary to obtain a good clinical outcome. Percutaneous VPD implantation has thus far been a safe intervention capable of improving surrogate markers of heart failure but there is still a need to develop more durable devices with a long-lasting hemodynamics effect.

  20. Delayed Union of a Sacral Fracture: Percutaneous Navigated Autologous Cancellous Bone Grafting and Screw Fixation

    International Nuclear Information System (INIS)

    Huegli, R. W.; Messmer, P.; Jacob, A. L.; Regazzoni, P.; Styger, S.; Gross, T.

    2003-01-01

    Delayed or non-union of a sacral fracture is a serious clinical condition that may include chronic pain, sitting discomfort, gait disturbances, neurological problems, and inability to work. It is also a difficult reconstruction problem. Late correction of the deformity is technically more demanding than the primary treatment of acute pelvic injuries. Open reduction, internal fixation (ORIF), excision of scar tissue, and bone grafting often in a multi-step approach are considered to be the treatment of choice in delayed unions of the pelvic ring. This procedure implies the risk of neurological and vascular injuries, infection, repeated failure of union, incomplete correction of the deformity, and incomplete pain relief as the most important complications. We report a new approach for minimally invasive treatment of a delayed union of the sacrum without vertical displacement. A patient who suffered a Malgaigne fracture (Tile C1.3) was initially treated with closed reduction and percutaneous screw fixation (CRPF) of the posterior pelvic ring under CT navigation and plating of the anterior pelvic ring. Three months after surgery he presented with increasing hip pain caused by a delayed union of the sacral fracture. The lesion was successfully treated percutaneously in a single step procedure using CT navigation for drilling of the delayed union, autologous bone grafting, and screw fixation