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Sample records for minimal incision congenital

  1. [Is minimal skin incision and partial sternotomy approach for congenital heart defects less invasive?; evaluation of SIRS on ventricular septal defect].

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    Nishi, H; Nishigaki, K; Kume, Y; Miyamoto, K

    2002-03-01

    Minimally invasive cardiac surgery (MICS) has been developed to offer patients the benefits of open heart operations with limited skin incision. But it is unclear whether this procedure is less invasive. We evaluate postoperative duration of systemic inflammatory response syndrome (SIRS) on ventricular septal defect (VSD). From August 1997 to March 2000, 47 patients VSD underwent total repair by the minimal skin incision and lower partial median sternotomy (MICS group). We compared duration of SIRS between MICS and conventional method group (n = 14) and between early MICS and recent MICS group. We also evaluated the relationship between MICS and postoperative clinical course. Duration of SIRS of MICS group were obviously shorter than that of conventional method group (p SIRS. The results of this study indicate that MICS for VSD may be less invasive method.

  2. Minimally invasive "pocket incision" aortic valve surgery.

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    Yakub, M A; Pau, K K; Awang, Y

    1999-02-01

    A minimally invasive approach to aortic valve surgery through a transverse incision ("pocket incision") at the right second intercostal space was examined. Sixteen patients with a mean age of 30 years underwent this approach. The third costal cartilage was either excised (n = 5) or dislocated (n = 11). The right internal mammary artery was preserved. Cardiopulmonary bypass (CPB) was established with aortic-right atrial cannulation in all except the first case. Aortic valve replacements (AVR) were performed in 15 patients and one had aortic valve repair with concomitant ventricular septal defect closure. There was no mortality and no major complications. The aortic cross-clamp, CPB and operative times were 72 +/- 19 mins, 105 +/- 26 mins and 3 hrs 00 min +/- 29 mins respectively. The mean time to extubation was 5.7 +/- 4.0 hrs, ICU stay of 27 +/- 9 hrs and postoperative hospital stay of 5.1 +/- 1.2 days. Minimally invasive "pocket incision" aortic valve surgery is technically feasible and safe. It has the advantages of central cannulation for CPB, preservation of the internal mammary artery and avoiding sternotomy. This approach is cosmetically acceptable and allows rapid patient recovery.

  3. Isolated subtalar arthrodesis through minimal incision surgery.

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    Carranza-Bencano, A; Tejero-García, S; Del Castillo-Blanco, G; Fernández-Torres, J J; Alegrete-Parra, A

    2013-08-01

    In recent years there has been an increase in the use of minimally invasive techniques, such as arthroscopy, percutaneous, and minimally invasive incisions, for foot and ankle surgery. The purpose of this study was to analyze the fusion rate and clinical results of isolated subtalar arthrodesis (ISA) using the novel and original technique of minimal incision surgery (MIS). There were a total of 77 feet in 76 patients who underwent ISA and were followed for 50 months on average (range, 15-108). The first 30 cases were evaluated retrospectively, and 47 cases were evaluated prospectively. MIS without tourniquet was used in all cases and fusion was assessed radiographically and clinically. Clinical outcome measures used were the Angus and Cowell Scoring System, AOFAS Ankle-Hindfoot, the SF-36, and a patient satisfaction questionnaire 12 months after the intervention. Radiographic and clinical consolidation was achieved in 92% of cases. Main outcomes were "good" in 57 patients as determined by the Angus and Cowell criteria, with 13 "fair" and 7 "poor" results. In the prospective group, AOFAS scores improved by 47.6 points (95% CI: 50.7-42.5) 12 months after surgical intervention. SF-36 outcomes improved by 14.5 points (95% CI: 11.58-17.31) in the mental summary component and 4.2 points (95% CI: 2.2-6.1) in the physical summary component. We recorded no cases of early complications such as wound infections, neurovascular damage, or delayed wound healing. To our knowledge, the present series represents the largest study on subtalar arthrodesis using minimally invasive surgery. The data obtained showed a similar rate of bony union and clinical outcomes compared with the literature, but without early wound complications. ISA using the MIS technique was a good option for patients at greater risk of wound healing complications. Level IV, case series.

  4. Repair of congenital diaphragmatic hernias through umbilical skin incisions.

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    Uehara, Shuichiro; Usui, Noriaki; Kamiyama, Masafumi; Masahata, Kazunori; Nara, Keigo; Ueno, Takehisa; Soh, Hideki; Oue, Takaharu; Fukuzawa, Masahiro

    2013-05-01

    The use of thoracoscopy and laparoscopy in the treatment of congenital diaphragmatic hernias (CDHs) has been recently reported; however, the use of these procedures still remains controversial due to CO2 insufflation and limited working space. In addition, because of difficult techniques, it has not been widely accepted. Among CDH patients, mild cases whose lung is not hypoplastic, and not associated with persistent pulmonary hypertension of the neonate (PPHN) often develop small defects in the diaphragm that can be repaired using "direct closure." Because direct closure does not require as wide an operative field as that needed for patch closure, we repaired CDH through umbilical skin windows in two neonates with mild CDH to minimize the wounds. With the creation of additional radical small incisions, the surgeries were successfully performed without any intra- or postoperative complications, and the wounds were cosmetically pleasing. The repair of CDHs through umbilical skin windows is a feasible and useful approach in neonates with mild CDH.

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

    Institute of Scientific and Technical Information of China (English)

    Xin-Lei Xia; Hong-Li Wang; Fei-Zhou Lyu; Li-Xun Wang; Xiao-Sheng Ma; Jian-Yuan Jiang

    2015-01-01

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

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

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    Xin-Lei Xia

    2015-01-01

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

  7. MINIMALLY INVASIVE LOW-COLLAR INCISION IN THYROID LOBECTOMY

    Institute of Scientific and Technical Information of China (English)

    刘宝国; 王成学; 张乃嵩

    2003-01-01

    Objective: To report the development of a technique for minimally invasive thyroid lobectomy. Method: The procedure was accepted by 200 patients with a nodule of the lobe of the thyroid. We performed hemithyroidectomys through a 2-4 cm low-collar horizontal skin incision by conventional instrumentation. Results: The recurrent laryngeal nerve and the parathyroid glands were easily identified and preserved. The amount of bleeding ranged from 5 to 50 ml (mean 15 ml). Mean Operation time was 52.2 minutes (ranged 32 to 80 minutes). No complication occurred. Mean postoperative stay was 5.5 days (ranged 4 to 7 days). The incision provided excellent cometic results because the small and lower incisions were completely hidden by clothing collar. Conclusion: The above technique is feasible, safe, minimally invasive, less time and cost consuming and cosmetical.

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

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    Pérez-Flores, I

    2016-07-01

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

  9. Minimal incision access for pediatric and adult cochlear implantation

    Institute of Scientific and Technical Information of China (English)

    Cui Danmo; Shi Ying; Su Qiaotong; Liu Ting; Han Demin; Li Yongxin

    2014-01-01

    Background Cochlear implant surgery is widely practiced.Minimal incision cochlear implant surgery has been developed with the aims of reducing the impact of surgery on the patient and improving cosmesis while maintaining the low morbidity of conventional wider access approaches.This study aimed to assess the surgical technique and complication rate of minimal incision cochlear implantation (MICI) for children and adults.Methods Data for this study were obtained via a retrospective analysis.Totally 378 patients were included in the study.All patients received minimal incision cochlear implantation,using the skin protector during the process of the operation.The surgical complications of MICI were recorded in a spreadsheet format.The incidence of major and minor complication were analyzed,and appropriate treatment was provided.Results A total of 40 (10.5%) complications were noted in the study.There were 0 life-threatening,9 major,and 31 minor complications.Of the nine major complications,five were device failures,one developed infection and extrusion,and three required receiver-stimulator repositioning.Conclusions MICI is as safe as standard cochlear implantation (SCI) and affords with it other benefits.Eliminating the scalp flap avoids devascularization and minimizes the opportunity of flap infection or necrosis.Complications not related to the flap are similar to SCI.

  10. 先天性心脏病患儿行腋下途径微创封堵术的围手术期护理%Perioperative nursing care of congenital heart disease underwent minimally invasive occlusion surgery via subaxillay incision

    Institute of Scientific and Technical Information of China (English)

    张林虹; 赵永红; 宋葆云

    2015-01-01

    Objective To explore the perioperative nursing method and effect of doing minimal invasive occlusion to children with congenital heart disease via subaxillary incision.Methods The data of 86 children patients with congenital heart disease underwent minimally invasive occlusion via right subaxillary incision were retrospectively analyzed and summarized nursing points including preoperative and postoperative mental nursing,postoperative postural care and sedative care,observing whether the occluder moved or detached and mechanical hemolysis,monitoring ECG and blood pressure,and preventing hemorrhage and thrombogenesis.Results One case of infracristal ventricular septal defect with frequent premature ventricular beat after occlusion was converted to thoracotomy surgery;one case of mixed atrial septal defect with heart rate increasing and dyspnea after 12 hours of occlusion was found occluder detached and immediately converted to remove the occluder and fix the atrial septal defect;The other children were successfully recovered and been discharged.Conclusions Full understanding and strengthened perioperative nursing care of complications of children with congenital heart disease after surgical minimally-invasive surgical closure is the key point to avoid the occurrence of fatal complications and ensure the children recover safely and smoothly.%目的 探讨对先天性心脏病(先心病)患儿行腋下途径微创封堵术的围手术期护理方法及效果.方法 对我院收治的86例先心病患儿的临床资料进行分析整理并总结护理要点,护理要点包括:术前术后心理护理;患儿术后的体位护理、镇静护理,封堵器有无移位与脱落及机械性溶血的观察,心电图和血压监测,预防出血及血栓形成的护理.结果 1例嵴下型室间隔缺损患儿放置封堵器后出现频发性室性早搏,改为开胸手术;1例混合型房间隔缺损患儿,放置封堵器12h后因躁动出现心率增快,呼吸困难,发现

  11. Minimal incisions for laparoscopic radical cystectomy with extracorporeal-assisted urinary diversion

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    Chih-Chin Yu

    2015-06-01

    Conclusion: Our experience shows that LRC with extracorporeal-assisted urinary diversion using minimal incisions is a safe and feasible surgical technique with less blood loss. Further reports with a longer follow-up period and large number of cases are necessary to validate our findings.

  12. The peripheral cannulation technique in minimally invasive congenital cardiac surgery.

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    Vida, Vladimiro L; Tessari, Chiara; Putzu, Alessandro; Tiberio, Ivo; Guariento, Alvise; Gallo, Michele; Stellin, Giovanni

    2016-08-19

    Congenital minimally invasive cardiac surgery has gained wide acceptance thanks to its favorable outcomes. The introduction of peripheral cannulation for cardiopulmonary bypass further reduces surgical trauma by decreasing surgical access and allowing the spectrum of surgical access for the correction of simple congenital heart defects to be widened. Right internal jugular vein percutaneous cannulation, together with the direct surgical cannulation of femoral vessels, proves to be a safe and effective tool in patients with body weight above 15 kg.

  13. [Minimally invasive technique for harvesting a saphenous vein via one small incision].

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    Sato, M; Suenaga, E; Koga, S; Matsuyama, S

    2007-08-01

    We report a minimally invasive technique for harvesting a saphenous vein graft (SVG) via 1 small skin incision. The expected advantages of this technique are better cosmetic results and fewer wound complications than the conventional open technique or the bridging technique. The SVG, 10-15 cm in length, can be harvested by about 3 cm-long single small skin incision. SaphLITE Retractor System (Genzyme Srugical Products, Cambridge), SLS Hematostatic Clip System (Vitalitec International, Plymouth), and curved scissors were necessary instruments for this technique. It is feasible for cases that require a shorter length of SVG.

  14. Multiple parallel skin markers for minimal incision lumbar disc surgery; a technical note

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    Chen Po-Quang

    2004-03-01

    Full Text Available Abstract Background Spinal surgery depends on accurate localization to prevent incorrect surgical approaches. The trend towards minimally invasive surgery that minimizes surgical exposure and reduces postoperative pain increasingly requires surgeons to accurately determine the operative level before an incision is made. Preoperative localization with a C-arm image intensifier is popular, but the exposure of both patients and theatre staff to radiation is a disadvantage, as well as being time-consuming. Methods We describe a simple surgical tool developed to help localize exact spinal levels in conjunction with a simple AP X-ray film immediately before surgery. Multiple parallel skin markers were made using a circular oven rack comprising multiple 1.5 cm spaced parallel wires attached to a circular outside rim. The longest line was placed on the line of the postero-superior iliac spine (PSIS over the junction of the L5-S1 region. Results and conclusions Based on the film taken, the incision can be accurately made at the intended level. The incision wound can be minimized to 3.0 cm even when using conventional disc surgery instruments.

  15. Comparison of Minimal Skin Incision Technique in Living Kidney Transplantation and Conventional Kidney Transplantation

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    Sang-Dong Kim; Ji-II Kim; In-Sung Moon; Sun-Cheol Park

    2016-01-01

    Background:Recently,the most common incision for kidney transplantation (KT) is an inverted J-shaped incision known as the "hockey-stick." However,demands for minimally invasive surgery in KT are increasing as in other various fields of surgery.Hence,we evaluated whether there is difference between minimal skin incision technique in kidney transplantation (MIKT) and conventional KT (CKT).Methods:Between June 2006 and March 2013,a total of 452 living kidney transplant patients were enrolled.The MIKT group included 17 young unmarried women whose body mass index was <25 kg/m2 and had no anatomic variation.The CKT group included 435 patients.The MIKT operation technique restricted to the 10 cm-sized skin incision in the lower right abdomen from laterally below the anterior superior iliac spine to the midline just above the pubis was performed.We compared the baseline clinical characteristics and postoperative results between two groups.For proper comparison,propensity score matching was implemented.Results:There was no difference in graft function,survival,and postoperative complication rate between MIKT and CKT groups (all P > 0.05).The 5-year graft survival was 92.3% and 85.7% in MIKT and CKT groups,respectively (P =0.786).Conclusions:Our results indicated that MIKT showed more favorable cosmetic results,and there were no statistical differences in various postoperative factors including graft function,survival,and complications compared with CKT.Hence,we suggested that MIKT is an appropriate method for selected patients in living KT.

  16. Simple in situ decompression for idiopathic cubital tunnel syndrome using minimal skin incision

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    Jeon In-Ho

    2010-01-01

    Full Text Available Cubital tunnel syndrome is one of the most frequently occurring compression neuropathy in the upper limb next to carpal tunnel syndrome. Recent minimal invasive technique has prompted us to gain clinical experience with simple in situ decompression with minimal skin incision for idiopathic cubital tunnel syndrome. Sixty six consecutive patients with cubital tunnel syndrome were treated using minimal skin incision technique. The mean age of the patients was 49.7 (range: 15-77 years and average follow up period was 23.9 months (range: 12-60 months. The severity of ulnar neuropathy was classified according to the McGowan classification: there were 17 in grade I , 47 in grade II and 2 in grade III. A preoperative nerve conduction study was done by inching method, which revealed motor conduction delay around the medial epicondyle. All operations were carried out in a day surgery unit under local anesthetics. The postoperative outcome was evaluated by Messina classification. The mean duration of the operation was 12 minutes. The technique was highly satisfactorily esthetic for all. Over 80% of the patients were completely satisfied with the procedure taking into consideration their symptoms. Postoperative outcome measures and patient satisfactions (pain, return to normal activities and work, scar and pillar tenderness were comparable with published series of anterior transposition. The overall satisfactory results were recorded 81% in the patients of McGowan stage I and II. There were 2 cases of hematoma as a postoperative complication. This procedure is comparably effective alternative which involves less surgical trauma, morbidity and rehabilitation time with good surgical outcomes especially in mild and moderate degrees. Minimal skin incision is a simple, safe and effective method to treat patients with idiopathic cubital tunnel syndrome.

  17. Modified minimally invasive two-incision total hip arthroplasty using large diameter femoral head

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    Kyung Soon Park

    2012-01-01

    Full Text Available Background: Minimally invasive (MI total hip arthroplasty (THA is an alternative to standard THA, but has created much controversy among orthopedic surgeons. The authors modified the original minimally invasive two-incision THA technique and used large-diameter (32 mm, 36 mm ceramic-on-ceramic articulation. Materials and Methods: One hundred and seventy patients that underwent unilateral MI two-incision THA were retrospectively reviewed, and surgical morbidity, functional recovery, radiological properties, and complications were assessed. Results: Mean Harris hip score (HHS improved from 41.8 to 96.1 at last followup, and mean Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC score from 66.2 to 26.9. The mean lateral opening angle of the acetabular component was 38.2° and the mean stem position was valgus 1.9°. There was an intraoperative femur fracture and one revision surgery due to stem subsidence. No patient had dislocation. Conclusions: Our data suggest that this modified technique combined with large ceramic femoral head is safe and reproducible in terms of achieving proper implant positioning and early functional recovery.

  18. Single minimal incision fasciotomy for chronic exertional compartment syndrome of the lower leg.

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    Maffulli, Nicola; Loppini, Mattia; Spiezia, Filippo; D'Addona, Alessio; Maffulli, Gayle D

    2016-05-24

    Chronic exertional compartment syndrome (CECS) involves a painful increase in compartment pressure caused by exercise and relieved by rest, common in athletes. The most common site for CECS in the lower limbs is the anterior leg compartment. The aim of this study is to evaluate the outcomes of a single minimal incision fasciotomy in athletes and their capability to return to high level sport activity. The study reports mid-term results in a series of 18 consecutive athletes with chronic exertional compartment syndrome of the leg who had undergone minimally invasive fasciotomy. Between 2000 and 2007, we prospectively enrolled 18 consecutive athletes (12 males and six females, median age 27 years) with unilateral or bilateral chronic exertional compartment syndrome undergoing unilateral or bilateral minimally invasive fasciotomy. Clinical outcomes were assessed with Short-Form Health Survey-36 (SF-36) and European Quality of Life-5 Dimension (EQ-5D) scale. The ability to participate in sport before and after surgery and the time to return to training (RTT) and to sport (RTS) were recorded. The median follow-up after surgery was 36 months. Both questionnaires showed a statistically significant improvement (P compartment syndrome of the anterior and lateral compartments of the leg with good results in the mid-term.

  19. Minimally invasive two-incision total hip arthroplasty:a short-term retrospective report of 27 cases

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    ZHANG Xian-long; WANG Qi; SHEN Hao; JIANG Yao; ZENG Bing-fang

    2007-01-01

    Background Total hip arthroplasty (THA) is widely applied for the treatment of end-stage painful hip arthrosis.Traditional THA needed a long incision and caused significant soft tissue trauma. Patients usually required long recovery time after the operation. In this research we aimed to study the feasibility and clinical outcomes of minimally invasive two-incision THA.Methods From February 2004 to March 2005, 27 patients, 12 males and 15 females with a mean age of 71 years (55-76), underwent minimally invasive two-incision THA in our department. The patients included 9 cases of osteoarthritis, 10 cases of osteonecrosis, and 8 cases of femoral neck fracture. The operations were done with VerSys cementless prosthesis and minimally invasive instruments from Zimmer China. Operation time, blood loss, length of incision, postoperative hospital stay, and complications were observed.Results The mean operation time was 90 minutes (80-170 min). The mean blood loss was 260 ml (170-450 ml) and blood transfusion was carried out in 4 cases of femoral neck fracture (average 400 ml). The average length of the anterior incision was 5.0 cm (4.6-6.5 cm) and of the posterior incision 3.7 cm (3.0-4.2 cm). All of the patients were ambulant the day after surgery. Nineteen patients were discharged 5 days post-operatively and 8 patients 7 days post-operatively. The patients were followed for 18 months (13-25 months). One patient was complicated by a proximal femoral fracture intraoperatively. No other complications, including infections, dislocations, and vascular injuries, occurred. The mean Harris score was 94.5 (92-96).Conclusions Two-incision THA has the advantage of being muscle sparing and minimally invasive with less blood loss and rapid recovery. However, this technique is time consuming, technically demanding, and requires fluoroscopy.

  20. Single laser incision for treatment of congenital bladder neck sclerosis: new technique.

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    Mattioli, Stefano; Picinotti, Alessandro; Burgio, Andreina

    2016-11-18

    The primary bladder neck obstruction (PBNO) has been recognized in 41-45% of young men suffering from a chronic lower urinary tract symptom (LUTS). Few studies are published in the literature about the use of laser devices in the surgical treatment of PBNO and none about the use of Thulium laser. The aim of our study is to report the results of our follow-up in the endoscopic treatment of PBNO with Thulium laser. From January 2012 to January 2015, we treated 214 patients using Thulium laser for primary bladder neck sclerosis. All patients had symptoms suggestive of LUTS or prostatism: filling or irritative symptoms and voiding or obstructive symptoms. In 157 patients, the incision was performed unilaterally at 7 o'clock of the bladder neck. In 57 cases, bilateral incision was performed at 5 and 7 o' clock without vaporizing the tissue between the two incisions. We chose to make the incision bilaterally in cases wherein a single incision was not enough to solve the obstruction from the bladder neck and prevent a recurrence. Bladder irrigation was used overnight in all cases, and the catheter was removed after 24 hours. One hundred ninety-six patients enrolled completed 1-year follow-up: 157 patients underwent unilaterally incision and 39 bilateral incision. In 179 cases (91.3%), there was unchanged antegrade ejaculation, while reduced semen volume was reported by 14 men (7.1%) and retrograde ejaculation by only 3 (1.5%), but these patients underwent bilateral incision. The quality of orgasm and sexual satisfaction was not permanently changed by the operation. In patients with PBNO, it is possible to perform endoscopic treatment with Thulium laser that we think is an effective and safe procedure, not affecting sexual functioning and particularly retrograde ejaculation.

  1. Prime Incision and Modified Moving Window: A Minimally Invasive Access for Breast Cancer Surgical Treatment

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    E. Bromberg, Silvio; Giordano, Roberto

    2016-01-01

    BACKGROUND Conservative surgical treatment has been the treatment of choice for early breast cancer. It allows feasible oncological treatment with a satisfactory cosmetic approach and fast recovery. However, in some cases mastectomy is necessary. This study proposes a surgical approach with only one surgical access through the same incision, which is in line with precepts mentioned above. It is called the prime incision and modified moving window techniques. METHODS Thirty one patients with a...

  2. Right parasternal incision: a uniform minimally invasive approach for valve operations.

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    Lazzara, R R; Kidwell, F E

    1998-01-01

    The right parasternal incision can be used for replacing or repairing cardiac valves. A specialized retractor system produces excellent exposure and helps avoid groin cannulation. The approach reduces surgical dissection and trauma, does not require sacrifice of mammary arteries, prevents rib spreading, avoids sternotomy, reduces the risk of cardiac injury at subsequent redo operations, and does not require specialized video or thoracoscopic equipment.

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

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    Sanoop Koshy Zachariah

    2014-09-01

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

  4. Minimally invasive per-catheter occlusion and dilation procedures for congenital cardiovascular abnormalities in dogs.

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    Tobias, Anthony H; Stauthammer, Christopher D

    2010-07-01

    With ever-increasing sophistication of veterinary cardiology, minimally invasive per-catheter occlusion and dilation procedures for the treatment of various congenital cardiovascular abnormalities in dogs have become not only available, but mainstream. Much new information about minimally invasive per-catheter patent ductus arteriosus occlusion has been published and presented during the past few years. Consequently, patent ductus arteriosus occlusion is the primary focus of this article. Occlusion of other less common congenital cardiac defects is also briefly reviewed. Balloon dilation of pulmonic stenosis, as well as other congenital obstructive cardiovascular abnormalities is discussed in the latter part of the article.

  5. Single minimal incision fasciotomy for the treatment of chronic exertional compartment syndrome: outcomes and complications.

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    Drexler, Michael; Rutenberg, T Frenkel; Rozen, N; Warschawski, Y; Rath, E; Chechik, O; Rachevsky, G; Morag, G

    2017-01-01

    Chronic exertional compartment syndrome (CECS) is a common injury in young athletes, causing pain in the involved leg compartment during strenuous exercise. The gold standard treatment is fasciotomy, but most of the reports on its effectiveness include relatively small cohorts and relatively short follow-up periods. This study reports the long-term results of a large cohort of young athletes who underwent single-incision fasciotomy for CECS. This a retrospective case-series study. All patients treated by fasciotomies performed for CECS between 2007 and 2011, in a tertiary medical institution. CECS was diagnosed following history taking and clinical evaluation, and confirmed by compartment pressure measurements. Ninety-five legs that underwent single-incision subcutaneous fasciotomy were included. Data on the numerical analog scale (NAS), Tegner activity score, and quality-of-life (QOL) as measured via the short form-12 (SF-12) were retrieved from all patients preoperatively and at the end of follow-up. The average time to diagnosis was 22 months and the mean follow-up was 50.1 months. Sixty-three legs underwent anterior compartment fasciotomy (an additional 30 legs also underwent lateral compartment release), and two legs underwent lateral and peroneal compartment releases. The average change in Tegner score was an improvement of 14.6 points. Similarly, the patients reported a significant improvement in the SF-12 and NAS scores. Satisfaction rates were high (average 75.5 %). The main complications were wound infection (2 patients) and nerve injuries (4 patients). Eight patients had recurrence. Single-incision fasciotomy leads to long-term improvement in the activity level and QOL of patients with CECS.

  6. Minimally invasive removal of a recurrent lumbar herniated nucleus pulposus by the small incised microendoscopic discectomy interlaminar approach.

    Science.gov (United States)

    Koga, S; Sairyo, K; Shibuya, I; Kanamori, Y; Kosugi, T; Matsumoto, H; Kitagawa, Y; Sumita, T; Dezawa, A

    2012-02-01

    In this report, we introduce two cases of recurrent herniated nucleus pulposus (HNP) at L5-S1 that were successfully removed using the small incised microendoscopic discectomy (sMED) technique, proposed by Dezawa and Sairyo in 2011. sMED was performed via the interlaminar approach with a percutaneous endoscope. The patients had previously underdone microendoscopic discectomy for HNP. For the recurrent HNP, the sMED interlaminar approach was selected because the HNP occurred at the level of L5-S1; the percutaneous endoscopic transforaminal approach was not possible for anatomical reasons. To perform sMED via the interlaminar approach, we employed new, specially made devices to enable us to use this technique. In conclusion, sMED is the most minimally invasive approach available for HNP, and its limitations have been gradually eliminated with the introduction specially made devices. In the near future, percutaneous endoscopic surgery could be the gold standard for minimally invasive disc surgery.

  7. Minimally invasive thoracic sympathectomy for palmar hyperhidrosis via a single unilateral incision approach by the pleura videoscope.

    Science.gov (United States)

    Yang, Yunhai; Zeng, Liping; An, Zhou; Wang, Luming; Hu, Jian

    2014-05-01

    Palmar hyperhidrosis is a common disease that causes intense significant embarassment for patients. Bilateral single-port thoracoscopic sympathectomy is an effective surgical treatment with high success rates and improvement in quality of life. In order to reduce surgical invasion and to seek better cosmetic results, we describe a novel protocol for thoracic sympathectomy in the treatment of palmar hyperhidrosis. Between January 2012 and September 2012, bilateral thoracic sympathectomy was performed through the anterior mediastinal pleura using the pleural videoscope with a single unilateral skin incision in 10 men and 6 women. In total, 16 patients were cured, and the skin temperature increased by a mean of 2.7±0.6°C. The average operation time was 67.9±15.8 minutes, with a postoperative hospital stay of 1.9±0.6 days and operative bleeding of less than 20 mL. All operations were successful, with no severe complications or perioperative mortality. Follow-up of 9.8±2.3 months (range, 7-14 months) showed that palmar sweating improved in all patients, and the effective rate was 100%. A single unilateral incision for two-sided thoracic sympathectomy through the anterior mediastinal pleura is an effective, feasible, safe, and minimally invasive procedure with excellent cosmetic results.

  8. Comparison of minimally invasive surgery and mini-incision technique for total hip arthroplasty: a sub-group meta-analysis

    Institute of Scientific and Technical Information of China (English)

    ZHAO Xiang; LIN Tiao; CAI Xun-zi; YAN Shi-gui

    2011-01-01

    Background It is well accepted that the minimally invasive surgery (MIS) for total hip arthroplasty (THA) should combine with less or no muscle damage and is different from mini-incision technique and MIS should have better outcomes than mini-incision surgery.The aim of current analysis was to apply an explicitly defined sub-group analysis to confirm whether this hypothesis is true.Methods A computerized literature search was applied to find any data concerning MIS or mini-incision THAs.A multistage screening was then performed to identify randomized studies fulfilling the inclusive criteria for the analysis.The data were extracted,and sub-group analyses of MIS or mini-incision surgery for different kinds of outcomes were carried out.The P(sub) value for difference between MIS sub-group and mini-incision sub-group was also calculated.Results Eleven studies that fulfilling the inclusion criteria were included,with 472 cases in the study group (MIS or mini-incision) and 492 cases in the conventional group.The overall analysis showed the study group would achieve less surgical duration (P=0.037),intraoperative blood (P <0.001) and incision length (P <0.001) than conventional group.The difference between sub-groups showed,the MIS would achieve shorter incision length (P(sub) <0.05) and bigger cup abduction angle (P(sub) <0.05),and cause more blood loss (P (sub) <0.05) than mini-incision technique.Other indexeswere comparable between the two sub-groups.Conclusions Though further high quality studies are still needed,the result of current analysis offered an initial conclusion that MIS THA failed to achieve a better clinical outcome than mini-incision technique.The exact definition of MIS still needs to be improved.

  9. 单切口微创重睑术临床应用探讨%The double eyelid plasty with single minimally invasive incision

    Institute of Scientific and Technical Information of China (English)

    朱薛锋; 邓景成; 蒋朝华; 丁架月

    2015-01-01

    Objective To discuss clinic significance of double eyelid plasty with single minimally invasive incision. Methods Since October 2012,49 cases(98 eyes)aged 17 to 30 years with single eyelid were treated by double eyelid plasty with single minimally invasive incision and followed prospectively.During the operation first cut a short incision about 1cm in the middle of the double eyelid line,and remove the pachyntic orbicularis muscle and redundant orbit fat through this incision, then suture the incision on the pretarsal fascia and make a needle with sutures at the two sides of the incision along the double eyelid line. Results 49 cases(98 eyes)were followed up for 3 months to 24 months,all swellings were recovered for 1 to 2 months after operation with lasting and natural double eyelid shape and slight scars.The satisfaction of all patients was high. Conclusion Double eyelid plasty with single minimally invasive incision has been more and more recognized by plastic and aesthetic surgeons for the advantage of minor damage,short swelling period and permanent effects.It should be widely spread in clinic.%目的:探讨单切口微创重睑术的临床应用价值。方法:自2012年10月以来共49例(98眼)17~30岁单睑女性患者,于重睑线中段行单点微创小切口,经此切口去除肥厚的眼轮匝肌和多余的眶隔脂肪,将切口边缘皮肤缝合于睑板前筋膜上,最后在重睑两侧分别行压线法缝合一针,6~7d拆线。结果:49例(98眼)术后随访3~24个月,所有患者均在1~2月内消肿,重睑线形成持久、自然,且瘢痕不明显,患者满意度高。结论:单切口微创重睑术具有创伤小、恢复快、效果可靠、持久等优点,得到了越来越多整形美容外科医师的认可,值得在临床推广使用。

  10. 美容微创切口在腋臭根治中的应用%Application of Beauty Minimally Invasive Incision in the Treatment of Osmidrosis

    Institute of Scientific and Technical Information of China (English)

    李远兵

    2014-01-01

    目的:探讨顺皮纹美容微创切口在腋臭根治术中的应用。方法:对10例腋臭患者实施腋臭根治术时,采取美容微创顺皮纹切口,术后观察治疗效果。结果:9例切口一类甲级愈合,切口瘢痕小,拆线时间平均为9d(7~12d),1例皮下积液、切口裂开伴感染使用美宝烧伤膏(每支装40g,北京光明中医烧伤创疡研究所研制生产,国药准字Z20000004)局部换药两周后创面愈合出现较大瘢痕,但瘢痕软、平,双上肢未见上举受限。结论:顺皮纹美容微创切口在腋臭根治术中的应用与传统腋皮切除术、激光治疗、超声波等治疗对比,前者具有不可比拟的优越性,值得在基层医院推广。%Objective:To explore the application of suitable dermatoglyph beauty minimally invasive incision in the treatment of osmidrosis. Methods:10 patients took the beauty of minimally invasive suitable dermatoglyph incision in the treatment of osmidrosis. Postoperative curative effect was observed. Results:9 cases had kind of first class incision healed, with small incision scar. The average time of taking out stitches was 9 days (7 to 12 days). 1 case with subcutaneous effusion, infection of incision dehiscence used Mabel burn ointment with topical treatment for two weeks. Big scar occurred but the scar was soft, smooth, without limited arm lift. Conclusion:Through comparing the dermatoglyph beauty of minimally invasive incision with the traditional axillary osmidrosis radical resection, laser treatment and ultrasonic treatment, the former has the incomparable superiority. So it is worth popularizing in basic-level hospitals.

  11. 外侧小切口全髋置换早期疗效对比研究%Early comparison of lateral approach minimally incision total hip arthroplasty with a conventional incision operation

    Institute of Scientific and Technical Information of China (English)

    徐耿填; 许少榆; 庄怀铭; 郭跃跃; 林勇彬

    2013-01-01

      目的评价外侧小切口全髋关节置换术(THA)的早期疗效。方法选择2005年1月—2010年1月行外侧小切口全髋关节置换术120例(132髋)患者作为试验组,选择同期接受常规外侧切口手术76例(82髋)作为对照组,比较2组患者术后3个月、术后6个月、术后1年假体位置及 Harris 评分等。结果术后2组患者假体位置比较无显著性差异,试验组在术后3,6个月 Harris 评分较对照组高;术后1年,2组 Harris 评分比较差异无统计学意义。结论外侧小切口全髋置换术术后早期在功能及软组织损伤上比常规切口全髋置换有明显优势,随着时间的推移,差异减小。外侧小切口全髋关节置换的中远期疗效需要进一步评估。%  Objective To report the early follow-up results of lateral opproach minimal incision and conventional incision for total hip arthroplasty (THA). Methods From February 2002 to June 2007, 132 cases (126 patients) of THA were performed through lateral mini-incision ,for comparison,another 82 cases (76 patients) of THA were performed through conventional lateral approach incision. All the patients were followed up for more than one year.The items compared included prosthesis position,Harris Hip Score (HHS)and Short Musculoskeletal Function Assessment (SMFA).Results The prosthesis positions were similar in both two groups. HHS was significantly higher in MI-THA group after patients were followed up for 3 and 6 months, but there was no statistical difference in one year. Conclusion Compared with conventional total hip arthroplasty, total hip arthroplasty with a lateral minimal incision was advanced in both early functional outcome and soft tissue injury . The difference of two groups was decreased with the lapse of time . Further evaluation of the long-term outcome was still needed for lateral approach MI-THA.

  12. 面中部除皱的小切口选择%Choice of Minimal Incision in Mid-Face Lift

    Institute of Scientific and Technical Information of China (English)

    闫飞; 王克明; 马继光

    2016-01-01

    皮肤衰老是多种机制共同参与的一种复杂的多因素过程。随着人们对面中部老化过程及解剖认识的进一步加深,各种手术方式得以改进,并出现一些新的微创外科技术,术后恢复快、瘢痕小,如小切口除皱、内窥镜除皱、埋线等。本文对近几年面中部微创除皱手术中有关切口选择的进展进行综述。%[Summary] Skin aging is a complex and multifactorial process with multiple mechanisms participating at the same time. More recently, improvements in understanding of mid-facial aging and anatomy have paralleled the development of minimally invasive surgical techniques. Those techniques provide rapid postoperative recovery and small scar, which contain small incision rhytidectomy, endoscopic rhytidectomy and thread-lift. In this paper, the choice of minimal incision in mid-face lift in recent years was reviewed.

  13. MINIMALLY-INVASIVE FIXATION OF SPINAL CORD INJURY PATIENT USING MIDLINE INCISION- AN ANALYSIS OF 11 CASES

    Directory of Open Access Journals (Sweden)

    Anand Shankar

    2017-02-01

    Full Text Available BACKGROUND Instrumenting the fractured spinal column has seen many changes in last 5 decades. Starting from Luque’s rod (Dr. Eduardo Luque, Hartshill’s rectangle, the Harrington rod (Dr. Paul Harrington, Variable Spinal Plating (VSP, pedicle screw and rod fixation being the latest. The emphasis is on minimally invasive and least possible trauma to paraspinal muscles. Percutaneous pedicle screw fixation is at present a gold standard of minimally-invasive procedure. MATERIALS AND METHODS 11 patients were operated between August 2013 till March 2016 with this method and the outcome was evaluated. RESULTS The neurological recovery is not the goal of spinal column fixation in SCI patients in most of the cases. The only goal is stabilisation of spinal column, pain relief, rehabilitation, prevention of bedsore, RTI by achieving vertical chest, UTI by preventing stasis of urine in bladder, etc. CONCLUSION The presenting operative procedure for achieving this goal of stabilisation is very well achieved in 10 out of 11 cases with minimal soft tissue trauma. The improvement in alignment and restoration of anatomy of spinal column, restoration of spinal canal diameter as judged radiologically is achieved in 9 of out of 11 cases.

  14. Lactacidosis in the neonate is minimized by prenatal detection of congenital heart disease

    NARCIS (Netherlands)

    Verheijen, PM; Lisowski, LA; Stoutenbeek, P; Hitchcock, JF; Bennink, GBWE; Meijboom, EJ

    2002-01-01

    Objectives To investigate the impact of prenatal detection of congenital heart disease on preventing severe preoperative lactacidosis. Design Patients operated upon for congenital heart disease during the first 31 days of life (n=209) were studied retrospectively, 21 were diagnosed prenatally and 18

  15. Rehabilitation of gait in patients after total hip arthroplasty: Comparison of the minimal invasive Yale 2-incision technique and the conventional lateral approach.

    Science.gov (United States)

    Böhm, Harald; Hagemeyer, Daniel; Thummerer, Yvonne; Kipping, Robert; Stöckle, Ulrich; Scheuerer, Konrad

    2016-02-01

    The minimal invasive anterolateral Yale 2-incision approach for total hip arthroplasty aims minimizing damage to the muscles for faster recovery of function. Therefore the hypothesis was investigated, that during the rehabilitation process the Yale approach shows a faster return to natural gait than a conventional lateral approach. Nineteen patients had the Yale, 16 the conventional Bauer approach. Instrumented gait analysis was performed 3 days, 3 and 12 month post operatively. Velocity, cadence, step length, weight bearing, thorax lean, Trendelenburg limp, hip abduction moments, and hip muscle activation times were evaluated. Three days post-surgery a significantly greater loading of the treated limb and increased hip abduction moment were observed in the Yale group. In addition, the Yale group showed its greatest improvement in walking speed and step length between at 3 days and 3 months, whereas the conventional group showed an additional significant gain between 3 and 12 month to reach a similar walking speed as the Yale group. For all hip muscles investigated, only muscle tensor fasciae latae in the conventional group showed a significant increase in activation time between 3 days and 3 months. This study showed significantly faster return to natural gait in the Yale compared to the conventional approach, which could be biomechanically related to less impairment of abductor muscles in the Yale approach.

  16. Modified skin incision for avoiding the lesser occipital nerve and occipital artery during retrosigmoid craniotomy: potential applications for enhancing operative working distance and angles while minimizing the risk of postoperative neuralgias and intraoperative hemorrhage.

    Science.gov (United States)

    Tubbs, R Shane; Fries, Fabian N; Kulwin, Charles; Mortazavi, Martin M; Loukas, Marios; Cohen-Gadol, Aaron A

    2016-10-01

    Chronic postoperative neuralgias and headache following retrosigmoid craniotomy can be uncomfortable for the patient. We aimed to better elucidate the regional nerve anatomy in an effort to minimize this postoperative complication. Ten adult cadaveric heads (20 sides) were dissected to observe the relationship between the lesser occipital nerve and a traditional linear versus modified U incision during retrosigmoid craniotomy. Additionally, the relationship between these incisions and the occipital artery were observed. The lesser occipital nerve was found to have two types of course. Type I nerves (60%) remained close to the posterior border of the sternocleidomastoid muscle and some crossed anteriorly over the sternocleidomastoid muscle near the mastoid process. Type II nerves (40%) left the posterior border of the sternocleidomastoid muscle and swung medially (up to 4.5cm posterior to the posterior border of the sternocleidomastoid muscle) as they ascended over the occiput. The lesser occipital nerve was near a midpoint of a line between the external occipital protuberance and mastoid process in all specimens with the type II nerve configuration. Based on our findings, the inverted U incision would be less likely to injure the type II nerves but would necessarily cross over type I nerves, especially more cranially on the nerve at the apex of the incision. As the more traditional linear incision would most likely transect the type I nerves and more so near their trunk, the U incision may be the overall better choice in avoiding neural and occipital artery injury during retrosigmoid approaches.

  17. Heart bypass surgery incision (image)

    Science.gov (United States)

    ... the left part of the chest between the ribs. This incision is much less traumatic than the traditional heart bypass surgery incision which separates the breast bone. Minimally invasive heart bypass surgery allows the patient less pain and a faster recovery.

  18. Speech outcomes at age 5 and 10 years in unilateral cleft lip and palate after one-stage palatal repair with minimal incision technique - a longitudinal perspective.

    Science.gov (United States)

    Nyberg, Jill; Peterson, Petra; Lohmander, Anette

    2014-10-01

    To investigate speech outcomes in 5- and 10-year-old children with unilateral cleft lip and palate (UCLP) treated according to minimal incision technique (MIT) - a one-stage palatal method. A retrospective, longitudinal cohort study of a consecutive series of 69 patients born with UCLP, treated with MIT (mean age 13 months) was included. Forty-two children (43%) received a velopharyngeal flap; 12 before 5 years and another 18 before 10 years of age. Cleft speech variables were rated from standardized audio recordings at 5 and 10 years of age, independently by three experienced, external speech-language pathologists, blinded to the material. The prevalences of cleft speech characteristics were determined, and inter- and intra-rater agreement calculated. More than mild hypernasality, weak pressure consonants and perceived incompetent velopharyngeal function were present in 19-22% of the children at 5 years, but improved to less than 5% at 10 years. However, audible nasal air leakage, prevalent in 23% at 5 years, did not improve by age 10. Thirty percent had frequent or almost always persistent compensatory articulation at 5 years, and 6% at age 10. The general impression of speech improved markedly, from 57% giving a normal impression at 5 years to 89% at 10 years. A high prevalence of distorted/s/was found at both 5 and 10 years of age. A high occurrence of speech deviances at 5 years of age after MIT was markedly reduced at 10 years in this study of children with unilateral cleft lip and palate. The high pharyngeal flap rate presumably accounted for the positive speech development. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  19. Minimally invasive incision for total hip arthroplasty:a systematic review%微创小切口在全髋关节置换应用的系统评价

    Institute of Scientific and Technical Information of China (English)

    王晓旭; 刘珏

    2012-01-01

    [Objective] A systematic review was conducted to assess the application of minimally invasive incision for total hiparthroplasty(THA). [Method] Using PubMed, Cochrane Library,EMBASE,Science Direct, CNKI,CBM and CMAC.we performed a literature search for all the studies published in the English and Chinese languages from January 2000 to January 2011 .reporting patients undergoing THA with minimally invasive incision. The bibliographic sections of identified papers were manually searched to identify additional papers. The Revman 4.2 provided by the Cochrane Collaboration was used for management and analysis. Meticulous data extraction and meta-analysis wexe performed according to a preset protocol to gain correlated evidence about THA with minimally invasive incision [Result] In 236 citations initially identified, 6 eligible papers, which included 551 patients,met all the final criteria. The combined results of meta-analysis showed that compared with conventional incision, minimally invasive incision for total hip arthroplasty could reduce the duration of operation, the amount of intra-operative blood loss,but the rate of complications and the length of stay had no difference. [Conclusion]Compared with conventional incision , minimally invasive incision for total hip arthroplasty can reduce operation time, and operation blood loss, but the complication rate and the hospital of stay has no difference. However, the trials available for this systematic review are too few and small for reliable estimate of the relative effects of minimally invasive and conventional incision for total hip arthroplasty. Further studies are needed to determine these effects.%[目的]对微创小切口在全髋置换术中的应用进行系统评价.[方法]在Pubmed、Cochrane Library、EMBASE、Science Direct以及CNKI、CBM、中国医学学术会议论文数据库等网站进行检索.文献检索起止时间为2000年1月~2011年1月.再对入选文献的参考文献进行手工检

  20. Minimalism

    CERN Document Server

    Obendorf, Hartmut

    2009-01-01

    The notion of Minimalism is proposed as a theoretical tool supporting a more differentiated understanding of reduction and thus forms a standpoint that allows definition of aspects of simplicity. This book traces the development of minimalism, defines the four types of minimalism in interaction design, and looks at how to apply it.

  1. Comparison of Surgical Efficacy of Levator Muscle Short-ening and Modified Levator Aponeurosis Tucking in Treat-ing Minimal and Moderate Congenital Blepharoptosis

    Institute of Scientific and Technical Information of China (English)

    Chong Wang; Yanli Wang

    2015-01-01

    Purpose:.To evaluate the surgical effect of levator muscle shortening and levator aponeurosis tucking in treating minimal and moderate congenital blepharoptosis. Methods:.Clinical data of 28 patients (40 eyes) diagnosed with mide and moderate congenital blepharoptosis at our institution were retrospectively analyzed. Postoperative efficacy was eval-uated and statistically compared between these two techniques. Results:.During 14 months follow-up,.16 eyes with ptosis un-dergoing levator muscle shortening were treated,.3 with un-dercorrection of ptosis and 1 with overcorrection of ptosis.In patients receiving levator aponeurosis tucking,.16 eyes were cured and 4 with undercorrection of ptosis. Conclusion:.Both levator muscle shortening and levator aponeurosis tucking are safe and efficacious for correcting minimal and moderate congenital blepharoptosis.

  2. Single-incision laparoscopy surgery: a systematic review

    Science.gov (United States)

    far, Sasan Saeed; Miraj, Sepide

    2016-01-01

    Background Laparoscopic surgery is a modern surgical technique in which operations are performed far from their location through small incisions elsewhere in the body. Objective This systematic review is aimed to overview single-incision laparoscopy surgery. Methods This systematic review was carried out by searching studies in PubMed, Medline, Web of Science, and IranMedex databases. The initial search strategy identified about 87 references. In this study, 54 studies were accepted for further screening and met all our inclusion criteria [in English, full text, therapeutic effects of single-incision laparoscopy surgery and dated mainly from the year 1990 to 2016]. The search terms were “single-incision,” “surgery,” and “laparoscopy.” Results Single-incision laparoscopy surgery is widely used for surgical operations in cholecystectomy, sleeve gastrectomy, cholecystoduodenostomy, hepatobiliary disease, colon cancer, obesity, appendectomy, liver surgery, rectosigmoid cancer, vaginal hysterectomy, vaginoplasty, colorectal lung metastases, pyloroplasty, endoscopic surgery, hernia repair, nephrectomy, rectal cancer, colectomy and uterus-preserving repair, bile duct exploration, ileo-ileal resection, lymphadenectomy, incarcerated inguinal hernia, anastomosis, congenital anomaly, colectomy for cancer. Conclusion Based on the findings, single-incision laparoscopy surgery is a scarless surgery with minimal access. Although it possesses lots of benefits, including less incisional pain and scars, cosmesis, and the ability to convert to standard multiport laparoscopic surgery, it has some disadvantages, for example, less freedom of movement, fewer number of ports that can be used, and the proximity of the instruments to each other during the operation. PMID:27957308

  3. Operational cooperation in replacement of mitral valve by minimally invasive small incision%心脏微创小切口直视下实施二尖瓣置换术的手术配合

    Institute of Scientific and Technical Information of China (English)

    金克非; 许斌; 尤斌

    2012-01-01

    目的 总结心脏微创小切口直视下实施二尖瓣置换术的手术配合要点.方法 对45例二尖瓣置换患者实施心脏微创小切口手术,并做好手术配合.结果 患者手术顺利,手术时间为140~205min,平均(163.6±17.8) min,术后未发生并发症,均痊愈出院.结论 心脏微创小切口手术创伤小,出血少,术后恢复快,术前做好患者配合手术的健康指导,术中做好抗凝剂应用护理及手术配合,其是手术成功的重要措施.%Objective To summarize the nursing experience in operational cooperation in replacement of mitral valve by minimally invasive small incision.Method Nursing and monitoring were carried out in 45 patients undergoing replacement of mitral valve by minimally invasive small incision.Result All of the 45 patients were uneventful,quickly recovered without complications and finally discharged.Conclusions Heart surgery via minimally invasive small incision has its advantages of little trauma,shorter operation time and less blood loss .The nursing cooperation is important for the successful performance of the operations.

  4. Minimally invasive repair of pectus excavatum in a 17-year-old boy with a history of congenital diaphragmatic hernia and lack of pericardium

    Directory of Open Access Journals (Sweden)

    Stefan M. van der Heide

    2016-06-01

    Full Text Available We reported a 17-year-old boy with very deep asymmetric pectus excavatum and with a history of congenital diaphragmatic hernia repair and hypoplastic left lung. We performed a minimally invasive repair of pectus excavatum as described by Nuss et al., in 1998. We performed a left-sided thoracoscopy, instead of the right-sided according our normal routine, to provide a safe route. We created a substernal tunnel to have a clear definition of the deviant anatomy after congenital diaphragmatic hernia repair. However, we noticed an absence of the pericardium, which, by itself, can increase the risk of cardiac injury in both bar insertion and removal. Instead of the usual right-sided thoracoscopy, we recommend providing a safe view by left-sided thoracoscopy in comparable cases (e.g. congenital diaphragmatic hernia, other cardiac or vascular malformations to reduce the risk of rupture or perforation of cardiac structures.

  5. Comparison the efficacy of minimally invasive and conventional incision in artificial hip replacement for treatment of femoral neck fracture in elderly%快捷小切口与常规切口人工髋关节置换术治疗老年股骨颈骨折的疗效对比

    Institute of Scientific and Technical Information of China (English)

    李军民; 肖信约; 张伟; 任云峰; 贾福; 张仲子; 吴中雄; 宣靖; 杨正宗

    2012-01-01

    Objective To compare the efficacy of the minimally invasive incision and conventional incision in artificial hip replacement for treatment of femoral neck fracture in elderly. Methods All of 240 old patients with displaced femoral neck fracture were randomly divided into four groups, the minimally invasive incision total hip replacement group, the conventional incision total hip replacement group, the minimally invasive incision femoral head arthroplasty group, and the conventional incision femoral head arthroplasty group, 60 cases each. Then each group underwent statistical analysis, for incision length, operation time, the amount of blooding, postoperative drainage volume,activity time and Harris score after operation. Results There was statistically significant difference in incision length, operation time, the amount of blooding, postoperative drainage volume and activity time between the minimally invasive incision total hip replacement group and conventional incision group (P 0.05). There was statistically significant difference in incision length, operation time, the amount of blooding, postoperative drainage volume and activity time between the minimally invasive incision femoral head arthroplasty group and conventional incision group (P 0.05). The efficacy of minimally invasive incision group was better than conventional incision group. Conclusion The minimally invasive incision hip arthroplasty has the advantages of minimal incision, short operation time, less trauma, little scar, quicker recovery. It is an ideal method for treatment of displaced femoral neck fracture in elderly.%目的 对比快捷小切口与常规切口行人工髋关节置换治疗老年股骨颈骨折的临床疗效.方法 将240例老年移位股骨颈骨折随机分为全髋置换小切口组、全髋置换常规切口组、半髋置换小切口组、半髋置换常规切口组(各60例).对每组切口长度、手术时间、出血量、术后引流量、下地活动时间、术

  6. The smal incision minimal y invasive total hip replacement perioperative nursing%微创小切口全髋关节置换术的围手术期护理

    Institute of Scientific and Technical Information of China (English)

    黎海燕

    2013-01-01

      目的:总结微创小切口全髋关节置换术的围手术期护理。方法:对50例行微创小切口全髋关节置换术的患者实施心理护理,术前进行病情评估、指导术前功能训练,术后严密病情观察,做好体位护理和术后功能锻炼的指导,加强术后并发症的观察和护理等系列护理干预措施。结果:50例患者均顺利完成手术,未出现术后感染、血管、神经损伤、明确关节功能障碍等并发症发生,术前Harris评分,45.56±5.3分,手术后4周Harris评分88.67±3.5分。结论:微创小切口全髋关节置换术围手术期实施系列积极有效的护理干预措施可以促使患者积极进行康复功能锻炼,有效预防术后并发症的发生,促进康复,提高患者的生活质量。%Objective:Conclusion the smal incision minimal y invasive total hip replacement perioperative nursing. Methods:For 50 smal incision minimal y invasive total hip replacement in patients with routine psychological nursing, preoperative condition assessment preoperative function training, instruction, postoperative close observation condition, make body position nursing and postoperative functional exercise guidance, strengthen the postoperative complications of observation and nursing, etc. Series of nursing intervention measures.Experimental:50 cases of patients were successful y completed surgery, does not appear postoperative infection, blood vessels, nerve damage, clear joint dysfunction complications occurred, such as preoperative Harris score, 45.56±5.3 points, 4 weeks after surgery, Harris scoring 88.67±3.5 points. Conclusion:Smal incision minimal y invasive total hip replacement perioperative series of positive effective nursing intervention measures can make active rehabilitation in patients with functional exercise, effectively prevent the occurrence of postoperative complications and promote the rehabilitation, to improve the patient's quality of life.

  7. Longitudinal Incision in Midaxillary Line in Nuss Procedure for Repairing Congenital Pectus Excavatum in Children%经腋中线直切口行Nuss手术纠治小儿漏斗胸

    Institute of Scientific and Technical Information of China (English)

    闫宪刚; 沈晟; 贾兵; 陈张根

    2013-01-01

    Objective To summarize the effect and technique of longitudinal incision at midaxillary line in Nuss procedure for children with congenital pectus excavatum.Metbods Nuss procedure were performed using the longitudinal incision at midaxillary line in 18 patients with congenital pectus excavatum from June 2010 to January 2012 in our hospital.The age of the patients ranged from 5 years and 2 months to 11 years and 8 months with an average of 7 years and 3 months.11 patients were symmetric pectus excavatum and 7 patients were asymmetric pectus excavatum according to Park' s classification.The Haller index ranged from 3.3 to 10.8 with a mean of (4.68 ± 1.73).Results All operations were successful.The operation time was 30-55 min with a mean of (42.2 ± 6.5) min,and the blood loss was less than 10 ml.One patient suffered from pneumothorax in early postoperative period and recovered after conservative treatment.The hospital stay was (5.1 ± 1.0) d.Three months of out-patient follow-up showed that 14 patients (77.8%) had excellent recovery and 4 patients (22.2%) had good results 3 months after the surgery.All patients were followed up for 3 to 18 months with a mean of (10.0 ±4.5) months (5 cases for more than 12 months).All steel support bars were in the original position without displacement.All patients had satisfactory deformity correction results with normal chest shape.The longitudinal incision was unable to be detected in the front and lateral side when arm was drooping.Conclusions The longitudinal incision at midaxillary line in Nuss procedure is a safe and reliable modified technique to be used clinically,especially suitable for female patients to avoid the impairment of their mammogenesis.%目的 总结经腋中线直切口行Nuss手术纠治小儿漏斗胸的手术技巧和疗效. 方法 2010年6月~2012年1月,对18例先天性漏斗胸采用两侧腋中线直切口进行胸腔镜辅助下Nuss手术,手术年龄5岁2个月~11岁8个月,平均7岁3

  8. 经后外侧入路小切口全髋关节置换治疗股骨颈骨折%Total hip arthroplasty with posterior minimal incision for the treatment of femoral neck fractures

    Institute of Scientific and Technical Information of China (English)

    刘程俊; 谢直跃; 顾祖超; 杨立明; 张宇

    2011-01-01

    背景:全髋关节置换已成为老年人创伤性股骨颈骨折常见的治疗方式之一,小切口微创方式可减少手术创伤及患者痛苦,便于老年患者假体置换后早期康复.目的:探讨经后外侧入路小切口行全髋关节置换后治疗股骨颈骨折的临床效果.方法:回顾性分析25例创伤后股骨颈骨折(Garden Ⅲ、Ⅳ型)患者资料,均行经后外侧入路小切口全髋关节置换.结果与结论:25例患者随访≥6个月.置换后复查X射线示假体位置良好;1例出现脱位,处理后未再发生脱位;1例下肢不等长,不影响行走.置换后9个月Harris评分平均85.7.置换后未发生感染、神经损伤、假体松动、假体周围骨质情况及深静脉血栓形成.说明经后外侧入路小切口全髋关节置换具有创伤小、人工关节稳定性强、患者恢复时间短等优点,适合老年股骨颈骨折(Garden Ⅲ、Ⅳ型)患者.%BACKGROUND: Total hip arthroplasty has become one of the common treatment modalities of the traumatic femoral neckfractures in the aged. Total hip arthroplasty with minimal incision not only reduces the surgical trauma and the patients suffering,but also benefits the recovery from operation in the aged.OBJECTIVE: To explore the clinical results of total hip arthroplasty with posterior minimal incision for the treatment of femoralneck fractures.METHODS: A total of 25 cases of traumatic femoral neck fractures (Garden Ⅲ and Ⅳ) underwent total hip arthroplasty withposterior minimal incision were retrospectively analyzed.RESULTS AND CONCLUSION: All 25 cases were followed up for more than 6 months. According to the X-ray examination afteroperation, the prosthesis was in good position. One case had prosthesis dislocation, and the dislocation didn't happen aftertreatment. One case had lower limb discrepancy which did not influence walks. The average Harris score was 85.7 in the 9thmonth after operation. There was no infection, nerve injury, prosthetic

  9. Medial canthopexy using Y-V epicanthoplasty incision in the correction of telecanthus.

    Science.gov (United States)

    Kim, Tae-Gon; Chung, Kyu-Jin; Kim, Yong-Ha; Lim, Jong-Hyo; Lee, Jun-Ho

    2014-02-01

    Telecanthus occurs because of the disruption of the medial canthal tendon (MCT). The deformity of medial canthus can result from nasoorbitoethmoid fractures, tumor resection, craniofacial exposure, congenital malposition, or aging. Repair of the MCT using transnasal wiring is regarded as a method of choice to treat telecanthus. We have introduced an oblique transnasal wiring using Y-V epicanthoplasty incision rather than the well-known classical bicoronal approach. Eight patients with telecanthus were treated with this method. Through the medial canthal horizontal and periciliary incision, we could have an access to the medial orbital wall and the MCT. An oblique transnasal wiring was performed with the following steps: (1) after slit skin incision on the nasal recession of the contralateral frontoglabella area, 2 drill holes were made from this point to the superior and posterior region of the lacrimal fossa of the affected orbit; (2) a 2-0 wire was passed through the MCT and the holes; (3) the wire was pulled and tightened until the MCT was ensured and was twisted in the contralateral side. After the repositioning of the MCT, the skin was simply sutured. The excess skin was trimmed, and then the skin was sutured with nylon 7-0. The remaining "dog ear" in the lateral portion can be removed by additional periciliary skin incision and excision. All the patients achieved an improvement and a prompt recovery. The interepicanthal distance was decreased by 6.3 mm on average compared with that in the preoperative condition. All patients had no complication associated with surgeries. Of posttraumatic telecanthus, 5 patients were much satisfied with the outcomes, and 1 patient had recurrence on postoperative month 3. In cases of congenital anomaly or neoplasm, the telecanthus was also improved. An oblique transnasal wiring using Y-V epicanthoplasty incision could be a simple, safe method to correct the telecanthus with the following advantages: first, we could fix the MCT

  10. Palatoplastia con incisiones mínimas: Proposición de una técnica y revisión de la literatura Palatoplasty with minimal incisions: Technique proposal and literature review

    Directory of Open Access Journals (Sweden)

    J.A. León Pérez

    2009-03-01

    Full Text Available Existen numerosas técnica quirúrgicas para la reparación de las fisuras del paladar, desde colgajos uni o bipediculados hasta Z-plastias, sin que se haya llegado a encontrar la técnica ideal. Proponemos una técnica quirúrgica con incisiones mínimas a fin de obtener mejores resultados y menor morbilidad, con menor número de complicaciones, tanto tempranas como tardías. Desde 1998 hemos empleado la técnica de palatoplastia con incisiones mínimas en un total de 336 niños, 195 mujeres (58% y 141 varones (42%, con una media de edad de 18 meses (de 6 a 36 meses, logrando disminuir el riesgo de hemorragia y fibrosis, así como el tiempo quirúrgico y la estancia hospitalaria. No se presentaron casos de sangrado postoperatorio, el porcentaje de dehiscencia de la herida y de fístulas secundarias fue del 5% y 323 casos (el 96% fueron intervenidos en régimen ambulatorio. Concluimos que se trata de una técnica fácil de realizar, con un porcentaje de fístulas menor al referido en la literatura y en general, con una menor morbilidad.There are several surgical techniques described for cleft palate reparing, from uni or bipediculated flaps to Z-plastias, without finding the ideal one. We propose a new technique with minimal incisions, to get better results, less morbidity and less early or delayed complications. Since 1998 we have used the technique of palatoplasty with minimal incisions in 336 children, 195 (58% girls and 141 (42% boys, with an average age of 18 months (6 to 36 months, diminishing risk of bleed and fibrosis, surgical time and reducing hospitalisation. In the postoperatory, did not appear bleed, the percentage of wound open and secondary fistula was 5% and 332 cases (96% were handled like ambulatory procedures. As a conclusion, we present an easy surgical technique, with an smaller reported percentage of fistula and less morbidity.

  11. Llioinguinal Minimally Invasive Incision in Pelvic Fracture Fixation Techniques%髂腹股沟微创切口内固定技术在骨盆骨折中的应用

    Institute of Scientific and Technical Information of China (English)

    许科峰; 汪建良; 朱亚文; 肖俊; 卢绪; 刘卫峰; 谭章勇

    2013-01-01

    Objective To explore the efficacy and features of fixation techniques in fractures of acetabular column or pubic rami through minimally invasive incision ilioinguinal approach. Methods From July 2007 to September 2011,31 cases of patients with pelvic fractures (including pubic rami fracture in 23 cases,acetabular anterior column fracture in 8 cases)were surgucally fixed through minimally invasive incision ilioinguinal approach. Patients using general anesthesia or spinal and epidural anesthesia,take both ends of the inner and outer incision traditional ilioinguinal approach,from both internal and external incision close to the bone-oriented intermediate sneak peel interconnected to form a pubic rami,acetabular anterior column interlinked the tunnel and periosteal stripping poking expand channel. Reconstruction plate channels within the bone surface,since the pre-bent titanium plate inserted the lateral incision close to the bone surface,respectively,in the titanium plate proximal and distal holes screwed three screws steel. Results All the patients were followed upo for 5 to 29 months with an average of 14. 1 months. All fractures healed. According to Matta reset standards, there were anatomical reductions of the hip inl4 cases,good inl6 cases,poor in one cases. The excellent and good rate was 96. 7%. According to Majeed score,excellent in 19 cases,good in 11 cases, fair in 1 case,The excellent and good rate was 96. 7%. No infection,injury of the femoral nerve,femoral vein thrombosis ,heterotopic ossification,osteoarthritis ,avascular necrosis and other complications were found. Conclusion Fracture fixation through minimally invasive ilioinguinal aproach is a good choice for acetabular or pubic rami fracture.%目的 研究采用髂腹股沟微创切口内固定技术治疗髋臼前柱或耻骨支骨折的疗效及特点.方法 自2007年7月至2011年9月,对31例骨盆骨折患者(其中耻骨支骨折23例,髋臼前柱骨折8例)采用髂腹股沟微创切口内

  12. A nondeforming rhytidectomy incision.

    Science.gov (United States)

    Talamas, I

    1999-01-01

    A new incision for facial rhytidectomy is presented that completely avoids deformation of the frame of the hair and allows the hair to be combed back without showing the scar, which becomes almost completely invisible in most patients if the incision is made at exactly the specified level. Several authors have tried to maintain the normal hairline, but some of their incisions deform the frame of the hair on the sides, higher than the level of the outer corner of the eye, and others go even higher than this point outside of the hairline, making the scar quite visible! The indications and contraindications for this operation and its designed incisions are discussed. These incisions encourage plastic surgeons not to remove any scalp in the rhytidectomy, but only the skin, because it is precisely the removal of scalp instead of skin that deforms the face, unless the amount of scalp tissue removed is very small. These same incisions are indicated for men.

  13. Minimally invasive paediatric cardiac surgery.

    Science.gov (United States)

    Bacha, Emile; Kalfa, David

    2014-01-01

    The concept of minimally invasive surgery for congenital heart disease in paediatric patients is broad, and has the aim of reducing the trauma of the operation at each stage of management. Firstly, in the operating room using minimally invasive incisions, video-assisted thoracoscopic and robotically assisted surgery, hybrid procedures, image-guided intracardiac surgery, and minimally invasive cardiopulmonary bypass strategies. Secondly, in the intensive-care unit with neuroprotection and 'fast-tracking' strategies that involve early extubation, early hospital discharge, and less exposure to transfused blood products. Thirdly, during postoperative mid-term and long-term follow-up by providing the children and their families with adequate support after hospital discharge. Improvement of these strategies relies on the development of new devices, real-time multimodality imaging, aids to instrument navigation, miniaturized and specialized instrumentation, robotic technology, and computer-assisted modelling of flow dynamics and tissue mechanics. In addition, dedicated multidisciplinary co-ordinated teams involving congenital cardiac surgeons, perfusionists, intensivists, anaesthesiologists, cardiologists, nurses, psychologists, and counsellors are needed before, during, and after surgery to go beyond apparent technological and medical limitations with the goal to 'treat more while hurting less'.

  14. 一次性负压引流球预防小切口根治腋臭术后血肿的临床研究%Clinical research of one-off negative-pressure drainage ball preventing hematoma from the radical surgery of osmidrosis via minimal crease incision

    Institute of Scientific and Technical Information of China (English)

    吴海龙; 刘烨; 李寅; 齐洪广; 张聪; 马群

    2012-01-01

      腋臭;小切口;一次性负压引流球;血肿%  Objective:To explore an effective method preventing hematoma from the radical surgery of osmidrosis via minimal axillary crease incisions. Methods:under tumescent anesthesia , 3.5 to 5cm incision along the central axillary crease was adopted and sharp dissection was conducted superficial layer of subcutaneous tissues were 1cm separated outside of the ampit hair field or appreciably 1cm beyond the border of hirci region. Then bilateral flaps were turned over, sweat glands and arm pit hair follicles were removed beneath the skin via small incisions, and the skin was shaved to full-thickness skin. One-off negative-pressure drainage ball was implanted under the full thick skin graft within the top of 1.5cm of incision on the edge, and was then deflated and plugged by ball plug, the flap adhered well to subcutaneous tissue by negative pressure, then pressure dressing. Results:Of 112patients,111 healed primarily with concealed scar ,1patient showed lateral subcutaneous hematoma and was healed finally after simple change dressings. There was no odor remained in each case .Conclusion:One-time negative-pressure drainage ball is very useful on surgical procedure concerning axillary osmidrosis via mini crease incision, and it can reduce efficiently hematoma complication and increase cure rate significantly. Therefore, it is worth popularized in clinic.

  15. Single Incision Laparoscopic Splenectomy: Our First Experiences

    Directory of Open Access Journals (Sweden)

    Umut Barbaros

    2011-06-01

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

  16. Long-term efficacy analysis of minimal incision osteotomy for treatment of hallux valgus%微创截骨治疗(足母)外翻的远期疗效分析

    Institute of Scientific and Technical Information of China (English)

    孙卫东; 吴夏勃; 戴鹤玲; 温建民; 胡海威; 孙永生; 桑志成; 蒋科卫; 梁朝; 程程; 林新晓

    2010-01-01

    Objective To evaluate the long-term results of minimal incision osteotomy for hallux valgus.Methods From February 1996 to May 1999,372 cases(705 feet)with hallux valgus were treated with minimal incision osteotomy.Seventy-nine cases after surgery were followed up for more than 5 years,including 6 males(10 feet)and 73 females(140 feet)with an average age of 47 years(range,13-75 years).The average follow-up time was 7.5 years(range,5.3-13.2 years).The preoperative and postoperative hallux valgus angles(HVA),intermetatarsal angles(IMA),the tibial sesamoid position(TSP),American orthopedic foot and ankle society(AOFAS)score,range of movement of the first metatarsophalangeal joint,and lateral metatarsalgia etc.were observed and measured.And the clinic outcome were studied and evaluated.Results Based on Wen Jian-min's clinic curative effect evaluation criterion(2001),56 feet(37.3%)were excellent,88 feet(58.7%)good ,6 feet(4.0%)fair.The rate of excellent or good was 96.0%(144/150).The postoperative mean AOFAS score was 84.20±4.32 points(range,60-100 points).The mean HVA decreased from 33.28 to 12.31 degrees,the mean IMA from 11.75 to 6.80 degrees.The TSP was corrected from an average preoperative grade of 4.29 to a grade of 3.07 at final follow-up.There are no nonunion or delayed union of osteotomy,avascular necrosis of the 1st metatarsal head,infection,hallux varus.Four feet(2.7%)had numbness in the medial of the big toe.The 1st metatarsophalangeal joint range of motion decreased from 70.20 to 69.53 degrees.There were 97 feet(64.7%)with the 2-5 metatarsalgia before operation,and 35 feet(23.3%)disappeared,54 feet(36.0%)improved,8 feet(5.3%)aggravated after operation.Conclusion Minimal incision osteotomy technique is sound and reliable method to treat hallux valgus.The osteotomy technique is simple,and could provide satisfactory long-term results with lower complication rate.%目的 评价微创截骨治疗(足母)外翻的远期疗效.方法 对1996年2月至1999年5月

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

    Directory of Open Access Journals (Sweden)

    Nidhi Jauhari

    2014-12-01

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

  18. Percutaneous internal jugular venous cannulation for extracorporeal circulation during minimally invasive technique in children with congenital heart disease: operative technique and results.

    Science.gov (United States)

    Vida, Vladimiro L; Tiberio, Ivo; Gallo, Michele; Guariento, Alvise; Suti, Emirjeta; Pittarello, Demetrio; Stellin, Giovanni

    2016-10-01

    The aim of this study was to evaluate the safety and efficacy of the percutaneous cannulation of the internal jugular venous (PCIJV) for extracorporeal circulation during minimally invasive cardiac surgery (MICS) in children with simple congenital heart disease. From September 2007, 83 children (<16 years) underwent PCIJV for extracorporeal circulation. Primary outcome of the study was to evaluate the safety and advantages of PCIJV technique. Technical steps and pitfalls of PCIJV technique are described. Median age at surgery was 9 years (range 3.5-16 years) and median body weight was 31 kilograms (range 13-72 kilograms); 32 patients (40%) had a body weight less than 30 kilograms. The PCIJV was achieved with a 14 French cannula in 61 pts (73%), with a 17 Fr cannula in 22 (23%). The PIJVC was judged difficult in 2 patients (2.4%); in both of them cannulation was achieved at a different venous site There were no procedure-related complications and no flow disturbances during the extracorporeal circulation. The PCIJV during MICS is an effective and reproducible technique for achieving peripheral CPB in children with simple CHDs. We progressively expanded the use of this technique in smaller children and this allows us to further minimize surgical trauma without experiencing venous drainage's problems.

  19. Current Status of Single-incision Laparoscopic Surgery

    DEFF Research Database (Denmark)

    Ahmed, Irfan; Ciancio, Fabio; Ferrara, Vincenzo;

    2012-01-01

    Recent advances in minimally invasive surgery have centered on reducing the number of incisions required, which has led to the development of the single-incision laparoscopic technique. A panel of European single-incision laparoscopy experts met to discuss the current status of, and the future...... expectations for, the technique. The experts reached agreement on a number of statements and recommendations, which will support surgeons in adopting the technique. The panel agreed that the single-incision technique may offer a number of benefits to patients; however, further clinical data need...

  20. Fontan operation for the Cantrell syndrome using a clamshell incision.

    Science.gov (United States)

    Ito, Hiroki; Ota, Noritaka; Murata, Masaya; Sakamoto, Kisaburo

    2013-10-01

    A median sternotomy could be difficult for a child with ectopia cordis and complex congenital cardiac anomalies. We report a patient with ectopia cordis, functionally single ventricle and bilateral superior vena cava, who underwent a staged Fontan procedure through a clamshell incision and the sternothoracotomy approach.

  1. Minimum-incision metatarsal ray resection: an observational case series.

    Science.gov (United States)

    Roukis, Thomas S

    2010-01-01

    This report describes the results of 17 metatarsal ray resections performed through a minimal incision in 13 consecutive patients. Each patient underwent minimum-incision metatarsal ray resection for either definitive treatment or as the index incision and drainage procedure followed by transmetatarsal amputation. There were 10 male and 3 female patients with a mean age of 68.8 +/- 8.5 years (range, 59-83 years). Twelve patients had diabetes mellitus and 7 had critical limb ischemia. There were 11 right feet and 6 left feet involved, and 3 second, 3 third, 3 fourth, and 8 fifth minimum-incision metatarsal ray resections performed. Direct primary-incision closure was performed 7 times (1 with adjacent percutaneous metatarsal osteotomy), delayed primary closure was performed 4 times (1 with external fixation), and conversion to a transmetatarsal amputation was performed 2 times. Fourteen of 17 minimum-incision metatarsal ray resections were deemed successful. Two failures occurred when skin necrosis developed from excessive tension along the incision line requiring conversion to a transmetatarsal amputation, and the other occurred in a patient with unreconstructed critical limb ischemia who underwent multiple repeated incision and drainage procedures and vascular bypass with ultimate healing via secondary intent. When properly performed in patients with adequate vascular inflow, minimum-incision metatarsal ray resection as the definitive procedure or in conjunction with an incision and drainage for unsalvageable toe infection or gangrene represents a safe, simple, useful technique.

  2. INCISIVE FORMAL VERIFIER

    Institute of Scientific and Technical Information of China (English)

    Cadence公司

    2007-01-01

    Incisive Formal Verifier为您的工作平台带来了形式分析的强大性能,能够令生产力大幅提高,并提升设计质量。作为Incisive平台的全套断言式验证解决方案的一个关键组件,Incisive Formal Verifier让你能够提前几个月开始验证,降低了重新投片的风险,加快了上市时间。

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

    Directory of Open Access Journals (Sweden)

    Fernando Passos Rocha

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

  4. Single incision laparoscopic surgery

    Institute of Scientific and Technical Information of China (English)

    Arun; Prasad

    2010-01-01

    As a complement to standard laparoscopic surgery and a safe alternative to natural orifice transluminal endoscopic surgery,single incision laparoscopic surgery is gaining popularity.There are expensive ports,disposable hand instruments and flexible endoscopes that have been suggested to do this surgery and would increase the cost of operation.For a simple surgery like laparoscopic cholecystectomy,these extras are not needed and the surgery can be performed using standard ports,instruments and telescopes.Tri...

  5. Congenital Hypothyroidism

    Science.gov (United States)

    ... Body in Balance › Congenital Hypothyroidism Fact Sheet Congenital Hypothyroidism March, 2012 Download PDFs English Espanol Editors Rosalind S. ... MD Susan R. Rose, MD What is congenital hypothyroidism? Newborn babies who are unable to make enough ...

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

    Science.gov (United States)

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

    2013-12-01

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

  7. Craniosynostosis incision: scalpel or cautery?

    Science.gov (United States)

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

    2014-07-01

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

  8. First Report: Linear Incision for Placement of a Magnetically Coupled Bone-Anchored Hearing Implant.

    Science.gov (United States)

    Barry, Jonnae Y; Reghunathan, Saranya; Jacob, Abraham

    2017-02-01

    Discuss use of a linear incision for placement of a magnetically coupled bone anchored hearing implant. Case series. Two patients underwent placement of magnetically coupled bone-anchored hearing implants (BAHI) through linear incisions. The first, a 40-year-old female with congenital single-sided deafness, previously had successful implantation of a percutaneous bone anchored hearing implant through a linear incision; unfortunately, she developed pain and intermittent drainage at her abutment site with time, resulting in a request for removal of her device. As an alternative to complete removal, we offered to replace the percutaneous implant with a magnetically coupled BAHI, employing the same linear incision previously. The second patient, a 53-year-old obese female with limited neck mobility and mixed hearing loss, underwent primary placement of a magnetically coupled BAHI through a linear incision. Limitations in neck mobility and patient body habitus precluded use of a traditional C-shaped incision. Both patients underwent surgery successfully, healed without incident, had their devices activated 6 weeks after their procedures, and are able to wear their implants more than 8 hours per day without discomfort. Surgical techniques for bone-anchored implants continue to evolve. Though manufacturers of magnetically coupled devices recommend using C-shaped incisions with large skin flaps, our first reported cases suggest that a small linear incision immediately overlying the implant magnet may be an acceptable alternative. Potential benefits include a smaller incision, less hair removal, smaller flap, decreased surgical time, and less postoperative pain.

  9. CORTICAL CLEANUP WITHOUT SIDE PORT IN SMALL INCISION CATARACT SURGERY

    Directory of Open Access Journals (Sweden)

    Udaya Kumar

    2015-11-01

    Full Text Available The aim of study was to achieve complete cortical cleanup and avoid problems related with sideport during Small Incision Cataract Surgery (SICS so as to have a good visual out come with minimal recovery period, and a better quality of life. After nucleus delivery, cortical cleanup is an important step in any cataract surgical procedure. Cortex especially subincisional area (11 to 1 o’clock is difficult to manage intraoperatively. Bimanual irrigation aspiration through two side ports, aspiration by J cannula, iris massage manoeuver, ice cream scoop manoeuver are various techniques of cortical matter aspiration. We acquired the technique of aspiration of subincisional cortex without using side port in all cases by paying attention on type of cataract, status of pupil, use of Adrenalin mixed BSS intraoperatively, Tunnel construction, Capsulorhexis size and capsular rim size at 12 o’clock. MATERIAL AND METHODS In this retrospective study of 1 year from 2013 to 2014, 60 patients (60 eyes aged 40 years or older attending the General Ophthalmic Department were included in the study group with another group of 60 patients (60 eyes as controls. The study was on age related cataracts which are basically. 1 Cortical cataract 2 Nuclear cataract 3 Subcapsular cataract. Proper assessment of cortical cataract based on its maturity such as a Immature b Mature c Hyper mature and d Morgagnian cataract, nucleus for its opalescence and color, size of posterior subcapsular opacity and pupillary status (Dilating well or not with mydriatics were taken into consideration. Eyes with pseudoexfoliation having poor pupillary dilation were also included. Eyes with congenital anomalies, congenital cataract, gross corneal and retinal pathologies, and glaucoma were excluded. RESULTS Among 60 study eyes in the study group 35 presented with cortical, 20 with nuclear cataract and 5 with posterior subcapsular cataracts. In 58(96.6% cases, sideport was not required; 3(5% eyes

  10. A congenital mucocele of the anterior dorsal tongue

    NARCIS (Netherlands)

    Wong Chung, J.E.; Ensink, R.J.H.; Thijs, H.F.; Hoogen, F.J.A. van den

    2014-01-01

    We report on a new-born with a congenital mucocele on the anterior dorsal side of the tongue. The presentation as well as the differential diagnosis of congenital oral swellings is discussed. Because of breastfeeding problems the mucinous swelling was incised and drained two days after birth. Immedi

  11. Channel incision and water quality

    Science.gov (United States)

    Shields, F. D.

    2009-12-01

    Watershed development often triggers channel incision that leads to radical changes in channel morphology. Although morphologic evolution due to channel incision has been documented and modeled by others, ecological effects, particularly water quality effects, are less well understood. Furthermore, environmental regulatory frameworks for streams frequently focus on stream water quality and underemphasize hydrologic and geomorphic issues. Discharge, basic physical parameters, solids, nutrients (nitrogen and phosphorus), chlorophyll and bacteria were monitored for five years at two sites along a stream in a mixed cover watershed characterized by rapid incision of the entire channel network. Concurrent data were collected from two sites on a nearby stream draining a watershed of similar size and cultivation intensity, but without widespread incision. Data sets describing physical aquatic habitat and fish fauna of each stream were available from other studies. The second stream was impacted by watershed urbanization, but was not incised, so normal channel-floodplain interaction maintained a buffer zone of floodplain wetlands between the study reach and the urban development upstream. The incised stream had mean channel depth and width that were 1.8 and 3.5 times as large as for the nonincised stream, and was characterized by flashier hydrology. The median rise rate for the incised stream was 6.4 times as great as for the nonincised stream. Correlation analyses showed that hydrologic perturbations were associated with water quality degradation, and the incised stream had levels of turbidity and solids that were two to three times higher than the nonincised, urbanizing stream. Total phosphorus, total Kjeldahl N, and chlorophyll a concentrations were significantly higher in the incised stream, while nitrate was significantly greater in the nonincised, urbanizing stream (p Ecological engineering of stream corridors must focus at least as much energy on mediating hydrologic

  12. A congenital mucocele of the anterior dorsal tongue.

    Science.gov (United States)

    Wong Chung, J E R E; Ensink, R J H; Thijs, H F H; van den Hoogen, F J A

    2014-07-01

    We report on a new-born with a congenital mucocele on the anterior dorsal side of the tongue. The presentation as well as the differential diagnosis of congenital oral swellings is discussed. Because of breastfeeding problems the mucinous swelling was incised and drained two days after birth. Immediately after drainage the swelling disappeared. Congenital oral swellings are rare. Most of them are mucoceles. Post-partum treatment is surgically, but spontaneous remission has been described. High incidence of recurrence should be taken into account when (micro-)marsupialization or incision as sole treatment is performed. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  13. Single incision laparoscopic liver resection: a case report

    Institute of Scientific and Technical Information of China (English)

    CAI Xiu-jun; ZHU Zhi-yi; LIANG Xiao; YU Hong; WANG Yi-fan; HE Ji-kai; LI Zhe-yong

    2010-01-01

    Laparoscopic procedure as a minimally invasive surgery has been introduced into many abdominal surgeries. Smaller incisions of the abdominal wall reduce postoperative pain and the risk of wound complications,and provide an excellent cosmetic result compared with open surgery. Natural orifice transluminal endoscopic surgery (NOTES), a no-scar surgery, is a hot spot of modern surgery.

  14. Congenital Hypothyroidism

    Science.gov (United States)

    ... Disease Featured Resource Find an Endocrinologist Search Congenital Hypothyroidism March 2012 Download PDFs English Espanol Editors Rosalind S. ... Pediatric Endocrine Society MedlinePlus (NIH) What is congenital hypothyroidism? Newborn babies who are unable to make enough ...

  15. The observation of curative effect of conventional incision versus minimally invasive techniques in the treatment of lateral tibial plateau fractures%传统切口与微创技术治疗胫骨外侧平台骨折的疗效观察

    Institute of Scientific and Technical Information of China (English)

    钱本俄; 张世华; 李祥; 章志祥; 张金林; 张世旭

    2015-01-01

    目的:分析比较传统切口加普通高尔夫钢板与解剖锁定板联合微创固定技术在治疗胫骨外侧平台骨折的临床疗效. 方法:回顾分析2010年1月至2013年12月收治胫骨外侧平台骨折患者100例 ,其中对照组49 例采用传统切口加普通高尔夫钢板治疗 ,观察组51例采用解剖锁定板联合微创技术治疗.术后随访9~15个月 ,比较分析两组患者的手术时间、骨折愈合时间、术后并发症及术后功能恢复情况.结果:观察组手术时间、骨折愈合时间短于对照组(P 0 .05 ).结论:解剖锁定板联合微创技术治疗胫骨外侧平台骨折具有优势 ,该方法局部组织创伤小 ,软组织破坏少 ,能有效保留骨折周围血液循环 ,手术切口愈合快 ,有利于早起功能锻炼 ,恢复关节功能.%Objective:To compare and analysis the clinical effects of the conventional incision using ordinary golf steel plate and mini-mally invasive techniques combined with dissection locKing plate in the treatment of lateral tibial plateau fractures .Methods :The clinical data of 100 patients with lateral tibial plateau fractures enrolled from January 2010 to December 2013 were retrospectively analyzed .In the control group ,49 cases were treated with conventional incision plus ordinary golf steel plate .The observation group of 51 cases re-ceived anatomical locKing plate combined with minimally invasive treatment .Patients were followed up for 9~15 months after the surger-y .The operation time ,fracture healing time ,postoperative complications and functional recovery of the two groups were compared and analyzed between the two groups .Results :The operation time and fracture healing time of the observation group were shorter than that of the control group( P 0 .05) .Conclusion:Minimally invasive technique combined with dissection locKing plate is an advantageous way to treat lateral tibial plateau fractures ,for it provides effective protection of blood cir

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

    Directory of Open Access Journals (Sweden)

    Tetsushi Aizawa, MD

    2014-11-01

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

  17. Time between skin incision and delivery during cesarean.

    Science.gov (United States)

    Rossouw, Jana N; Hall, David; Harvey, Justin

    2013-04-01

    To investigate factors influencing skin incision-to-delivery time (including sub-divisions thereof) and the effect of these surgical intervals on immediate neonatal outcome. A prospective cohort analysis was conducted of all women undergoing cesarean delivery at Tygerberg Hospital, Cape Town, South Africa, from May 24 to November 2, 2010. Three surgical intervals were evaluated: skin incision to myometrium, myometrium to delivery, and skin incision to delivery. Neonatal outcome was assessed by the 5-minute Apgar score. Of 1120 cesarean deliveries recorded during the study period, 77.2% were emergency procedures, which were performed more quickly at all surgical planes (Pdelivery time was significantly extended among repeat procedures (Pdeliveries. Repeat procedures, adhesions, and obesity prolonged the time taken for cesarean delivery. Nevertheless, the effect of these factors on the 5-minute Apgar score was minimal. Copyright © 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  18. A Prospective, Randomized Study of Component Position in Two-Incision MIS Total Hip Arthroplasty: A Preliminary Study.

    Science.gov (United States)

    Meneghini, R Michael; Smits, Shelly A

    2011-12-01

    Controversy exists regarding the ability to position the implants reliably in minimally invasive surgery (MIS) total hip arthroplasty (THA). This study compared the ability to accurately position components in the MIS two-incision versus single-incision approaches. Twenty-four patients were randomized to THA through one of three approaches, including the two-incision approach. Component position was measured with computed tomography. The mean deviation from the target acetabular anteversion was 14.8 degrees in the two-incision MIS group versus 6.4 degrees in the other two approaches (p = 0.006). A mean of 9.8 degrees deviation from the target femoral anteversion in the two-incision MIS approach group was observed compared with 5.3 degrees in the single-incision groups (p = 0.05). These results suggest there is a decreased ability to accurately position the components in the two-incision approach.

  19. A single incision transaxillary thoracoscopic sympathectomy

    Directory of Open Access Journals (Sweden)

    Marić Nebojša

    2014-01-01

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

  20. Treatment of congenital thoracic scoliosis with associated rib fusions using VEPTR expansion thoracostomy: a surgical technique.

    Science.gov (United States)

    Dayer, Romain; Ceroni, Dimitri; Lascombes, Pierre

    2014-07-01

    Untreated growing patients with congenital scoliosis and fused ribs will develop finally thoracic insufficiency syndrome. The technique of expansion thoracoplasty with implantation of a vertical expandable prosthetic titanium rib (VEPTR) was introduced initially to treat these children. This article attempts to provide an overview of the surgical technique of opening-wedge thoracostomy and VEPTR instrumentation in children with congenital thoracic scoliosis and fused ribs. Our modification of the surgical approach using a posterior midline incision rather than the modified thoracotomy incision initially described could potentially help to diminish wound dehiscence and secondary infection, while preserving a more acceptable esthetic appearance of the back. Vertical expandable prosthetic titanium rib-based treatments should be undertaken only with a good knowledge of its numerous specific complications. Every aspect of the treatment should be oriented to minimize these complications. At the same time it should be kept in mind that the ultimate step of this long-term fusionless treatment strategy will be a technically demanding spine fusion.

  1. Histomorphological and immunofluorescence evaluation of bimanual and coaxial phacoemulsification incisions in rabbits.

    Science.gov (United States)

    Johar, S R Kaid; Vasavada, Abhay R; Praveen, Mamidipudi R; Pandita, Deepak; Nihalani, Bharati; Patel, Udayan; Vemuganti, Geeta

    2008-04-01

    To compare the changes in the histomorphology and immunofluorescence of collagen type I in clear corneal incisions (CCIs) at the end of bimanual and coaxial phacoemulsification in rabbits. Iladevi Cataract and IOL Research Centre, Ahmedabad, India. In this randomized study, the left eye of 30 rabbits had bimanual phacoemulsification through 1.2 mm CCIs for phaco tip access accompanied by an additional 1.4 mm incision for irrigating chopper access or coaxial phacoemulsification through a 2.6 mm single-plane CCI. The right eyes acted as controls. Samples collected at the end of surgery were processed for histomorphology using periodic acid-Schiff-hematoxylin staining and immunofluorescence localization of type I collagen. Incisions exposed to bimanual phacoemulsification had loss of epithelium, stromal fiber shrinkage, keratocyte nuclei fragmentation and condensation, ragged tunnel margins, and Descemet membrane and endothelial cell loss. The changes were minimal or absent in incisions exposed to coaxial phacoemulsification. Immunofluorescence showed a loss of parallel arrangement of type I collagen fibers in bimanual phacoemulsification incisions, while the fibers were well preserved in coaxial phacoemulsification incisions. The changes were more prominent in the roof of the incision tunnel than in the floor. Corneal incisions for bimanual phacoemulsification were more prone to damage than those for coaxial phacoemulsification. This may be attributed to the absence of a sleeve, which places the incision tunnel in direct contact with the metal phaco tip.

  2. Simultaneous minimally invasive technique for congenital heart disease and pectus excavatum%微创技术同期治疗漏斗胸合并先天性心脏病

    Institute of Scientific and Technical Information of China (English)

    石卓; 李建华; 徐玮泽; 张泽伟; 陈自力; 俞建根; 粱靓

    2011-01-01

    Objective To investigate the safty and feasibility of simultaneous minimally invasive technique for congenital heart disease (CHD) and pectus excavatum (PE).Methods From July 2006 to June 2011,6 children with PE associated with CHD were treated by simultaneous minimally invasive technique.They were 4 boys and 2 girls,aged from 4 years to 6 years 5 months ( average 5 years and 4 month),.The body weight were from 16 kg to 20 kg [ average ( 18.00 ± 1.79kg ].CT Hailer index were 3.9 - 5.0 ( average 4.35 ± 0.43 ).4 patients with ventricular septal defect (VSD) were treated by minimally invasive closure device,including 3 membranous VSD and 1 subaortic VSD.The defect diameter was 4 - 5 mm.2 cases with atrial septal defect (ASD) were treated using the same technique.the diameter of ASD was 12 - 16 mm.After minimally invasive heart surgery,Nuss operation was carried out in all 6 patients for their PE.Results All operations were successful and patients were extubated 5 - 11 h after operation [ mean ( 8.17 ± 2.04) h ].The pericardial mediastinal drainage was removed at 48 h postoperatively.There were no operative mortality and severe postoperative complications.1 patient had delayed wound healing and was successfully discharged.The plate was removed in 3 cases,and they all had satisfactory outcomes.Conclusion Simultaneous minimally invasive technique is a safe and effeictive mothod for treating pectus excavatum and congenital heart disease.%目的 探讨应用微创技术同期治疗漏斗胸合并先天性心脏病(先心)的方法及可行性.方法 2006年7月至2011年6月应用双微创技术6例,其中男4例,女2例;年龄4~6岁5月,平均5岁4月;体重16 ~ 20 kg,平均(18.00±1.79) kg.CT Haller指数3.9 ~5.0,平均(4.35±0.43).其中4例行室间隔缺损微创伞封术(3例膜部和1例主动脉瓣下室间隔缺损,缺损直径4 ~5 mm);2例行中央型继发孔房间隔缺损微创伞封术,直径12~16mm.先心微创术后行Nuss手术,术后

  3. Incision for pleural tissue biopsy (image)

    Science.gov (United States)

    ... the pleural tissue is removed through a surgical incision in the chest. After the sample is obtained, a chest tube is placed and the incision is closed with stitches. Abnormal results may indicate ...

  4. SMART micro-scissors based precise incision

    Science.gov (United States)

    Park, Hyun-Cheol; Yeo, Chaebeom; Song, Cheol

    2015-03-01

    Hand tremor reduction is important to achieve stable micro manipulation of the tool tip. A micro-scissors can be used for cutting delicate tissues safely. Here, we implement an OCT distance sensor guided SMART micro-scissors which could incise micro-surgical targets precisely and horizontally. Compared to freehand incision, it demonstrates enhanced incision performance on dry phantoms with great tremor suppression.

  5. CLINICAL APPLICATION OF WEAR BUCCAL APPARATUS COMBINED WITH INTRAORAL INCISION MINIMALLY INVASIVE TREATMENT ON MANDIBULAR ANGLE AND RAMI FRACTURES%穿颊器联合口内切口微创治疗下颌骨角部及升支骨折的临床应用

    Institute of Scientific and Technical Information of China (English)

    林旭征; 魏福海; 罗衍靖; 朱敏姬; 潘慧琦

    2015-01-01

    目的:探究分析利用穿颊器联合口内切口微创治疗下颌骨角部、升支骨折的临床应用及治疗效果。方法选取我院自2012年10月1日~2015年3月31日期间收治的下颌骨角部、升支骨折患者62例,作为临床研究对象。将所有患者进行随机分为对照组和观察组,每组各31例,对照组采用常规下颌下入路行骨折固定,观察组采用穿颊器联合口内切口入路微创治疗行骨折固定。对患者术后进行随访,记录并比较两组患者术后半年面颈部瘢痕、张口受限、腮腺涎漏、面神经损伤等并发症发生率及其临床疗效。结果观察组术后半年上下颌颌关系恢复情况明显优于对照组,其半年面颈部瘢痕、张口受限、腮腺涎漏、面神经损伤等并发症发生率(3.23%、0.00%、3.23%、6.45%)均明显小于对照组(29.03%、25.81%、32.26%、35.48%),且其手术显效率及总有效率(58.06%、90.32%)也均明显高于对照组(22.58%、29.03%),( p<0.05),差异具有统计学意义。结论利用穿颊器联合口内切口微创治疗下颌骨角部、升支骨折优势明显,手术创伤小,术后并发症少,患者颌关系恢复情况良好,有一定的临床优势,值得推广使用。%Objective To explore the clinical application and effect of wearing buccal apparatus combined with intraoral incision minimally invasive treatment of mandibular angle and rami fractures .Methods 62 patients of Mandibular angle and ramus fractures during the march month 31 from October 1, 2012 to 2015 in our hospital were selected as a clinical research object .All the patients were grouped randomly with 31 cases in each group .The con-trol group was treated with conventional submandibular approach for fracture fixation , and the observation group were treated by wearing buccal apparatus combined with intraoral incision minimally invasive treatment for bone fracture

  6. SIMPLIFIED LAPAROSCOPIC CHOLECYSTECTOMY WITH TWO INCISIONS

    Science.gov (United States)

    ABAID, Rafael Antoniazzi; CECCONELLO, Ivan; ZILBERSTEIN, Bruno

    2014-01-01

    Background Laparoscopic cholecystectomy has traditionally been performed with four incisions to insert four trocars, in a simple, efficient and safe way. Aim To describe a simplified technique of laparoscopic cholecystectomy with two incisions, using basic conventional instrumental. Technique In one incision in the umbilicus are applied two trocars and in epigastrium one more. The use of two trocars on the same incision, working in "x" does not hinder the procedure and does not require special instruments. Conclusion Simplified laparoscopic cholecystectomy with two incisions is feasible and easy to perform, allowing to operate with ergonomy and safety, with good cosmetic result. PMID:25004296

  7. Comparison of clinical outcomes and postoperative recovery between two open heart surgeries:minimally invasive right subaxillary vertical thoracomy and traditional median sternotomy

    Institute of Scientific and Technical Information of China (English)

    Chuan-Xian Hu; Juan Tan; Sheng Chen; Hui Ding; Zhi-Wei Xu

    2014-01-01

    Objective:To compare the clinical outcomes of minimally invasive right subaxillary vertical thoracotomy and traditional median sternotomy through right atrium in treatment of common congenital heart diseases.Methods:Clinical data of59 cases of common congenital heart diseases treated with minimally invasive right axillary vertical thoracotomy fromMay,2011 to February,2013 and77 cases of same diseases withtraditional median sternotomy in the past three years were retrospectively analyzed, including atrial septal defect, membranous ventricular septal defect and partial endocardial cushion defect.The results were compared from the two groups, including the time for operation and cardiopulmonary bypass, amount of blood transfusion, postoperative drainage, ventilation time, hospital stay, and prognosis.Results:No severe complications happened in both groups, like deaths or secondary surgery caused by bleeding.No significant differences were inCPB time and postoperative ventilator time between groups(P>0.05), while for all of the operative time, the length of incision, postoperative drainage and hospital stay, minimally invasive right axillary vertical thoracotomy was superior to median sternotomy, with statistically significant differences(P<0.05).In six-month followup after operation, no complications of residual deformity and pericardial effusion were found in both groups by doing echocardiography, but mild pectus carinatum was found in8 patients in the traditional median sternotomy group(traditional group), whereas patients in another group were well recovered. Conclusions:Minimally invasive right subaxillary vertical thoracotomy for common congenital heart diseases is as safe as traditional median sternotomy, without the increasing incidence of postoperative complications.Additionally, compared with traditional median sternotomy, minimally invasive right subaxillary vertical thoracotomy is better in the aspects of hidden incision, appearance, and postoperative

  8. [Congenital thrombophilia].

    Science.gov (United States)

    Kojima, Tetsuhito

    2016-03-01

    Congenital thrombophilia is a thrombotic diathesis caused by a variety of genetic abnormalities in blood coagulation factors or their inhibitory factors associated with physiological thrombus formation. Patients with congenital thrombophilia often present with unusual clinical episodes of venous thrombosis (occasionally combined with pulmonary embolism, known as venous thromboembolism) at a young age and recurrence in atypical vessels, such as the mesenteric vein and superior sagittal sinus, often with a family history of this condition. Studies in Japan as well as in western countries have shown congenital thrombophilia to be caused by a wide variety of genetic abnormalities in natural anticoagulant proteins, such as antithrombin, protein C, and protein S. However, there may still be many unknown causes of hereditary thrombosis. We recently reported a case of hereditary thrombosis induced by a novel mechanism of antithrombin resistance, that is, congenital thrombophilia caused by a gain-of-function mutation in the gene encoding the coagulation factor prothrombin.

  9. Congenital Myopathy

    Science.gov (United States)

    ... evaluate the electrical activity of the muscle, a muscle biopsy, and genetic testing. There are currently seven distinct types of congenital myopathy, with some variation in symptoms, complications, treatment options, and outlook. Nemaline ...

  10. Congenital syphilis

    Science.gov (United States)

    Congenital syphilis is caused by the bacteria Treponema pallidum , which is passed from mother to child during fetal development or at birth. Nearly half of all children infected with syphilis while they ...

  11. A modified two-incision technique for primary total hip arthroplasty

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    Bal B

    2008-01-01

    Full Text Available Background: Minimally invasive surgery can be technically demanding but minimizes surgical trauma, pain and recovery. Two-incision minimally invasive surgery allows only intermittent visualization and may require fluoroscopy for implant positioning. We describe a modified technique for primary total hip arthroplasty, using two small incisions with a stepwise approach and adequate visualization to reliably and reproducibly perform the surgery without fluoroscopy. Materials and Methods: One hundred and two patients with an average age of 60 years underwent modified two-incision minimally invasive technique for primary THA without fluoroscopy. The M/L taper femoral stem (Zimmer, Warsaw, IN and Trilogy (Zimmer hemispherical titanium shell, with a highly cross-linked polyethylene liner, was used. Operative time, blood loss, postoperative hospital stay, radiographic outcomes and complications were recorded. Results: The mean operating time was 77 min. The mean blood loss was 335 cc. The mean hospital stay was 2.4 days. Mean cup abduction angle was 43.8°. Mean leg length discrepancy was 1.7 mm. Thirteen patients had lateral thigh numbness and two patients had wound complications that resolved without any treatment. Conclusion: A modified two-incision technique without fluoroscopy for primary total hip arthroplasty has the advantage of preserving muscles and tendons, shorter recovery and return to function with minimal complications. Provided that the surgeon has received appropriate training, primary total hip arthroplasty can be performed safely with the modified two-incision technique.

  12. ROLE OF INCISION SITE IN REDUCING SURGICALLY INDUCE D ASTIGMATISM IN MANUAL SMALL INCISION CATARACT SURGE RY

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    Sathish

    2013-04-01

    Full Text Available INTRODUCTION: Phacoemulsification and foldable IOLs allow modern day surgeon to aim at minimal induction of any astigmatic error as well a s correct any pre-operative refractive errors thus making patients’ life, spectacle free i.e. una ided emmetropia. But its high price and maintenance with a long learning curve for the surg eon make it unsuitable for the Indian camp scenario. Manual SICS in comparison needs a larger incision f or both nucleus removal and a rigid IOL insertion, but still provides for a sutureless and c onvenient alternative to phaco. Manual SICS does induce some amount of astigmatism by altering corneal curvatures (i.e., by coupling effect, while phaco surgery with 3 mm incision is astigmatic ally neutral. Manifold of studies have been done to compare Surgically Induced Astigmatism of ma nual SICS to phaco surgery but not much has been done to compare various techniques in manua l SICS itself. In this study an attempt has been made to analyze t he role of incision site depending on the pre operative keratometry readings in reducing su rgically induced astigmatism in manual small incision cataract surgery.

  13. Transumbilical multiport laparoscopic nephroureterectomy for congenital renal dysplasia in children: midterm follow-up from a single institution

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    Hong eMei

    2013-12-01

    Full Text Available OBJECTIVE: To assess the clinical utility and efficiency of transumbilical multiport laparoscopic nephroureterectomy (TMLN for the treatment of congenital renal dysplasia in children by analyzing consecutive cases from a single institution. METHODS: Sixteen children underwent TMLN procedure due to dysplastic kidney between January 2010 and December 2011. The surgery was transperitoneally performed through three transumbilical incisions for two 5-mm and one 3-mm ports, which duplicated the standard laparoscopic steps with the usual laparoscopic instruments. Demographic, perioperative, and follow-up data were analyzed. RESULTS: TMLN was performed in all patients, without additional ports or conversion to open surgery. The mean operation time was 108.4 minutes (range 90–125, and the blood loss was minimal. There were no severe intraoperative or postoperative complications. The postoperative recovery was uneventful in all patients. No urinary incontinence or umbilical hernias occurred. The cosmetic result was excellent as the incision scar was hidden inside the belly button. CONCLUSION: TMLN is a safe and efficient procedure for the management of congenital renal dysplasia in children with good cosmesis. Future randomized studies with a larger number of cases and a longer follow-up are warranted to elucidate the benefits and limitations of TMLN in children.

  14. Transumbilical multiport laparoscopic nephroureterectomy for congenital renal dysplasia in children: midterm follow-up from a single institution.

    Science.gov (United States)

    Mei, Hong; Qi, Teng; Li, Shuai; Pu, Jiarui; Cao, Guoqing; Tang, Shaotao; Zheng, Liduan; Tong, Qiangsong

    2013-01-01

    To assess the clinical utility and efficiency of transumbilical multiport laparoscopic nephroureterectomy (TMLN) for the treatment of congenital renal dysplasia in children by analyzing consecutive cases from a single institution. Sixteen children underwent TMLN procedure due to dysplastic kidney between January 2010 and December 2011. The surgery was transperitoneally performed through three transumbilical incisions for two 5-mm and one 3-mm ports, which duplicated the standard laparoscopic steps with the usual laparoscopic instruments. Demographic, perioperative, and follow-up data were analyzed. TMLN was performed in all patients, without additional ports or conversion to open surgery. The mean operation time was 108.4 min (range 90-125), and the blood loss was minimal. There were no severe intraoperative or post-operative complications. The post-operative recovery was uneventful in all patients. No urinary incontinence or umbilical hernias occurred. The cosmetic result was excellent as the incision scar was hidden inside the belly button. TMLN is a safe and efficient procedure for the management of congenital renal dysplasia in children with good cosmesis. Future randomized studies with a larger number of cases and a longer follow-up are warranted to elucidate the benefits and limitations of TMLN in children.

  15. A two-incision approach: promises and pitfalls.

    Science.gov (United States)

    Rosenberg, Aaron G

    2005-09-01

    Is this an optimal procedure? Clearly, it is not for every patient, but it does serve patients who can benefit from rapid recovery as well as those patients truly interested in minimizing their down time. It also is clearly not for the occasional total hip surgeon. It is a technique that brings to the patient the maximum potential for speed of recovery. However, it is important to stress again that the surgical approach is just one factor facilitating the recovery curve. While the benefits are real, their importance must be weighed by both surgeon and patient relative to the risks. The risks are not insignificant, but generally decrease with time and experience. As opposed to several smaller incision modifications of routine approaches to THA, the two-incision approach does require a separate and distinctively different skill set, including alternative methods to make up for the lack of standard visualization and careful attention to details such as incision placement and location of the starting point in the intramedullary canal. However, in the rest of the medical world, that is what minimally invasive surgery is about.

  16. Modified tubularized incised plate urethroplasty

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    Shivaji Mane

    2013-01-01

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

  17. Supra-Pubic Single Incision Cholecystectomy

    OpenAIRE

    Hagen, Monika E.; Wagner, Oliver J.; Thompson, Kari; Jacobsen, Garth; Spivack, Adam; Wong, Brian; Talamini, Mark; Horgan, Santiago

    2009-01-01

    Introduction Surgery is moving towards less invasive and cosmetically superior approaches such as single incision laparoscopy (SIL). While trans-umbilical SIL is gaining popularity, incisions may lead to post-operative deformations of the umbilicus and the possibility of an increased rate of incisional hernias. Access within the pubic hairline allows preservation of the umbilicus and results in a scar which is concealed within the pubic hair. Methods Supra-pubic single incision cholecystectom...

  18. Multidirectional Vector Excision Leads to Better Outcomes than Traditional Elliptical Excision of Facial Congenital Melanocytic Nevus

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    Seung Il Oh

    2013-09-01

    Full Text Available Background The elliptical excision is the standard method of removing benign skin lesions,such as congenital melanocytic nevi. This technique allows for primary closure, with little to nodog-ear deformity, but may sacrifice normal tissue adjacent to the lesion, resulting in scarswhich are unnecessarily long. This study was designed to compare the predicted results ofelliptical excision with those resulting from our excision technique.Methods Eighty-two patients with congenital melanocytic nevus on the face were prospectivelystudied. Each lesion was examined and an optimal ellipse was designed and marked onthe skin. After an incision on one side of the nevus margin, subcutaneous undermining wasperformed in the appropriate direction. The skin flap was pulled up and approximated alongseveral vectors to minimize the occurrence of dog-ear deformity.Results Overall, the final wound length was 21.1% shorter than that achieved by ellipticalexcision. Only 8.5% of the patients required dog-ear repair. There was no significant distortionof critical facial structures. All of the scars were deemed aesthetically acceptable based ontheir Patient and Observer Scar Assessment Scale scores.Conclusions When compared to elliptical excision, our technique appears to minimize dogeardeformity and decrease the final wound length. This technique should be considered analternative method for excision of facial nevi.

  19. Minimal Pairs: Minimal Importance?

    Science.gov (United States)

    Brown, Adam

    1995-01-01

    This article argues that minimal pairs do not merit as much attention as they receive in pronunciation instruction. There are other aspects of pronunciation that are of greater importance, and there are other ways of teaching vowel and consonant pronunciation. (13 references) (VWL)

  20. Minimally invasive cardiac surgery in the adult: surgical instruments, equipment, and techniques.

    Science.gov (United States)

    Kitamura, M; Uwabe, K; Hirota, J; Kawai, A; Endo, M; Koyanagi, H

    1998-09-01

    To clarify the special instruments and equipment used for minimally invasive cardiac surgery (MICS), we examined the initial experiences with MICS operations with ministernotomy or minithoracotomy at our institution. Fifty adult patients with congenital, valvular, and/or ischemic heart diseases underwent MICS operations, and all surgical procedures were completed without conversion to full sternotomy. The length of the skin incision was about 10 cm or less in all patients. Postoperative recovery was favorable, and the majority of the patients were discharged from the hospital around the end of the second postoperative week. In this series of patients, an oscillating bone saw, lifting type retractor, 2 blade spreader, cannula with a balloon, and right-angled aortic clamp among other items, were very useful for successfully performing various operations with MICS approaches and techniques. The associated results suggest that MICS with ministernotomy or minithoracotomy was feasible using special instruments and equipment and could be encouraged for adult patients with various cardiovascular diseases.

  1. Clinical outcomes of and patient satisfaction with different incision methods for donor hepatectomy in living donor liver transplantation.

    Science.gov (United States)

    Suh, Suk-Won; Lee, Kwang-Woong; Lee, Jeong-Moo; Choi, YoungRok; Yi, Nam-Joon; Suh, Kyung-Suk

    2015-01-01

    With the decrease in the average donor age and the increase in the proportion of female donors, both donor safety and cosmetic appearance are major concerns for some living donors in living donor liver transplantation (LDLT) because a large abdominal incision is needed that may influence the donor's quality of life. In all, 429 donors who underwent donor hepatectomy for LDLT from April 2010 to February 2013 were included in the study. Donors were divided into 3 groups based on the type of incision: conventional inverted L incision (n = 268; the C group), upper midline incision (n = 147; the M group), and transverse incision with laparoscopy (n = 14; the T group). Demographics, perioperative outcomes, postoperative complications for donors and recipients, and questionnaire-derived donor satisfaction with cosmetic appearance were compared. The mean age was lower (P self-confidence were noted in the M and T groups versus the C group. In conclusion, the use of a minimal incision is technically feasible for some donor hepatectomy cases with a favorable safety profile. The patient satisfaction levels were greater with improved cosmetic outcomes in cases of minimal incision versus cases of conventional incision.

  2. Patient Satisfaction with Postaural Incision Site

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    George Barrett

    2014-01-01

    Full Text Available Introduction. Controversy exists over the optimum incision placement when performing ear surgery via the postauricular approach. Little is known about the impact of incision placement on future comfort in wearing audio or visual aids or the effect on the minor auricular muscles cut in the approach. Objective. (1 To establish patient satisfaction with their postauricular surgical incision, and to establish the impact on comfort wearing hearing or visual aids. (2 To establish whether patients’ voluntary ear movements were affected by surgery. Materials and Methods. In January 2014, questionnaires were sent to 81 patients who underwent mastoid surgery requiring a postauricular incision between January 2004 and December 2012. The incision placement was broadly the same for all patients as they were operated on by the same surgeon (or under his supervision. The incision is sited far posteriorly at the hairline. Results. 42 (52% of the patients contacted responded. 80% of patients wearing glasses reported no discomfort or problems associated with their incision. 82% of patients who wear hearing aids were comfortable. Only 1 of the 5 patients who could move their ears preoperatively noticed a change afterwards. Conclusion. A hairline incision is well tolerated by most of the patients.

  3. [Congenital epulis].

    Science.gov (United States)

    Braga-Tavares, H; Santos, H; M-Pinto, I; Ramos, M; de Sousa, P

    2009-01-01

    Congenital epulis or gingival granular cell tumor is an uncommon benign tumor, usually diagnosed at birth as a pediculated maxilar gingival mass. Although some cases of spontaneous regression have been described, most of the lesions are surgically removed with excelent prognosis and cosmetic final result. The authors describe a case report as well as a short revision on this pathology.

  4. Congenital amusias.

    Science.gov (United States)

    Tillmann, B; Albouy, P; Caclin, A

    2015-01-01

    In contrast to the sophisticated music processing reported in the general population, individuals with congenital amusia show deficits in music perception and production. Congenital amusia occurs without brain damage, sensory or cognitive deficits, and has been suggested as a lifelong deficit with genetic origin. Even though recognized for a long time, this disorder has been systematically studied only relatively recently for its behavioral and neural correlates. The currently most investigated hypothesis about the underlying deficits concerns the pitch dimension, notably with impaired pitch discrimination and memory. Anatomic and functional investigations of pitch processing revealed that the amusic brain presents abnormalities in the auditory and inferior frontal cortices, associated with decreased connectivity between these structures. The deficit also impairs processing of pitch in speech material and processing of the time dimension in music for some of the amusic individuals, but does not seem to affect spatial processing. Some studies suggest at least partial dissociation in the disorder between perception and production. Recent studies revealed spared implicit pitch perception in congenital amusia, supporting the power of implicit cognition in the music domain. Current challenges consist in defining different subtypes of congenital amusia as well as developing rehabilitation programs for this "musical handicap."

  5. Hillslope-derived blocks retard river incision

    Science.gov (United States)

    Shobe, Charles M.; Tucker, Gregory E.; Anderson, Robert S.

    2016-05-01

    The most common detachment-limited river incision models ignore the effects of sediment on fluvial erosion, yet steep reaches of mountain rivers often host clusters of large (>1 m) blocks. We argue that this distribution of blocks is a manifestation of an autogenic negative feedback in which fast vertical river incision steepens adjacent hillslopes, which deliver blocks to the channel. Blocks inhibit incision by shielding the bed and enhancing form drag. We explore this feedback with a 1-D channel-reach model in which block delivery by hillslopes depends on the river incision rate. Results indicate that incision-dependent block delivery can explain the block distribution in Boulder Creek, Colorado. The proposed negative feedback may significantly slow knickpoint retreat, channel adjustment, and landscape response compared to rates predicted by current theory. The influence of hillslope-derived blocks may complicate efforts to extract base level histories from river profiles.

  6. RECENT ADVANCES IN THE TREATMENT OF CONGENITAL CLUBFOOT

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    Vane Antolič

    2003-09-01

    Full Text Available Background. In the article the etiology and pathological changes in congenital clubfoot are described. The manipulation and casting technique according to Ponseti is presented: the foot is abducted with dorsiflexion of the first ray while pressure is maintained on the lateral aspect of the talar neck in front of the lateral maleolus. The additional skin incision in the line of Achilles tendon is no longer used and the Cincinatti incision is slightly modified in the posterior part of the foot. The operative reposition of the talanavicular joint is in most of cases no longer necessary because of the succesful manipulation and casting technique according to Ponseti. Consequently, the operative time is shortened.Conclusions. Due to recent advances in the treatment of congenital clubfoot patients stay in the hospital only 24 hour after surgery. However the course and result of congenital clubfoot remains to be impredictable to some degree, presumably etiological heterogenity.

  7. Best practices for minimally invasive procedures.

    Science.gov (United States)

    Ulmer, Brenda C

    2010-05-01

    Techniques and instrumentation for minimally invasive surgical procedures originated in gynecologic surgery, but the benefits of surgery with small incisions or no incisions at all have prompted the expansion of these techniques into numerous specialties. Technologies such as robotic assistance, single-incision laparoscopic surgery, natural orifice transluminal endoscopic surgery, and video-assisted thoracoscopic surgery have led to the continued expansion of minimally invasive surgery into new specialties. With this expansion, perioperative nurses and other members of the surgical team are required to continue to learn about new technology and instrumentation, as well as the techniques and challenges involved in using new technology, to help ensure the safety of their patients. This article explores the development of minimally invasive procedures and offers suggestions for increasing patient safety.

  8. Endoscopy-assisted cerebral falx incision via unilateral

    Directory of Open Access Journals (Sweden)

    DONG Ji-rong

    2012-04-01

    Full Text Available 【Abstract】Objective: To investigate the clinical features and treatment strategy of dissymmetric bilateral frontal contusion, and to summarize our experience in treat-ing these patients by minimally invasive surgery. Methods: Over the past 3 years, we have treated a total of 31 patients with dissymmetric bilateral frontal contusion using endoscopy-assisted unilateral cerebral falx incision. Other 30 patients treated by routine bilateral approaches within the same period were taken as control. Results: Seventeen cases (54.8% in the unilateral operation group survived and were in good condition, 8 (25.8% had moderate disability, 4 (12.9% had severe disability, 1 (3.2% was in vegetative state, and 1 (3.2% died. Compared with the control group, the Glasgow Out-come Scale score was not significantly different in the uni-lateral operation group, but the operation time, blood trans-fusion volume, the length of hospital stay, the incidences of mental disorder and olfactory nerve injury were greatly reduced in the unilateral operation group. Conclusions: Endoscopy-assisted unilateral cerebral falx incision can shorten the operation time, reduce surgical trauma and complications in treatment of patients with dis-symmetric bilateral frontal contusion. It can obviously di-minish the chance of delayed intracerebral hematoma and subsequently minimize the incidences of subfalcial and centrencephalic herniation. Key words: Brain injuries; Intracranial hemorrage, traumatic; Endoscopy; Surgically procedures, minimally invasive

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

    Institute of Scientific and Technical Information of China (English)

    Hongyi Cui

    2011-01-01

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

  10. Ultrasonic incisions produce less inflammatory mediator response during early healing than electrosurgical incisions.

    Directory of Open Access Journals (Sweden)

    Bindu Nanduri

    Full Text Available As the use of laparoscopic surgery has become more widespread in recent years, the need has increased for minimally-invasive surgical devices that effectively cut and coagulate tissue with reduced tissue trauma. Although electrosurgery (ES has been used for many generations, newly-developed ultrasonic devices (HARMONIC® Blade, HB have been shown at a macroscopic level to offer better coagulation with less thermally-induced tissue damage. We sought to understand the differences between ES and HB at a microscopic level by comparing mRNA transcript and protein responses at the 3-day timepoint to incisions made by the devices in subcutaneous fat tissue in a porcine model. Samples were also assessed via histological examination. ES-incised tissue had more than twice as many differentially-expressed genes as HB (2,548 vs 1,264 respectively, and more differentially-expressed proteins (508 vs 432 compared to control (untreated tissue. Evaluation of molecular functions using Gene Ontology showed that gene expression changes for the energized devices reflected the start of wound healing, including immune response and inflammation, while protein expression showed a slightly earlier stage, with some remnants of hemostasis. For both transcripts and proteins, ES exhibited a greater response than HB, especially in inflammatory mediators. These findings were in qualitative agreement with histological results. This study has shown that transcriptomics and proteomics can monitor the wound healing response following surgery and can differentiate between surgical devices. In agreement with clinical observations, electrosurgery was shown to incur a greater inflammatory immune response than an ultrasonic device during initial iatrogenic wound healing.

  11. Congenital parotid fistula

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    Shiggaon Natasha

    2014-01-01

    Full Text Available Parotid fistula is a cause of great distress and embarrassment to the patient. Parotid fistula is most commonly a post-traumatic situation. Congenital parotid salivary fistulas are unusual entities that can arise from accessory parotid glands or even more infrequently, from normal parotid glands through an aberrant Stensen′s duct. The treatment of fistulous tract is usually surgical and can be successfully excised after making a skin incision along the skin tension line around the fistula opening. This report describes a case of right accessory parotid gland fistula of a 4-year-old boy with discharge of pus from right cheek. Computed tomography (CT fistulography and CT sialography demonstrated fistulous tract arising from accessory parotid gland. Both CT fistulography and CT sialography are very helpful in the diagnosis and surgical planning. In this case, superficial parotidectomy is the treatment of choice. A detailed history, clinical and functional examination, proper salivary gland investigations facilitates in correct diagnosis followed by immediate surgical intervention helps us to restore physical, psychological health of the child patient.

  12. [Congenital hydrocephalus].

    Science.gov (United States)

    Malagón-Valdez, J

    2006-04-10

    Congenital hydrocephalus or ventriculomegaly is a disorder that now can be diagnosed in uterus with ultrasonography, this gives the chance of being able to give a treatment the earliest as possible. The clinical manifestations are reviewed, the diagnosis, the frequent treatment and causes of congenital hydrocephalus, being the first agenesis of the Sylvius' aqueduct, followed by Arnold-Chiari's malformations with mielomeningocele. In most of the cases the peritoneal-ventricle shunt is the best surgery treatment and now, the treatment with ventriculostomy of third ventricle by endoscopy has fewer complications apparently and in several cases it is the definitive treatment. The evolution of the diagnosis with the support of specific therapies is effective and the early treatment is good, of course taking into account the etiology.

  13. Congenital scoliosis - Quo vadis?

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    Debnath Ujjwal

    2010-01-01

    Full Text Available Congenital spinal vertebral anomalies can present as scoliosis or kyphosis or both. The worldwide prevalence of the vertebral anomalies is 0.5-1 per 1000 live births. Vertebral anomalies can range from hemi vertebrae (HV which may be single or multiple, vertebral bar with or without HV, block vertebrae, wedge shaped or butterfly vertebrae. Seventy per cent of congenital vertebral anomalies result in progressive deformities. The risk factors for progression include: type of defect, site of defect (junctional regions and patient′s age at the time of diagnosis. The key to success in managing these spinal deformities is early diagnosis and anticipation of progression. One must intervene surgically to halt the progression of deformity and prevent further complications associated with progressive deformity. Planning for surgery includes a preoperative MRI scan to rule out spinal anomalies such as diastematomyelia. The goals of surgical treatment for congenital spinal deformity are to achieve a straight growing spine, a normal standing sagittal profile, and a short fusion segment. The options of surgery include in situ fusion, convex hemi epiphysiodesis and hemi vertebra excision. These basic surgical procedures can be combined with curve correction, instrumentation and short segment fusion. Most surgeons prefer posterior (only surgery for uncomplicated HV excision and short segment fusion. These surgical procedures can be performed through posterior, anterior or combined approaches. The advocates of combined approaches suggest greater deformity correction possibilities with reduced incidence of pseudoarthrosis and minimize crankshaft phenomenon. We recommend posterior surgery for curves involving only an element of kyphosis or modest deformity, whereas combined anterior and posterior approach is indicated for large or lordotic deformities. In the last decade, the use of growing rods and vertebral expandable prosthetic titanium rib has improved the

  14. [Congenital aniridia].

    Science.gov (United States)

    Chiruţa, Daria; Stan, Cristina

    2014-01-01

    Aniridia is a rare congenital, hereditary, bilateral disease which is associated with various systemic and ocular defects. We present the case of a 61 year old patient who was admitted in the hospital of ophthalmology Cluj Napoca, for the symptoms caused by the ocular defects associated with aniridia. In this case, aniridia is autosomal dominant transmitted with incomplete penetrance and it is not accompanied by any systemic defects. The disease also affects three of her sons and two nephews of the patient.

  15. Congenital Hydrocephalus.

    Science.gov (United States)

    Estey, Chelsie M

    2016-03-01

    There are several types of hydrocephalus, which are characterized based on the location of the cerebrospinal fluid (CSF) accumulation. Physical features of animals with congenital hydrocephalus may include a dome-shaped skull, persistent fontanelle, and bilateral ventrolateral strabismus. Medical therapy involves decreasing the production of CSF. The most common surgical treatment is placement of a ventriculoperitoneal shunt. Postoperative complications may include infection, blockage, drainage abnormalities, and mechanical failure.

  16. Congenital Thrombocytopenia

    Institute of Scientific and Technical Information of China (English)

    王兆钺

    2011-01-01

    @@ Platelets are essential for normal hemostasis.Platelets adhere to damaged blood vessels, and then aggregate and promote activation of coagulation factors, resulting to ceasing bleeding.Both quantitative and qualitative abnormalities of platelets can cause bleeding problems.Among them, immune thrombocytopenias are the most common conditions.However, congenital thrombocytopenias are often neglected because of their relative rarity and complex laboratory tests.That causes misdiagnosis and unnecessary and potentially harmful treatments for many patients.

  17. Congenital diplopodia

    Energy Technology Data Exchange (ETDEWEB)

    Brower, Jason S.; Wootton-Gorges, Sandra L.; Costouros, John G.; Boakes, Jennette; Greenspan, Adam [University of California, Davis, Department of Radiology, 4860 Y. Street, Suite 3100, CA 95817, Davis (United States)

    2003-11-01

    Diplopodia, or duplicated foot, is a rare congenital anomaly. It differs from polydactyly in that supernumerary metatarsal and tarsal bones are present as well as extra digits. Only a few cases of this anomaly have been reported in the literature to date. We present a newborn male without intrauterine teratogen exposure who was born with a duplicate foot of the left lower extremity and imperforate anus. (orig.)

  18. [Congenital ranula].

    Science.gov (United States)

    Marques, Maria Inês; Morais, Sofia; Coutinho, Sílvia; de Castro, Ochoa; Rei, Ana Isabel

    2010-01-01

    The authors describe a case of congenital ranula diagnosed by a routine prenatal ultrasonography at 21 weeks of gestation. The fetal kariotype was normal. Follow-up ultrasound scans revealed no changes in the size or the position of the cyst. Fetal growth was normal as was the amniotic fluid volume. Surgical treatment was performed 3 days after a normal vaginal delivery, with excellent results.

  19. SCAR AFTER SURGICAL INCISION FOR APPENDECTOMY: S-SHAPE VS LINEAR INCISION

    Directory of Open Access Journals (Sweden)

    M OMRANI FARD

    2003-03-01

    Full Text Available Introduction: Hyperthrophic scar and keloid is a big problem after many operation. Hypertrophic scar depended on many factor one of them is Incision. Method: This is a randomized clinical trial and sequential sampling in Alzahra hospital and Kashani hospital. we selected two groups, one group we used S shape incision and observed group linear incision. Age was between 10-30 years and dermatological problems and cigaret smoking was Negative in two groups perforated and secondly skin closure was excluded in our study. patient divided in two group each group was twenty and fllowed for one year. Patients satisfaction and skin collor normality and itchiny was evaluated in two groups. Results: Appearance of scar was different in collor much and shape. Normality for collor of incision in s shape groups were 68.4% but in linar incision was 31.6% (Pvalue= 0.026 with statically meaningful. Mean of scar width: In 5-shape =1.33+0.49mm in Linear shape = 2.23+0.92. P = 0.001. Prevalence of itching was same in both groups. Discussion: patients overall satisfaction and itching were the same for both groups. skin color normality was 68.4% in 5 shape incision groups versus 31.6% in linear incision groups which has been shown to be statistically meaningful using chi-square test so it seems reasonable to conclude that calor mathing is more favorable in 5 shape incisions rather than linear incision. Mean of scare width in licear incision group was 2.23+0.92 mm versus 1.32+0.49 mm in 5 shape incision group. this difference is also statistically meaningful using T test. 50 it can be concluded that using 5 shape incision is better because post operative scar is smaller and exposure is like linear incision.

  20. [The treatment of otosclerosis using laser assisted stapedotomy with mini incision in external auditory meatus].

    Science.gov (United States)

    Hao, Xinping; Chen, Shubin; Yu, Zilong; Liang, Fenghe; Li, Yongxin

    2016-03-01

    To investigate the feasibility of the treatment of otosclerosis using laser stapedotomy with mini incision in the external auditory meatus. Thirteen patients(15 ears) with otosclerosis evidence on clinic history. They were all operated using the laser assisted stapedotomy by mini incision in external auditory meatus because of the wide straight canal. Laser resection the tendo musculistapedius and anterior and postrior arch, breaking the articulatioincudostapedia, removing the stapes superstructure, making a hole of 6mm diameter in the rear of stapes footplate by laser drilling, implanting the corresponding length Piston artificial ossicle. All the surgeries were successful and the operation time was about one hour. There was only one patient manifested vertigo and nausea after the operation. But the symptoms improved three days later after the expectant treatment. All the incisions were healed in the externals. There was significant difference between the preoperative and postoperative PTA. The air conduct improved in every frequent and the bone conduct improved in 1 kHz, 2 kHz and 4 kHz. Laser assisted stapedotomy by mini incision in the external auditory meatus in patients having wide straight canal with otosclerosis can shorten the operation time, minimize the tissue damage, fasten the healing of the incision and reduce the complications postoperatively. In addition, the mini incision is beauty and easy to nurse.

  1. Single-incision total laparoscopic hysterectomy

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    Sinha Rakesh

    2011-01-01

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

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

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

    2016-03-01

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

  3. DNA Methylation Modulates Nociceptive Sensitization after Incision.

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    Yuan Sun

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

  4. Congenital syphilis

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    Lee, Sang Wook; Kim, Kyung Soo; Hur, Don [Chosun University College of Medicine, Kwangju (Korea, Republic of)

    1983-12-15

    In recent years, marked increase in incidence of congenital syphilis has occurred throughout the world due to changes in social norms and development of penicillin-resistant strains. Early diagnosis plays an important role in congenital syphilis as the clinical manifestations may simulate many other conditions in the paediatric age group. The authors analyzed 52 cases of congenital syphilis admitted to the department of paediatrics, Chosun University Hospital, clinically and radiologically. Among them, 18 cases were born in this hospital and 34 cases were admitted from OPD, during the period of 8 years from January, 1975 to December, 1982. The results obtained were as follows; 1. In 28 of 34 cases (82%), the first clinical manifestations were below the age of 3 months. 2. Among the 52 cases, a male predominance was observed with a male to female ratio of 2 : 1. 3. The serologic test (VDRL) of the 52 studied cases showed reactive response in 49 cases (94%), and that of syphilitic mothers except 6 cases, reactive in all studied cases. 4. The major manifestations of the 52 cases were bone tenderness (12%) and swelling of the joints (7%) in skeletal system, hepatosplenomegaly (79%) and skin lesions (73%) in extraskeletal one. 5. The radiological skeletal changes were detected in 45 of 52 cases (87%), and the commonest findings were detected in 45 of 52 cases (87%), and the commonest findings were metaphysitis (83%) and periostitis (81%). The most characteristic type of metaphysitis were transverse trophic line (74%) and zone of rarefaction (65%). 6. The commonest bones to be affected were growing metaphyses of the long bones, particulary about the wrist and the knee. The order of frequency were radius (80%), uina (80%), tibia (77%), femur (69%) and humerus (40%)

  5. Congenital hypoaldosteronism.

    Science.gov (United States)

    Sethupathi, Vanathi; Vijayakumar, M; Janakiraman, Lalitha; Nammalwar, B R

    2008-08-01

    Congenital hypoaldosteronism due to an isolated aldosterone biosynthesis defect is rare. We report a 4 month old female infant who presented with failure to thrive, persistent hyponatremia and hyperkalemia. Investigations revealed normal serum 17 hydroxy progesterone and cortisol. A decreased serum aldosterone and serum 18 hydroxy corticosterone levels with a low 18 hydroxy corticosterone: aldosterone ratio was suggestive of corticosterone methyl oxidase type I deficiency. She was started on fludrocortisone replacement therapy with a subsequent normalization of electrolytes. Further molecular analysis is needed to ascertain the precise nature of the mutation.

  6. Vaginal Delivery After Dührssen Incisions in a Patient With Bladder Exstrophy and Uterine Prolapse.

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    Lachica, Ruben; Chan, Yen; Uquillas, Kristen R; Lee, Richard H

    2017-04-01

    Bladder exstrophy is a rare congenital anomaly affecting the lower abdominal wall, pelvis, and genitourinary structures. Pregnant women with bladder exstrophy present a unique challenge to the obstetrician. The patient is a 35-year old pregnant woman with bladder exstrophy, an extensive surgical history, and uterine prolapse with an abnormal, rubbery consistency to her cervix. Prenatally, she was counseled on the potential use of Dührssen incisions to facilitate vaginal delivery. Labor was induced at 36 4/7 weeks of gestation after her pregnancy was complicated by recurrent pyelonephritis. Vaginal delivery was achieved 8 minutes after the creation of Dührssen incisions. The care of pregnant women with bladder exstrophy requires multidisciplinary management and careful delivery planning. Successful vaginal delivery can be attained in these patients.

  7. COMPARISION OF RESULTS OF TWO DIFFERENT INCISIONS IN POSTERO MEDIAL SOFT TISSUE RELEASE IN IDIOPATHIC CLUB FOOT

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    Ramkishan

    2015-10-01

    Full Text Available : OBJECTIVE: To acess and compare the results of two different incisions in Turco’s postero medial soft tissue release. MATERIAL & METHODS: 48Cases in 1-2Yr age group, 69 rigid feet of which 34 male, 14 female 12bilateral feet, 10left feet, 17right feet. 5patients have positive family history. RESULTS: In all cases one stage STR performed, excellent in 35 feet, good in 25feet, skin necrosis in 6patients. 6patients did not turned up for follow up. The one-stage postermedial soft tissue release performed by using a straight medial horizontal and postero medial curvilinear incisions is an excellent way of managing the problem of congenital talipes equinovarus with few complications like skin edges necrosis. The both incisions are given best results if applied in appropriate selection of child.

  8. Single incision laparoscopic colorectal resection: Our experience

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    Chinnusamy Palanivelu

    2012-01-01

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

  9. Minimally Invasive Osteotomies of the Calcaneus.

    Science.gov (United States)

    Guyton, Gregory P

    2016-09-01

    Osteotomies of the calcaneus are powerful surgical tools, representing a critical component of the surgical reconstruction of pes planus and pes cavus deformity. Modern minimally invasive calcaneal osteotomies can be performed safely with a burr through a lateral incision. Although greater kerf is generated with the burr, the effect is modest, can be minimized, and is compatible with many fixation techniques. A hinged jig renders the procedure more reproducible and accessible. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Sigmoid volvulus treated by mini-incision.

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    Seow-En, I; Seow-Choen, F

    2014-12-01

    Definitive surgical management of sigmoid volvulus is usually via a midline laparotomy or laparoscopy. We report our experience with a series of five consecutive cases over a 10-year period. All patients had definitive surgery via a left iliac fossa mini-incision after prior decompression. For four patients, it was the first episode of sigmoid volvulus and one patient had a recurrent sigmoid volvulus after previous sigmoid colectomy. The latter patient had pan colonic megacolon diagnosed at initial surgery. All five cases were surgically treated successfully via a mini-incision on the left iliac fossa. There were no instances of recurrence at a median follow-up duration of 95 months (range 7-132 months). A left iliac fossa mini-incision is sufficient for the definitive management of non-perforated sigmoid volvulus. Larger studies are warranted to draw definitive conclusions.

  11. Single incision endoscopic surgery for lumbar hernia.

    Science.gov (United States)

    Kawaguchi, Masahiko; Ishikawa, Norihiko; Shimizu, Satsuki; Shin, Hisato; Matsunoki, Aika; Watanabe, Go

    2011-01-01

    Single Incision Endoscopic Surgery (SIES) has emerged as a less invasive surgery among laparoscopic surgeries, and this approach for incisional hernia was reported recently. This is the first report of SIES for an incisional lumbar hernia. A 66-year-old Japanese woman was referred to our institution because of a left flank hernia that developed after left iliac crest bone harvesting. A 20-mm incision was created on the left side of the umbilicus and all three trocars (12, 5, and 5 mm) were inserted into the incision. The hernial defect was 14 × 9 cm and was repaired with intraperitoneal onlay mesh and a prosthetic graft. The postoperative course was uneventful. SIES for lumbar hernia offers a safe and effective outcome equivalent compared to laparoscopic surgery. In addition, SIES is less invasive and has a cosmetic benefit.

  12. Subciliary incision and lateral cantholysis in rigid internal fixation of zygomatic complex fractures

    Institute of Scientific and Technical Information of China (English)

    钟来平; 陈关福

    2004-01-01

    Objective: To introduce the technique of subciliary incision and lateral cantholysis with tri-dimension reduction and rigid internal fixation to treat zygomatic complex fractures.Methods: The subciliary incision and lateral cantholysis combined with tri-dimension reduction and rigid internal fixation of zygomatic complex fractures with titanium microplates were applied in 56 patients with zygomatic complex fractures. Another lateral eyebrow incision or sublabial incision was used to simplify the operation.Results: The postoperative follow-up period ranged from 6 months to 5 years. During the follow-up period, all the patients had satisfying postoperative results. All clinical symptoms disappeared except the numbness in the infraorbital region in 2 patients. In 94.6% patients no complications such as obvious scar, ectropion, entropion or blepharoedema were found, only 5.4% of the patients had slight ectropion 6 months after operation.Conclusions: The subciliary incision and lateral cantholysis have many advantages such as invisible scar,sufficient exposure, minimal injury, and few complications and combined with rigid internal fixation with titanium microplates this technique could be used as one of the routine operation methods to treat zygomatic complex fractures.

  13. A Semicircular Incision in the Superior Umbilical Fold for SILS Preserves the Umbilical Profile

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    S. C. Blackburn

    2012-01-01

    Full Text Available Background. Single Incision Laparoscopic Surgery (SILS has been highlighted in the recent literature as a means of performing a range of common, minimal access, paediatric surgical procedures. The primary attraction is the absence of visible scarring. Aim. This study aims to describe a cosmetically advantageous means of SILS port placement in children, which preserves the umbilical profile. Methods. We describe a paediatric case series utilising a semicircular incision in the superior umbilical fold for SILS procedures. The linea alba is exposed over 2 cm just superior to the umbilical ring and stay sutures are applied. A vertical incision is made over this distance without entering the umbilical ring. Data were recorded prospectively in a Microsoft Excel database. Results. Twenty-one cases were performed in a 1-year period. Ten appendicectomies, 5 ovarian/paraovarian cystectomies, 2 Palomo procedures, 3 nephrectomy/heminephrectomies, and 1 Meckel’s diverticulectomy were performed. There was 1 wound infection. No incisional hernias occurred. Discussion. We believe that our technique, which maintains the integrity of the umbilical ring and allows preservation of the umbilical profile, offers a distinct cosmetic advantage over other incisions for SILS which distort it. Conclusion. We have demonstrated the aesthetic benefits of utilising a superior umbilical-fold incision for SILS in children.

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

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    Md Shafiqul Alam

    2014-01-01

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

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

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    Benzing, Christian

    2015-12-01

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

  16. Avoiding Facial Incisions with Midface Free Tissue Transfer

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    Stalder, Mark W.; Sosin, Michael; Urbinelli, Leo J.; Mayo, James L.; Dorafshar, Amir H.; Hilaire, Hugo St.; Borsuk, Daniel E.

    2017-01-01

    Background: We have adopted an intraoral microsurgical anastomosis to the facial vessels to eliminate the need for any visible facial incisions. Methods: Cadaveric dissection was used to demonstrate accessibility of the facial artery and vein through an intraoral approach. Additionally, 5 patients underwent free tissue transfer for reconstruction of major defects of the midface through an intraoral, transmucosal approach, obviating the need for visible skin incisions. Results: The pathology included palatal defects due to mucoepidermoid carcinoma and ischemic necrosis from cocaine abuse, maxillary defects secondary to fibrous dysplasia and avascular necrosis from traumatic blast injury, and a residual posttraumatic bony deformity of the zygoma. Reconstructions were performed with a free ulnar forearm flap, a free vastus lateralis muscle flap, a deep circumflex iliac artery myoosseous flap, a free fibula flap, and a deep circumflex iliac artery osseous flap, respectively. The facial artery and vein were used as recipient vessels for microvascular anastomosis for all cases. Mean follow-up was 12.2 months. All free tissue transfers were successful, and each patient had a satisfactory aesthetic outcome with no associated facial scars. Conclusion: This technique can be employed during reconstruction of an array of bony or soft-tissue midface deficits with minimal morbidity. This small series effectively demonstrates the varied pathologies and tissue deficiencies that can be successfully reconstructed with free tissue transfer using an entirely intraoral approach to the recipient facial vessels, resulting in no visible scars on the face and an improvement in the overall aesthetic outcome. PMID:28280662

  17. Single-Incision Laparoscopic Total Colectomy

    Science.gov (United States)

    Ojo, Oluwatosin J.; Carne, David; Guyton, Daniel

    2012-01-01

    Background and Objectives: To present our experience with a single-incision laparoscopic total colectomy, along with a literature review of all published cases on single-incision laparoscopic total colectomy. Methods: A total of 22 cases were published between 2010 and 2011, with our patient being case 23. These procedures were performed in the United States and United Kingdom. Surgical procedures included total colectomy with end ileostomy, proctocolectomy with ileorectal anastomosis, and total proctocolectomy with ileopouch-anal anastomosis. Intraoperative and postoperative data are analyzed. Results: Twenty-two of the 23 cases were performed for benign cases including Crohns, ulcerative colitis, and familial adenomatous polyposis. One case was performed for adenocarcinoma of the cecum. The mean age was 35.3 years (range, 13 to 64), the mean body mass index was 20.1 (range, 19 to 25), mean operative time was 175.9 minutes (range, 139 to 216), mean blood loss was 95.3mL (range, 59 to 200), mean incision length was 2.61cm (range, 2 to 3). Average follow-up was 4.6 months with 2 reported complications. Conclusions: Single-incision laparoscopic total colectomy is feasible and safe in the hands of an experienced surgeon. It has been performed for both benign and malignant cases. It is comparable to the conventional multi-port laparoscopic total colectomy. PMID:22906326

  18. Differential diagnosis and management of giant fibroadenoma: comparing excision with reduction mammoplasty incision and excision with inframammary incision.

    Science.gov (United States)

    Ugburo, Andrew O; Olajide, Thomas O; Fadeyibi, Idowu O; Mofikoya, Bolaji O; Lawal, Abdulrazzaq O; Osinowo, Adedapo O

    2012-10-01

    Giant fibroadenoma (GFA) may present with breast asymmetry and can be excised with an inframammary incision (IFI) or reduction mammoplasty incision (RMI). This study investigated the clinical presentation and compared excision with the IFI and RMI. All patients with benign breast tumours greater than 5 cm underwent core needle biopsy and a histopathological diagnosis. All confirmed GFA had their clinical details documented and randomised into two groups for excision with an IFI or RMI. Twenty-two patients were studied. The age range was 12-46 years, mean 21.18 ± 2.22 years. The patients were divided into two groups: a juvenile group (n = 16) (73%) aged 12-18 years, mean age 14.06 ± 0.42 years, and a perimenopausal group (n = 5) aged 28-46 years. The juvenile group showed cyclic increases in breast size monthly with menstruation while the perimenopausal showed an initial slow growth of 6-24 months followed by a rapid growth. Fifteen patients (68%) had excision biopsy with IMI and seven patients with RMI. Seven of the patients treated with IFI had minimal preoperative asymmetry and satisfactory aesthetic outcome. Among the patients with severe preoperative asymmetry treated with IFI (n = 8) and RMI (n = 7), those treated with IFI had persistent postoperative skin redundancy and asymmetry, which was not found in those treated with RMI. In conclusion, for patients with significant asymmetry, excision with the IFI was associated with persistent asymmetry while excision with RMI was associated with restoration of symmetry.

  19. Congenital Heart Disease in Adults

    Science.gov (United States)

    ... and genetics may play a role. Why congenital heart disease resurfaces in adulthood Some adults may find that ... in following adults with congenital heart disease. Congenital heart disease and pregnancy Women with congenital heart disease who ...

  20. Incisiones verticales en SARPE Vertical incisions in SARPE

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    J. Gonzalez Lagunas

    2005-06-01

    Full Text Available La expansión rápida de paladar asistida quirúrgicamente (SARPE es una de las opciones terapeuticas de los transtornos transversales del maxilar superior. Presentamos nuestra experiencia inicial con una variante técnica consistente en una corticotomía de la pared lateral del maxilar combinada con una osteotomía palatina media transincisal, y efectuadas a través de tres pequeñas incisiones verticales.Surgically assisted rapid palatal expansion (SARPE is one of the therapeutic options for the correction of transverse maxillary collapse. We present our initial experience with a technique consisting in a lateral corticotomy of the maxilla plus a transincisal midpalatal osteotomy, both performed through minimal vertical incisions.

  1. Single incision laparoscopic splenectomy, technical aspects and feasibility considerations.

    Science.gov (United States)

    Cabras, Francesco; Fabrizio, Lazzara; Bracale, Umberto; Andreuccetti, Jacopo; Pignata, Giusto

    2014-12-01

    Minimally invasive techniques have been introduced to reduce morbidity related to standard laparoscopic procedures. One such approach is laparoendoscopic single-site surgery. The aim of the study was to present our initial clinical experience of using this technique for elective splenectomy. We carried out single access laparoscopic splenectomy (SALS) for an 8 cm cystic lesion of the spleen, involving the hilum, on a 38-year-old woman. The procedure was performed with a single-port device (4-channel) via a 2.5-cm umbilical incision. A flexible 5-mm optic and straight laparoscopic instruments were used. The operative time was 75 min. There was no blood loss. No complications were observed. The postoperative period was uneventful. Although substantial development of the instruments and skills is needed, this SALS technique appears to be feasible and safe. Nevertheless, further experience and observations are necessary.

  2. Radiological findings after endoscopic incision of ureterocele

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    Cheon, Jung Eun; Kim, In One; Seok, Eul Hye; Cha, Joo Hee; Choi, Gook Myung; Kim, Woo Sun; Yeon, Kyung Mo; Kim, Kwang Myung; Choi, Hwang [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of); Cheon, Jung Eun [Chungmu General Hospital, Chungmu (Korea, Republic of); Seok, Eul Hye [Seran General Hospital, Seoul (Korea, Republic of); Cha, Joo Hee [Green General Hospital, Seoul(Korea, Republic of); Choi, Guk Myung [Halla General Hospital, Cheju (Korea, Republic of)

    2001-01-01

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

  3. C-shaped Incision for Far-Lateral Suboccipital Approach: Anatomical Study and Clinical Correlation.

    Science.gov (United States)

    Lau, Tsz; Reintjes, Stephen; Olivera, Raul; van Loveren, Harry R; Agazzi, Siviero

    2015-03-01

    Background The standard incision for far-lateral suboccipital approaches has been the classic "reverse hockey stick." Although that incision provides ample exposure, concern has been raised that excessive muscle dissection and skin elevation might lead to accumulation of cerebrospinal fluid (CSF) under the flap with increased risk of CSF leak. We hypothesize that the C-shaped incision can minimize the amount of muscle dissection and provide optimal exposure and surgical outcomes. Objective To describe the anatomical dissection for the C-shaped incision and clinical application of the C-shaped incision for the far-lateral approach. Methods A retrospective analysis of all the patients operated on at our center using this approach for the treatment of aneurysm of the posterior inferior cerebellar artery (PICA) from 2005 to 2011. Results of clinical and operative outcome are evaluated. Surgical techniques are described in detail. Cadaveric dissections using the C-shaped incision were performed to assess the exposure of the far-lateral suboccipital area. Results Eleven consecutive patients who had undergone this procedure were selected. All patients underwent clipping of PICA aneurysms. Nine patients (82%) presented with ruptured aneurysms and subarachnoid hemorrhage. All of them underwent suboccipital craniectomy and C1 laminectomy. The dura mater was closed in a watertight fashion in 10 patients (91%). No CSF leak or pseudomeningocele were reported. In nine SAH patients, two (22%) had postoperative dysphagia and required long-term percutaneous endoscopic gastrostomy tube placement. One patient (11%) had chronic respiratory failure and required a tracheostomy. Three patients (33%) developed hydrocephalus and required a ventriculoperitoneal shunt. Conclusions The C-shaped incision is a valid alternative to the classic reverse hockey-stick incision to gain exposure for far-lateral craniotomies. Knowing the anatomy and dissection techniques can provide an easy

  4. Congenital pachygyria

    Directory of Open Access Journals (Sweden)

    Jing-xia HU

    2016-02-01

    Full Text Available Objective To investigate the imaging and clinicopathological features of pachygyria limited in the right temporo-parieto-occipital lobe and the key points of its diagnosis and treatment, in order to improve the recognition of this disease.  Methods and Results A 2-year-old boy was admitted to hospital because of paroxysmal loss of consciousness and convulsion for 18 months with progressive aggravation. MRI showed malformations of cortical development in the right temporo-parieto-occipital lobe. Epileptic foci resection on the right temporo-parieto-occipital lobe was made. Histological examination after operation showed uneven thickening of gray matter, shrinking of white matter and disappearing cortical stratification, while a lot of dysmorphic neurons, balloon cells and scattered balloon cells in white matter appeared. Immunohistochemical staining revealed that dysmorphic neurons were positive for non-phosphorylated neurofilament protein SMI-32, microtubule-associated protein-2 (MAP-2 and vimentin (Vim or neurofilament protein (NF. Both dysmorphic neurons and balloon cells expressed phosphorylated ribosomal S6 protein (RPS6, while the former was stronger than the latter. Balloon cells were not positive for MAP-2 or Vim. No disturbance of consciousness or limb twitches occurred in this patient during one-year follow-up.  Conclusions Congenital pachygyria was cortical dysplasia caused by the early proliferation and migration disorder of brain, and should be distinguished with focal cortical dysplasia (FCD type Ⅱ b and tuberous sclerosis complex (TSC. Clinical history, imaging and histological features should be included in the diagnosis. DOI: 10.3969/j.issn.1672-6731.2016.02.005

  5. Longitudinal incision in surgical release of De Quervain disease.

    Science.gov (United States)

    Gundes, Hakan; Tosun, Bilgehan

    2005-09-01

    The objective of this paper is to contrast the use of a longitudinal incision in surgical decompression of De Quervain disease with a transverse incision. The advantages are ease in recognition of compartment variations and superficial branches of radial nerve and prevention of palmar tendon subluxation by permitting a more dorsal release of the compartment sheath. Since 2002, we have used a longitudinal skin incision instead of the classic transverse incision to release the first dorsal compartment.

  6. Congenital platelet function defects

    Science.gov (United States)

    ... storage pool disorder; Glanzmann's thrombasthenia; Bernard-Soulier syndrome; Platelet function defects - congenital ... Congenital platelet function defects are bleeding disorders that ... function, even though there are normal platelet numbers. Most ...

  7. Congenital heart disease

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/001114.htm Congenital heart disease To use the sharing features on this page, please enable JavaScript. Congenital heart disease (CHD) is a problem with the heart's structure ...

  8. Comparison of three incisions to repair complete unilateral cleft lip.

    NARCIS (Netherlands)

    Reddy, S.; Reddy, R.R.; Bronkhorst, E.M.; Prasad, R.; Kuijpers-Jagtman, A.M.; Berge, S.J.

    2010-01-01

    BACKGROUND: The incision design for correcting a unilateral cleft lip is important because all subsequent stages of surgery depend on the access and maneuverability of the incision. This prospective cohort study compares the aesthetic and functional outcomes of three different skin incisions for pri

  9. Comparison of three incisions to repair complete unilateral cleft lip.

    NARCIS (Netherlands)

    Reddy, S.; Reddy, R.R.; Bronkhorst, E.M.; Prasad, R.; Kuijpers-Jagtman, A.M.; Berge, S.J.

    2010-01-01

    BACKGROUND: The incision design for correcting a unilateral cleft lip is important because all subsequent stages of surgery depend on the access and maneuverability of the incision. This prospective cohort study compares the aesthetic and functional outcomes of three different skin incisions for pri

  10. Effects of Camera Arrangement on Perceptual-Motor Performance in Minimally Invasive Surgery

    Science.gov (United States)

    Delucia, Patricia R.; Griswold, John A.

    2011-01-01

    Minimally invasive surgery (MIS) is performed for a growing number of treatments. Whereas open surgery requires large incisions, MIS relies on small incisions through which instruments are inserted and tissues are visualized with a camera. MIS results in benefits for patients compared with open surgery, but degrades the surgeon's perceptual-motor…

  11. Effects of Camera Arrangement on Perceptual-Motor Performance in Minimally Invasive Surgery

    Science.gov (United States)

    Delucia, Patricia R.; Griswold, John A.

    2011-01-01

    Minimally invasive surgery (MIS) is performed for a growing number of treatments. Whereas open surgery requires large incisions, MIS relies on small incisions through which instruments are inserted and tissues are visualized with a camera. MIS results in benefits for patients compared with open surgery, but degrades the surgeon's perceptual-motor…

  12. Neck incision planning for total laryngectomy: A finite element analysis.

    Science.gov (United States)

    Feng, Allen L; Clark, James H; Agrawal, Nishant; Moussa, Walied; Richmon, Jeremy D

    2015-11-26

    Post-operative complications can be attributed to technical aspects of surgery, yet no studies have investigated the mechanics behind commonly used incisions for total laryngopharyngectomies (TLP). This procedure, seen in head and neck cancer patients, necessitates free tissue transfer to construct a neo-pharynx, creating an inherently greater risk of complications. We sought to investigate the impact of neck incision location on these post-operative complications for TLP using finite element analysis (FEA). A nonlinear hyperelastic 2-D finite element model was used to evaluate the stress and strain along the incision line of two separate neck incision models commonly used for TLP: low-neck apron (LNA) incisions that incorporate the patient׳s tracheostoma and mid-neck apron (MNA) incisions that do not communicate with the tracheostoma. A constant displacement was applied to the incision to simulate normal neck extension experienced during the post-operative phase. Each neck incision was also modeled at varying strain energy densities to simulate various stages of wound healing. For a constant displacement of 40mm, the principal von Mises stress of the LNA incision varied between 5.87 and 6.41MPa, depending on the hyperelastic properties of the healing incision. This stress was concentrated at the junction of the incision and the fixed tracheostomal edge. The MNA model demonstrated a principal von Mises stress that varied between 0.558 and 0.711MPa and was concentrated along the midline of the neck incision. MNA incisions for TL patients result in principal von Mises stresses which are up to 11 times lower than those seen in LNA incisions. These results coincided with clinical observations from a concurrent study that showed a decrease in rate of wound dehiscence for patients undergoing TLP with an MNA incision.

  13. 飞秒激光2.0 mm微切口角膜基质透镜取出术屈光矫正效果的临床初步研究%Two millimeter micro incision lenticule extraction surgery with minimal invasion: a preliminary clinical report

    Institute of Scientific and Technical Information of China (English)

    王雁; 武志清; 汤欣; 张佳媚; 窦瑞; 耿维莉; 金颖; 左彤

    2014-01-01

    不对称指数(IVA)与SMILE组相比差异均无统计学意义(F =0.902、0.744,P>0.05),但术后各时期MILE组ISV和IVA值均低于SMILE组,两组间差值有随时间增大趋势.术后6例(9只眼)在手术中扫描过程出现不透明气泡层,2只眼切口边缘轻度裂开,1只眼术后1d局部弥漫性炎性渗出,无光敏综合征、角膜透明度下降及感染出现.结论 MILE手术(1.5~2.0 mm或更小)安全有效,具有良好的可预测性和稳定性,减少了斜轴方向上的散光量,较好的维持了角膜组织的完整性与稳定性.%Objective To report the clinical results of micro incision lenticule extraction (MILE) to correct myopia or myopia with astigmatism,and enlighten its viability and mechanism.Methods Prospective case-control study.All patients enrolled were treated by the VisuMax femtosecond laser system to correct refractive errors.Sixty-one patients underwent MILE with an incision of 2 mm.Another 53 patients underwent small incision lenticule extraction (SMILE) with a 3-5 mm incision as the control group.All patients took measurements of uncorrected visual acuity (UCVA),best corrected visual acuity (BCVA),refractive power and intraocular pressure,slit-lamp microscopy,and corneal topography preoperatively and at 1 day,1 week,1 month,6 months postoperatively.The visual acuity was presented as median.To compare the visual acuity and astigmatism between the MILE group and the SMILE group,as well as before surgery and at each time point after surgery,non-parametric tests were applied in this study.The repeated measures analysis of variance was used to compare the differences between these two surgeries and between pre-and post-operation in diopters and morphological parameters.The paired-sample t test was used to compare the diopters and morphological parameters at each time point postoperatively and preoperatively.The independent-sample t test was applied to compare the basic characteristics preoperatively and the diopters

  14. The assessment of cold hyperalgesia after an incision.

    Science.gov (United States)

    Scherer, Moritz; Reichl, Sylvia U; Augustin, Miriam; Pogatzki-Zahn, Esther M; Zahn, Peter K

    2010-01-01

    Although cold hypersensitivity is a well-documented phenomenon in animals and humans with inflammatory and neuropathic pain, little is known about the presence of cold hyperalgesia after surgery. Therefore, we studied primary cold hyperalgesia after a surgical incision in mice. Before and after plantar incision, inflammation with complete Freund adjuvant, and spared nerve ligation, unrestrained male animals were placed on a Peltier-cooled cold plate with a surface temperature of 0 degrees C and withdrawal latencies were measured. Additionally, incision-induced cold hyperalgesia was also assessed in female animals. Furthermore, skin temperature before and after plantar incision and inflammation were assessed by using infrared thermography (Varioscan LW 3011; Infratec, Dresden, Germany). Cold hyperalgesia to a noxious cold stimulus was observed after inflammation and nerve injury but not after a surgical incision. Similar results were demonstrated for female animals after incision. Furthermore, a significant increase in skin temperature was recorded after inflammation but not after incision, indicating that a surgery evokes only minor inflammatory effects. The present data give strong evidence that a surgical incision does not cause cold hyperalgesia. Furthermore, a lack of cold hyperalgesia in unrestrained male and female mice after incision was not due to increased skin temperature after incision. Finally, we demonstrated that in contrast to a surgical incision, inflammation and nerve injury generate intense cold hyperalgesia and an increase in skin temperature, suggesting that different mechanisms are involved in surgical and inflammatory or neuropathic pain.

  15. Closed incision management with negative pressure wound therapy (CIM): biomechanics.

    Science.gov (United States)

    Wilkes, Robert Peyton; Kilpad, Deepak V; Zhao, Yabin; Kazala, Richard; McNulty, Amy

    2012-03-01

    A novel closed incision management with negative pressure wound therapy (CIM) has been developed for convenient use with closed incisions that has the potential to be beneficial for patients at risk for postoperative complications. Incisions are typically under lateral tension. This study explored the biomechanical mechanisms by which integrity of the incisional closure is enhanced by CIM. CIM was hypothesized to affect local stresses around closed incisions in a beneficial manner. Finite element analyses (FEA) indicated that application of CIM decreased the lateral stresses ~50% around the incision and changed the direction of the stresses to a distribution that is typical of intact tissue. Bench evaluations corroborated findings that CIM significantly increased the force required to disrupt the closed incision by ~50% as compared with closure alone. In conclusion, using 2 FEAs and bench modeling, CIM was shown to reduce and normalize tissue stresses and bolster appositional forces at the incision.

  16. The use of a surgical incision management system on vascular surgery incisions: a pilot study.

    Science.gov (United States)

    Weir, Gregory

    2014-06-01

    Health care-associated infections in hospitals, including surgical site infections, contribute significantly to morbidity as well as mortality. Surgical incision management (SIM) using negative pressure wound therapy (Prevena™ Incision Management System, Kinetic Concepts, Inc., San Antonio, TX, USA) is designed to cover and protect closed surgical incisions from external factors including infectious sources and local trauma, while negative pressure removes fluid and infectious material from the surgical incision. A prospective case-control study assessed wound complications in patients undergoing vascular bypass procedures, where both femoral areas were incised to gain access to the femoral arteries. SIM was placed on one femoral area while a standard postoperative wound dressing was placed on the contralateral femoral area. Eight patients were included in this pilot study. All of them required bilateral femoral artery access. During the follow-up period patients were monitored for wound complications. All wound complications requiring surgical intervention were considered significant. No significant wound complications occurred in wounds treated with SIM, compared with three significant complications in control wounds. These preliminary data would suggest a potential reduction in wound complications and no observed increase in haemorrhage in high-risk patients with severe co-morbidities undergoing vascular surgery.

  17. Right Kocher’s incision: a feasible and effective incision for right hemicolectomy: a retrospective study

    Directory of Open Access Journals (Sweden)

    Theodosopoulos Theodosios

    2012-06-01

    Full Text Available Abstract Background The choice of surgical incision is determined by access to the surgical field, particularly when an oncological resection is required. Special consideration is also given to other factors, such as postoperative pain and its sequelae, fewer complications in the early postoperative period and a lower occurrence of incisional hernias. The purpose of this study is to compare the right Kocher’s and the midline incision, for patients undergoing right hemicolectomy, by focusing on short- and longterm results. Methods Between 1995 and 2009, hospital records for 213 patients that had undergone a right hemicolectomy for a right- sided adenocarcinoma were retrospectively studied. 113 patients had been operated via a Kocher’s and 100 via a midline incision. Demographic details, operative data (explorative access to the peritoneal cavity, time of operation, recovery parameters (time with IV analgesic medication, time to first oral fluid intake, time to first solid meal, time to discharge, and oncological parameters (lymph node harvest, TNM stage and resection margins were analyzed. Postoperative complications were also recorded. The two groups were retrospectively well matched with respect to demographic parameters and oncological status of the tumor. Results The median length of the midline incision was slightly longer (12 vs. 10 cm, p  Conclusions The Kocher’s incision approach for right- sided colon cancer is technically feasible, safe and overall very well tolerated. It can achieve the same standards of tumor resection and surgical field accessibility as the midline approach, while reducing postoperative recovery.

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

    Directory of Open Access Journals (Sweden)

    Ishizaka Toru

    2011-09-01

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

  19. [3 1/2 years experiences with ECCE with tunnel incision].

    Science.gov (United States)

    Häberle, H; Anders, N; Antoni, H J; Pham, D T; Wollensak, J

    1997-01-01

    Since January 1992 planned extracapsular cataract extraction (ECCE) is performed routinely with the no-stitch technique at our clinic. To minimize surgically induced astigmatism further, modified wound constructions for planned ECCE with on 1.1-mm tunnel width were evaluated. The follow-up time was up to 3 years postoperatively. For 250 eyes wound closure was performed prospectively either sutureless (n = 70), with a single perpendicular suture (n = 100) or cross sutures (n = 40) at the 12 o'clock position or sutureless in the temporal position (n = 40). The complication rate was 4% (filtering bleb, iris prolapse or transient hypotonia). There were no wound ruptures, but once endophthalmitis was observed. Late mean astigmatism after up to 3 years follow-up for vertical incision was 2.05 +/- 1.16 D (1.01 +/- 0.96 D preoperatively) for sutureless wound closure, 1.63 +/- 1.08 D (0.86 +/- 0.95 D) for perpendicular and 1.76 +/- 0.88 D (0.73 +/- 0.55 D) for cross-sutures. A temporal incision resulted in 0.78 +/- 0.52 D (1.0 +/- 0.69 D) of astigmatism and was only performed on eyes with against the rule astigmatism preoperatively. Surgically induced astigmatism was stabilized early. For with the rule astigmatism preoperatively, a 12 o'clock incision with a perpendicular single suture is recommended and for against the rule astigmatism, a temporal incision.

  20. Quality of Life after Video-assisted Thoracoscopic Surgery or Minimal Incision Thoracotomy for Early Stage Nonsmall Cell Lung Cancer : A Prospective, Randomized Controlled Trial%电视胸腔镜与小切口开胸治疗临床早期非小细胞肺癌患者术后生活质量的前瞻性随机对照研究

    Institute of Scientific and Technical Information of China (English)

    龙浩; 郑燕; 林勇斌; 司徒冬荣; 马国伟; 姜龙

    2012-01-01

    Objective To evaluate video-assisted thoracic surgery (VATS) and minimal incision thoracotomy (MIT) lobectomy for early stage non-small cell lung cancer patients and the impact upon postoperative quality of life (QOL). Methods A prospective randomized controlled trial was conducted. From January 1, 2008 to December 10, 2011, the qualified patients with early stage NSCLC were recruited and randomized to VATS group (57 patients) and MIT group (49 patients), totally 106 patients, 57 males and 49 females, aged 57. 60 years. The quality of life was assessed using Lung Cancer Symptom Scale (LCSS) before operation and at 1,3,6,9,12 months after operation. Results There were no significant differences between the 2 groups in age, sex, the location of tumor, tumor pathologic stage, pathological types, postoperative complications, tumor size, operative time, operative bleeding and air leak days. There were no symptoms after operation at the VATS group worse than the leve before operation. Five major symptoms, including appetite (1.04 ± 0. 71 vs.2.00+0. 83,F=6.357, P=0.021), fatigue(4.55+1.17 vs. 10. 19+2.10,F=A.721, P=0.043),dyspnea(2.18±0.86 vs. 10.26±2.05,F=10.020,P=0.005),normal activity(5.16±1.70 vs. 17.60±3.17,F=12.319.P=0. 002)attheMIT group were deteriorated significantly at 1 month after the operation (P < 0. 05). Conclusion The VATS will lead to better quality of life for the patients with early stage NSCLC after surgery and lead to a smooth postoperative recovery.%目的 比较电视胸腔镜手术(video-assisted thoracoscopic surgery,VATS)与小切口开胸手术(minimal incision thoracotomy,MIT)治疗临床早期非小细胞肺癌(non-small cell lung cancer,NSCLC)及其两种手术方式术后患者生活质量的变化特点.方法 我们的研究为前瞻性随机对照临床研究生活质量的阶段分析.共纳入2008年1月1日至2011年12月10日中山大学肿瘤防治中心收治的106例NSCLC患者(男57例、女49例,平均年龄57,60岁),采

  1. Evolution of cataract surgery: Smaller incision - less complications

    Directory of Open Access Journals (Sweden)

    Draganić Vladimir

    2012-01-01

    Full Text Available Background/Aim. Cataract surgery has become one of the safest procedures in medicine thanks to advances in technology and surgical techniques. Although minimal, we still witness different complications. The aim of this study was to compare visual outcome and complication rate in different techniques of cataract surgery, ie in cataract surgeries with various corneal incision width. Methods. The study included 3,457 consecutive patients, ie 4,670 eyes that had undergone cataract surgery. The used surgical techniques were: extracapsular cataract extraction, phacoemulsification/ forceps IOL implantation, phacoemulsification/ injector IOL implantation, microincision cataract surgery (MICS. Patient follow up was 6 months. Patients were evaluated for: visual aquity, corneal astigmatism, cellular reaction in the anterior chamber, IOL position. Results. Uncorrected visual aquity 30 days postoperatively was ≥ 0.5 in 30% of the eyes - ECCE; 54.7% of the eyes - phacoemulsification/forceps IOL implantation; 63.0% of the eyes - phacoemulsification/injector IOL implantation; 5/8 of the eyes - MICS. Endophthalmitis was detected in 0.15% of the eyes - ECCE and 0.1% of the eyes - phacoemulsification/forceps IOL implantation. In eyes with phacoemulsification/injector IOL implantation or microincision cataract surgery (MICS there were no cases of endophthalmitis. After a 6-month period intraocular lens were dislocated in 7.2% of the eyes - ECCE, and 0.6% of the eyes - phacoemulsification/PMMA IOL. There was no IOL dislocation in other surgical techniques. Conclusion. Shorter corneal incision implies less complications, less operative trauma, faster visual rehabilitation and better visual outcome.

  2. [Evolution of cataract surgery: smaller incision--less complications].

    Science.gov (United States)

    Draganić, Vladimir; Vukosavljević, Miroslav; Milivojević, Milorad; Resan, Mirko; Petrović, Nenad

    2012-05-01

    Cataract surgery has become one of the safest procedures in medicine thanks to advances in technology and surgical techniques. Although minimal, we still witness different complications. The aim of this study was to compare visual outcome and complication rate in different techniques of cataract surgery, ie in cataract surgeries with various corneal incision width. The study included 3,457 consecutive patients, ie 4,670 eyes that had undergone cataract surgery. The used surgical techniques were: extracapsular cataract extraction, phacoemulsification/forceps IOL implantation, phacoemulsification/injector IOL implantation, microincision cataract surgery (MICS). Patient follow up was 6 months. Patients were evaluated for: visual aquity, corneal astigmatism, cellular reaction in the anterior chamber, IOL position. Uncorrected visual aquity 30 days postoperatively was > or = 0.5 in 30% of the eyes - ECCE; 54.7% of the eyes - phacoemulsification/forceps IOL implantation; 63.0% of the eyes - phacoemulsification/injector IOL implantation; 5/8 of the eyes - MICS. Endophthalmitis was detected in 0.15% of the eyes - ECCE and 0.1% of the eyes - phacoemulsification/forceps IOL implantation. In eyes with phacoemulsification/injector IOL implantation or microincision cataract surgery (MICS) there were no cases of endophthalmitis. After a 6-month period intraocular lens were dislocated in 7.2% of the eyes - ECCE, and 0.6% of the eyes - phacoemulsification/PMMA IOL. There was no IOL dislocation in other surgical techniques. Shorter corneal incision implies less complications, less operative trauma, faster visual rehabilitation and better visual outcome.

  3. Clinical Use of a Drain Incision Placed Below and Bilaterial to Near Total Thyroidectomy Incision

    Institute of Scientific and Technical Information of China (English)

    LIU Bao-guo; ZHAO Qi-kang; CHEN Rong-rui; LI Ming-qiang; WANG Jian-jun

    2008-01-01

    Objective:To design a new draining method for near total thyroidectomy at the lower two sides of the neck.Methods:Near total thyroidectomies in 63 cases were performed with new drain incisions at the lower two sides of the neck between December 1998 and July 2004. Results:All the draining operative procedures were performed smoothly,and all produced cosmetic scars were effective. The mean amount drained was 38 ml(minimum 10 ml,maximum 120 ml)and no patient developed wound infection. Conclusion:The drain incision for near total thyroidectomy placed at the lower sides of the neck results in a cosmetic scar which is easily covered by the collar,and was safe and efiective.We thereby recommend the use of this drain incision for near total thyroidectomy.

  4. CLINICAL USE OF A DRAIN INCISION PLACED BELOW AND LATERIAL TO THE THYROIDECTOMY INCISION

    Institute of Scientific and Technical Information of China (English)

    刘宝国; 王斌; 张乃嵩

    2004-01-01

    Objective: To design a new draining method for hemithyroidectomy at the lower side of the neck. Methods:Hemithyroidectomies of 235 cases were performed with the new drain incision at the lower side of the neck between December 1998 and July 2003. Results: All the draining operative procedures were performed smoothly, and produced a cosmeticulous scar. The mean amount drained was 20 ml (minimum 5 ml, maximum 80 ml) and no patients developed wound infection. Conclusion: The drain incision for hemithyroidectomy placed at the lower side of the neck results in a cosmeticulous scar which is easily covered by the collar and was safe and effective. We thereby recommend the use of this drain incision for hemithyroidectomy.

  5. Autogenic incision and terrace formation resulting from abrupt late-glacial base-level fall, lower Chippewa River, Wisconsin, USA

    Science.gov (United States)

    Faulkner, Douglas J.; Larson, Phillip H.; Jol, Harry M.; Running, Garry L.; Loope, Henry M.; Goble, Ronald J.

    2016-08-01

    stream systems would have led to renewed knickpoint migration and incision when floods of sufficient magnitude to breach the channel armor occurred. Minimal floodplain development along the upper section of the present-day LCR, along with the channel morphology of an unstable wandering gravel-bed river immediately downstream from it, suggest that the river is still responding to the base-level falls that happened many millennia ago. The autogenic controls on the LCR's response to UMR incision are a direct consequence of the thick fills of noncohesive sediment that accumulated in its valley and the valleys of its tributary streams during the Late Wisconsinan, making the LCR a prime example of a former proglacial river that remains a paraglacial fluvial system.

  6. Diagnosis and treatment of congenital heart defects

    Energy Technology Data Exchange (ETDEWEB)

    Peuster, M.; Beerbaum, P.; Meyer, H. [Ruhr-Universitaet Bochum, Bad Oeyenhausen (Germany). Herz- und Diabeteszentrum NRW

    2004-07-01

    The Clinic for Congenital Heart Defects in Bad Oeynhausen, Germany, specializes in the interdisciplinary care of children and adolescents with congenital heart defects. The available expertise covers all aspects of diagnosis and treatment, as well as clinical research at the highest level. The clinic has a complete array of imaging systems, including a Philips Integris BV5000 Biplane cath lab system, Philips Gyroscan Intera CV MR system, ultrasound and PET systems. The range of available equipment makes it possible to select the most appropriate imaging modality for each situation, with particular reference to the need to minimize the overall radiation exposure. (orig.)

  7. Surgical approaches for minimally invasive plate osteosynthesis in dogs.

    Science.gov (United States)

    Pozzi, A; Lewis, D

    2009-01-01

    Fracture stabilisation techniques continue to evolve and to provide approaches which minimise the iatrogenic trauma associated with surgery. Minimally invasive plate osteosynthesis (MIPO) is a recently described method of biological internal fixation performed by introducing a bone plate via small insertional incisions that are made remote to the fracture site. The plate is slid adjacent to the bone in an epiperiosteal tunnel connecting the two insertional incisions. Screws are placed in the plate through the insertional incisions or via additional stab incisions made over the holes in the plate. In this paper we describe the surgical approaches used to perform MIPO in humeral, radial, femoral and tibial fractures in dogs. We found that these approaches allowed safe insertion of the plate without grossly damaging neuro-vascular structures. Further studies are needed to evaluate the clinical outcome of MIPO in dogs.

  8. Small-incision lenticule extraction (SMILE)

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  9. Transanal polypectomy using single incision laparoscopic instruments.

    Science.gov (United States)

    Dardamanis, Dimitrios; Theodorou, Dimitrios; Theodoropoulos, George; Larentzakis, Andreas; Natoudi, Maria; Doulami, Georgia; Zoumpouli, Christina; Markogiannakis, Haridimos; Katsaragakis, Stylianos; Zografos, George C

    2011-04-27

    Transanal excision of rectal polyps with laparoscopic instrumentation and a single incision laparoscopic port is a novel technique that uses technology originally developed for abdominal procedures from the natural orifice of the rectum. Transanal endoscopic microsurgery (TEM) is a well established surgical approach for certain benign or early malignant lesions of the rectum, under specific indications. Our technique is a hybrid technique of transanal surgery, a reasonable method for polyp resection without the need of the sophisticated and expensive instrumentation of TEM which can be applied whenever endoscopic or conventional transanal surgical removal is not feasible.

  10. Congenital right hemidiaphragmatic agenesis

    OpenAIRE

    Bilal Mirza; Zahid Bashir; Afzal Sheikh

    2012-01-01

    Congenital diaphragmatic hernia is a congenital defect of the diaphragm through which intestine and other viscera herniate into the chest. In extreme form of diaphragmatic maldevelopment, there might be a complete agenesis of diaphragm. A 45-day old male infant was presented with fever, cough and respiratory distress for a week. Chest radiograph showed right-sided congenital diaphragmatic hernia. The patient underwent surgical exploration and found to have an unusual and large defect of right...

  11. Genetics of congenital hypothyroidism

    OpenAIRE

    Park, S.; Chatterjee, V

    2005-01-01

    Congenital hypothyroidism is the most common neonatal metabolic disorder and results in severe neurodevelopmental impairment and infertility if untreated. Congenital hypothyroidism is usually sporadic but up to 2% of thyroid dysgenesis is familial, and congenital hypothyroidism caused by organification defects is often recessively inherited. The candidate genes associated with this genetically heterogeneous disorder form two main groups: those causing thyroid gland dysgenesis and those causin...

  12. Single incision laparoscopic TAPP with standard laparoscopic instruments and suturing of flaps: A continuing study

    Directory of Open Access Journals (Sweden)

    Rajeev Sinha

    2015-01-01

    Full Text Available Background: Single incision laparoscopic surgery, especially transumbilical, should be the closest to replicate the minimal access results achieved by natural orifice endoscopic surgery (NOTES. This study of single incision transabdominal preperitoneal (SITAPP inguinal hernia repair is a continuing study exploring the peroperative variables and short and long term complications of this procedure. Patients and Methods: All the 183 patients were operated by the same surgeon through a horizontal transumbilical incision positioned across the lower third of the umbilicus. Port access was through three separate transfacial punctures. Routine rigid instruments were used and the peritoneal flaps were either tacked or sutured into place. Patients with irreducible hernia and obstructed hernia were included, while those with strangulated hernia were excluded. Results: All the patients were male with an average age of 41.4 years. Twenty four patients had bilateral hernia, 15 patients had irreducible and 6 patients had obstructed hernia. The mean operating time was 38.3 mins for unilateral hernias completed with tackers and 42.8 mins in those with intracorporeal suturing. The corresponding operating time for bilateral hernias was 53.2 and 62.7 minutes. There was minimal serous discharge from the umbilicus in 8 patients, port site infection in 1 patient and recurrence in 2 patients over a 36 months period. Conclusions: SITAPP for groin hernias, performed with conventional instruments is feasible, easy to learn, has a very high patient acceptance and is cosmetically superior to conventional TAPP. The use of tackers reduces the operating time significantly.

  13. [Incisions for biaxial and coaxial microincision cataract surgery].

    Science.gov (United States)

    Müller, M; Kohnen, T

    2010-02-01

    Microincision cataract surgery (MICS) represents a new level in the development of cataract surgery. Phacoemulsification with intraocular lens (IOL) implantation via incisions of phaco tip (C-MICS), or by the biaxial approach, with separation of the phaco tip and irrigation (B-MICS). Compared with standard small-incision cataract surgery, the advantages of MICS are less corneal astigmatism and fewer corneal surface irregularities, with favorable implications for visual quality and early rehabilitation. In the effort toward smaller incisions, special interest should be given to wound integrity, especially regarding the risk of endophthalmitis. With limited corneal elastic capacity, irreversible expansion of the incision with tissue laceration may occur. Smaller incisions are superior only if they cause less trauma. This requires an optimized relationship between incision size and manipulation during IOL implantation as well as attention to safety issues. MICS offers a platform for new benchmarks in phacoemulsification.

  14. Vertical compared with transverse incisions in abdominal surgery

    DEFF Research Database (Denmark)

    Grantcharov, T P; Rosenberg, J

    2001-01-01

    OBJECTIVE: To reach an evidence-based consensus on the relative merits of vertical and transverse laparotomy incisions. DESIGN: Review of all published randomised controlled trials that compared the postoperative complications after the two main types of abdominal incisions, vertical and transverse......, and late complications (incisional hernia). RESULTS: Eleven randomised controlled trials and seven retrospective studies were identified. The transverse incision offers as good an access to most intra-abdominal structures as a vertical incision. The transverse incision results in significantly less.......0001), and regarding late incisional hernia the pooled odds ratio was 1.68 (95% confidence interval 1.10 to 2.57. p = 0.02). CONCLUSIONS: Transverse incisions in abdominal surgery are based on better anatomical and physiological principles. They should be recommended, as the early postoperative period is associated...

  15. Mini-incision microdissection testicular sperm extraction: a useful technique for men with cryptozoospermia.

    Science.gov (United States)

    Alrabeeah, K; Witmer, J; Ruiz, S; AlMalki, A; Phillips, S; Zini, A

    2016-03-01

    Microdissection testicular sperm extraction (micro-TESE) was developed to minimize the testicular injury associated with multiple open TESEs. We sought to evaluate a mini-incision micro-TESE in men with cryptozoospermia and non-obstructive azoospermia (NOA). We conducted a retrospective study of 26 consecutive men with NOA and cryptozoospermia who underwent a primary (first) micro-TESE between March 2015 and August 2015. Final assessment of sperm recovery (reported on the day of intra-cytoplasmic sperm injection (ICSI)) was recorded as (i) successful (available spermatozoa for ICSI) or (ii) unsuccessful (no spermatozoa for ICSI). The decision to perform a mini-incision micro-TESE (with limited unilateral micro-dissection) or standard/extensive (with unilateral or bilateral micro-dissection) was guided by the intra-operative identification of sperm recovery (≥5 spermatozoa) from the first testicle. Overall, sperm recovery was successful in 77% (20/26) of the men. In 37% of the men (8/26), the mini-incision micro-TESE was successful (positive sperm recovery). The remaining 18 men required a standard (extensive) microdissection: 61% (11/18) underwent a unilateral and 39% (7/18) a bilateral micro-TESE. We found that 90% (9/10) of the men with cryptozoospermia and 63% (10/16) of the men with NOA underwent a unilateral (mini or standard micro-TESE). The mini-incision micro-TESE allowed for successful sperm recovery in 60% (6/10) of the men with cryptozoospermia and 13% (2/16) of the men with NOA. The data demonstrate that a mini-incision micro-TESE together with rapid intra-operative assessment and identification of spermatozoa recovery can be useful in men undergoing microTESE, particularly, men with cryptozoospermia.

  16. Genetics Home Reference: congenital hypothyroidism

    Science.gov (United States)

    ... Understand Genetics Home Health Conditions congenital hypothyroidism congenital hypothyroidism Enable Javascript to view the expand/collapse boxes. Download PDF Open All Close All Description Congenital hypothyroidism is a partial or complete loss of function ...

  17. What Are Congenital Heart Defects?

    Science.gov (United States)

    ... page from the NHLBI on Twitter. What Are Congenital Heart Defects? Congenital (kon-JEN-ih-tal) heart defects are problems ... carry blood to the heart or the body Congenital heart defects change the normal flow of blood through the ...

  18. Single-incision laparoscopic bariatric surgery

    Directory of Open Access Journals (Sweden)

    Huang Chih-Kun

    2011-01-01

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

  19. Rock slope response to fluvial incision in the central Swiss Alps

    Science.gov (United States)

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

    2016-04-01

    The longitudinal profile of rivers intersecting the Rhone Valley in the central Swiss Alps suggests the development of topography throughout much of this region has been dominated by interglacial fluvial incision and ongoing tectonic uplift with only minimal glacial erosion since the mid-Pleistocene transition. Evidence indicates bedrock river incision during this period reflects a base level fall of between 500 m and 800 m (depending on the degree of overdeepening following an early period of enhanced glacial incision). This observation raises important questions regarding the preservation, or development of hillslope morphologies through multiple glacial-interglacial cycles. Since the pioneering works of Richter (1900) and Penck and Brückner (1909), Alpine geomorphologists have commented on a sequence of between three and five moderately dipping matched terraces that converge toward inferred paleo-river channels up to 800 m above the axis of many valleys. Here, we use a combination of integral analysis, forward streampower models, and a new method of topographic analysis based on high resolution LiDAR DEMs in order to test the correspondence of valley morphologies in this formerly glaciated landscape, with hillslope processes initiated by fluvial incision up to 700,000 years ago. Results indicate topography adjacent to reaches subjected to transient fluvial incision is characterized by a coherent region of consistently steep slopes, while narrow gorges correspond to rapid incision close to the Rhone valley since MIS 5. A majority of hillslopes converge to our initial fluvial valley floor, or the location of propagating knickpoints. The correspondence between intermediate-level terraces and modeled stages of river incision is, however, currently unclear. These results offer a unique insight into the long-term response of bedrock slopes to varying rates of base level fall, and the cumulative impact of glacial erosion on Alpine valley walls since MIS 11. Penck, A

  20. Umbilical incision laparoscopic surgery with one assist port for an elderly patient with recurrent sigmoid volvulus.

    Science.gov (United States)

    Matsuoka, Tasuku; Osawa, Naoshi; Yoh, Taiho; Hirakawa, Kosei

    2012-12-12

    Single-port access laparoscopic surgery has recently emerged as a method to improve morbidity and cosmetic benefit of conventional laparoscopic surgery. Herein, we report the experience of transumbilical incision laparoscopic sigmoidectomy with one assist port in a 71-year-old man who had developed recurrent sigmoid volvulus in these several years since his first visit to the hospital. The patient presented abdominal distension and severe constipation. A plain x-ray film and CT of the abdomen showed grossly distended sigmoid colon loops and stenosis of recto-sigmoid colon. Sigmoid volvulus associated with megacolon was diagnosed and emergence endoscopic decompression was performed. After his condition improved, transumbilical incision laparoscopic sigmoidectomy was carried out as the minimally invasive approach, due to the several risk of patient such as aging and pulmonary disorder. Postoperative course was uneventful and on postoperative visit to the hospital he reported resolution of abdominal distension.

  1. Minimally Invasive Video-Assisted versus Minimally Invasive Nonendoscopic Thyroidectomy

    Directory of Open Access Journals (Sweden)

    Zdeněk Fík

    2014-01-01

    Full Text Available Minimally invasive video-assisted thyroidectomy (MIVAT and minimally invasive nonendoscopic thyroidectomy (MINET represent well accepted and reproducible techniques developed with the main goal to improve cosmetic outcome, accelerate healing, and increase patient’s comfort following thyroid surgery. Between 2007 and 2011, a prospective nonrandomized study of patients undergoing minimally invasive thyroid surgery was performed to compare advantages and disadvantages of the two different techniques. There were no significant differences in the length of incision to perform surgical procedures. Mean duration of hemithyroidectomy was comparable in both groups, but it was more time consuming to perform total thyroidectomy by MIVAT. There were more patients undergoing MIVAT procedures without active drainage in the postoperative course and we also could see a trend for less pain in the same group. This was paralleled by statistically significant decreased administration of both opiates and nonopiate analgesics. We encountered two cases of recurrent laryngeal nerve palsies in the MIVAT group only. MIVAT and MINET represent safe and feasible alternative to conventional thyroid surgery in selected cases and this prospective study has shown minimal differences between these two techniques.

  2. Healing and evaluating guinea pig skin incision after surgical suture and laser tissue by welding using in vivo Raman spectroscopy

    Science.gov (United States)

    Alimova, A.; Sriramoju, V.; Chakraverty, R.; Muthukattil, R.; Alfano, R. R.

    2010-02-01

    Changes in collagen in the wound during the healing process of guinea pig skin following surgical incisions and LTW was evaluated using in vivo, using Raman spectroscopy. Raman spectroscopy provided information regarding the internal structure of the proteins. After the incisions were closed either by suturing or by LTW the ratio of the Raman peaks of the amide III (1247 cm-1) band to a peak at 1326 cm-1 used to evaluate the progression of collagen deposition. Histopathology was used as the gold standard. LTW skin demonstrated better healing than sutured skin, exhibiting minimal hyperkeratosis, minimal collagen deposition, near-normal surface contour, and minimal loss of dermal appendages. This work is important to plastic surgery.

  3. 经胸微创封堵治疗对先天性心脏病患者心脏重构的近期影响%Short-term effect of minimally invasive transthoracic closure on cardiac remodeling in patients with congenital heart disease

    Institute of Scientific and Technical Information of China (English)

    王海永; 陈辉; 阳玉晶; 胡江苇; 李安桂; 杜振宗; 宋剑非

    2015-01-01

    目的:探讨经胸微创封堵治疗先天性心脏病术后近期心脏几何构型的变化。方法先天性心脏病患者31例,其中单纯性室间隔缺损(VSD)10例和房间隔缺损(ASD)21例,观察患者封堵术前、术后3个月左室内径(LVD)、左房内径(LAD)、右房内径(RAD)和右室内径(RVD)大小及左室射血分数(LVEF)变化。结果31例患者中封堵成功29例(93.5%),其中单纯性VSD患者10例,单纯性ASD患者19例;失败2例(6.5%)均为单纯性ASD患者。封堵术后3个月,10例VSD患者LAD和LVD较术前明显缩小(P<0.05),RVD及LVEF明显增加(P<0.05);19例ASD患者RAD及RVD较术前明显减小(P<0.05),LVD及LVEF明显增加(P<0.05)。结论经胸微创封堵治疗ASD和VSD能有效地改善先天性心脏病患者近期心脏重构。%Objective To explore the short-term changes of cardiac geometric morphology after minimally invasive transthoracic closure of congenital heart disease.Methods Thirty-one patients with congenital heart disease were enrolled in this study,including 10 cases of ventricular septal defect (VSD) and 21 cases of atrial septal defect(ASD).Left ventricular diameter(LVD),left atrial diameter (LAD),right atrial diameter(RAD),right ventricular diameter(RVD) and left ventricular ejection fraction(LVEF) were measured before and three months after the closure.Results Of 31 cases,the closure was successfully completed in 29 cases(93.5%) including 10 cases of VSD and 19 cases of ASD,but was failed in 2 cases of ASD(6.5%).Three months after the closure,for the 10 patients with VSD,LAD and LVD decreased significantly,while RVD and LVEF increased significantly compared with those before the closure(both P<0.05). For the 19 patients with ASD,RAD and RVD decreased significantly,while LVD and LVEF increased significantly compared with those before the closure(both P<0.05).Conclusion Minimally invasive

  4. Congenital Insensitivity to Pain

    Directory of Open Access Journals (Sweden)

    Praveen Kumar B,

    2011-01-01

    Full Text Available Congenital Insensitivity to Pain belongs to the family of Hereditary Sensory and Autonomic Neuropathies (HSAN. It is a rare disorder of unknown etiology associated with loss of pain sensation. Cognition and sensation is otherwise normal and there is no detectable physical abnormality. We report a case of Congenital Insensitivity to Pain in a 3 year old female child.

  5. Multifocal Congenital Hemangiopericytoma.

    Science.gov (United States)

    Robl, Renata; Carvalho, Vânia Oliveira; Abagge, Kerstin Taniguchi; Uber, Marjorie; Lichtvan, Leniza Costa Lima; Werner, Betina; Mehrdad Nadji, Mehrdad

    2017-01-01

    Congenital hemangiopericytoma (HPC) is a rare mesenchymal tumor with less aggressive behavior and a more favorable prognosis than similar tumors in adults. Multifocal presentation is even less common than isolated HPC and hence its clinical and histologic recognition may be challenging. A newborn infant with multifocal congenital HPC causing severe deformity but with a favorable outcome after chemotherapy and surgical removal is reported.

  6. Laparoscopic vs mini-incision open appendectomy

    Institute of Scientific and Technical Information of China (English)

    Fatih; ?ift?i

    2015-01-01

    AIM: To compare laparoscopic vs mini-incision open appendectomy in light of recent data at our centre.METHODS: The data of patients who underwen appendectomy between January 2011 and June 2013 were collected. The data included patients’ demographic data, procedure time, length of hospital stay, the need for pain medicine, postoperative visual analog scale o pain, and morbidities. Pregnant women and patients with previous lower abdominal surgery were excluded Patients with surgery converted from laparoscopic appendectomy(LA) to mini-incision open appendectomy(MOA) were excluded. Patients were divided into two groups: LA and MOA done by the same surgeon. The patients were randomized into MOA and LA groups a computer-generated number. The diagnosis of acute appendicitis was made by the surgeon with physica examination, laboratory values, and radiological tests(abdominal ultrasound or computed tomography). Al operations were performed with general anaesthesia The postoperative vision analog scale score was recorded at postoperative hours 1, 6, 12, and 24. Patients were discharged when they tolerated normal food and passed gas and were followed up every week for three weeks as outpatients.RESULTS: Of the 243 patients, 121(49.9%) underwen MOA, while 122(50.1%) had laparoscopic appendectomy There were no significant differences in operation time between the two groups(P = 0.844), whereas the visua analog scale of pain was significantly higher in the open appendectomy group at the 1st hour(P = 0.001), 6th hour(P = 0.001), and 12 th hour(P = 0.027). The need for analgesic medication was significantly higher in the MOA group(P = 0.001). There were no differences between the two groups in terms of morbidity rate(P = 0.599)The rate of total complications was similar between the two groups(6.5% in LA vs 7.4% in OA, P = 0.599). Al wound infections were treated non-surgically. Six ou of seven patients with pelvic abscess were successfully treated with percutaneous drainage; one

  7. Key aspects congenital infection

    Directory of Open Access Journals (Sweden)

    Yu. V. Lobzin

    2014-01-01

    Full Text Available The key questions to solve the problem of congenital infection in the Russian Federation are: using in national practice over world accepted terminology adapted to the recommendations of the World Health Organization; representation of the modern concepts of an infectious process in the classification of congenital infections; scientific development and introducing in clinical practice the «standard case definitions», applied to different congenital infections; optimization of protocols and clinical guidelines for diagnosis, treatment and prevention of congenital infections; improvement a knowledge in the infectious disease for all  pecialists involved in the risk assessment of congenital infections, manage pregnancy and children. Based on our experience and analysis of publications, the authors suggest possible solutions.

  8. Computer guidance system for single-incision bimanual robotic surgery.

    Science.gov (United States)

    Carbone, Marina; Turini, Giuseppe; Petroni, Gianluigi; Niccolini, Marta; Menciassi, Arianna; Ferrari, Mauro; Mosca, Franco; Ferrari, Vincenzo

    2012-01-01

    The evolution of surgical robotics is following the progress of developments in Minimally Invasive Surgery (MIS), which is moving towards Single-Incision Laparoscopic Surgery (SILS) procedures. The complexity of these techniques has favored the introduction of robotic surgical systems. New bimanual robots, which are completely inserted into the patient's body, have been proposed in order to enhance the surgical gesture in SILS procedures. However, the limited laparoscopic view and the focus on the end-effectors, together with the use of complex robotic devices inside the patient's abdomen, may lead to unexpected collisions, e.g., between the surrounding anatomical organs not involved in the intervention and the surgical robot. This paper describes a computer guidance system, based on patient-specific data, designed to provide intraoperative navigation and assistance in SILS robotic interventions. The navigator has been tested in simulations of some of the surgical tasks involved in a cholecystectomy, using a synthetic anthropomorphic mannequin. The results demonstrate the usability and efficacy of the navigation system, underlining the importance of avoiding unwanted collisions between the robot arms and critical organs. The proposed computer guidance software is able to integrate any bimanual surgical robot design.

  9. Single-Incision Laparoscopic Surgery (SILS Assisted Sigma Resection Via Pfannenstiel Incision for Complicated Diverticulitis

    Directory of Open Access Journals (Sweden)

    Arne Dietrich

    2014-02-01

    Results: The operation time ranged from 89 to 280 min. There were no conversions, and no additional trocars were used. The postoperative hospital stay ranged from 5 to 14 days. All patients were discharged without any intraoperative or postoperative complications. Conclusions: SILS sigma or anterior rectum resection for complicated diverticulitis can be performed via a Pfannenstiel incision. This approach provides direct visualization and access into the pelvis as well as the option to benefit from open surgery devices. The Pfannenstiel incision may generally be recommended for the favorable cosmetic effect and the very low rate of incisional hernias, as reported in the literature. [Arch Clin Exp Surg 2014; 3(1.000: 10-15

  10. Transurethral incision of urethral diverticulum in the female

    DEFF Research Database (Denmark)

    Miskowiak, J; Honnens de Lichtenberg, M

    1989-01-01

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

  11. The stream channel incision syndrome and water quality

    Science.gov (United States)

    Watershed development often triggers channel incision, which accounts for 60-90% of sediments leaving many disturbed watersheds. Impacts of such incision on water quality processes and the implication of such impairment on stream biota are relevant to issues associated with establishing total maxim...

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

    DEFF Research Database (Denmark)

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

    2012-01-01

    Specially designed surgical instruments have been developed for single-incision laparoscopic surgery, but high instrument costs may impede the implementation of these procedures. The aim of this study was to compare the cost of operative implements used for elective cholecystectomy performed...... as conventional laparoscopic 4-port cholecystectomy or as single-incision laparoscopic cholecystectomy....

  13. Modeling the Evolution of Incised Streams: III. Model Application

    Science.gov (United States)

    Incision and ensuing widening of alluvial stream channels is widespread in the midsouth and midwestern United States and represents an important form of channel adjustment. Two accompanying papers have presented a robust computational model for simulating the long-term evolution of incised and resto...

  14. SMA Syndrome Treated by Single Incision Laparoscopic Duodenojejunostomy.

    Science.gov (United States)

    Kim, Sungsoo; Kim, Yoo Seok; Min, Young-Don

    2014-01-01

    Superior mesenteric artery (SMA) syndrome is a mechanical duodenal obstruction by the SMA. The traditional approach to SMA syndrome was open bypass surgery. Nowadays, a conventional approach has been replaced by laparoscopic surgery. But single incision laparoscopic approach for SMA syndrome is rare. Herein, we report the first case of SMA syndrome patient who was treated by single incision laparoscopic duodenojejunostomy.

  15. Single incision laparoscopic right hemicolectomy:different approaches

    Institute of Scientific and Technical Information of China (English)

    WONG Tak-man; DAY Weida; KWOK Shu-yan; LAU Ying-yu Patrick; YIP Wai-chun Andrew

    2013-01-01

    Background Single incision laparoscopic colectomy has been performed in recent years,and has been shown to be feasible and safe.This study was to assess the feasibility of single incision laparoscopic right hemicolectomy and to compare the differences in different approaches.Methods This retrospective study included eighteen patients with carcinoma of caecum and ascending colon,undergoing single incision laparoscopic right hemicolectomy.This study also compared single incision laparoscopic right hemicolectomy using different approaches:(1) single incision multiport,(2) single access port and (3) glove port.Results There was no statistical difference in surgical outcomes.Concerning the surgeon's satisfaction toward three methods,overcrowding and durability were similar but the single incision multiport was associated with the highest gas-leak and the "glove" port was associated with poor durability.However,the method of single incision multiport has the lowest average cost of the special trocar or port in each operation.The operative time and blood loss of the operations in this study were comparable to previous publications.Conclusion There was no significant difference between different approaches of single incision laparoscopic right hemicolectomy for colonic cancer in right side colon.

  16. Effects of teat cistern mural biopsy and teatoscopy stab versus longitudinal incision with or without tube implant on incisional healing in lactating dairy cattle.

    Science.gov (United States)

    Tulleners, E; Hamir, A

    1990-08-01

    irritations of the mucous membrane developed in 2 teats proximally and in 6 teats distally. Mastitis developed in 6 (50%) quarters. Longitudinal incisions healed with moderate submucosal fibrosis. All sutured incisions had multifocal microgranulomata in which suture material was in various stages of degradation. At 8 weeks, localized teat wall thickening could be detected at incisional and biopsy sites, but did not obstruct milk flow. Excessive granulation tissue was at the biopsy sites (72 total) at 2 weeks, and at this time, the sites were partially covered by metaplastic squamous epithelium. However, by 8 weeks, 71 (98%) of the areas were replaced by fibrous tissue with minimal protrusion into the teat cistern.

  17. First Canadian experience with robotic single-incision pyeloplasty: Comparison with multi-incision technique

    Science.gov (United States)

    Law, Jeffrey; Rowe, Neal; Archambault, Jason; Nastis, Sofia; Sener, Alp; Luke, Patrick P.

    2016-01-01

    Introduction: We compared the outcomes of single-incision, robot-assisted laparoscopic pyeloplasty vs. multiple-incision pyeloplasty using the da Vinci robotic system. Methods: We reviewed all consecutive robotic pyeloplasties by a single surgeon from January 2011 to August 2015. A total of 30 procedures were performed (16 single:14 multi-port). Two different single-port devices were compared: the GelPort (Applied Medical, Rancho Santa Margarita, CA) and the Intuitive single-site access port (Intuitive Surgical, Sunnyvale, CA). Results: Patient demographics were similar between the two groups. Mean operating time was similar among the single and multi-port groups (225.2 min vs. 198.9 minutes [p=0.33]). There was no significant difference in length of hospital stay in either group (86.2 hr vs. 93.2 hr [p=0.76]). There was no difference in success rates or postoperative complications among groups. Conclusions: Single-port robotic pyeloplasty is non-inferior to multiple-incision robotic surgery in terms of operative times, hospitalization time, success rates, and complications. Verifying these results with larger cohorts is required prior to the wide adoption of this technique. Ongoing objective measurements of cosmesis and patient satisfaction are being evaluated. PMID:27217850

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-05-11

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

  19. Congenital subtalar dislocation--a case report.

    Science.gov (United States)

    Saini, Raghav; Dhillon, M S; Gill, S S

    2009-09-01

    Congenital dislocation of the subtalar joint is one of the rarest forms of presentation of a calcaneo-valgus foot. We report the second case of this type published; an 18-month female child aged was seen with calcaneo-valgus deformity of left foot since birth. She was walking over the medial malleolus and medial border of foot. Radiographs and 3D CT scan of the left foot confirmed the diagnosis of a congenital subtalar dislocation. Surgical correction was achieved through a posterolateral incision, and the reduced joint was fixed with a k-wires for 6 weeks; the foot was immobilized in below knee cast for another 6 weeks, and an ankle foot orthosis was used for another 3 years. At 3 years post-surgical follow up, the child has a plantigrade foot with no functional impairment. Follow up radiographs and 3D CT scan confirmed the maintenance of well aligned talo-calcaneal joint. This type of dislocation should be considered in the differential diagnosis of calcaneo-valgus foot; a clear understanding of the pathology, a precise operative reduction, and long-term use of orthosis results in a favourable outcome.

  20. Congenital short pancreas

    Institute of Scientific and Technical Information of China (English)

    DU Juan; XU Guo-qiang; XU Ping; JIN En-yun; LIU Qiong; LI You-ming

    2007-01-01

    @@ Congenital short pancreas, also known as partial agenesis or hypoplasia of the dorsal pancreas1 is a rare congenital abnormality consisting of the parenchyma and ductal system restricted to the head with some residual dorsal tapering and arborizing ducts communicating with the minor papill.2 Complete pancreatic agenesis is fatal, and only nine possible examples of partial agenesis have been previously reported in adults in the literature.3-10 Three of them were polysplenia syndrome associated with short pancreas,and only six patients with congenital short pancreas with normal situs. Here we present a new case associated with steatorrhoea.

  1. Congenital symmastia revisited

    DEFF Research Database (Denmark)

    Sillesen, Nanna H; Hölmich, Lisbeth R; Siersen, Hans Erik

    2012-01-01

    Symmastia is defined as medial confluence of the breast. The term 'symmastia' is modified from Greek (syn meaning 'together', and mastos meaning 'breast') and was first presented by Spence et al. in 1983. Two forms of symmastia exist: an iatrogenic and a congenital version. Congenital symmastia...... is a rare condition in which web-like soft tissue traverses the sternum to connect the breasts medially. The literature on congenital symmastia is limited, few cases have been published, and knowledge about ideal treatment is still insufficient....

  2. Minimal cosmography

    CERN Document Server

    Piazza, Federico

    2015-01-01

    The minimal requirement for cosmography - a nondynamical description of the universe - is a prescription for calculating null geodesics, and timelike geodesics as a function of their proper time. In this paper, we consider the most general linear connection compatible with homogeneity and isotropy, but not necessarily with a metric. A light-cone structure is assigned by choosing a set of geodesics representing light rays. This defines a "scale factor" and a local notion of distance, as that travelled by light in a given proper time interval. We find that the velocities and relativistic energies of free-falling bodies decrease in time as a consequence of cosmic expansion, but at a rate that can be different than that dictated by the usual metric framework. By extrapolating this behavior to photons redshift, we find that the latter is in principle independent of the "scale factor". Interestingly, redshift-distance relations and other standard geometric observables are modified in this extended framework, in a w...

  3. Minimal cosmography

    Science.gov (United States)

    Piazza, Federico; Schücker, Thomas

    2016-04-01

    The minimal requirement for cosmography—a non-dynamical description of the universe—is a prescription for calculating null geodesics, and time-like geodesics as a function of their proper time. In this paper, we consider the most general linear connection compatible with homogeneity and isotropy, but not necessarily with a metric. A light-cone structure is assigned by choosing a set of geodesics representing light rays. This defines a "scale factor" and a local notion of distance, as that travelled by light in a given proper time interval. We find that the velocities and relativistic energies of free-falling bodies decrease in time as a consequence of cosmic expansion, but at a rate that can be different than that dictated by the usual metric framework. By extrapolating this behavior to photons' redshift, we find that the latter is in principle independent of the "scale factor". Interestingly, redshift-distance relations and other standard geometric observables are modified in this extended framework, in a way that could be experimentally tested. An extremely tight constraint on the model, however, is represented by the blackbody-ness of the cosmic microwave background. Finally, as a check, we also consider the effects of a non-metric connection in a different set-up, namely, that of a static, spherically symmetric spacetime.

  4. Outcomes for single-incision laparoscopic colectomy surgery in obese patients: a case-matched study.

    Science.gov (United States)

    Keller, Deborah S; Ibarra, Sergio; Flores-Gonzalez, Juan Ramon; Ponte, Oscar Moreno; Madhoun, Nisreen; Pickron, T Bartley; Haas, Eric M

    2016-02-01

    Single-incision laparoscopic surgery (SILS) is safe and feasible for benign and malignant colorectal diseases. SILS offers several patient-related benefits over multiport laparoscopy. However, its use in obese patients has been limited from concerns of technical difficulty, oncologic compromise, and higher complication and conversion rates. Our objective was to evaluate the feasibility and efficacy of SILS for colectomy in obese patients. Review of a prospective database identified patients undergoing elective colectomy using SILS from 2009 to 2014. They were stratified into obese (BMI ≥ 30 kg/m(2)) and non-obese cohorts (BMI obese cohort had significantly higher BMI (p obese. There were no significant differences in conversion rates (p = 0.682), final incision length (p = 0.088), LOS (p = 0.332), postoperative complications (p = 0.430), or readmissions (p = 1.000) in the obese versus non-obese. Further, in malignant cases, lymph nodes harvested (p = 0.757) and negative distal margins (p = 1.000) were comparable across cohorts. Single-incision laparoscopic colectomy in obese patients had significantly longer operative times, but comparable conversion rates, oncologic outcomes, lengths of stay, complication, and readmission rates as the non-obese cohorts. In the obese, where higher morbidity rates are typically associated with surgical outcomes, SILS may be the ideal platform to optimize outcomes in colorectal surgery. With additional operative time, the obese can realize the same clinical and quality benefits of minimally invasive surgery as the non-obese.

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

    Directory of Open Access Journals (Sweden)

    Amedo AO

    2016-04-01

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

  6. Genetics Home Reference: Leber congenital amaurosis

    Science.gov (United States)

    ... amaurosis, Leber congenital congenital amaurosis of retinal origin congenital retinal blindness CRB dysgenesis neuroepithelialis retinae hereditary epithelial dysplasia of retina hereditary retinal aplasia heredoretinopathia congenitalis LCA ...

  7. Congenital orbital teratoma

    Directory of Open Access Journals (Sweden)

    Shereen Aiyub

    2013-01-01

    Full Text Available We present a case of mature congenital orbital teratoma managed with lid-sparing exenteration and dermis fat graft. This is a case report on the management of congenital orbital teratoma. A full-term baby was born in Fiji with prolapsed right globe which was surrounded by a nonpulsatile, cystic mass. Clinical and imaging features were consistent with congenital orbital teratoma. Due to limited surgical expertise, the patient was transferred to Adelaide, Australia for further management. The patient underwent a lid-sparing exenteration with frozen section control of the apical margin. A dermis fat graft from the groin was placed beneath the lid skin to provide volume. Histopathology revealed mature tissues from each of the three germ cell layers which confirmed the diagnosis of mature teratoma. We describe the successful use of demis fat graft in socket reconstruction following lid-sparing exenteration for congenital orbital teratoma.

  8. Congenital Ocular Motor Apraxia

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2007-06-01

    Full Text Available The clinical and neuroradiological findings, and long-term intellectual prognosis in 10 patients (4 boys and 6 girls with congenital ocular motor apraxia (COMA are reviewed by researchers at Tottori University, Yonago, Japan.

  9. Congenital Adrenal Hyperplasia

    National Research Council Canada - National Science Library

    Speiser, Phyllis W

    2015-01-01

    Congenital adrenal hyperplasia associated with deficiency of steroid 21-hydroxylase is the most common inborn error in adrenal function and the most common cause of adrenal insufficiency in the pediatric age group...

  10. Congenital cutis laxa

    Directory of Open Access Journals (Sweden)

    Acharya K

    1996-01-01

    Full Text Available A 16 days old male baby had congenital cutis laxa without family history. He had redundant and lax skin all over the body with slanting of the palpebral fissures medially and broad nasal root.

  11. Congenital lobar emphysema

    Science.gov (United States)

    Tural-Kara, Tuğçe; Özdemir, Halil; Çiftçi, Ergin; İnce, Erdal

    2016-01-01

    Congenital lobar emphysema is a rare disease, which is characterized by pulmoner hyperinflation. Depending on the degree of bronchial obstruction, the clinical presentation may be variable. We report a rare case with congenital lobar emphysema in a 38-days-old male infant who presented with severe respiratory distress and hypertension. Air trapping in the left upper lung and significant mediastinal shift to the right were observed on the chest x-ray. Emphysematous changes were detected on the thorax computed tomography and considered as congenital lobar emphysema. The upper left lobectomy was successfully performed by pediatric surgeons. On postoperative follow up, no sign of respiratory distress occurred and the patient was normotensive. In this report, a case with congenital lobar emphysema, which is a rare cause of respiratory distress and hypertension is discussed. PMID:27381542

  12. Congenital tracheobiliary fistula.

    NARCIS (Netherlands)

    Croes, F.; Nieuwaal, N.H. van; Heijst, A.F.J. van; Enk, G.J. van

    2010-01-01

    Congenital tracheobiliary fistula is a rare malformation that can present with a variety of respiratory symptoms. We present a case of a newborn patient with a tracheobiliary fistula and severe respiratory insufficiency needing extracorporal membrane oxygenation to recover.

  13. Congenital adrenal hyperplasia

    Science.gov (United States)

    ... to treat congenital adrenal hyperplasia do not usually cause side effects such as obesity or weak bones, because the doses replace the hormones that the child's body cannot make. It is important for parents ...

  14. Testing bedrock incision models: Holocene channel evolution, High Cascades, Oregon

    Science.gov (United States)

    Sweeney, K. E.; Roering, J. J.; Fonstad, M. A.

    2013-12-01

    There is abundant field evidence that sediment supply controls the incision of bedrock channels by both protecting the bed from incision and providing tools to incise the bed. Despite several theoretical models for sediment-dependent bedrock abrasion, many investigations of natural channel response to climatic, lithologic, or tectonic forcing rely on the stream power model, which does not consider the role of sediment. Here, we use a well-constrained fluvial channel cut into a Holocene lava flow in the High Cascades, Oregon to compare incision predictions of the stream power model and of the full physics of theoretical models for saltation-abrasion incision by bedload and suspended load. The blocky andesite of Collier lava flow erupted from Collier Cone ~1500 years ago, paving over the existing landscape and erasing fine-scale landscape dissection. Since the eruption, a 6 km stream channel has been incised into the lava flow. The channel is comprised of three alluvial reaches with sediment deposits up to 2 m thick and two bedrock gorges with incision of up to 8 m, with larger magnitude incision in the upstream gorge. Abraded forms such as flutes are present in both gorges. Given the low magnitude and duration of modern snowmelt flow in the channel, it is likely that much of the incision was driven by sediment-laden outburst floods from the terminus of Collier Glacier, which is situated just upstream of the lava flow and has produced two outburst floods in the past 100 years. This site is well suited for comparing incision models because of the relatively uniform lithology of the lava flow and our ability to constrain the timing and depth of incision using the undissected lava surface above the channel as an initial condition. Using a simple finite difference scheme with airborne-Lidar-derived pre-incision topography as an initial condition, we predict incision in the two gorges through time with both stream power and sediment-dependent models. Field observations

  15. The Surgical Release of Dupuytren's Contracture Using Multiple Transverse Incisions

    Directory of Open Access Journals (Sweden)

    Hyunjic Lee

    2012-07-01

    Full Text Available Dupuytren's contracture is a condition commonly encountered by hand surgeons, although it is rare in the Asian population. Various surgical procedures for Dupuytren's contracture have been reported, and the outcomes vary according to the treatment modalities. We report the treatment results of segmental fasciectomies with multiple transverse incisions for patients with Dupuytren's contracture. The cases of seven patients who underwent multiple segmental fasciectomies with multiple transverse incisions for Dupuytren's contracture from 2006 to 2011 were reviewed retrospectively. Multiple transverse incisions to the severe contracture sites were performed initially, and additional incisions to the metacarpophalangeal (MCP joints, and the proximal interphalangeal (PIP joints were performed if necessary. Segmental fasciectomies by removing the fibromatous nodules or cords between the incision lines were performed and the wound margins were approximated. The mean range of motion of the involved MCP joints and PIP joints was fully recovered. During the follow-up periods, there was no evidence of recurrence or progression of disease. Multiple transverse incisions for Dupuytren's contracture are technically challenging, and require a high skill level of hand surgeons. However, we achieved excellent correction of contractures with no associated complications. Therefore, segmental fasciectomies with multiple transverse incisions can be a good treatment option for Dupuytren's contracture.

  16. The Surgical Release of Dupuytren's Contracture Using Multiple Transverse Incisions

    Directory of Open Access Journals (Sweden)

    Hyunjic Lee

    2012-07-01

    Full Text Available Dupuytren’s contracture is a condition commonly encountered by hand surgeons, although itis rare in the Asian population. Various surgical procedures for Dupuytren’s contracture havebeen reported, and the outcomes vary according to the treatment modalities. We report thetreatment results of segmental fasciectomies with multiple transverse incisions for patientswith Dupuytren’s contracture. The cases of seven patients who underwent multiple segmentalfasciectomies with multiple transverse incisions for Dupuytren’s contracture from 2006 to 2011were reviewed retrospectively. Multiple transverse incisions to the severe contracture sites wereperformed initially, and additional incisions to the metacarpophalangeal (MCP joints, and theproximal interphalangeal (PIP joints were performed if necessary. Segmental fasciectomiesby removing the fibromatous nodules or cords between the incision lines were performed andthe wound margins were approximated. The mean range of motion of the involved MCP jointsand PIP joints was fully recovered. During the follow-up periods, there was no evidence ofrecurrence or progression of disease. Multiple transverse incisions for Dupuytren’s contractureare technically challenging, and require a high skill level of hand surgeons. However, weachieved excellent correction of contractures with no associated complications. Therefore,segmental fasciectomies with multiple transverse incisions can be a good treatment option forDupuytren’s contracture.

  17. Minimally Invasive Dentistry

    Science.gov (United States)

    ... to your desktop! more... What Is Minimally Invasive Dentistry? Article Chapters What Is Minimally Invasive Dentistry? Minimally ... techniques. Reviewed: January 2012 Related Articles: Minimally Invasive Dentistry Minimally Invasive Veneers Dramatically Change Smiles What Patients ...

  18. Surgical Repair of a Median Cleft of the Upper Lip via a Pfeifer Incision: A Case Report

    Science.gov (United States)

    Pandey, Rajeev; Gupta, Rajat; Bhagat, Nitin; Verma, Aviral

    2016-01-01

    Median cleft is the midline cleft of the lip. It develops due to incomplete or failed fusion of the median nasal prominence. It can present with minimal deformities such as involvement of the vermilion border, or complex clefting of the midline structures and brain. Median clefts are broadly classified as true and false clefts. This case report describes a rare case of median cleft of the upper lip involving the white roll, which was not associated with any other deformities. Treatment included reconstruction of the philtrum and the cupid's bow while maintaining vermilion fullness and continuity, and minimizing scar formation. Various techniques have been advocated for treatment of this type of median upper lip cleft. Here we describe a technique using Pfeifer incision to correct our patient's defect. Pfeifer incision consists of wavy lines and its use has been advocated for correction of various craniofacial abnormalities. PMID:27928243

  19. Congenital imprinting disorders

    DEFF Research Database (Denmark)

    Eggermann, Thomas; Netchine, Irène; Temple, I Karen

    2015-01-01

    Imprinting disorders (IDs) are a group of eight rare but probably underdiagnosed congenital diseases affecting growth, development and metabolism. They are caused by similar molecular changes affecting regulation, dosage or the genomic sequence of imprinted genes. Each ID is characterised...... EUCID.net (European network of congenital imprinting disorders) now aims to promote better clinical care and scientific investigation of imprinting disorders by establishing a concerted multidisciplinary alliance of clinicians, researchers, patients and families. By encompassing all IDs and establishing...

  20. A COMPARA TIVE STUDY OF MANUAL INCISION WITH RADIOSURGERY INCISION INDACRYOCYSTORHYNOSTOMY SURGERY

    Directory of Open Access Journals (Sweden)

    Shailly

    2015-03-01

    Full Text Available MATERIAL & METHODS : This randomized , prospective study was carried out on patient attending out patients department of ophthalmology L . L . R . hospital ( G S V M Medical College Kanpur during the time period of 2 years . Detailed history , general examination & ophthalmic examination done . Then they under went Dacryocystorhinostomy surgery . These patients divided into two groups the Group ‘A’ and Group ‘B’ . Group . A patients underwent the dacryocystorhinostomy surgery with manual scalpel incision and Group B patients underwent the surgery with radiofrequency tools . The subsequent follow up was done at the intervals at one week , 3 weeks , 6 weeks and 6 months . Some w ere followed more frequently whenever needed . RESULTS : The present study was conducted on 118 eyes of 102 patients , o f these 56 eyes ( 48 patients received skin incision with manual scalpel ( Group ‘A’ and 62 eyes ( 54 patients received skin incision with r adiofrequency knife ( Group ‘B’ . The intraoperative bleeding and mean surgical time per case was less with rad i frequency knife that is in group B . There was also faster wound healing with more numbers cases of excellent scar quality on postoperative follo w up in Group B . DISCUSSION : Intraoperative average numbers of gauze pieces used per case was less in Group B because of electrocoagulation action of radiofrequency tools . That is why the mean surgical time per case was less in Group B . Patients was compar ed for scar quality by giving them scores according to Manchester scar scale score and60% patients in Group B achieves excellent scar quality scores in comparison to group A in which only 48% patients achieves excellent scar quality scores . CONCLUSION : There is less intraoperative bleeding and less mean surgical time per case and faster healing with excellent scar quality postoperatively in early and late follow ups with radiofrequency tools than manual scalpel .

  1. Surgical treatment of congenital biliary duct cyst

    Directory of Open Access Journals (Sweden)

    Wang De-chun

    2012-03-01

    Full Text Available Abstract Background It is acknowledged that total cyst excision is a safe and ideal surgical treatment for congenital biliary duct cyst, compared to simple internal drainage. The aim of this study was to determine the optimal operation occasion and the effect of laparoscopy on congenital biliary duct cyst based upon total cyst excision. Methods From January 2002 to January 2011, 217 patients were admitted to Southwest Hospital for congenital biliary duct cyst. To determine the optimal surgery occasion, we divided these subjects into three groups, the infant group (age ≤ 3 years, the immaturity group (3 18 years, and then evaluated the feasibility, risk and long-term outcome after surgery in the three groups. To analyze the effect of laparoscopic technique on congenital biliary duct cyst, we divided the patients into the laparoscopy and the open surgery groups. Results Among the three groups, the morbidity from cholangiolithiasis before surgical treatment had obvious discrepancy (p 0.05. Similarly, no significant discrepancy was observed in the morbidity from postoperative complications or long-term postoperative complications (p > 0.05 between the laparoscopic and the open surgery groups. Conclusions We conclude that total cyst excision should be performed as early as possible. The optimal treatment occasion is the infant period, and laparoscopic resection may be a new safe and feasible minimally invasive surgery for this disease.

  2. Resection of an Occipital-Cervical Junction Schwannoma through a modified minimally invasive approach: Technical Note

    Directory of Open Access Journals (Sweden)

    Michael Feldman

    2015-01-01

    Conclusion: In properly selected patients, minimally invasive approaches to the OCJ for resection of mass lesions are feasible, provide adequate visualization of tumor and surrounding structures, and may even be preferable given the lower morbidity of a smaller incision and minimal soft tissue dissection.

  3. Techniques for posterior lamellar keratoplasty through a scleral incision

    NARCIS (Netherlands)

    Melles, GRJ; Kamminga, N

    2003-01-01

    Purpose. To describe several techniques for posterior lamellar keratoplasty through a scleral incision, for management of corneal endothelial disorders like pseudophacic bullous keratopathy and Fuchs' endothelial dystrophy, and to report the mid-term clinical results. Methods. Three techniques have

  4. Single-incision laparoscopic management of a giant hepatic cyst.

    Science.gov (United States)

    Willems, Kaitlin; Monsivais, Sharon; Vassaur, Hannah; Buckley, Francis P

    2015-07-29

    Large symptomatic hepatic cysts may warrant surgical management. Traditional multiport laparoscopic technique is typically preferred over open laparotomy, but the use of the single-incision laparoscopic approach for this diagnosis is not well documented. Here, we describe the case of a 68-year-old woman who underwent complete anterior wall fenestration, excision and cauterization of a simple hepatic cyst via a single-incision laparoscopic technique through an incision at the umbilicus. The objective of this case report is to document single-incision laparoscopy as a safe, feasible and cosmetically appealing approach for the management of a large hepatic cyst. Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author 2015.

  5. Landscape evolution due to river incision in active mountains

    Science.gov (United States)

    Lavé, L.; Attal, A.

    2003-04-01

    It is commonly accepted that fluvial network incision control the local base level for hillslopes and therefore controls the rate of landscape denudation, and thus the way the landscape will respond to tectonic or climatic forcings. For that reason, many studies have focused for the last ten years in quantifying fluvial incision rates and the mechanisms of fluvial incision into bedrock. In many morphotectonic settings the shear stress model has been widely used and provided satisfactory first order description of the river incision in active mountains. Across the Siwaliks range in front of the Himalaya, the shear stress model (that also includes bedload mean pebble size and explicit channel width variations), provides a good proxy to estimate incision and uplift rate, that can be measured independently from fluvial terraces studies. By transposition and after calibration to more resistant crystalline lithologies, this model helped to define the incision rate profiles across the whole Himalayan ranges. These profiles were found coherent with current seismotectonic model, sediment budget, fluvial terrace studies and geochronology results. More importantly, the incision model was found to provide good results in two other active regions: across the Nanga Parbat massif in Pakistan, and in the San Gabriel Ranges in California, with only minor required changes of the erodibility coefficient despite very different hydroclimatic setting. However, this semi-empirical model is not mechanically satisfying: in many settings, river bedload fluxes exert an important control on incision rates, by limiting bedrock exposure or by providing an efficient tool for river mechanical abrasion. A reappraisal of the former examples as thus conducted in order to test different models including the role of sediment fluxes. General results and models will be first discussed in light of their physical consistency with field and experimental data on pebble and bedrock abrasion, and second in

  6. Transumbilical single-incision laparoscopic hepatectomy: an initial report

    Institute of Scientific and Technical Information of China (English)

    HU Ming-gen; ZHAO Guo-dong; XU Da-bing; LIU Rong

    2011-01-01

    Transumbilical single-incision laparoscopic surgeries have attracted the attention of surgeon. Here we report a patient with multiple hepatic hemagiomas and symptomatic cholelithiasis who underwent laparoscopic left lateral hepatecomy and left hepatic hemangioma enucleation with single incision followed by cholecystectomy. The duration of the operation was 155 minutes and the blood loss was 100 ml. There were no complications during or after the treatment. This surgical treatment yields a good cosmetic effect and rapid recovery.

  7. Usefulness of Ω-shaped Incision in Skin Tumor Excision

    Directory of Open Access Journals (Sweden)

    Naoshige Iida, MD, PhD

    2014-01-01

    Full Text Available Summary: We devised the Ω-shaped incision as a technique for skin tumor resection on the areas of skin with an arc-shaped fold. With this technique, the dog-ear that is formed during 6 wound closure can be resected within the range of the first skin incision. We report this technique after performing it on the face or trunk of 18 patients and confirmed its usefulness.

  8. Comparison between Limbal and Pars Plana Approaches Using Microincision Vitrectomy for Removal of Congenital Cataracts with Primary Intraocular Lens Implantation

    Science.gov (United States)

    Liu, Xin; Zheng, Tianyu; Zhou, Xingtao; Lu, Yi; Zhou, Peng; Fan, Fan; Luo, Yi

    2016-01-01

    Purpose. To compare the surgical outcomes of limbal versus pars plana vitrectomy using the 23-gauge microincision system for removal of congenital cataracts with primary intraocular lens implantation. Methods. We retrospectively reviewed all eyes that underwent cataract removal through limbal or pars plana incision. Main outcome measures included visual outcomes and complications. Results. We included 40 eyes (26 patients) in the limbal group and 41 eyes (30 patients) in the pars plana group. The mean age was 46 months. There was no significant difference in best-corrected visual acuity between the two groups (P = 0.64). Significantly, more eyes had at least one intraoperative complication in the limbal group than in the pars plana group (P = 0.03) that were mainly distributed at 1.5–3 years of age (P = 0.01). The most common intraoperative complications were iris aspiration, iris prolapse, and iris injury. More eyes in the limbal group had postoperative complications and required additional intraocular surgery, but the difference was not significant (P = 0.19). Conclusions. The visual results were encouraging in both approaches. We recommend the pars plana approach for lower incidence of complications. The limbal approach should be reserved for children older than 3 years of age and caution should be exercised to minimize iris disturbance. PMID:27313872

  9. Minimal Invasive Decompression for Lumbar Spinal Stenosis

    Directory of Open Access Journals (Sweden)

    Victor Popov

    2012-01-01

    Full Text Available Lumbar spinal stenosis is a common condition in elderly patients and may lead to progressive back and leg pain, muscular weakness, sensory disturbance, and/or problems with ambulation. Multiple studies suggest that surgical decompression is an effective therapy for patients with symptomatic lumbar stenosis. Although traditional lumbar decompression is a time-honored procedure, minimally invasive procedures are now available which can achieve the goals of decompression with less bleeding, smaller incisions, and quicker patient recovery. This paper will review the technique of performing ipsilateral and bilateral decompressions using a tubular retractor system and microscope.

  10. Genetics of Congenital Cataract.

    Science.gov (United States)

    Pichi, Francesco; Lembo, Andrea; Serafino, Massimiliano; Nucci, Paolo

    2016-01-01

    Congenital cataract is a type of cataract that presents at birth or during early childhood, and it is one of the most easily treatable causes of visual impairment and blindness during infancy, with an estimated prevalence of 1-6 cases per 10,000 live births. Approximately 50% of all congenital cataract cases may have a genetic cause, and such cases are quite heterogeneous. Although congenital nuclear cataract can be caused by multiple factors, genetic mutation remains the most common cause. All three types of Mendelian inheritance have been reported for cataract; however, autosomal dominant transmission seems to be the most frequent. The transparency and high refractive index of the lens are achieved by the precise architecture of fiber cells and homeostasis of the lens proteins in terms of their concentrations, stabilities, and supramolecular organization. Research on hereditary congenital cataract has led to the identification of several classes of candidate genes that encode proteins such crystallins, lens-specific connexins, aquaporin, cytoskeletal structural proteins, and developmental regulators. In this review, we highlight the identified genetic mutations that account for congenital nuclear cataract.

  11. Endoscopy-assisted cerebral falx incision via unilateral approach for treatment of dissymmetric bilateral frontal contusion

    Institute of Scientific and Technical Information of China (English)

    DONG Ji-rong; HU Xu; XU Qin-yi; CAI Xue-jian; WANG Biao; WANG Yu-hai; SHI Zhong-hua; LIU Bing; CAI Sang; HE Jian-qing

    2012-01-01

    Objective: To investigate the clinical features and treatment strategy of dissymmetric bilateral frontal contusion,and to summarize our experience in treating these patients by minimally invasive surgery.Methods: Over the past 3 years,we have treated a total of 31 patients with dissymmetric bilateral frontal contusion using endoscopy-assisted unilateral cerebral falx incision.Other 30 patients treated by routine bilateral approaches within the same period were taken as control.Results: Seventeen cases (54.8%) in the unilateral operation group survived and were in good condition,8 (25.8%) had moderate disability,4 (12.9%) had severe disability,1 (3.2%) was in vegetative state,and 1 (3.2%) died.Compared with the control group,the Glasgow Outcome Scale score was not significantly different in the unilateral operation group,but the operation time,blood transfusion volume,the length of hospital stay,the incidences of mental disorder and olfactory nerve injury were greatly reduced in the unilateral operation group.Conclusions: Endoscopy-assisted unilateral cerebral falx incision can shorten the operation time,reduce surgical trauma and complications in treatment of patients with dissymmetric bilateral frontal contusion.It can obviously diminish the chance of delayed intracerebral hematoma and subsequently minimize the incidences of subfalcial and centrencephalic herniation.

  12. The Role of the Single Incision Laparoscopic Approach in Liver and Pancreatic Resectional Surgery

    Directory of Open Access Journals (Sweden)

    Nikolaos A. Chatzizacharias

    2016-01-01

    Full Text Available Introduction. Single incision laparoscopic surgery (SILS has gained increasing support over the last few years. The aim of this narrative review is to analyse the published evidence on the use and potential benefits of SILS in hepatic and pancreatic resectional surgery for benign and malignant pathology. Methods. Pubmed and Embase databases were searched using the search terms “single incision laparoscopic”, “single port laparoscopic”, “liver surgery”, and “pancreas surgery”. Results. Twenty relevant manuscripts for liver and 9 for pancreatic SILS resections were identified. With regard to liver surgery, despite the lack of comparative studies with other minimal invasive techniques, outcomes have been acceptable when certain limitations are taken into account. For pancreatic resections, when compared to the conventional laparoscopic approach, SILS produced comparable results with regard to intra- and postoperative parameters, including length of hospitalisation and complications. Similarly, the results were comparable to robotic pancreatectomies, with the exception of the longer operative time reported with the robotic approach. Discussion. Despite the limitations, the published evidence supports that SILS is safe and feasible for liver and pancreatic resections when performed by experienced teams in the tertiary setting. However, no substantial benefit has been identified yet, especially compared to other minimal invasive techniques.

  13. Eyebrow incision with supraorbital trephination for endoscopic corpus callosotomy: a feasibility study.

    Science.gov (United States)

    Tubbs, R Shane; Smyth, Matthew D; Salter, George; Doughty, Kyle; Blount, Jeffrey P

    2004-03-01

    We describe a novel technique for the partial bisection of the corpus callosum in order to increase the minimally invasiveness of this procedure. Brow incisions with midline trephinations were performed in six adult cadavers. An endoscope was next introduced and used to transect approximately the anterior two-thirds of the corpus callosum. No complications such as injury to the superior sagittal sinus or anterior cerebral artery were encountered in any of our cadaveric specimens. The corpus callosum was easily transected in each specimen. As a feasibility study, we believe this technique could provide a less invasive mechanism for patients who require corpus callosotomy and will minimize much of the morbidity associated with the traditional methods of sectioning the corpus callosum.

  14. Adults with Congenital Heart Defects

    Science.gov (United States)

    ... Disease Venous Thromboembolism Aortic Aneurysm More Web Booklet: Adults With Congenital Heart Defects Updated:Aug 29,2017 ... the list below to learn more. Web Booklet: Adults With Congenital Heart Defects Introduction Introduction: Adults with ...

  15. Congenital tracheobronchial stenosis.

    Science.gov (United States)

    Hewitt, Richard J; Butler, Colin R; Maughan, Elizabeth F; Elliott, Martin J

    2016-06-01

    Congenital tracheobronchial stenosis is a rare disease characterized by complete tracheal rings that can affect variable lengths of the tracheobronchial tree. It causes high levels of morbidity and mortality both due to the stenosis itself and to the high incidence of other associated congenital malformations. Successful management of this complex condition requires a highly individualized approach delivered by an experienced multidisciplinary team, which is best delivered within centralized units with the necessary diverse expertise. In such settings, surgical correction by slide tracheoplasty has become increasingly successful over the past 2 decades such that long-term survival now exceeds 88%, with normalization of quality of life scores for patients with non-syndrome-associated congenital tracheal stenosis. Careful assessment and planning of treatment strategies is of paramount importance for both successful management and the provision of patients and carers with accurate and realistic treatment counseling. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Congenital cataract screening

    Directory of Open Access Journals (Sweden)

    Zhale Rajavi

    2016-01-01

    Full Text Available Congenital cataract is a leading cause of visual deprivation which can damage the developing visual system of a child; therefore early diagnosis, management and long-term follow-up are essential. It is recommended that all neonates be screened by red reflex examination at birth and suspected cases be referred to ophthalmic centers. Early surgery (1 year is highly recommended. After surgery, amblyopia treatment and periodic follow-up examinations should be started as soon as possible to achieve a satisfactory visual outcome. Practitioners should consider the possibility of posterior capsular opacity, elevated intraocular pressure and amblyopia during follow-up, especially in eyes with microphthalmia and/or associated congenital anomalies. All strabismic children should undergo slit lamp examination prior to strabismus surgery to rule out congenital lens opacities. From a social point of view, equal and fair medical care should be provided to all children regardless of gender.

  17. Congenital Syphilis: literature review

    Directory of Open Access Journals (Sweden)

    Eduardo Chaida Sonda

    2013-06-01

    Full Text Available Syphilis is an infectious disease caused by Treponema pallidum and has high rates of vertical transmission, which can reach 100% depending on the maternal disease and stage of pregnancy. The diagnosis of gestational syphilis is simple and its screening is required during the prenatal period. However, this disease still has a high prevalence, affecting two million pregnant women worldwide. The procedures performed in newborns with congenital syphilis represent costs that are three-fold higher than the ones spent with a baby without this infection. The treatment is generally carried out with penicillin and must be extended to sexual partners. Inadequate or lack of treatment of congenital syphilis can result in miscarriage, premature birth, acute complications and other fetal sequelae. KEYWORDS: Congenital syphilis. Treponema pallidum. Vertical transmission.

  18. Congenital right hemidiaphragmatic agenesis

    Directory of Open Access Journals (Sweden)

    Bilal Mirza

    2012-01-01

    Full Text Available Congenital diaphragmatic hernia is a congenital defect of the diaphragm through which intestine and other viscera herniate into the chest. In extreme form of diaphragmatic maldevelopment, there might be a complete agenesis of diaphragm. A 45-day old male infant was presented with fever, cough and respiratory distress for a week. Chest radiograph showed right-sided congenital diaphragmatic hernia. The patient underwent surgical exploration and found to have an unusual and large defect of right hemidiaphragm. The diaphragm was absent on anterior and lateral aspects of the chest wall and only a small rim of diaphragm was present on posterior aspect. The defect was identified as agenesis of right hemidiaphragm and successfully managed by suturing the posterior rim of diaphragm to the intercostal muscles and ribs. This report describes successful management of hemidiaphragmatic agenesis without incorporating a prosthetic material.

  19. Congenital right hemidiaphragmatic agenesis.

    Science.gov (United States)

    Mirza, Bilal; Bashir, Zahid; Sheikh, Afzal

    2012-01-01

    Congenital diaphragmatic hernia is a congenital defect of the diaphragm through which intestine and other viscera herniate into the chest. In extreme form of diaphragmatic maldevelopment, there might be a complete agenesis of diaphragm. A 45-day old male infant was presented with fever, cough and respiratory distress for a week. Chest radiograph showed right-sided congenital diaphragmatic hernia. The patient underwent surgical exploration and found to have an unusual and large defect of right hemidiaphragm. The diaphragm was absent on anterior and lateral aspects of the chest wall and only a small rim of diaphragm was present on posterior aspect. The defect was identified as agenesis of right hemidiaphragm and successfully managed by suturing the posterior rim of diaphragm to the intercostal muscles and ribs. This report describes successful management of hemidiaphragmatic agenesis without incorporating a prosthetic material.

  20. Nitrofurantoin and congenital abnormalities

    DEFF Research Database (Denmark)

    Czeizel, A.E.; Rockenbauer, M.; Sørensen, Henrik Toft;

    2001-01-01

    Objective: To study human teratogenic potential of oral nitrofurantoin treatment during pregnancy. Materials and Methods: Pair analysis of cases with congenital abnormalities and matched population controls in the population-based dataset of the Hungarian Case-Control Surveillance of Congenital...... or fetuses with Down’s syndrome (patient controls), 23 (2.8%) pregnant women were treated with nitrofurantoin. The above differences between population controls and cases may be connected with recall bias, because the case-control pair analysis did not indicate a teratogenic potential of nitrofurantoin use...... during the second and the third months of gestation, i.e. in the critical period for major congenital abnormalities. Conclusion: Treatment with nitrofurantoin during pregnancy does not present detectable teratogenic risk to the fetus....

  1. Congenital Cataract Screening

    Science.gov (United States)

    Rajavi, Zhale; Sabbaghi, Hamideh

    2016-01-01

    Congenital cataract is a leading cause of visual deprivation which can damage the developing visual system of a child; therefore early diagnosis, management and long-term follow-up are essential. It is recommended that all neonates be screened by red reflex examination at birth and suspected cases be referred to ophthalmic centers. Early surgery (1 year) is highly recommended. After surgery, amblyopia treatment and periodic follow-up examinations should be started as soon as possible to achieve a satisfactory visual outcome. Practitioners should consider the possibility of posterior capsular opacity, elevated intraocular pressure and amblyopia during follow-up, especially in eyes with microphthalmia and/or associated congenital anomalies. All strabismic children should undergo slit lamp examination prior to strabismus surgery to rule out congenital lens opacities. From a social point of view, equal and fair medical care should be provided to all children regardless of gender. PMID:27621790

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

    Directory of Open Access Journals (Sweden)

    Yongqi He

    2009-01-01

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

  3. Congenital Heart Defects (For Parents)

    Science.gov (United States)

    ... Old Feeding Your 1- to 2-Year-Old Congenital Heart Defects KidsHealth > For Parents > Congenital Heart Defects A A A What's in this article? How ... a Problem en español Anomalías cardíacas congénitas A congenital heart defect is a problem in the heart's structure that ...

  4. Congenital Abdominal Wall Defects

    DEFF Research Database (Denmark)

    Risby, Kirsten; Jakobsen, Marianne Skytte; Qvist, Niels

    2016-01-01

    complications were seen in five (15%) children: four had detachment of the mesh and one patient developed abdominal compartment syndrome. Mesh related clinical infection was observed in five children. In hospital mortality occurred in four cases (2 gastroschisis and 2 omphalocele) and was not procedure......OBJECTIVE: To evaluate the clinical utility of GORE® DUALMESH (GDM) in the staged closure of large congenital abdominal wall defects. MATERIALS AND METHODS: Data of patients with congenital abdominal wall defects managed with GDM was analyzed for outcome regarding complete fascial closure; mesh...

  5. Congenital Toxoplasmosis: A Review.

    Science.gov (United States)

    Hampton, Marissa Martinez

    2015-01-01

    Acute infection of toxoplasmosis during pregnancy is detrimental to the developing fetus. In the United States, approximately 1 in 10,000 live births are affected by congenital toxoplasmosis. Although multifactorial in etiology, maternal infection is primarily attributed to the consumption of contaminated meat or water. Infection and transmission to the fetus may result in devastating neurologic impairment. Screening methods for all pregnant women should be implemented in routine prenatal care. This article will highlight the inherent dangers of congenital toxoplasmosis, while including general care of the fetus for prevention of transmission, medical management, and long-term outcomes.

  6. Congenital preduodenal portal vein

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sang Jin; Hwang, Mi Soo; Huh, Young Soo; Park, Bok Hwan [College of Medicine, Youngnam University, Gyeongsan (Korea, Republic of)

    1991-03-15

    Congenital preduodenal portal vein, first reported by Knight in 1921, is an extremely rare congenital anomaly in which the portal vein passes anteriorly to the duodenum rather than posteriorly in its normal location. It is of surgical significance because it may cause difficulties in operations involving the gall bladder, biliary duct, or duodenum. Recently, we experienced 2 cases of preduodenal portal vein. One was found during surgical exploration for the diagnosis and correction of malrotation of the bowels and the other in a 3 day-old male newborn associated with dextrocardia, situs inversus, and duodenal obstruction by diaphragm. We report these 2 cases with a review of the literature.

  7. Ullrich Congenital Muscular Dystrophy

    Directory of Open Access Journals (Sweden)

    Goknur Haliloglu

    2011-09-01

    Full Text Available ObjectiveUllrich congenital muscular dystrophy is a rather severe type of congenitalmuscular dystrophy with early onset features related to motor development.In general it is inherited in autosomal recessive principles, however in theWestern world mostly seen with de novo dominant mutations in the collagenVI genes. Milder form of the condition is the Bethlem myopathy. There may beoverlap forms in the clinic resembling the Ehler-Danlos syndrome. There hasbeen some radical efforts for cure especially through the apoptosis cascades.Key words: Ullrich congenital muscular dystrophy, collgen VI genes, Bethlemmyopathy, autophagy.

  8. Ullrich Congenital Muscular Dystrophy

    Directory of Open Access Journals (Sweden)

    Goknur Haliloglu

    2011-06-01

    Full Text Available ObjectiveUllrich congenital muscular dystrophy is a rather severe type of congenital muscular dystrophy with early onset features related to motor development.In general it is inherited in autosomal recessive principles, however in the Western world mostly seen with de novo dominant mutations in the collagen VI genes. Milder form of the condition is the Bethlem myopathy. There may be overlap forms in the clinic resembling the Ehler-Danlos syndrome. There has been some radical efforts for cure especially through the apoptosis cascades.

  9. Congenital heart disease

    Institute of Scientific and Technical Information of China (English)

    1995-01-01

    950283 Surgical treatment of congenital coronaryartery fistula.CAO Qingheng(曹庆亨),et al.DeptCardiovasc Surg,Shanghai Chest Hosp,Shanghai,200030.Shanghai Med J 1995;18(1):10-12.From October 1957 through December 1990,twenty-five patients with congenital coronary artery fistula(CCAF),including 3 cases complicated with giantcoronary artery aneurysms,underwent surgical repair.The ages ranged from 4 to 47 years (mean 19.8years).CCAF originated from the right coronaryartery in 17 cases (68.0%) and terminated into RA,RV,pulmonary artery (PA) or LV,in 8 cases (32.

  10. Congenital laryngeal anomalies,

    Directory of Open Access Journals (Sweden)

    Michael J. Rutter

    2014-12-01

    Full Text Available Introduction: It is essential for clinicians to understand issues relevant to the airway management of infants and to be cognizant of the fact that infants with congenital laryngeal anomalies are at particular risk for an unstable airway. Objectives: To familiarize clinicians with issues relevant to the airway management of infants and to present a succinct description of the diagnosis and management of an array of congenital laryngeal anomalies. Methods: Revision article, in which the main aspects concerning airway management of infants will be analyzed. Conclusions: It is critical for clinicians to understand issues relevant to the airway management of infants.

  11. Minimally invasive treatment of oral ranula with a mucosal tunnel.

    Science.gov (United States)

    Jia, T; Xing, L; Zhu, F; Jin, X; Liu, L; Tao, J; Chen, Y; Gao, Z; Zhang, H

    2015-02-01

    We have developed a new method for minimally-invasive treatment of uncomplicated oral ranulas using a mucosal tunnel, and we report the clinical outcome. We constructed a mucosal tunnel for each of 35 patients who presented with an oral ranula, by making 2 parallel incisions across the top of the protruding ranula 2-3mm apart, and dissected the soft tissue along the incisions to its wall. The fluid was removed and the cavity irrigated with normal saline. The wall of the ranula was not treated. The first mucosal tunnel was made by suturing the base of the mucosal strip to the deepest part of the wall of the ranula. The mucosal base of the tunnel and the deepest part of the base of the ranula were fixed with absorbable sutures. The two external edges of the incisions were sutured together to form the second mucosal tunnel, and apposing sutures were inserted between the two parallel incisions to form two natural mucosal tunnels. The duration of follow-up ranged from 1 to 5 years. One patient was lost to follow-up and 34 patients were cured. Outcomes were satisfactory without relapse during the follow-up period and the patients were satisfied with the outcome. The mucosal tunnel is a safe, effective, simple, and minimally-invasive treatment for oral ranula.

  12. Anaesthetic management of a child with congenital afibrinogenemia - A rare inherited coagulation disorder

    Directory of Open Access Journals (Sweden)

    Sham Sunder Goyal

    2011-01-01

    Full Text Available Congenital afibrinogenemia is a very rare autosomal recessive disorder, results from mutation that affects plasma fibrinogen concentration. It is frequently associated with bleeding diathesis of varying severity. We describe the case of a 10-year-old child diagnosed of congenital afibrinogenemia who presented to hospital with subperiosteal haematoma and was posted for incision and drainage. Replacement therapy is the mainstay of treatment of bleeding episodes in this patient and plasma-derived fibrinogen concentrate is the agent of choice. Cryoprecipitate and fresh frozen plasma are alternative treatments. Appropriate amount of cryoprecipitate were transfused pre-operatively to the child. Individuals with congenital afibrinogenemia should be managed by a comprehensive bleeding disorder care team experienced in diagnosing and managing inherited bleeding disorders. Anaesthesiologist, surgeons and haematologist should work like a unit to manage the surgical emergencies.

  13. Nail bed expansion: A new technique for correction of multiple isolated congenital micronychia

    Directory of Open Access Journals (Sweden)

    Gholamhossein Ghaffarpour

    2014-01-01

    Full Text Available Congenital micronychia may involve big toes or may involve other nails. The etiology of micronychia is not clear but amniotic bands, teratogens (drugs, alcohol, Nail Patella Syndrome etc. A 44-year-old woman with multiple isolated congenital micronychia over her hands and feet was selected. The major affected nails were thumbs and Index fingers. Surgical method were done step by step: Anesthesia of the area, extraction of short nail, elevation of nail bed, longitudinal nail bed incisions, suturing the lateral nail bed to the nail wall, covering the nail bed by a splint of plastic suction tube, bandage with gauze Vaseline. Finally, we hypnotized that in congenital micronychia, the main pathology is in nail bed; through this theory by nail bed expansion better outcomes are coming.

  14. Effectiveness comparison of channel-assisted mini-incision and open Achilles shortening for treatment of healed Achilles tendon rupture

    Directory of Open Access Journals (Sweden)

    Hong-zhe QI

    2017-08-01

    Full Text Available Objective To compare the clinical effectiveness between the channel-assisted mini-invasion and open Achilles shortening for treatment of the elongated Achilles tendon following previous rupture. Methods The clinical data of 19 patients admitted from Dec. 2013 to Dec. 2015 and met the inclusion criteria were analyzed retrospectively. Eight patients were treated with shortening operation by channel-assisted minimally invasive repair system, while 11 patients received dissection of Krackow Achilles tendon shortening. There was no significant difference between the two groups in gender, age, injury to operation time, preoperative calf circumference and preoperative AOFAS (American Orthopaedic Foot & Ankle Society score (P>0.05. Results The operation time, incision length and postoperative hospital days were significantly less in min-invasion group than in incision group (P0.05. Conclusion Channel-assisted minimally invasive Achilles tendon shortening operation has not only similar effectiveness to the incision shorting operation for the treatment of elongated Achilles tendon following previous rupture, but also has the advantages of shortening operation time and stay in hospital and avoidance of sural nerve injury. DOI: 10.11855/j.issn.0577-7402.2017.07.12

  15. Morphine reduces local cytokine expression and neutrophil infiltration after incision

    Directory of Open Access Journals (Sweden)

    Li Xiangqi

    2007-10-01

    Full Text Available Abstract Background Inflammation and nociceptive sensitization are hallmarks of tissue surrounding surgical incisions. Recent studies demonstrate that several cytokines may participate in the enhancement of nociception near these wounds. Since opioids like morphine interact with neutrophils and other immunocytes, it is possible that morphine exerts some of its antinociceptive action after surgical incision by altering the vigor of the inflammatory response. On the other hand, keratinocytes also express opioid receptors and have the capacity to produce cytokines after injury. Our studies were directed towards determining if opioids alter cytokine production near incisions and to identify cell populations responsible for producing these cytokines. Results A murine incisional model was used to measure the effects of acute morphine administration (0.1–10 mg/kg on nociceptive thresholds, neutrophil infiltration and cytokine production in hind paw skin 30 minutes and 2 hours after incision. Incised hind paws displayed profound allodynia which was reduced by morphine (0.1–10 mg/kg in the 2 hours following incision. Skin samples harvested from these mice showed enhanced levels of 5 cytokines: IL-1β, IL-6, tumor necrosis factor alpha (TNFα, granulocyte colony stimulating factor (G-CSF and keratinocyte-derived cytokine (KC. Morphine reduced these incision-stimulated levels. Separate analyses measuring myeloperoxidase (MPO and using immunohistochemistry demonstrated that morphine dose-dependently reduced the infiltration of neutrophils into the peri-incisional tissue. The dose of morphine required for reduction of cytokine accumulation, however, was below that required for inhibition of peri-incisional neutrophil infiltration. Additional immunohistochemical studies revealed wound edge keratinocytes as being an important source of cytokines in the acute phase after incision. Conclusion Acute morphine administration of doses as low as 0.1 mg/kg reduces

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

    Science.gov (United States)

    Gran, K. B.

    2015-12-01

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

  17. Pseudoamblyopia in Congenital Cyclotropia

    Directory of Open Access Journals (Sweden)

    Antonio Frattolillo

    2017-01-01

    Full Text Available Purpose. To study the effect of surgery on amblyopia and suppression associated with congenital cyclovertical strabismus. Methods. The fixation pattern was investigated with microperimetry before and soon after surgery in ten consecutive children operated for congenital superior oblique palsy at the S. Martino Hospital, Belluno, Italy, between September 2014 and December 2015. Changes in visual performance in terms of best-corrected visual acuity (BCVA and stereopsis between the day before and one week after surgery were also evaluated. No other amblyopia treatment has been administered during the time study. Results. Surgical correction of the excyclodeviation in congenital SO palsy determined monocular and binocular sensory consequences: monocularly, in the cyclodeviated amblyopic eye, BCVA (0.46–0.03 LogMAR; p<0.0001 and the fixation pattern improved, as demonstrated by microperimetry examination. Binocularly, stereopsis improved or emerged while suppression at the Worth four-dot test disappeared. Conclusions. In the absence of further amblyopic factors such as coexisting constant vertical and/or horizontal deviation and anisometropia, the amblyopia encountered in congenital SO palsy may resolve soon after the surgical alignment. Therefore, it may be considered and defined “pseudoamblyopia.”

  18. Identification of congenital deafblindness

    DEFF Research Database (Denmark)

    Dammeyer, Jesper Herup

    2012-01-01

    the complexity in identifying congenital deafblindness. It is concluded that determining deafblindness should not be limited to medical procedures (vision and hearing tests) alone, but may also involve a lengthy process to assess the level of sense functioning the individual possesses....

  19. Congenital Erythropoietic Porphyria (CEP)

    Science.gov (United States)

    ... gov Website: http://www2.niddk.nih.gov/ References JOURNAL ARTICLES Christiansen AL, Aagaard L, Krag A, Rasmussen ... homeostasis of human uroporphyrinogen III synthase by enzyme engineering at a single hotspot of congenital erythropoietic ... a Doctor Clinical Studies Porphyria featured Television and Other Media AIP ...

  20. Congenital cutis laxa

    Directory of Open Access Journals (Sweden)

    Pavithran K

    1992-01-01

    Full Text Available A case of congenital cutis laxa is reported in a male infant. Heavy wrinkles on the forehead, ectropion of the lower eyelids and sagging of the skin of the cheeks and chin gave the appearance of ar, old man. In spite of extensive skin involvement, the general health of the child remained unaffected.

  1. Giant Congenital Melanocytic Nevus

    DEFF Research Database (Denmark)

    Rasmussen, Bo Sonnich; Henriksen, Trine Foged; Kølle, Stig-Frederik Trojahn

    2015-01-01

    Giant congenital melanocytic nevi (GCMN) occur in 1:20,000 livebirths and are associated with increased risk of malignant transformation. The treatment of GCMN from 1981 to 2010 in a tertiary referral center was reviewed evaluating the modalities used, cosmetic results, associated complications...

  2. Congenital Heart Information Network

    Science.gov (United States)

    ... and Uwe Baemayr for The Congenital Heart Information Network Exempt organization under Section 501(c)3. Copyright ©1996 - 2016 C.H.I.N. All rights reserved TX4-390-685 Original site design and HTML by Panoptic Communications

  3. Congenital contractural arachnodactyly.

    Science.gov (United States)

    Bjerkreim, I; Skogland, L B; Trygstad, O

    1976-06-01

    Five cases of congenital contractural arachnodactyly (CCA) are reported. Three belong to the one family. CCA has often been mistaken for Marfan's disease and arthrogrypois multiplex. Because CCA has a more favourable prognosis, it is very important to be able to recognize this syndrome.

  4. Congenital heart disease

    Institute of Scientific and Technical Information of China (English)

    1997-01-01

    970296 Evaluating the degree of pulmonary vascularlesions in congenital heart disease with selective pul-monary angiography. PAN Shiwei(潘世伟), et al.Fuwai Hosp, CAMS & PUMC, Beijing, 100037. Chin JCardiol 1997; 25(1): 39-41. Objective: To evaluate the degree of pulmonary vas-

  5. Congenital Absence of Tibia

    Directory of Open Access Journals (Sweden)

    Sudesh Sharma, Saleem Mir, Vikrant Sharma, Irshad Dar, Rafee

    2002-10-01

    Full Text Available Congenital absence of tibia is a rare anomaly. We repol1 a case who presented at the age of 3 years withabsence of tibia right side with associated anomolies and was managed by reconstruction of the kneeand ankle joints b transfer of fibula

  6. Congenital Lumbar Hernia

    Directory of Open Access Journals (Sweden)

    Sanjay Sharma

    2008-01-01

    Full Text Available Lumbar hernia is a rare hernia. It constitutes less than one percent of all abdominal hernias. It can becongenital or acquired. Acquired can occur either spontaneously or after surgery or trauma. Only 300cases of lumbar hernia are reported till date. We report a case of congenital lumbar hernia in one month oldmale baby

  7. Experiência inicial com operações cardíacas minimamente invasivas Initial experience with minimally invasive cardiac operations

    Directory of Open Access Journals (Sweden)

    Francisco Costa

    2012-09-01

    initial experience with minimally invasive operations, with emphasis on technical aspects and the learning curve. METHODS: Between July 2009 and March 2012, 95 patients were operated using minimally invasive operations. Mean age was 55 ± 15 years and 53% were females. The operations performed were atrial septal defect closure (25, aortic valve replacement (32, mitral valve repair (23, mitral valve replacement (12, excision of atrial myxoma (2 and resection of subaortic membrane (1. The incision was a mini right thoracotomy in 87 cases and ministernotomy in 8. RESULTS: Early mortality was 4.2%. Mean size of the incision was 6.3 ±1.2 cm. Extension of the original thoracotomy was necessary in only one case. Two patients suffered a stroke, and the mean total blood loss was 470 ± 277 ml. There were no cases of incision infection and 67% the patients had no major morbidity. CONCLUSIONS: Our initial results with minimally invasive operations demonstrated that it was safe and with good clinical results. Patient satisfaction is quite high. After the learning phase has been transversed, minimally invasive operations may be an excellent alternative for many patients with congenital and acquired diseases.

  8. Relationship of Incisive Papilla to Maxillary Incisors and Canines.

    Science.gov (United States)

    Shrestha, Suraksha; Joshi, Sarita Pradhan; Yadav, Santosh Kumar

    2016-04-01

    The study was carried to find a relationship between the postextraction stable landmark, the incisive papilla, and the most labial position of the maxillary central incisor teeth, which occurred in Nepalese population. Casts of the subjects selected by nonprobability random sampling meeting the inclusion criteria were obtained. Each casts were standardized with respect to the occlusal plane and a photographic technique was used to measure the distance from the tangent of the labial surface of the central incisors to the posterior border of the incisive papilla. The measurements were made using Adobe Photoshop and results were analyzed by using appropriate statistical methods. Most appropriate software (SPSS) for the purpose was used to generate all desired values. The data obtained suggested that the distance from the labial surface of maxillary central incisors to the posterior border of the incisive papilla ranged from 9 to 15.9 mm with a mean of 11.59 mm (SD 1.3). Various other results were also found after evaluation of the arch forms in relation to sex and race. Within the limitations of the study, these results suggested that there is a relationship between the maxillary central incisors and the incisive papilla aiding in the anteroposterior positioning of the anterior tooth. The clinical relevance of the study lies in application of the incisive papilla as a starting point in the preliminary location of maxillary incisors and canines during construction of the denture in absence of preextraction records.

  9. Slide crown lengthening procedure using wide surface incisions and cyanoacrylate.

    Science.gov (United States)

    Szymaitis, Dennis W

    2011-01-01

    This article introduces the slide crown lengthening procedure (SCLP), which incorporates surgical design features to overcome present crown lengthening procedure (CLP) shortcomings. The result is a 75% decrease in required surgery on adjacent teeth and a corresponding 75% reduction in surgical time. Other advantages include a reduction in surgical morbidity, improvement in terminal esthetics, and fewer teeth subject to papillae removal and apically repositioned gingiva. The 20 to 30 degree incision forming the slide is the pivotal feature; it allows effortless flap positioning. This incision angle enables wide surface incisions to adhere flaps together by producing stronger fibrin clots, decreasing tissue retraction angles, and reforming disrupted fibrin clots as incision sides slide while maintaining contact. This enhanced fibrin clot eliminates the need for sutures. The slide produced by the 20 to 30 degree incision functions for crown lengthening on all sites (facial, lingual, or palatal). This versatile surgical design introduces a new healing dimension that adapts to and provides benefits for other dental surgeries, such as gingival grafts, endodontic surgery, implants, and extractions.

  10. Congenitally corrected transposition

    Directory of Open Access Journals (Sweden)

    Debich-Spicer Diane

    2011-05-01

    Full Text Available Abstract Congenitally corrected transposition is a rare cardiac malformation characterized by the combination of discordant atrioventricular and ventriculo-arterial connections, usually accompanied by other cardiovascular malformations. Incidence has been reported to be around 1/33,000 live births, accounting for approximately 0.05% of congenital heart malformations. Associated malformations may include interventricular communications, obstructions of the outlet from the morphologically left ventricle, and anomalies of the tricuspid valve. The clinical picture and age of onset depend on the associated malformations, with bradycardia, a single loud second heart sound and a heart murmur being the most common manifestations. In the rare cases where there are no associated malformations, congenitally corrected transposition can lead to progressive atrioventricular valvar regurgitation and failure of the systemic ventricle. The diagnosis can also be made late in life when the patient presents with complete heart block or cardiac failure. The etiology of congenitally corrected transposition is currently unknown, and with an increase in incidence among families with previous cases of congenitally corrected transposition reported. Diagnosis can be made by fetal echocardiography, but is more commonly made postnatally with a combination of clinical signs and echocardiography. The anatomical delineation can be further assessed by magnetic resonance imaging and catheterization. The differential diagnosis is centred on the assessing if the patient is presenting with isolated malformations, or as part of a spectrum. Surgical management consists of repair of the associated malformations, or redirection of the systemic and pulmonary venous return associated with an arterial switch procedure, the so-called double switch approach. Prognosis is defined by the associated malformations, and on the timing and approach to palliative surgical care.

  11. Single-incision laparoscopic colectomy without using special articulating instruments: an initial experience

    Directory of Open Access Journals (Sweden)

    Trakarnsanga Atthaphorn

    2011-12-01

    Full Text Available Abstract Background Single-incision laparoscopic colectomy (SILC was introduced as a novel minimally invasive technique. The benefits of this technique include reducing number of the incision and cosmetic improvement. Unlike the conventional laparoscopic colectomy, majority of previously reported SILC need to be performed using special curved or articulated instruments. The purpose of this study is to demonstrate our initial experience of SILC, which could be performed using the standard laparoscopic instruments. Material and methods Retrospective review of 14 patients who underwent SILC at Siriraj Hospital from May to December 2010, patient's demographic data, perioperative outcomes, early postoperative complications and pathological data were collected and analyzed. Results The mean age of all patients was 60 years. The most common operation with SILC was sigmoidectomy (n = 9, followed by right hemicolectomy (n = 2, left hemicolectomy (n = 1, anterior resection (n = 1, and total colectomy (n = 1. The trocar insertion techniques were multi-fascial incision using regular port (n = 11 and GelPOINT® (n = 3. The mean operative time was 155 minutes (range 90-280 and the mean estimate blood loss was 32.1 mL (range 10-100. All patients were successfully operated without conversion. The mean length of hospital stay was 9 days (range 5-20. There was no mortality. The pathological results revealed colorectal cancer (n = 12, neoplastic polyp (n = 1 and Familial adenomatous polyposis (FAP (n = 1. The mean number of lymph nodes retrieval was 16.6 (range 3-34. Conclusion SILC can successfully and safely be performed with standard laparoscopic instruments. This technique might be an alternative procedure to conventional laparoscopic colectomy with better cosmetic result.

  12. Sharp compared with blunt fascial incision at cesarean delivery

    DEFF Research Database (Denmark)

    Aabakke, Anna J M; Hare, Kristine J; Krebs, Lone

    2014-01-01

    OBJECTIVE: To compare patient preference for either sharp incision with scissors or blunt manual cleavage of the fascia at cesarean delivery in a randomized controlled trial in which each woman was her own control. STUDY DESIGN: Women undergoing primary cesarean delivery (n=34) were randomized...... to side distribution of sharp or blunt incision of the fascia (sharp right and blunt left or blunt right and sharp left) and followed three months postoperatively. The primary outcome was patient preference for the right or left side of the scar 3 months postoperatively and modeled by polytomous logistic...... difference was found in patient preference with regard to sharp or blunt incision of the fascia, nor was there a significant difference in postoperative pain scores. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov: www.clinicaltrials.org;NCT01297725....

  13. Congenital defects of the pericardium: a review.

    Science.gov (United States)

    Shah, Ankit B; Kronzon, Itzhak

    2015-08-01

    Pericardial defects are a rare disorder that can be characterized as acquired or congenital. Congenital defects can be further characterized by location and size of the defect, e.g. left- or right-sided and partial or complete absence of the pericardium. While physical examination and electrocardiogram are not diagnostic, chest radiographs and echocardiography have findings that should alert the clinician to the absence of the pericardium as a possible diagnosis. Despite its limitations with visualizing the normal pericardium in areas of minimal adipose, cardiac magnetic resonance is currently the gold standard for diagnosing the congenital absence of the pericardium. Patients have a similar life expectancy to those without pericardial defects; however in certain cases, herniation and strangulation of cardiac chambers can be life threatening and lead to sudden cardiac death. Treatment is tailored to the patient's symptoms, presentation, and the size and location of the defect. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

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

    LENUS (Irish Health Repository)

    Ahmad, Nasir Zaheer

    2012-02-01

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

  15. Simulation of channel sandstone architecture in an incised valley

    Energy Technology Data Exchange (ETDEWEB)

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

    1998-12-31

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

  16. Tubularised Incised Plate Urethroplasty is an Applicable Method for the Treatment of the Hypospadiac Type of Urethral Duplication

    Directory of Open Access Journals (Sweden)

    Ömer Yılmaz

    2011-09-01

    Full Text Available Urethral duplication is a rare congenital anomaly usually seen in males. We present a case of urethral duplication treated by a tubularised incised plate urethroplasty (TIPU technique. A 5-year-old male boy was admitted to the clinic with the complaints of thin calibrated urinating and diurnal enuresis. We diagnosed distal penile hypospadias. During the operation, another urethral opening was found proximal to the previously seen hypospadiac meatus, localised on the coronary sulcus. We performed the TIPU procedure without excising the duplicated urethra. We only excised the common wall between the two urethras, and used the dorsal urethral plate of the duplicated urethra for tubularisation of the neourethra. The postoperative course was uneventful. A cystoscopy was done for suspected urogenital sinus. There was no further complaint at the third postoperative month. The TIPU technique can be successfully applied in such cases. The dorsal plate of the duplicated urethra can be used to form the neourethra.

  17. Closure of skin incisions by laser-welding with a combination of two near-infrared diode lasers: preliminary study for determination of optimal parameters.

    Science.gov (United States)

    Hu, Liming; Lu, Zhihua; Wang, Biao; Cao, Junsheng; Ma, Xiaobo; Tian, Zhenhua; Gao, Zhijian; Qin, Li; Wu, Xiaodong; Liu, Yun; Wang, Lijun

    2011-03-01

    Laser welding has the potential to become an effective method for wound closure and healing without sutures. Closure of skin incisions by laser welding with a combination of two near-infrared lasers (980 and 1064 nm), was performed for the first time in this study. One centimeter long, full-thickness incisions were made on the Wistar rat's dorsal skin. The efficiencies of laser-welding with different parameters were investigated. Incision-healing, histology examination, and a tensile strength test of incisions were recorded. Laser welding with the irradiance level of 15.9 W∕cm(2) for both 980 and 1064-nm lasers and exposure time of 5 s per spot in continuous wave mode yielded a more effective closure and healing with minimal thermal damage, faster recovery, and stronger apposition in comparison with a suturing technique. The conclusion is that skin welding with a combination of two near-infrared diode lasers can be a good candidate for incision closure, and further investigations are in progress for clinical use.

  18. Management of congenital choanal atresia: A pedodontist′s role

    Directory of Open Access Journals (Sweden)

    Fathima Niloofar

    2015-01-01

    Full Text Available Choanal atresia is a rare cryptic congenital anomaly with developmental failure of the nasal cavity to communicate with the nasophaynx, resulting in a significant physiological and anatomical alteration of the dento-facial complex. It is considered as a life-threatening or lethal congenital malformation in an obligatory nasal breathing neonate. Elective transnasal endoscopic repair is the most preferred and minimally invasive procedure to correct this anomaly. This case report describes the multi-disciplinary team approach that included pedodontists to manage the case of a 6-month-old infant with choanal atresia suffering from breathlessness, feeding difficulty, and disturbed sleep.

  19. Lymphoscintigraphy patterns in newborns and children with congenital lymphatic dysplasia.

    Science.gov (United States)

    Bellini, C; Villa, G; Sambuceti, G; Traggiai, C; Campisi, C; Bellini, T; Morcaldi, G; Massocco, D; Bonioli, E; Boccardo, F

    2014-03-01

    We performed lymphoscintigraphy on 31 patients (newborns and children) affected by congenital lymphatic dysplasia according to our previously published protocol. Congenital lymphatic dysplasia may present with various degrees of clinical severity, ranging from nonimmune hydrops fetalis with visceral effusions to lymphedema alone. We recommend that lymphoscintigraphy should be strongly considered in all patients with signs of lymphatic dysplasia, including those with minimal and initial signs of lymphatic impairment, in order to obtain a very early diagnosis and to start treatment. Lymphoscintigraphy is safe and useful in the diagnosis of lymphatic dysplasia in the newborn and children. Moreover, it is well tolerated by patients and well accepted by their parents.

  20. Minimally invasive procedures on the lumbar spine

    Science.gov (United States)

    Skovrlj, Branko; Gilligan, Jeffrey; Cutler, Holt S; Qureshi, Sheeraz A

    2015-01-01

    Degenerative disease of the lumbar spine is a common and increasingly prevalent condition that is often implicated as the primary reason for chronic low back pain and the leading cause of disability in the western world. Surgical management of lumbar degenerative disease has historically been approached by way of open surgical procedures aimed at decompressing and/or stabilizing the lumbar spine. Advances in technology and surgical instrumentation have led to minimally invasive surgical techniques being developed and increasingly used in the treatment of lumbar degenerative disease. Compared to the traditional open spine surgery, minimally invasive techniques require smaller incisions and decrease approach-related morbidity by avoiding muscle crush injury by self-retaining retractors, preventing the disruption of tendon attachment sites of important muscles at the spinous processes, using known anatomic neurovascular and muscle planes, and minimizing collateral soft-tissue injury by limiting the width of the surgical corridor. The theoretical benefits of minimally invasive surgery over traditional open surgery include reduced blood loss, decreased postoperative pain and narcotics use, shorter hospital length of stay, faster recover and quicker return to work and normal activity. This paper describes the different minimally invasive techniques that are currently available for the treatment of degenerative disease of the lumbar spine. PMID:25610845

  1. Single-Incision Multi-Port Appendectomy for a Patient with Situs Inversus Totalis

    Science.gov (United States)

    Rajkumar, J. S.; Syed, Akbar; Anirudh, J.R.; Kishor, C.M.; Ganesh, Deepa

    2016-01-01

    Situs inversus totalis (SIT) is a rare autosomal recessive condition involving the complete lateral transposition of the organs. When individuals with this condition suffer from appendicitis, associated pain and symptoms are usually present on the left side, resulting in diagnostic difficulties. Moreover, the laparoscopic removal of the left-sided appendix may pose practical problems during surgery. Removal of an inflamed appendix is generally performed using a multiple-port laparoscopy. We report a 22-year-old male who presented to the Lifeline Institute of Minimal Access Surgery in Chennai, India, in April 2015 with pain in the left iliac fossa. Chest X-rays and ultrasonography confirmed SIT with an acutely inflamed appendix on the left side. The patient underwent a single-incision multi-port laparoscopic appendectomy with a successful outcome. To the best of the authors’ knowledge, this is the first report in the literature of a single-incision multi-port appendectomy in a patient with SIT. PMID:27226919

  2. SINGLE INCISION LAPAROSCOPIC SURGERY: USE OF CONVENTIONAL LAPAROSCOPIC INSTRUMENTS IN SINGLE INCISION LAPAROSCOPIC SURGERY: OUR EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Haridarshan Sira

    2016-04-01

    Full Text Available BACKGROUND Laparoscopic surgery has undergone several modifications since its advent. There has been a shift from a standard multiport approach to more minimalistic approaches. SILS is a major step in this evolutionary process. We present our experience with SILS using conventional laparoscopic instruments and without the need for a SILS port. METHODS 211 patients in Fortis Hospitals, Bangalore, India, who underwent SILS for various abdominal conditions from May 2009 to May 2011 were included in the study. Variables such as operating time, conversion to multi-port laparoscopy or open surgery, complications, analgesia requirements and hospital stay were included. RESULTS 211 patients underwent SILS using conventional laparoscopic instruments for Gallstones, Appendicitis, Morbid Obesity, Gynaecological conditions and Renal cysts. Average age group was 48.5 years; mean duration of hospital stay was 46.5 hours; 166 Laparoscopic cholecystectomies were done, out of which 47 were acute cholecystitis. There were no cases converted to open surgeries. CONCLUSION Single Incision Laparoscopic surgery is technically feasible and as effective as conventional laparoscopic surgery. It is a safe procedure and provides an advantage with regards to analgesia requirement, length of hospital stay and early return to work. Cosmetically, it is superior to multiport laparoscopy.

  3. Congenital Pouch Colon

    Directory of Open Access Journals (Sweden)

    Vivek Gharpure

    2012-07-01

    Full Text Available Face The Examiner:QUESTIONS1. What are the diagnostic features of congenital pouch colon (CPC?Ans: A male patient with CPC often have a wide colovesical fistula and present with anorectal malformation and meconuria; on plain abdominal film, a single large bowel loop occupying more than 50% of the abdominal cavity is also a diagnostic sign. Girls (persistent cloaca/vestibular fistula/anteriorly placed anus etc. often present late with intractable constipation or multiple episodes of enterocolitis and persistent abdominal distension with common cloaca or anterior ectopic anus/ rectovestibular fistula. The congenital pouch colon can be identified as replacement of a part or entire colon in the configuration of pouch that lacks taenia coli, haustrations, appendices epiploicae, abnormal blood supply and a wide fistula with genitourinary system in a patient of anorectal malformation.

  4. Fetal congenital lobar emphysema.

    Science.gov (United States)

    Chia, Chun-Chieh; Huang, Soon-Cen; Liu, Min-Chang; Se, Tung-Yi

    2007-03-01

    To report a rare fetal congenital lung anomaly characterized by over inflation of a pulmonary lobe. A 28-year-old systemic lupus erythematous mother, gravida 1 para 0, who had normal prenatal care in our department, was admitted for labor pain and an abnormal fetal heart location was noted incidentally during labor. The baby showed rib retraction in room air but no obvious cyanotic change after delivery. Both the fetus chest X-ray and ultrasound showed a hyperechogenic tumor in the left thoracic cavity with a right-side-shifted heart and trachea. Computed tomography showed a hypodense and multiseptal tumor in the left thoracic cavity with right-sided shift of the heart and trachea. It was a soft, solid tumor in the parenchyma of the left lung and the histopathology confirmed it to be benign congenital lobar emphysema. The favorable outcome in both asymptomatic and mildly symptomatic children suggests that a nonsurgical approach should be considered for these patients.

  5. Congenital lipodystrophies and dyslipidemias.

    Science.gov (United States)

    Prieur, Xavier; Le May, Cedric; Magré, Jocelyne; Cariou, Bertrand

    2014-09-01

    Lipodystrophies are rare acquired and genetic disorders characterized by the selective loss of adipose tissue. One key metabolic feature of patients with congenital inherited lipodystrophy is hypertriglyceridemia. The precise mechanisms by which the lack of adipose tissue causes dyslipidemia remain largely unknown. In recent years, new insights have arisen from data obtained in vitro in adipocytes, yeast, drosophila, and very recently in several genetically modified mouse models of generalized lipodystrophy. A common metabolic pathway involving accelerated lipolysis and defective energy storage seems to contribute to the dyslipidemia associated with congenital generalized lipodystrophy syndromes, although the pathophysiological changes may vary with the nature of the mutation involved. Therapeutic management of dyslipidemia in patients with lipodystrophy is primarily based on specific approaches using recombinant leptin therapy. Preclinical studies suggest a potential efficacy of thiazolidinediones that remains to be assessed in dedicated clinical trials.

  6. Congenital intestinal lymphangiectasia

    Directory of Open Access Journals (Sweden)

    Popović Dušan Đ.

    2011-01-01

    Full Text Available Background. Congenital intestinal lymphangiectasia is a disease which leads to protein losing enteropathy. Tortous, dilated lymphatic vessels in the intestinal wall and mesenterium are typical features of the disease. Clinical manifestations include malabsorption, diarrhea, steatorrhea, edema and effusions. Specific diet and medication are required for disease control. Case report. A 19-year old male patient was hospitalized due to diarrhea, abdominal swelling, weariness and fatigue. Physical examination revealed growth impairment, ascites, and lymphedema of the right hand and forearm. Laboratory assessment indicated iron deficiency anaemia, lymphopenia, malabsorption, inflammatory syndrome, and urinary infection. Enteroscopy and video capsule endoscopy demonstrated dilated lymphatic vessels in the small intestine. The diagnosis was confirmed by intestinal biopsy. The patient was put on high-protein diet containing medium-chain fatty acids, somatotropin and suportive therapy. Conclusion. Congenital intestinal lymphangiectasia is a rare disease, usually diagnosed in childhood. Early recognition of the disease and adequate treatment can prevent development of various complications.

  7. Congenital hemifacial hyperplasia

    Directory of Open Access Journals (Sweden)

    S A Deshingkar

    2011-01-01

    Full Text Available Congenital hemifacial hyperplasia (CHH is a rare congenital malformation characterized by marked unilateral overdevelopment of hard and soft tissues of the face. Asymmetry in CHH is usually evident at birth and accentuated with age, especially at puberty. The affected side grows at a rate proportional to the nonaffected side so that the disproportion is maintained thr oughout the life. Multisystem involvement has resulted in etiological heterogeneity including heredity, chromosomal abnormalities, atypical forms of twinning, altered intrauterine environment, and endocrine dysfunctions; however, no single theory explains the etiology adequately. Deformities of all tissues of face, including teeth and their related tissues in the jaw, are key findings for correct diagnosis of CHH. Here an attempt has been made to present a case of CHH with its archetypal features and to supplement existing clinical knowledge.

  8. Congenital diaphramatic hernia

    Energy Technology Data Exchange (ETDEWEB)

    Kline-Fath, Beth M. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Fetal Care Center of Cincinnati, Cincinnati, OH (United States); Cincinnati Children' s Hospital Medical Center, Department of Radiology, MLC 5031, Cincinnati, OH (United States)

    2012-01-15

    Congenital diaphragmatic hernia, despite advances in therapy, remains a complex condition with significant morbidity and mortality. The etiology of the disorder is still incompletely understood, though the pulmonary hypoplasia and pulmonary hypertension that develop secondarily must be overcome to improve survival. Prenatal US and fetal MRI have helped in the development of a greater understanding of this disease. Also with these modalities, measurement techniques have been developed in an attempt to provide prognosticators for the development of pulmonary hypoplasia and pulmonary hypertension. There is a broad range of approaches for performing these measurements, and variability among imaging centers is noted. Despite inconsistent approaches, these techniques have become the foundation for counseling and prenatal and postnatal therapy. It is hoped that with further research with prenatal US and fetal MRI and the development of innovative medical and surgical therapies that the morbidity and mortality of children with congenital diaphragmatic hernias can be significantly reduced. (orig.)

  9. Congenital alopecia universalis

    Directory of Open Access Journals (Sweden)

    Vicente de Jesús Alvarez Yabor

    2015-11-01

    Full Text Available Congenital alopecia universalis is a type of infrequent recessive autosomal alopecia caused by genetic mutations; it is characterized by the total or localized absence of hair due to any birth disorder. This is a case of a 4-year-old female patient born with total absence of hair, both her scalp and whole body; she received medical treatment without satisfactory results. All the investigations were within normal limits, the differential diagnosis was ruled out through the analysis of family medical history and not showing alterations in bone or teeth structure, as well as normal sweating; the final diagnosis was confirmed through a scalp biopsy that revealed dermis with rudimentary sebaceous glands, immature and scarce hair follicles and corneous plugs compatible with congenital alopecia universalis without associated defects. The patient is treated and followed in dermatology and psychology consultations. The clinical situation has not been resolved to the moment.

  10. Rhinoplasty: congenital deficiencies of the alar cartilage.

    Science.gov (United States)

    Kosins, Aaron M; Daniel, Rollin K; Sajjadian, Ali; Helms, Jill

    2013-08-01

    Congenital deficiencies of the alar cartilages are rare and often visible at birth but can occasionally present later. The authors review the anatomical development and discuss the incidence and treatment of congenital defects within the alar cartilages seen in rhinoplasty cases. The charts of 869 consecutive patients who underwent open rhinoplasty were retrospectively reviewed, and 8 cases of congenital defects of the alar cartilage within the middle crura were identified. Intraoperative photographs were taken of the alar deformities, and each patient underwent surgical correction. To simplify analysis, a classification of the defects was developed. A division was a cleft in the continuity of the alar cartilage with the 2 ends separate. A gap was a true absence of cartilage ranging from 1 to 4 mm, which can be accurately assessed in unilateral cases. A segmental loss was a defect greater than 4 mm. The 8 cases of deformity could be classified as 4 divisions, 3 gaps, and 1 segmental loss. None of the patients had a history of prior nasal trauma or nasal surgery. Six patients were women and 2 patients were men. In all cases, adequate projection and stability were achieved with a columellar strut. Asymmetry was minimized through concealer or tip grafts. There were no complications. Surgeons performing rhinoplasty surgery will encounter and should be prepared to deal with unexpected congenital defects of the alar cartilage. These defects within the middle crura will require stabilization with a columellar strut and, often, coverage with a concealer tip graft. We speculate that the cause of these defects is a disruption of the hedgehog signals that may arrest the condensation or block the differentiation of the underlying neural crest cells.

  11. CONGENITAL ANTERIOR TIBIOFEMURAL SUBLUXATION

    Directory of Open Access Journals (Sweden)

    A. Shahla

    2008-06-01

    Full Text Available Congenital anterior tibiofemoral subluxation is an extremely rare disorder. All reported cases accompanied by other abnormalities and syndromes. A 16-year-old high school girl referred to us with bilateral anterior tibiofemoral subluxation as the knees were extended and reduced at more than 30 degrees flexion. Deformities were due to tightness of the iliotibial band and biceps femuris muscles and corrected by surgical release. Associated disorders included bilateral anterior shoulders dislocation, short metacarpals and metatarsals, and right calcaneuvalgus deformity.

  12. Ullrich Congenital Muscular Dystrophy

    OpenAIRE

    2011-01-01

    ObjectiveUllrich congenital muscular dystrophy is a rather severe type of congenitalmuscular dystrophy with early onset features related to motor development.In general it is inherited in autosomal recessive principles, however in theWestern world mostly seen with de novo dominant mutations in the collagenVI genes. Milder form of the condition is the Bethlem myopathy. There may beoverlap forms in the clinic resembling the Ehler-Danlos syndrome. There hasbeen some radical efforts for cure espe...

  13. Ultrasonic diagnosis and transurethral incision of ureterocele with hydronephrosis

    DEFF Research Database (Denmark)

    Waaddegaard, P; Miskowiak, J; Stage, P

    1991-01-01

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

  14. Ankle fusion using a 2-incision, 3-screw technique

    NARCIS (Netherlands)

    R.P.M. Hendrickx; G.M.M.J. Kerkhoffs; S.A.S. Stufkens; C.N. van Dijk; R.K. Marti

    2011-01-01

    Reliable fusion and optimal correction of the alignment of the ankle joint using a 2-incision, 3-screw technique. Symptomatic osteoarthritis of the ankle joint after insufficient other treatment, severe deformity of the osteoarthritic ankle joint, or salvation procedure after failed arthroplasty. Ac

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

    African Journals Online (AJOL)

    primary techniques are unsatisfactory. ... TIP urethroplasty in the management of recurrent ... was used for quantitative data. .... erection and the risk of infection, especially in patients .... currently considered the best tool for complicated .... 10 Mustafa M. The concept of tubularized incised plate hypospadias repair for different ...

  16. Mesenchymal stem cells promote incision wound repair in a mouse ...

    African Journals Online (AJOL)

    Full-thickness cutaneous wounds (4 × 2 cm) were made by incision on the dorsal side of the mice. The wound was then ..... on age as well as the type and size of injury. In .... stem cells favour healing of the cutaneous radiation syndrome in a ...

  17. Surgical removal of large central neurocytomas with small incision approach

    Directory of Open Access Journals (Sweden)

    Shu-mao LU

    2014-01-01

    Full Text Available Objective To investigate the strategy and technique of small incision surgery through interhemispheric transcallosal approach for removal of large central neurocytomas in supratentorial ventricule. Methods Clinical data and therapy of 6 cases with central neurocytomas were retrospectively studied. All tumors were removed through small incision interhemispheric transcallosal approach, and the clinical data were analyzed. Results Total resection was achieved in all cases. Three cases experienced transient mutism and one case experienced hemiparalysis. All of them received nerve-nurturing treatment and recovered within 2 weeks. Five cases were followed-up from 6 months to 2 years and there was no recurrence. Conclusions The advantages of interhemispheric transcallosal approach include provision of sufficient surgical visual field and space, protection of normal brain tissue by natural cavity and shortest surgical pathway. Small incision surgery may not only reduce invalid brain exposure and hemorrhage during operation, but also decrease operation time. The small incision surgery through interhemispheric transcallosal approach is an effective choice for removal of central neurocytomas involved in supratentorial ventricule.

  18. Time from uterine incision to delivery and hypoxic neonatal outcomes.

    Science.gov (United States)

    Spain, Janine E; Tuuli, Methodius; Stout, Molly J; Roehl, Kimberly A; Odibo, Anthony O; Macones, George A; Cahill, Alison G

    2015-04-01

    The objective of this study was to estimate the association between time from uterine incision to delivery and hypoxic neonatal outcomes in nonanomalous term infants. All women undergoing in-labor term cesarean deliveries (CDs) in the first 2 years of an ongoing prospective cohort study were included. The primary exposure was time in seconds from uterine incision to delivery. The primary outcome was a composite of hypoxia-associated neonatal outcomes, defined as at least one of: seizures, hypoxic ischemic encephalopathy, need for hypothermia treatment, and death within 7 days. Of 812 patients who underwent in-labor CD, the composite hypoxia outcome occurred in 18 (2.2%) neonates. There was no significant difference in the rate of hypoxic morbidity with increasing increments of 60 seconds from uterine incision to delivery (p = 0.35). There was a significantly increased risk of hypoxic morbidity in those delivered in the highest quintile (>240 seconds) compared with those in the lowest quintile (≤ 60 seconds) in cesareans performed for an indication other than nonreassuring fetal status (relative risk, 5.58; 95% confidence interval, 1.30-23.91). Overall, duration from uterine incision to delivery for in-labor cesareans of nonanomalous term infants was not associated with an increase in risk of hypoxia-associated morbidities. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  19. Single-Incision Cholecystectomy in about 200 Patients

    Directory of Open Access Journals (Sweden)

    Roland Raakow

    2011-01-01

    Full Text Available Background and Aims. We describe our experience of performing transumbilical single-incision laparoendoscopic cholecystectomy as standard procedure for acute and chronic gallbladder diseases. Methods. Between September 2008 and March 2010, 220 patients underwent laparoscopic single-incision surgery. A single port was used for 196 patients and two conventional 5 mm and one 10 mm port in 24 cases. All operations were performed with straight instruments. Results. Single-incision surgery was successfully performed in 215 patients (98%. Three patients (1.4% required conversion to a three-port technique and two patients (0.9% to an open procedure. Average age of 142 women (65% and 78 men (35% was 47 years (range: 15–89, average ASA status 2 (range: 1–3 and BMI 28 (range: 15–49. Mean operative time was 62 minutes (range: 26–174 and 57 patients (26% had histopathological signs of acute cholecystitis. Eleven patients (5% developed to surgery-related complications and nine (4% of these required a reoperation. The mean followup was 331.5 (range: 11–590 days. Conclusion. Transumbilical single-incision cholecystectomy is a feasible and safe new approach for routine cholecystectomy. After a short learning curve, operation time and complication rate are comparable with standard multiport operation. In addition, most cases of acute cholecystitis can be performed with this technique.

  20. Laparoskopisk rectumresektion med salpingo-ooforektomi gennem en enkelt incision

    DEFF Research Database (Denmark)

    Bulut, Orhan; Nielsen, Claus B.

    2011-01-01

    Single-Incision Laparoscopic Surgery (SILS) is an evolving alternative to conventional laparoscopic surgery. We present the case of a low anterior resection combined with left salpingo-oophorectomy performed as a SILS procedure. The patient was a 83-year-old woman, who had a T3N1 rectal cancer 10...

  1. Congenital syphilis, still a reality.

    Science.gov (United States)

    Gupta, Rajat; Vora, Rita V

    2013-01-01

    Congenital syphilis is a potentially serious pathology affecting newborns of infected mothers. Even one case of congenital syphilis is a sentinel public health event, since timely diagnosis and treatment of syphilis infected pregnant woman should prevent transmission almost entirely. Here, we are reporting a case of early symptomatic congenital syphilis presented with severe desquamating papulosquamous lesions over multiple body parts along with erosive lesions around oral cavity and nostrils.

  2. Congenital agenesis of seminal vesicle

    Institute of Scientific and Technical Information of China (English)

    Hong-Fei Wu; Di Qiao; Li-Xin Qian; Ning-Hong Song; Ning-Han Feng; Li-Xin Hua; Wei Zhang

    2005-01-01

    Congenital agenesis of the seminal vesicle (CASV) is frequently associated with congenital absence of the vas deferens (CAVD) or ipsilateral congenital vasoureteral communication. We reported two cases of a rare condition that the vas deferens open ectopically into Mullerian duct cyst associated with agenesis of the ipsilateral seminal vesicle. The diagnosis was confirmed by vasography. Transurethral unroofing of the Mullerian duct cyst was performed in both patients with favourable results, however, assisted reproductive technology (ART) was still necessary for them to father children.

  3. Cosmetic selection of skin incision for resection of choledochal cyst in young female patients

    Science.gov (United States)

    Choi, Jong-Woo; Ha, Tae-Yong; Song, Gi-Won; Jung, Dong-Hwan

    2016-01-01

    Backgrounds/Aims Open surgery for choledochal cyst has a disadvantage of skin incision scar from operative wound, which can be a definite disadvantage especially in young female patients. This study focused on the cosmetic aspect of skin incision for resection of choledochal cyst in young female patients. Methods During a 2-year study period, 11 adult female patients aged less than 40 years underwent primary resection of choledochal cyst by a single surgeon. The cosmetic effect of two types of skin incision was evaluated. Results The patients underwent mini-laparotomy through either a right subcostal incision (n=8) or an upper midline incision (n=3). The mean length of skin incision was 10 cm for right subcostal incisions and 9 cm for upper midline incisions. It took approximately 1 hour to repair the operative wound meticulously in both groups. At the 6 month to 1 year follow-up, a slight bulge on the skin scar was observed in 3 (37.5%) patients of the right subcostal incision group and 1 (33.3%) patient of the upper midline incision group. Conclusions The results of this preliminary study support the claim that cosmetic effect of the upper midline incision for CCD surgery appears to be non-inferior to that of the right subcostal incision if the incision is placed accurately and repaired very meticulously. PMID:27621750

  4. Late Quaternary rates of stream incision in Northeast Peloponnese, Greece

    Science.gov (United States)

    Karymbalis, Efthimios; Papanastassiou, Dimitrios; Gaki-Papanastassiou, Kalliopi; Ferentinou, Maria; Chalkias, Christos

    2016-09-01

    This study focuses on defining rates of fluvial incision for the last 580±5 kyr along valley systems of eight streams that drain the eastern part of the northern Peloponnese. The streams are developed on the uplifted block of the offshore-running Xylokastro normal fault, one of the main faults bounding the southern edge of the Gulf of Corinth half-graben, and have incised a set of ten uplifted marine terraces having an amphitheatric shape. These terraces range in age from 60±5 kyr to 580±5 kyr and have been mapped in detail and correlated with late Pleistocene oxygen-isotope stages of high sea-level stands by previous studies. The terraces were used in this paper as reference surfaces in order to define fluvial incision rates at the lower reaches of the studied streams. To evaluate incision rates, thirty-three topographic valley cross-sections were drawn using fieldwork measurements as well as using a highly accurate (2×2 cell size) Digital Elevation Model (DEM) at specific locations where streams cut down the inner edges of the marine terraces. For each cross-section the ratio of valley floor width to valley height (Vf) and long-term mean stream incision rates were estimated for the last 580±5 kyr, while rock uplift rates were estimated for the last 330±5 kyr. The geomorphic evolution of the valleys on the uplifted block of the Xylokastro fault has been mainly driven by the lithology of the bedrock, sea level fluctuations during the late Quaternary, and incision of the channels due to the tectonic uplift. Stream incision rates range from 0.10±0.1 mm/yr for the last 123±7 kyr to 1.14±0.1 mm/yr for the last 310±5 kyr and are gradually greater from east to west depending on the distance from the trace of the fault. Downcutting rates are comparable with the rock uplift rates, which range from 0.4±0.02 mm/yr to 1.49±0.12 mm/yr, over the last 330±5 kyr.

  5. Early detection of congenital syphilis

    Directory of Open Access Journals (Sweden)

    Nagalakshmi Chowdhary

    2014-01-01

    Full Text Available Late congenital syphilis is a very rare clinical entity, and its early diagnosis and treatment is essential. Dental findings often provide valuable evidence for the diagnosis of late congenital syphilis. It occurs due to the transmission of the disease from an infected mother to her fetus through placenta. This long forgotten disease continues to effect pregnant women resulting in perinatal morbidity and mortality. Congenital syphilis is a preventable disease, and its presence reflects a failure of prenatal care delivery system, as well as syphilis control programs. We are reporting a case of late congenital syphilis with only Hutchinson′s teeth.

  6. MINIMUM INCISION PERCUTANEOUS PLATE OSTEOSYNTHESIS FOR DISTAL FIBULAR FRACTURES: A PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Ramkumar Reddy

    2015-09-01

    Full Text Available Distal fibular fractures are usually communitted and most of the times osteoporotic especially if they are occurring in females and in geriatric age group. These fractures are usu ally associated with other fractures, which necessitates them to be fixed accurately. Owing to the fact that distal fragment is subcutaneous with scanty soft tissue over bone, which pose these fracture fixations become difficult by open methods in view of wound healing. A prospective study of 26 patients with distal fibular fractures were treated with MIPPO with hook plate were healed with less complications and better outcome. With this background we suggest a minimally invasive incision over proximal frag ment where sufficient soft tissue cover is present. From there pushing the special hook plate subperiosteally to distal fragment, hooking the tip of fibula and fixing the proximal fragment after reduction gives a simple and effective stable fixation

  7. Genetics Home Reference: critical congenital heart disease

    Science.gov (United States)

    ... Health Conditions critical congenital heart disease critical congenital heart disease Printable PDF Open All Close All Enable Javascript ... view the expand/collapse boxes. Description Critical congenital heart disease (CCHD) is a term that refers to a ...

  8. Genetics Home Reference: congenital diaphragmatic hernia

    Science.gov (United States)

    ... Home Health Conditions congenital diaphragmatic hernia congenital diaphragmatic hernia Enable Javascript to view the expand/collapse boxes. ... PDF Open All Close All Description Congenital diaphragmatic hernia is a defect in the diaphragm. The diaphragm, ...

  9. Congenital cholesteatoma of the middle ear - uncommon clinical presentation

    Directory of Open Access Journals (Sweden)

    Bukurov Bojana

    2014-01-01

    Full Text Available Introduction. Congenital cholesteatoma of the middle ear is un uncommon and yet not well-defined disease. Only few cases of cholesteatoma in the fossa ovalis with unusual clinical presentation have been reported in medical literature. Case report. We reported a 16-year-old girl with congenital cholesteatoma in the fossa ovalis with minimal clinical presentation. A small mass was found occluding the fossa ovalis and mimicking otosclerotic process within tympanic cavity. The operation started as stapedotomy, and when the process was confirmed it converted to mastoidectomy via the retroauricular approach. Conclusion. The diagnosis of congenital cholesteatoma in children should always be considered, even if the clinical symptoms imitate other ear disorders, in our case otosclerosis. [Projekat Ministarstva nauke Republike Srbije, br. 179055: Cochlear implantation impact on education of deaf and hearing-impaired

  10. Severe ocular sequelae of congenital toxoplasmosis: huge macular scar.

    Science.gov (United States)

    Zahir, Fadoua; Abdellaoui, Meriem; Younes, Samar; Benatiya, Idriss A; Tahri, Hicham

    2015-01-01

    Retinochoroiditis is the most common ocular manifestation of congenital toxoplasmosis, but other associated ophthalmological pathologies can also occur. Ophthalmologists are rarely able to distinguish between toxoplasmic retinochoroiditis due to infection acquired before or after birth, unless other clinical or serological indications are present. This article reports a case of a 3-year-old boy with abnormalities suggestive of congenital toxoplasmosis. The clinical and complementary examinations are discussed. The education of pregnant women is crucial for the prevention of congenital toxoplasmosis. Awareness of antenatal and postnatal presenting signs and symptoms is important for clinicians, because early diagnosis and treatment may minimize sequelae. Untreated, the majority of affected infants will develop chorioretinitis, deafness and/or neurological symptoms.

  11. Westernmost Grand Canyon incision: Testing thermochronometric resolution

    Science.gov (United States)

    Fox, M.; Tripathy-Lang, A.; Shuster, D. L.; Winn, C.; Karlstrom, K.; Kelley, S.

    2017-09-01

    distributions are relatively uniform and not strongly zoned, thus supporting a ;young; canyon model interpretation of the 4He/3He data. Furthermore, we show that for the mapped zonation, the difference between predicted 4He/3He data for a uniform crystal and a 3D model of the crystal are minimal, highlighting that zonation is unlikely to lead us to falsely infer an ;old; Grand Canyon.

  12. Early outcome of minimally invasive mitral valve surgery

    Directory of Open Access Journals (Sweden)

    Shawky Fareed

    2016-08-01

    Conclusion: Right anterolateral mini-thoracotomy minimally invasive technique provides excellent exposure of the mitral valve, even with a small atrium and offers a better cosmetic lateral scar which is less prone to keloid formation. In addition, minimally invasive right anterolateral mini-thoracotomy is as safe as median sternotomy for mitral valve surgery, with fewer complications and postoperative pain, less ICU and hospital stay, fast recovery to work with no movement restriction after surgery. It should be used as an initial approach for mitral valve surgery. Furthermore, it was believed that less spreading of the incision, no interference with the diaphragm and less tissue dissection might improve outcomes, particularly respiratory function.

  13. 右腋下小切口在小儿心内直视手术中的应用研究%Application of the right axillary incision in pediatric heart surgery

    Institute of Scientific and Technical Information of China (English)

    陈仁伟; 罗金文; 曾德斌; 阳广贤; 王敬华

    2014-01-01

    Objetive To compare the clinical data of open heart surgery using the right axillary incision with using median sternotomy incision,to explore the clinical effect of right axillary incision surgery for congeni-tal heart disease. Methods We have performed 102 cases of open heart surgery in the right axillary incision, and in median sternotomy incision respectively.They have similar primary diagnosis at the same period,were retrospectively analyzed since December 2012 to December 2013. Results The aortic clamping time,cardiop-ulmonary bypass time and operation time,the difference was not statistically significant (P>0.05).Mechanical ventilation time,24 h after drainage and postoperative hospital stay compared with right axillary incision superior median sternotomy,the difference was statistically significant (P<0.01).Conclusion The right axillary inci-sion can accomplished congenital heart heart surgery safely and effectively,rapid postoperative recovery,and good incision appearance.%目的:比较小儿右腋下小切口与胸骨正中切口行心内直视手术的临床资料,探讨右腋下小切口先心病手术的临床效果。方法我们自2012年12月至2013年12月实施右腋下小切口小儿心内直视手术102例,与同期胸骨正中切口手术主要诊断类似患儿102例比较,进行回顾性分析。结果两组主动脉阻断时间、体外循环时间及手术时间比较,差异无统计学意义(P>0.05)。呼吸机辅助通气时间、术后24 h引流量以及术后住院时间比较,右腋下小切口优于胸骨正中切口,差异有统计学意义(P<0.01)。结论采用右腋下小切口能安全有效地完成先心病心内直视手术,治疗效果好,术后恢复快,切口美观。

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

    Energy Technology Data Exchange (ETDEWEB)

    Roh, Yang Gyun; Jang, Hyun Seon; Kim, Byung Ock; Kim, Jin Soo [Chosun Univ. College of Dentistry, Gwangju (Korea, Republic of)

    2006-09-15

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

  15. In vivo molecular evaluation of guinea pig skin incisions healing after surgical suture and laser tissue welding using Raman spectroscopy.

    Science.gov (United States)

    Alimova, A; Chakraverty, R; Muthukattil, R; Elder, S; Katz, A; Sriramoju, V; Lipper, Stanley; Alfano, R R

    2009-09-01

    The healing process in guinea pig skin following surgical incisions was evaluated at the molecular level, in vivo, by the use of Raman spectroscopy. After the incisions were closed either by suturing or by laser tissue welding (LTW), differences in the respective Raman spectra were identified. The study determined that the ratio of the Raman peaks of the amide III (1247 cm(-1)) band to a peak at 1326 cm(-1) (the superposition of elastin and keratin bands) can be used to evaluate the progression of wound healing. Conformational changes in the amide I band (1633-1682 cm(-1)) and spectrum changes in the range of 1450-1520 cm(-1) were observed in LTW and sutured skin. The stages of the healing process of the guinea pig skin following LTW and suturing were evaluated by Raman spectroscopy, using histopathology as the gold standard. LTW skin demonstrated better healing than sutured skin, exhibiting minimal hyperkeratosis, minimal collagen deposition, near-normal surface contour, and minimal loss of dermal appendages. A wavelet decomposition-reconstruction baseline correction algorithm was employed to remove the fluorescence wing from the Raman spectra.

  16. Molecular and Genetic Studies of Congenital Myopathies

    Science.gov (United States)

    2016-12-08

    Central Core Disease; Centronuclear Myopathy; Congenital Fiber Type Disproportion; Multiminicore Disease; Myotubular Myopathy; Nemaline Myopathy; Rigid Spine Muscular Dystrophy; Undefined Congenital Myopathy

  17. Application of a cervical low incision in the functional neck dissection of thyroid papillary carcinoma

    OpenAIRE

    Xu, Jiajie; Chen, Chao; Zheng,ChuanMing; Wang, Kejing; Shang, Jinbiao; FANG, XIANHUA; Ge, Minghua; TAN, ZHUO

    2016-01-01

    The present study aimed to discuss the advantage of the application of a cervical low incision for functional neck dissection in patients with thyroid papillary carcinoma. The study was a retrospective analysis of 87 thyroid papillary carcinoma patients; cervical low incision in the functional neck dissection was applied for 47 cases and the classic ‘L’ incision was applied for 40 cases. The different integrity, surgical time, blood loss and the aesthetic property of the incision were compare...

  18. Minimally Invasive Approach of a Retrocaval Ureter

    Science.gov (United States)

    Pinheiro, Hugo; Ferronha, Frederico; Morales, Jorge; Campos Pinheiro, Luís

    2016-01-01

    The retrocaval ureter is a rare congenital entity, classically managed with open pyeloplasty techniques. The experience obtained with the laparoscopic approach of other more frequent causes of ureteropelvic junction (UPJ) obstruction has opened the method for the minimally invasive approach of the retrocaval ureter. In our paper, we describe a clinical case of a right retrocaval ureter managed successfully with laparoscopic dismembered pyeloplasty. The main standpoints of the procedure are described. Our results were similar to others published by other urologic centers, which demonstrates the safety and feasibility of the procedure for this condition. PMID:27635277

  19. Single-incision cholecystectomy in a patient with situs inversus totalis presenting with cholelithiasis: A case report.

    Science.gov (United States)

    Deguchi, Yoshio; Mitamura, Keitaro; Omotaka, Shunsuke; Eguchi, Jun-ichi; Sakuma, Dai; Sato, Masashi; Nomura, Norihiro; Ito, Takayoshi; Grimes, Kevin Lawrence; Inoue, Haruhiro

    2015-08-01

    Laparoscopic cholecystectomy has become the gold standard for the treatment of cholelithiasis, and many reports of single-incision laparoscopic cholecystectomy have been published in the past few years. Situs inversus totalis is a very rare condition, but the variant anatomy should not preclude a minimally invasive approach to surgery. We report a case of successful single-port laparoscopic cholecystectomy in a patient with situs inversus totalis, describe the technical advantages, and review the literature. © 2015 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and Wiley Publishing Asia Pty Ltd.

  20. Prevalence of Congenital Malformations

    Directory of Open Access Journals (Sweden)

    Akhavan Karbasi Sedighah

    2009-05-01

    Full Text Available Congenital malformation (CM will begin to emerge as one of the major childhood health problems .Treatment and rehabilitation of children with congenital malformations are costly and complete recovery is usually impossible. The aim of this study was to determine frequency of CM in Yazd central city of the Islamic Republic of Iran to find out if there has been any difference in the rate and types of CM in this area. This descriptive-observational study carried on 4800 births delivered at all maternity hospitals in Yazd from October 2003 to June 2004. Prevalence of CM was 2.83% (2.86 % in male and 2.68 % in female out of the 136 cases 69(51.88% were males and 64 (48.12% were females and 3 with ambiguous genitalia. Positive family history of CM in sibling was in only 6 cases (4.41%.Overall, musculoskeletal (0.83%, central nerv-ous system (0.47% and genital system (0.37% were accounted as the most common. Frequency of CM was more seen in still birth (12.5% as in comparison to live birth (2.71%. There was not statistical difference be-tween prevalence of CM and neonatal's gender, gestational age, birth order and mother's age, drug ingestion, illness and parental consanguinity. In this study the overall prevalence of congenital malformation among the newborn was higher than those previous reported in Iran and determining the causes of this difference needs more extensive studies.

  1. [Prevention of congenital toxoplasmosis in a Buenos Aires hospital].

    Science.gov (United States)

    Carral, Liliana; Kaufer, Federico; Olejnik, Patricia; Freuler, Cristina; Durlach, Ricardo

    2013-01-01

    The prevention of congenital toxoplasmosis is based on providing information to women, serologic diagnosis and treatment of the infected mother and child. In this article we present the results of 12 years of implementation of a congenital toxoplasmosis prevention program in which we measured the mother's infection incidence rate, the transmission rate and the number and severity of infection in newborns. The study was performed on 12035 pregnant women in the period 2000-2011. The prevalence rate of antibodies against Toxoplasma gondii was 18.33% (2206/12035). Thirty-seven out of 9792 susceptible women presented acute infection and the mother's infection incidence rate was 3.78 per 1000 births. The transplacental transmission rate was 5.4% (2/37). Two newborns presented congenital toxoplasmosis infection, one had no clinical signs while the other presented strabismus and chorioretinitis. Thirty-five infected mothers and the two children with congenital infection were treated. The transmission rates obtained allow consider this prevention program as a valid resource to minimize the impact of congenital toxoplasmosis.

  2. Congenital Diaphragmatic Hernia

    Directory of Open Access Journals (Sweden)

    Tovar Juan A

    2012-01-01

    Full Text Available Abstract Congenital Diaphragmatic Hernia (CDH is defined by the presence of an orifice in the diaphragm, more often left and posterolateral that permits the herniation of abdominal contents into the thorax. The lungs are hypoplastic and have abnormal vessels that cause respiratory insufficiency and persistent pulmonary hypertension with high mortality. About one third of cases have cardiovascular malformations and lesser proportions have skeletal, neural, genitourinary, gastrointestinal or other defects. CDH can be a component of Pallister-Killian, Fryns, Ghersoni-Baruch, WAGR, Denys-Drash, Brachman-De Lange, Donnai-Barrow or Wolf-Hirschhorn syndromes. Some chromosomal anomalies involve CDH as well. The incidence is

  3. Congenital erythropoietic porphyria

    Directory of Open Access Journals (Sweden)

    Wen-Hao Lee

    2012-06-01

    Full Text Available Congenital erythropoietic porphyria (CEP, or “Günther disease”, is a rare variant of porphyria. It is an autosomal recessive disease caused by deficient uroporphyrinogen III synthase (URO-III-synthase, the fourth enzyme in the heme biosynthetic pathway. We herein report a case of a man with the typical clinical presentations of hyper- and hypo-pigmentation and blister formation over sun-exposed areas, mutilation of the fingers, dark-purple urine, and erythrodontia with pinkish fluorescence under a Wood’s lamp. The diagnosis was confirmed by decreased activity of URO-III-synthase in red blood cells (RBC and a porphyrin profile compatible with CEP.

  4. Surgery for Congenital Cataract

    Directory of Open Access Journals (Sweden)

    David Yorston FRCS FRCOphth

    2004-01-01

    Full Text Available The management of congenital cataract is very different to the treatment of a routine age-related cataract. In adults, surgery may be delayed for years without affecting the visual outcome. In infants, if the cataract is not removed during the first year of life, the vision will never be fully regained after surgery. In adults, if the aphakia is not corrected immediately, it can be corrected later. In young children, if the aphakia is not corrected, the vision will never develop normally.

  5. Congenital familial hypertonia.

    Science.gov (United States)

    DeLuca, Carl F; Cashore, William J

    2002-09-01

    1. This complex of symptoms appears to be congenital, familial, and hereditary. It is apparently transmitted by a dominant gene, probably on chromosome 5. 2. Hypertonicity with rigidity of all voluntary muscles usually presents at birth. 3. Feeding problems are due to dysphagia or laryngospasm associated with aspiration and dyspnea. 4. Respiratory problems are characterized by apneic episodes due to muscle spasm. 5. Prolonged episodes of muscular rigidity secondary to sudden stimuli result in frequent falls, characteristically en bloc, like a statue. 6. Continuous electromyographic activity even at rest (with absence of fasciculations) improves after intravenous diazepam.

  6. Systemic congenital lymphangiomatosis

    Directory of Open Access Journals (Sweden)

    Ligia Maria Suppo de Souza

    Full Text Available Systemic lymphangiomatosis is a rare disease characterized by the exageration of lymphatic channel proliferation, occurring in children and young adults. We describe an extremely rare case of congenital systemic lymphangiomatosis in a newborn who had ascitis and respiratory failure develop immediately after delivery. Death occurred during the first hour of life. Autopsy findings showed numerous cysts in soft tissues of the cervical area, mediastinum and diaphragm, and several other organs including the liver, spleen, thyroid and kidneys. The severe and diffuse involvement with cysts in both lungs by lymphangiomatosis was associated with poor prognosis and death in our case.

  7. Nonclassic Congenital Adrenal Hyperplasia

    Directory of Open Access Journals (Sweden)

    Selma Feldman Witchel

    2010-01-01

    Full Text Available Nonclassic congenital adrenal hyperplasia (NCAH due to P450c21 (21-hydroxylase deficiency is a common autosomal recessive disorder. This disorder is due to mutations in the CYP21A2 gene which is located at chromosome 6p21. The clinical features predominantly reflect androgen excess rather than adrenal insufficiency leading to an ascertainment bias favoring diagnosis in females. Treatment goals include normal linear growth velocity and “on-time” puberty in affected children. For adolescent and adult women, treatment goals include regularization of menses, prevention of progression of hirsutism, and fertility. This paper will review key aspects regarding pathophysiology, diagnosis, and treatment of NCAH.

  8. Congenital acute megakaryocytic leukemia

    Directory of Open Access Journals (Sweden)

    N B Mathur

    2011-01-01

    Full Text Available Congenital leukemia (CL is an extremely rare disorder in the newborn, significant proportion of which is of myeloid origin, primarily of M4 or M5 morphology. As compared to pediatric leukemia, CL is a more aggressive disease. Acute myeloid leukemia (AML-M7 or acute megakaryocytic leukemia is a rare type of AML with an incidence of 0.5 per million per year. Median age of presentation is 6 years, and children may present with a broad variety of symptoms including low-grade fever, diarrhea, easy bruising, failure to gain weight and life-threatening conditions.

  9. Congenital granular cell epulis.

    Science.gov (United States)

    Conrad, Rachel; Perez, Mia C N

    2014-01-01

    Congenital granular cell epulis is a rarely reported lesion of unknown histogenesis with a strong predilection for the maxillary alveolar ridge of newborn girls. Microscopically, it demonstrates nests of polygonal cells with granular cytoplasm, a prominent capillary network, and attenuated overlying squamous epithelium. The lesion lacks immunoreactivity for S-100, laminin, chromogranin, and most other markers except neuron-specific enolase and vimentin. Through careful observation of its unique clinical, histopathologic, and immunohistochemical features, this lesion can be distinguished from the more common adult granular cell tumor as well as other differential diagnoses.

  10. Congenital nystagmus and negative electroretinography

    Directory of Open Access Journals (Sweden)

    Roussi M

    2011-04-01

    Full Text Available Mirella Roussi, Hélène Dalens, Jean Jacques Marcellier, Franck BacinDepartment of Ophthalmology, Clermont-Ferrand University, Clermont-Ferrand, FranceAbstract: Congenital nystagmus is a pathologic oculomotor state appearing at about three to four months of age. The precise diagnosis requires detailed clinical examination and electrophysiological findings. This case report presents two male patients with congenital nystagmus examined longitudinally from the age of six months until 17-18 years of age. Clinical and electrophysiological protocols were detailed. The first results showed electronegative electroretinography in the two cases and examination combined with electroretinographic findings helped us to make the diagnosis of Congenital Night Stationary Blindness (CSNB. This diagnosis was confirmed by genetic studies. CSNB is interesting to study because through electrophysiological findings, it enables a better understanding of the physiology of neural transmission in the outer part of the retina.Keywords: Congenital nystagmus, negative electroretinography, congenital night stationary blindness

  11. Congenital upper urinary tract abnormalities: new images of the same diseases

    Energy Technology Data Exchange (ETDEWEB)

    Maranhao, Carol Pontes de Miranda; Santos, Carla Jotta dos [Clinica de Medicina Nuclear e Radiologia de Maceio (MedRadiUS), AL (Brazil); Miranda, Christiana Maia Nobre Rocha de; Farias, Lucas de Padua Gomes de; Padilha, Igor Gomes, E-mail: maiachristiana@globo.com [Universidade Federal de Alagoas (UFAL), Maceio, AL (Brazil)

    2013-01-15

    Congenital upper urinary tract abnormalities imply a variable clinical spectrum of morphofunctional changes ranging from asymptomatic conditions to renal failure and incompatibility with life. Computed tomography, which has overcome excretory urography imaging, has been playing a key role in the diagnosis of congenital anomalies, serving as a better guidance in the therapeutic and surgical decision-making process, besides acting as an essential tool in the identification of associated complications and aiding in the performance of minimally invasive surgery techniques. (author)

  12. Is There a Cosmetic Advantage to Single-Incision Laparoscopic Surgical Techniques Over Standard Laparoscopic Surgery? A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Evans, Luke; Manley, Kate

    2016-06-01

    Single-incision laparoscopic surgery represents an evolution of minimally invasive techniques, but has been a controversial development. A cosmetic advantage is stated by many authors, but has not been found to be universally present or even of considerable importance by patients. This systematic review and meta-analysis demonstrates that there is a cosmetic advantage of the technique regardless of the operation type. The treatment effect in terms of cosmetic improvement is of the order of 0.63.

  13. Congenital peritoneal encapsulation

    Institute of Scientific and Technical Information of China (English)

    Diana; Teixeira; Vítor; Costa; Paula; Costa; Carlos; Alpoim; Pinto; Correia

    2015-01-01

    Peritoneal encapsulation(PE) is a rare congenital malformation, characterized by a thin accessory peritoneal membrane which covers all or part of the small bowel, forming an accessory peritoneal sac. Most cases areasymptomatic and diagnosed incidentally during surgery and/or autopsy. Clinical presentation with intestinal obstruction is extremely rare and we report a case. A 25-year-old male, referred to emergency department with diffuse abdominal pain, crampy, with 8 h evolution, associated with nausea, vomiting and constipation in the last 48 h. The abdominal examination revealed an asymmetric and fixed distension, with hard consistency on palpation of lower abdominal quadrants. The abdominal radiography reveals a small bowel distension and fluid levels. Submitted to laparoscopic surgery that recourse to conversion because there is a total peritoneal encapsulation of the small bowel. After opening the peritoneal sac, we find a rotation of mesentery, at its root, conditioning twisting of small bowel and consequently occlusion. Uneventful postoperative with discharged at the 6th day. The PE is a very rare congenital anomaly characterized by abnormal bowel back into the abdominal cavity in the early stages of development. Your knowledge becomes important because, although rare, it might be diagnosis in patients with intestinal obstruction, in the absence of other etiologic factors.

  14. Congenital extrahepatic portosystemic shunts

    Energy Technology Data Exchange (ETDEWEB)

    Murray, Conor P.; Yoo, Shi-Joon; Babyn, Paul S. [Department of Diagnostic Imaging, Hospital for Sick Children, 555 University Avenue, M5G 1X8, Toronto, Ontario (Canada)

    2003-09-01

    A congenital extrahepatic portosystemic shunt (CEPS) is uncommon. A type 1 CEPS exists where there is absence of intrahepatic portal venous supply and a type 2 CEPS where this supply is preserved. The diagnosis of congenital portosystemic shunt is important because it may cause hepatic encephalopathy. To describe the clinical and imaging features of three children with CEPS and to review the cases in the published literature. The diagnostic imaging and medical records for three children with CEPS were retrieved and evaluated. An extensive literature search was performed. Including our cases, there are 61 reported cases of CEPS, 39 type 1 and 22 type 2. Type 1 occurs predominantly in females, while type 2 shows no significant sexual preponderance. The age at diagnosis ranges from 31 weeks of intrauterine life to 76 years. Both types of CEPS have a number of associations, the most common being nodular lesions of the liver (n=25), cardiac anomalies (n=19), portosystemic encephalopathy (n=10), polysplenia (n=9), biliary atresia (n=7), skeletal anomalies (n=5), and renal tract anomalies (n=4). MRI is recommended as an important means of diagnosing and classifying cases of CEPS and examining the associated cardiovascular and hepatic abnormalities. Screening for CEPS in patients born with polysplenia is suggested. (orig.)

  15. [Genetics of congenital deafness].

    Science.gov (United States)

    Faundes, Víctor; Pardo, Rosa Andrea; Castillo Taucher, Silvia

    2012-10-20

    Congenital deafness is defined as the hearing loss which is present at birth and, consequently, before speech development. It is the most prevalent sensor neural disorder in developed countries, and its incidence is estimated between 1-3 children per 1,000 newborns, of which more than 50% are attributable to genetics causes. Deafness can be classified as syndromic or non-syndromic. In the first case, it is associated with outer ear malformations and/or systemic findings. More than 400 syndromes accompanied of deafness have been described, which represent about 30% of cases of congenital hearing loss. The remaining percentage corresponds to non-syndromic cases: 75-85% are autosomal recessive, 15-24% are autosomal dominant, and 1-2% are X-linked. The evaluation of a child with deafness requires a multidisciplinary collaboration among specialists, who must coordinate themselves and give information to the affected family. The aims of establishing a diagnosis are to predict other manifestations that may suggest some syndrome and to anticipate their management, as well as to perform genetic counseling to parents and affected individuals.

  16. Congenital nephrotic syndrome

    Directory of Open Access Journals (Sweden)

    Claudia Fanni

    2014-06-01

    Full Text Available CNS (Congenital nephrotic syndrome is a disorder characterized by the presence of a nephrotic syndrome in the first three months of life. Different pathologies can cause this syndrome. In general, we can distinguish primary forms (sporadic and hereditary and secondary forms (acquired and associated with other syndromes. The most common form is the Finnish CNS (CNF, congenital nephrotic syndrome of the Finnish type, a hereditary form whose name derives from the fact that the highest incidence is described in that country (1.2:10,000. The pathogenesis, the clinical picture, the diagnostic criteria, the therapy and the outcome are described in details.  Proceedings of the International Course on Perinatal Pathology (part of the 10th International Workshop on Neonatology · October 22nd-25th, 2014 · Cagliari (Italy · October 25th, 2014 · The role of the clinical pathological dialogue in problem solving Guest Editors: Gavino Faa, Vassilios Fanos, Peter Van Eyken

  17. Castration of dromedary camel through prescrotal midline incision

    Directory of Open Access Journals (Sweden)

    S.A. Taleb

    2012-10-01

    Full Text Available A total of 165 camels of different ages were castrated through a small, prescrotal midline incision between January, 2010 and December, 2011. The incision was closed with one interrupted, horizontal mattress suture using USP-2 chromic catgut. In 14/165 animals (8.5% postoperative infection (sepsis developed, which healed in two to three weeks after open wound management. The remaining 151 animals had an uneventful recovery, but a slight edematous swelling of the scrotum was observed in 8 of the 151 animals (5.3%, which was self-limiting and of no significance. No primary or secondary postoperative bleeding was noticed in any of the animals. It was concluded that this technique was less time consuming with negligible postoperative care and complications when performed under standard surgical principles.

  18. Closed incision management with negative pressure wound therapy.

    Science.gov (United States)

    Dohmen, Pascal M; Misfeld, Martin; Borger, Michael A; Mohr, Friedrich W

    2014-07-01

    Post-sternotomy mediastinitis is the most severe surgical site infection after sternotomy with an incidence between 1-4% related to the patient co-morbidity. This complication will increase morbidity and mortality and may also have an economic impact. There are guidelines to prevent surgical site infections; however, age and co-morbidities increase and therefore it is important to develop new tools to improve wound healing. This manuscript will give an overview of a new concept using negative pressure wound therapy over a closed incision (so-called, closed incision management) after surgery and will include the principles of negative pressure wound therapy and the positively applied mechanical forces as a permutation of Wolff's law. The use and indication of this therapy is supported by experimental studies divided into physiological and biomechanical property studies. Finally, an overview of clinical studies is given based on the evidence rating scale for therapeutic studies.

  19. Single incision laparoscopic hepatectomy: Advances in laparoscopic liver surgery

    Directory of Open Access Journals (Sweden)

    Tayar Claude

    2014-01-01

    Full Text Available Background: Laparoscopic liver surgery is now an established practice in many institutions. It is a safe and feasible approach in experienced hands. Single incision laparoscopic surgery (SILS has been performed for cholecystectomies, nephrectomies, splenectomies and obesity surgery. However, the use of SILS in liver surgery has been rarely reported. We report our initial experience in seven patients on single incision laparoscopic hepatectomy (SILH. Patients and Methods: From October 2010 to September 2012, seven patients underwent single-incision laparoscopic liver surgery. The abdomen was approached through a 25 mm periumbilical incision. No supplemental ports were required. The liver was transected using a combination of LigaSure TM (Covidien-Valleylab. Boulder. USA, Harmonic Scalpel and Ligaclips (Ethicon Endo-Surgery, Inc.. Results: Liver resection was successfully completed for the seven patients. The procedures consisted of two partial resections of segment three, two partial resections of segment five and three partial resections of segment six. The mean operative time was 98.3 min (range: 60-150 min and the mean estimated blood loss was 57 ml (range: 25-150 ml. The postoperative courses were uneventful and the mean hospital stay was 5.1 days (range: 1-13 days. Pathology identified three benign and four malignant liver tumours with clear margins. Conclusion: SILH is a technically feasible and safe approach for wedge resections of the liver without oncological compromise and with favourable cosmetic results. This surgical technique requires relatively advanced laparoscopic skills. Further studies are needed to determine the potential advantages of this technique, apart from the better cosmetic result, compared to the conventional laparoscopic approach.

  20. Open femoral hernia repair: one skin incision for all

    Directory of Open Access Journals (Sweden)

    El-Masry Nabil S

    2009-11-01

    Full Text Available Abstract Background Femoral hernias are relatively uncommon, however they are the most common incarcerated abdominal hernia, with strangulation of a viscus carrying significant mortality. Classically three approaches are described to open femoral hernia repair: Lockwood's infra-inguinal, Lotheissen's trans-inguinal and McEvedy's high approach. Each approach describes a separate skin incision and dissection to access the femoral sac. The decision as to which approach to adopt, predominantly dependent on the suspicion of finding strangulated bowel, is often a difficult one and in our opinion an unnecessary one. Methods We propose a technique for open femoral hernia repair that involves a single skin incision 1 cm above the medial half of the inguinal ligament that allows all of the above approaches to the hernia sac depending on the operative findings. Thus the repair of simple femoral hernias can be performed from below the inguinal ligament. If found, inguinal hernias can be repaired. More importantly, resection of compromised bowel can be achieved by accessing the peritoneal cavity with division of the linea semilunaris 4 cm above the inguinal ligament. This avoids compromise of the inguinal canal, and with medial retraction of the rectus abdominis muscle enables access to the peritoneal cavity and compromised bowel. Discussion This simple technique minimises the preoperative debate as to which incision will allow the best approach to the femoral hernia sac, allow for alteration to a simple inguinal hernia repair if necessary, and more importantly obviate the need for further skin incisions if compromised bowel is encountered that requires resection.

  1. Increasingly minimal bias routing

    Energy Technology Data Exchange (ETDEWEB)

    Bataineh, Abdulla; Court, Thomas; Roweth, Duncan

    2017-02-21

    A system and algorithm configured to generate diversity at the traffic source so that packets are uniformly distributed over all of the available paths, but to increase the likelihood of taking a minimal path with each hop the packet takes. This is achieved by configuring routing biases so as to prefer non-minimal paths at the injection point, but increasingly prefer minimal paths as the packet proceeds, referred to herein as Increasing Minimal Bias (IMB).

  2. Single incision thoracoscopic sympathectomy for palmar and axillary hyperhidrosis

    Directory of Open Access Journals (Sweden)

    Aram Baram

    2014-02-01

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

  3. Modelling of meander migration in an incised channel

    Institute of Scientific and Technical Information of China (English)

    Jianchun HUANG; Blair P GREIMANN; Timothy J RANDLE

    2014-01-01

    An updated linear computer model for meandering rivers with incision has been developed. The model simulates the bed topography, flow field, and bank erosion rate in an incised meandering channel. In a scenario where the upstream sediment load decreases (e.g., after dam closure or soil conservation), alluvial river experiences cross section deepening and slope flattening. The channel migration rate might be affected in two ways:decreased channel slope and steeped bank height. The proposed numerical model combines the traditional one-dimensional (1D) sediment transport model in simulating the channel erosion and the linear model for channel meandering. A non-equilibrium sediment transport model is used to update the channel bed elevation and gradations. A linear meandering model was used to calculate the channel alignment and bank erosion/accretion, which in turn was used by the 1D sediment transport model. In the 1D sediment transport model, the channel bed elevation and gradations are represented in each channel cross section. In the meandering model, the bed elevation and gradations are stored in two dimensional (2D) cells to represent the channel and terrain properties (elevation and gradation). A new method is proposed to exchange information regarding bed elevations and bed material fractions between 1D river geometry and 2D channel and terrain. The ability of the model is demonstrated using the simulation of the laboratory channel migration of Friedkin in which channel incision occurs at the upstream end.

  4. Single incision thoracoscopic sympathectomy for palmar and axillary hyperhidrosis

    Science.gov (United States)

    2014-01-01

    Background: Primary hyperhidrosis is characterized by excessive sweating beyond physiological needs. It is a common disease (incidence 2.8%) that causes intense discomfort for patients. In the last decade, advantages of Single-Incision Thoracoscopic Sympathectomy have become clear, particularly in decreasing morbidity of sympathectomy. Patients and methods: From January 2010 to December 2012, 39 patients (29 females and 10 males) with primary palmar or axillary hyperhidrosis were treated by thoracoscopic sympathectomy. The age ranged from 18 to 40 years with a mean of 26.28 years. We used single incision thoracoscopic electrocoagulation through 10 mm incision for thoracic sympathetic chain (T2–T4). Results: The mean follow-up was 23.6 ± 14.2 months (range = 4–24 months). A total of 97.42% of patients were satisfied with the results. A total of 72.5% of patients had cure, one patient (2.5%) and another patient (2.5%) presented with recurrent axillary hyperhidrosis. The morbidity was 10.2% with no mortality. Percentage of compensatory sweating and gustatory sweating were 5.1% (p = .353) and 2.5% (p = .552), respectively. The result of sympathectomy in patients with both palmar and axillary hyperhidrosis was significantly better (17, 43.58%) compared to palmar type (14, 35.89%) or axillary type (7, 17.94%). Conclusion: Thoracoscopic sympathectomy is a simple, safe, and cost-effective therapy with good results and low complications. PMID:26770711

  5. Bedrock incision by bedload: insights from direct numerical simulations

    Science.gov (United States)

    Aubert, Guilhem; Langlois, Vincent J.; Allemand, Pascal

    2016-04-01

    Bedload sediment transport is one of the main processes that contribute to bedrock incision in a river and is therefore one of the key control parameters in the evolution of mountainous landscapes. In recent years, many studies have addressed this issue through experimental setups, direct measurements in the field, or various analytical models. In this article, we present a new direct numerical approach: using the classical methods of discrete-element simulations applied to granular materials, we explicitly compute the trajectories of a number of pebbles entrained by a turbulent water stream over a rough solid surface. This method allows us to extract quantitatively the amount of energy that successive impacts of pebbles deliver to the bedrock, as a function of both the amount of sediment available and the Shields number. We show that we reproduce qualitatively the behaviour observed experimentally by Sklar and Dietrich (2001) and observe both a "tool effect" and a "cover effect". Converting the energy delivered to the bedrock into an average long-term incision rate of the river leads to predictions consistent with observations in the field. Finally, we reformulate the dependency of this incision rate with Shields number and sediment flux, and predict that the cover term should decay linearly at low sediment supply and exponentially at high sediment supply.

  6. Progressive incision of the Channeled Scablands by outburst floods.

    Science.gov (United States)

    Larsen, Isaac J; Lamb, Michael P

    2016-10-13

    The surfaces of Earth and Mars contain large bedrock canyons that were carved by catastrophic outburst floods. Reconstructing the magnitude of these canyon-forming floods is essential for understanding the ways in which floods modify planetary surfaces, the hydrology of early Mars and abrupt changes in climate. Flood discharges are often estimated by assuming that the floods filled the canyons to their brims with water; however, an alternative hypothesis is that canyon morphology adjusts during incision such that bed shear stresses exceed the threshold for erosion by a small amount. Here we show that accounting for erosion thresholds during canyon incision results in near-constant discharges that are five- to ten-fold smaller than full-to-the-brim estimates for Moses Coulee, a canyon in the Channeled Scablands, which was carved during the Pleistocene by the catastrophic Missoula floods in eastern Washington, USA. The predicted discharges are consistent with flow-depth indicators from gravel bars within the canyon. In contrast, under the assumption that floods filled canyons to their brims, a large and monotonic increase in flood discharge is predicted as the canyon was progressively incised, which is at odds with the discharges expected for floods originating from glacial lake outbursts. These findings suggest that flood-carved landscapes in fractured rock might evolve to a threshold state for bedrock erosion, thus implying much lower flood discharges than previously thought.

  7. Progressive incision of the Channeled Scablands by outburst floods

    Science.gov (United States)

    Larsen, Isaac J.; Lamb, Michael P.

    2016-10-01

    The surfaces of Earth and Mars contain large bedrock canyons that were carved by catastrophic outburst floods. Reconstructing the magnitude of these canyon-forming floods is essential for understanding the ways in which floods modify planetary surfaces, the hydrology of early Mars and abrupt changes in climate. Flood discharges are often estimated by assuming that the floods filled the canyons to their brims with water; however, an alternative hypothesis is that canyon morphology adjusts during incision such that bed shear stresses exceed the threshold for erosion by a small amount. Here we show that accounting for erosion thresholds during canyon incision results in near-constant discharges that are five- to ten-fold smaller than full-to-the-brim estimates for Moses Coulee, a canyon in the Channeled Scablands, which was carved during the Pleistocene by the catastrophic Missoula floods in eastern Washington, USA. The predicted discharges are consistent with flow-depth indicators from gravel bars within the canyon. In contrast, under the assumption that floods filled canyons to their brims, a large and monotonic increase in flood discharge is predicted as the canyon was progressively incised, which is at odds with the discharges expected for floods originating from glacial lake outbursts. These findings suggest that flood-carved landscapes in fractured rock might evolve to a threshold state for bedrock erosion, thus implying much lower flood discharges than previously thought.

  8. [Minimally Invasive Mitral Valve Plasty;My Technique].

    Science.gov (United States)

    Ito, Toshiaki

    2016-07-01

    We perform minimally invasive mitral valve plasty under totally endoscopic view. Skin incisions are composed of a 3 to 5 cm of main wound along the right 4th intercostal space, 1 trocar port in the 3rd intercostal space, and a camera port in the 5th intercostal space. Matal rib spreader is not used. A 3-dimensional endoscope was recently introduced. Forceps controlled by the left hand are inserted through the independent trocar port in the 3rd intercostal space. Left atrial retractor, aortic clamp, and all the cannulae are inserted through the main incision. Cardio-pulmonary bypass is established through the right femoral artery and vein cannulation. No additional venous cannula through the right jugular vein is used. Posterior leaflet lesions are repaired by resection and suture technique. Anterior leaflet prolapse is repaired mainly using the loop technique. Bleeding from the chest wall is meticulously checked before closing the chest.

  9. Developing and Evaluating Virtual Cardiotomy for Preoperative Planning in Congenital Heart Disease

    DEFF Research Database (Denmark)

    Sørensen, Thomas Sangild; Beerbaum, Philipp; Mosegaard, Jesper;

    2009-01-01

    Careful preoperative planning is of outmost importance -- in particular when considering complex corrective surgery on congenitally malformed hearts. As an aid to such decisionsmaking we describe a system for virtual reconstruction of patient-specific morphology from 3D-capable imaging modalities...... such as MRI and CT. We introduce and illustrate the concept of virtual cardiotomy as a new tool to preoperatively evaluate the feasibility of different surgical strategies by investigating the anatomical spatial relations through any number of virtual incisions. Ve review the technical and clinical...

  10. Congenital hypothyroidism: current perspectives

    Directory of Open Access Journals (Sweden)

    Dayal D

    2015-07-01

    Full Text Available Devi Dayal, Rajendra Prasad Department of Pediatrics, Pediatric Endocrinology and Diabetes Unit, Postgraduate Institute of Medical Education and Research, Chandigarh, India Abstract: Congenital hypothyroidism (CH, the most common pediatric endocrine disorder with an estimated prevalence of 1:2,000 to 1:4,000, is an under-recognized problem in countries without routine newborn screening (NBS programs. Thyroid dysgenesis (TD is the most common cause of primary CH accounting for approximately 85% of all cases; most of the remaining patients have dyshormonogenesis. Transient CH and CH with eutopic gland, are increasingly being identified after introduction of routine NBS. The clinical features of CH are often subtle resulting in delayed diagnosis and eventually poor intellectual outcome. In developed countries, detection by NBS and early initiation of treatment has largely eliminated the intellectual disability caused by this disorder. The lower screening thyroid stimulating hormone (TSH cutoff and changes in birth demographics in some countries have been associated with an increase in the reported incidence of CH. However, the additional cases detected by the lower TSH cutoff tend to have either milder or transient hypothyroidism. Diagnosis of CH is made on the basis of serum concentrations of TSH and thyroxine (T4. Thyroid ultrasound, radionuclide scintigraphy, serum thyroglobulin (TG levels and specific genetic tests help ascertaining the exact etiological diagnosis. Non-availability of later tests should not deter the pediatrician from initiation of treatment. Age at initiation of treatment and starting dose of levothyroxine are critical factors that determine the long-term outcome. Higher doses of levothyroxine at 10–15 µg/kg/day are required in infants, with titration based on T4 and TSH levels, which are repeated frequently. Coexistence of other congenital anomalies in children with CH adds to the morbidity. Approximately 70% of babies

  11. Minimally invasive tethered cord release in children: A technical note

    Directory of Open Access Journals (Sweden)

    S. Kağan Başarslan

    2014-03-01

    Full Text Available Tethered cord release is commonly performed in pediatric neurosurgery. Nowadays, minimally invasive procedures are created growing interest due to its highly tolerable nature for surgery. It has been main purpose a minimal damaging on access route and maximum protection of normal structures in surgery. We present a surgical treatment of tethered cord syndrome, by which is provided the cord releasing unlike the many methods being applied with tissue removal. The main advantage of performing this surgery through 2 cm hole is to avoid removing ligamentum flavum and bony structure like lamina in addition to reduce the length of the incision and the related scar tissue. J Clin Exp Invest 2014; 5 (1: 115-117 Technical note: the patient was taken on the operating table in the sitting-prone position, and L5-S1 distance was determined by fluoroscopy. The skin and subcutaneous tissues was passed via a 2 cm vertical incision settled in 0.5 cm laterally from midline. L5-S1 distance and its covering ligamentum flavum are displayed by the guidance of L5 lamina. Williams’s retractor was placed in the distance after fetching microscope. The foregoing procedures are the same with microdiscectomic surgery. By a vertical incision made on the flavum, its both layer was lifted up and hanged with simple suture on the back tissue for a comfortable exposure of the Dura. Thecal sac was opened by 0.5 cm long vertical incision on the Dura after obtaining secure CSF drainage with the help of yellow-tipped syringe needle. With finding by a nerve hook, the phylum was burned and released securely. Then the Dura was sutured primarily for the closure by means of microsurgery instruments, and flavum was laid on it again.

  12. Complications from a Distal Bicep Repair: A Meta-Analysis of a Single Incision Versus Double Incision Surgical Technique

    OpenAIRE

    Toossi, Nader; Amin, Nirav Hasmukh; Cerynik, Douglas L.; Jones, Morgan H.

    2014-01-01

    Objectives: Anatomical reinsertion of the distal biceps is critical for restoring elbow flexion and forearm supination strength. Surgical techniques utilizing one and two incisions have been reported in the literature, describing complications and outcomes. However, which technique is associated with a lower complication rate remains unclear. Methods: A systematic review was conducted using the PubMed, Medline, CINAHL (Cumulative Index to Nursing and Allied Health Literature), SPORTSDiscus, a...

  13. Treatment of congenital aniridia associated with subluxated infantile cataract.

    Science.gov (United States)

    Jusufovic, Vahid; Cabric, Emir; Popovic-Beganovic, Allen; Musanovic, Zlatko; Zvornicanin, Jasmin

    2014-06-01

    A 5 year old boy was presented at Eye clinic University clinical center Tuzla with congenital aniridia in both eyes. Clinical examination revealed visual acuity of 0,08 without correction in right and 0.7 with -5.0 Dsph and -1.0 Dcyl Axx 109° in left eye. Opthalmologic examination showed bilateral aniridia associated with moderate cataract in the right and incipient cataract in the left eye. In the right eye, zonular weakness with incipient capsular displacement and esotropia of Δ6º, were noted. The patient underwent phacoemulsification, implantation of capsular tension ring and Artificial Iris implant in the capsular bag. Phacoemulsification went uneventful and early postoperative recovery was successful with no signs of aniridia-associated keratopathy development and normal values of intra ocular pressure. Patient was not motivated for operation of the left eye and it was corrected with soft contact lens. Six month after the operation visual acuity in the right eye improved to 0.9 with +1.25Dsph and maintained stable in left eye, with complete elimination of esotropia and signs of binocular vision restoration. Small incision cataract extraction with IOL and Artificial Iris implantation in one procedure can be used to correct congenital aniridia and cataract with significant visual function improvement.

  14. Treatment of congenital aniridia associated with subluxated infantile cataract.

    Science.gov (United States)

    Jusufovic, Vahid; Cabric, Emir; Popovic-Beganovic, Allen; Musanovic, Zlatko; Zvornicanin, Jasmin

    2014-01-01

    A 5 year old boy was presented at Eye clinic University clinical center Tuzla with congenital aniridia in both eyes. Clinical examination revealed visual acuity of 0.08 without correction in right and 0.7 with -5.0 Dsph and -1.0 Dcyl Axx 109 degrees in left eye. Opthalmologic examination showed bilateral aniridia associated with moderate cataract in the right and incipient cataract in the left eye. In the right eye, zonular weakness with incipient capsular displacement and esotropia of delta6 degrees, were noted. The patient underwent phacoemulsification, implantation of capsular tension ring and Artificial Iris implant in the capsular bag. Phacoemulsification went uneventful and early postoperative recovery was successful with no signs of aniridia-associated keratopathy development and normal values of intra ocular pressure. Patient was not motivated for operation of the left eye and it was corrected with soft contact lens. Six month after the operation visual acuity in the right eye improved to 0.9 with +1.25 Dsph and maintained stable in left eye, with complete elimination of esotropia and signs of binocular vision restoration. Small incision cataract extraction with IOL and Artificial Iris implantation in one procedure can be used to correct congenital aniridia and cataract with significant visual function improvement.

  15. Innovative technique for correction of the congenital lop ear.

    Science.gov (United States)

    Ho, K; Boorer, C; Khan, U; Deva, A; Chang, L

    2006-01-01

    Congenital lop ear is a deformity affecting the upper third of the ear. It is characterised by varying degrees of lidding of the helix, reduction in the fossa triangularis, scapha compression, reduction or absence of the superior crus of the antihelix and an associated reduction in vertical height of the external ear. Reported strategies for the surgical correction of this deformity include simple excision of the excess overhanging cartilage, radial cartilage incisions of the helix to reverse its memory, various cartilage grafts from the surrounding ear or rib to strut or fill the defect, and mastoid hitching stitches to reinforce the repair. We present a novel technique using a reversed conchal cartilage graft to strut the deformed antihelix. The memory of the reversed conchal cartilage is used to correct lidding of the superior helix and obviates the need for intrinsic cartilage modification or excision. We have found a good aesthetic and structural result in a patient with bilateral congenital lop ear with 12 months follow up.

  16. Congenital Temporomandibular Joint Ankylosis: Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Ryan Chin Taw Cheong

    2016-01-01

    Full Text Available Congenital temporomandibular joint (TMJ ankylosis is an uncommon condition that presents itself at or soon after birth in the absence of acquired factors that could have contributed to the ankylosis such as infection and trauma. The experience of managing one such case is reported in light of a review of the literature on this condition. Key management principles include adequate removal of the ankylotic mass, costochondral grafting, and post-op physiotherapy. Most patients reported in the literature with the condition experienced relapse. This echoes our own experience where there was recurrence of the ankylosis. However, after removal of the ankylotic mass, the patient maintains a satisfactory maximal incisal opening (MIO till the present day. The additional challenges faced in the congenital form in addition to the already complex management of acquired paediatric temporomandibular joint ankylosis are (1 much earlier insult to the TMJ, (2 reduced opportunity for neuromuscular development of the muscles of mastication, and (3 reduced compliance with postoperative physiotherapy programmes due to the younger age of these patients.

  17. Congenital Goitre in Goats

    Directory of Open Access Journals (Sweden)

    A. H. Cheema, A. Shakoor and A. H. Shahzad

    2010-01-01

    Full Text Available One full-term, dead foetus was successfully removed from a 5-year old, crossbred black and white goat. The goat was stall-fed with green fodder and it delivered two dead foetuses in the previous pregnancy. The foetus had a large swelling in the cranio-ventral neck region. Upon cutting skin, the swelling revealed extremely enlarged thyroid gland having two asymmetrical lobes with the right lobe was 8.10 x 15.0 cm and the left 5.5 x 8.6 cm in size. The skin was devoid of hair, pale-white and thickened with myxedema. Histologically, the enlarged thyroid consisted of colloid goitre and the lungs were oedematous. This case of congenital goitre was unusual and differed from the reported cases in two aspects viz 1 the two lobes were enlarged but unequal and 2 histologically goitre was colloid instead of usual hyperplastic type.

  18. Congenital pyriform aperture stenosis

    Energy Technology Data Exchange (ETDEWEB)

    Osovsky, Micky [Schneider Pediatric Hospital, Department of Neonatology, Petach Tikvah (Israel); Rabin Medical Center, Department of Neonatology, Schneider Children' s Medical Center of Israel, Beilinson Campus, Petah Tikvah (Israel); Aizer-Danon, Anat; Horev, Gadi [Schneider Pediatric Hospital, Department of Pediatric Radiology, Petach Tikvah (Israel); Sirota, Lea [Schneider Pediatric Hospital, Department of Neonatology, Petach Tikvah (Israel)

    2007-01-15

    Nasal airway obstruction is a potentially life-threatening condition in the newborn. Neonates are obligatory nasal breathers. The pyriform aperture is the narrowest, most anterior bony portion of the nasal airway, and a decrease in its cross-sectional area will significantly increase nasal airway resistance. Congenital nasal pyriform aperture stenosis (CNPAS) is a rare, unusual form of nasal obstruction. It should be considered in the differential diagnosis of any neonate or infant with signs and symptoms of upper airway compromise. It is important to differentiate this level of obstruction from the more common posterior choanal stenosis or atresia. CNPAS presents with symptoms of nasal airway obstruction, which are often characterized by episodic apnea and cyclical cyanosis. (orig.)

  19. Characterizing congenital amusia.

    Science.gov (United States)

    Stewart, Lauren

    2011-04-01

    The ability to make sense of the music in our environment involves sophisticated cognitive mechanisms that, for most people, are acquired effortlessly and in early life. A special population of individuals, with a disorder termed congenital amusia, report lifelong difficulties in this regard. Exploring the nature of this developmental disorder provides a window onto the cognitive architecture of typical musical processing, as well as allowing a study of the relationship between processing of music and other domains, such as language. The present article considers findings concerning pitch discrimination, pitch memory, contour processing, experiential aspects of music listening in amusia, and emerging evidence concerning the neurobiology of the disorder. A simplified model of melodic processing is outlined, and possible loci of the cognitive deficit are discussed.

  20. Congenital hypothyroidism: Screening dilemma

    Directory of Open Access Journals (Sweden)

    Meena P Desai

    2012-01-01

    Full Text Available Primary sporadic congenital hypothyroidism (CH is the most common cause of hypothyroidism infancy early childhood in iodine sufficient region. Screening for neonatal CH began in 1970s. The rationale and reason for neonatal screening for CH (NSCH are well established. It is mandatory in most developed countries along with the screen for metabolic disorder. The possibility of measuring TSH and thyroid hormones in cord blood paved the way for newborn screening (NS for CH. Worldwide it is estimated that 25% of the live born population of 130 million babies undergo NSCH. Klein et al., by 1972 had shown improved CNS prognosis in CH treated by age 3 months. NSCH has largely eradicated the severe irreversible neurodevelopmental damage and reversed the chances of growth failure in infancy and early childhood.

  1. Congenital heart defects and medical imaging.

    Science.gov (United States)

    Gehin, Connie; Ragsdale, Lisa

    2013-01-01

    Radiologic technologists perform imaging studies that are useful in the diagnosis of congenital heart defects in infants and adults. These studies also help to monitor congenital heart defect repairs in adults. This article describes the development and functional anatomy of the heart, along with the epidemiology and anatomy of congenital heart defects. It also discusses the increasing population of adults who have congenital heart defects and the most effective modalities for diagnosing, evaluating, and monitoring congenital heart defects.

  2. Genetic and biochemical characterization of human AP endonuclease 1 mutants deficient in nucleotide incision repair activity.

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    Aurore Gelin

    Full Text Available BACKGROUND: Human apurinic/apyrimidinic endonuclease 1 (APE1 is a key DNA repair enzyme involved in both base excision repair (BER and nucleotide incision repair (NIR pathways. In the BER pathway, APE1 cleaves DNA at AP sites and 3'-blocking moieties generated by DNA glycosylases. In the NIR pathway, APE1 incises DNA 5' to a number of oxidatively damaged bases. At present, physiological relevance of the NIR pathway is fairly well established in E. coli, but has yet to be elucidated in human cells. METHODOLOGY/PRINCIPAL FINDING: We identified amino acid residues in the APE1 protein that affect its function in either the BER or NIR pathway. Biochemical characterization of APE1 carrying single K98A, R185A, D308A and double K98A/R185A amino acid substitutions revealed that all mutants exhibited greatly reduced NIR and 3'-->5' exonuclease activities, but were capable of performing BER functions to some extent. Expression of the APE1 mutants deficient in the NIR and exonuclease activities reduced the sensitivity of AP endonuclease-deficient E. coli xth nfo strain to an alkylating agent, methylmethanesulfonate, suggesting that our APE1 mutants are able to repair AP sites. Finally, the human NIR pathway was fully reconstituted in vitro using the purified APE1, human flap endonuclease 1, DNA polymerase beta and DNA ligase I proteins, thus establishing the minimal set of proteins required for a functional NIR pathway in human cells. CONCLUSION/SIGNIFICANCE: Taken together, these data further substantiate the role of NIR as a distinct and separable function of APE1 that is essential for processing of potentially lethal oxidative DNA lesions.

  3. The effects of fentanyl on sevoflurane requirements for loss of consciousness and skin incision.

    Science.gov (United States)

    Katoh, T; Ikeda, K

    1998-01-01

    Fentanyl produces a minimal reduction in the minimum alveolar concentration of sevoflurane to prevent response to a verbal command in 50% of patients (MAC[awake]) at low but analgesic plasma concentrations. The reduction in MAC(awake), however, is still unknown at higher fentanyl concentrations. The reduction in the MAC of sevoflurane by fentanyl has not been described accurately. The purpose of this study was to determine the MAC(awake) and MAC reduction of sevoflurane by fentanyl. Ninety-two patients were randomly allocated to seven fentanyl concentration groups (target plasma concentrations of 0, 1, 1.5, 3, 6, 10, and 14 ng/ml). Responses to verbal command were observed for MAC(awake) assessment at predetermined sevoflurane concentrations. Thereafter, in patients whose target fentanyl concentration was 0 to 10 ng/ml, responses to skin incision were observed for MAC assessment at new steady-state sevoflurane concentrations. The reduction in the MAC(awake) and MAC of sevoflurane by the measured fentanyl concentration was calculated. There was an initial steep reduction in the MAC of sevoflurane by fentanyl, with 3 ng/ml resulting in a 59% MAC reduction. A ceiling effect was observed, with 10 ng/ml providing only a further 17% reduction in MAC. The initial reduction in MAC(awake) was not as steep as that in MAC. Fentanyl reduced MAC(awake) by approximately 24% at a plasma concentration of 3 ng/ml. Although the reduction curve of MAC(awake) was parabolic, no manifest ceiling effect was observed at concentrations administered in the present study. The reduction in sevoflurane requirements for loss of consciousness and skin incision by fentanyl was determined. Fentanyl reduced both requirements, but the mode of the reduction was not comparable.

  4. Imaging findings in congenital hepatic fibrosis

    Energy Technology Data Exchange (ETDEWEB)

    Akhan, Okan [Department of Radiology, Hacettepe University, School of Medicine, 06100 Ankara (Turkey)]. E-mail: akhano@tr.net; Karaosmanoglu, Ali Devrim [Department of Radiology, Hacettepe University, School of Medicine, 06100 Ankara (Turkey); Ergen, Bilge [Department of Radiology, Hacettepe University, School of Medicine, 06100 Ankara (Turkey)

    2007-01-15

    Congenital hepatic fibrosis (CHF) is a rare congenital multisystemic disorder, mostly inherited in autosomal recessive fashion, primarily affecting renal and hepatobiliary systems. Main underlying process of the disease is the malformation of the ductal plate, the embryological precursor of the biliary system, and secondary biliary strictures and periportal fibrosis ultimately leading to portal hypertension. The natural course of the disease is highly variable ranging from minimally symptomatic disease to true cirrhosis of the liver. However, in most patients the most common manifestations of the diseases that are related to portal hypertension, particularly splenomegaly and bleeding varices. Many other disease processes may co-exist with the disease including Caroli's disease, choledochal cysts and autosomal recessive polycystic kidney disease (ARPKD) reflecting the mulstisystemic nature of the disease. The associating biliary ductal disease led the authors to think that all these entities are a continuum and different reflections of the same underlying pathophysiological process. Although, conventional method of diagnosis of CHF is the liver biopsy the advent of imaging technologies and modalities, today, may permit the correct diagnosis in a non-invasive manner. Characteristic imaging features are generally present and recognition of these findings may obviate liver biopsy while preserving the diagnostic accuracy. In this article, it is aimed to increase the awareness of the practising radiologists to the imaging findings of this uncommon clinical disorder and trail the blaze for future articles relating to this issue.

  5. Occlusion of atrial septal defect utilizing occluder devise via minimally invasive right chest approach

    Institute of Scientific and Technical Information of China (English)

    励峰; 李伟; 康宁; 龚宝生; 吴东进; 徐方杰; 邱兆昆; 吴卫华

    2011-01-01

    Objective To evaluate atrial septal defect (ASD) occlusion employing a small right anterior thoracotomy approach. Methods A total of 21 patients with ASD underwent general anesthesia and 2 -3 cm incision was made in the fourth right intercostal space. Utilizing transesophageal or transthoracic echocardiography, the occluder was released using a monotube unit. Results All patients were occluded successfully. No patient required open surgery utilizing extracorporeal circulation. There were no major complications and no evidence of residual atrial shunt. Conclusion ASD occlusion via a minimal surgical incision is safe, less invasive, and has excellent outcomes.

  6. Types of Congenital Heart Defects

    Science.gov (United States)

    ... heart develops. Examples of Simple Congenital Heart Defects Holes in the Heart (Septal Defects) The septum is ... Google+ SITE INDEX ACCESSIBILITY PRIVACY STATEMENT FOIA NO FEAR ACT OIG CONTACT US National Institutes of Health ...

  7. CONGENITAL QUADRICUSPID AORTIC-VALVE

    NARCIS (Netherlands)

    BROUWER, MHJ; DEGRAAF, JJ; EBELS, T

    1993-01-01

    Two patients with a quadricuspid aortic valve are described, one of them with concomitant juxtaposed coronary orifices facing the right hand facing sinus. The etiology and incidence of this congenital anomaly will be discussed.

  8. A modified minimally invasive technique for the surgical management of large trichobezoars

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    Amit Javed

    2013-01-01

    Full Text Available Background: Trichobezoar which were traditionally managed by open surgical retrieval are now often managed by minimally invasive surgical approach. Removal of a large trichobezoar by laparoscopy, however, needs an incision (usually 4-5 cm in size for specimen removal and has the risk of intra-peritoneal spillage of hair and inspissated secretions. Materials and Methods : The present paper describes a modified laparoscopy-assisted technique with temporary gastrocutaneopexy for the effective removal of a large trichobezoar using a camera port and a 4-5 cm incision (which is similar to that needed for specimen removal during laparoscopy. Results: Three patients with large trichobezoar were managed with the described technique. The average duration of surgery was 45 (30-60 min and the intraoperative blood loss was minimal. There was no peritoneal spillage and the trichobezoar could be retrieved through a 4-5 cm incision in all patients. All had an uneventful recovery and at a median followup of 6 months had excellent cosmetic and functional results. Conclusion: The described technique is a minimally invasive alternative for trichobezoar removal. There is no risk of peritoneal contamination and the technical ease and short operative time in addition to an incision limited to size required for the specimen removal, makes it an attractive option.

  9. In vivo and in vitro analysis of topographic changes secondary to DSAEK venting incisions

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    Church D

    2011-08-01

    Full Text Available Majid Moshirfar, Monette T Lependu, Dane Church, Marcus C Neuffer John A Moran Eye Center, University of Utah, Salt Lake City, UT, USA Introduction: Descemet’s stripping automated endothelial keratoplasty (DSAEK venting incisions may induce irregular corneal astigmatism. The study examines in vivo and in vitro astigmatic effects of venting incisions. Patients and methods: In vivo analysis examined eleven eyes of eleven patients who had received DSAEK with venting incisions. A chart review of the eleven eyes including assessment of pre and postoperative refraction and topography was performed. In vitro analysis examined three cadaver eyes which received topographic imaging followed by venting incisions at 4 mm, 6 mm, and 7 mm optical zones. Topographic imaging was then performed again after the incisions. Results: Postoperative topographies of eleven eyes demonstrated localized flattening at incision sites and cloverleaf pattern astigmatism. There was a significant difference in corneal irregularity measurement (P = 0.03, but no significant difference in shape factor or change of topographic cylinder. The cloverleaf pattern was found in cadaver eyes with incisions placed at 4 mm and 6 mm optical zones but not at the 7 mm zone. Conclusion: DSAEK venting incisions can cause irregular corneal astigmatism that may affect visual outcomes. The authors recommend placement of venting incisions near the 7 mm optical zone. Keywords: DSAEK, venting incisions, endothelial keratoplasty, astigmatism, endothelium, endothelial transplant

  10. The clinical significance of abdominal right lower paramedian incision inrectal cancer operation

    Institute of Scientific and Technical Information of China (English)

    Chong Shu Wang; Shou Jiang Wei; Jing Dong Li

    2000-01-01

    AIM The incision in rectal cancer operation is adopted commonly in the left mid-lower abdomen. But thereare some defects for the incision, which is close to the artificial colotomy, readily be contaminated by feces,difficult to treat the lesions in hepatic and cholecystic area at the same time and in the weakened area ofabdominal wall. So, we employed the abdominal right lower paramedian incision to solve these problems.METHODS The abdominal right lower paramedian incision is from publc tubercle upward to 3 cm- 4 cmabove navel. The incision should be extended upward if individual need of performing hepatic and cholecysticoperation, or placing catheter or pump in hepatic artery or portal vein for chemotherapy at the same time.RESULTS One hundred and eighty three cases with rectal cancer were adopted this incision in differentoperation procedure, and out of them 41 patients were taken different operation on hepatic and cholecysticlesions and place a catheter or pump to hepatic artery or portal vein. Operators feel that the incision dose nothinder exploring and operating in all of the patients.CONCLUSION The right lower paramedian incision of abdomen is far away from the artificial colotomy,and it can reduce the feces contamination, lower down the rate of incision hernia and paramedian hernia orfistula. Furthermore, it is easy to treat the complicated hepatic and cholecystic lesion. So, authors suggestthat this incision is useful for the operation of rectal cancer, and it is worth to populize in clinical practice.

  11. [Congenital Adrenal Hyperplasia in Adults].

    Science.gov (United States)

    Vrbíková, Jana

    2016-01-01

    Congenital adrenal hyperplasia is a life-long disease requiring an integrated therapy. It may negatively influence the quality of life. In childhood, the main problems of the care of these patients involve sex determination and ensuring optimum growth and puberty. The therapeutic goals for adults are the prevention of Addisonian crisis and ensuring the best possible quality of life, including fertility.Key words: androgens - cardiovascular risk - congenital adrenal hyperplasia - bone density - testicular rest tumors.

  12. [Congenital galactosaemia: an unusual presentation].

    Science.gov (United States)

    Marcoux, M O; Laporte-Turpin, E; Alberge, C; Fournie-Gardini, E; Castex, M P; Rolland, M; Brivet, M; Broue, P

    2005-02-01

    Congenital galactosaemia reveals usually in the second and third weeks of life with a severe liver dysfunction. We report on a case of congenital galactosaemia with, on the one hand, an early onset liver failure, without any free interval, and on the other hand, an hemophagocytic syndrome as a severe secondary outbreak with pulmonary haemorrhage. Appropriate diet led to normalisation of liver function. Hemophagocytosis, probably linked to an associated Klebsiella Pneumoniae sepsis, had a favourable outcome after antibiotic and corticosteroid therapy.

  13. Congenital and perinatal cytomegalovirus infection

    Directory of Open Access Journals (Sweden)

    Chun Soo Kim

    2010-01-01

    Full Text Available Cytomegalovirus (CMV is currently the most common agent of congenital infection and the leading infectious cause of brain damage and hearing loss in children. Symptomatic congenital CMV infections usually result from maternal primary infection during early pregnancy. One half of symptomatic infants have cytomegalic inclusion disease (CID, which is characterized by involvement of multiple organs, in particular, the reticuloendothelial and central nervous system (CNS. Moreover, such involvement may or may not include ocular and auditory damage. Approximately 90% of infants with congenital infection are asymptomatic at birth. Preterm infants with perinatal CMV infection can have symptomatic diseases such as pneumonia, hepatitis, and thrombocytopenia. Microcephaly and abnormal neuroradiologic imaging are associated with a poor prognosis. Hearing loss may occur in both symptomatic and asymptomatic infants with congenital infection and may progress through childhood. Congenital infection is defined by the isolation of CMV from infants within the first 3 weeks of life. Ganciclovir therapy can be considered for infants with symptomatic congenital CMV infection involving the CNS. Pregnant women of seronegative state should be counseled on the importance of good hand washing and other control measures to prevent CMV infection. Heat treatment of infected breast milk at 72?#608;for 5 seconds can eliminate CMV completely.

  14. Congenital bronchoesophageal fistula in adults

    Institute of Scientific and Technical Information of China (English)

    Bao-Shi Zhang; Nai-Kang Zhou; Chang-Hai Yu

    2011-01-01

    AIM: To study the clinical characteristics, diagnosis and surgical treatment of congenital bronchoesophageal fistulae in adults. METHODS: Eleven adult cases of congenital bronchoesophageal fistula diagnosed and treated in our hospital between May 1990 and August 2010 were reviewed. Its clinical presentations, diagnostic methods, anatomic type, treatment, and follow-up were recorded. RESULTS: Of the chief clinical presentations, nonspecific cough and sputum were found in 10 (90.9%), recurrent bouts of cough after drinking liquid food in 6 (54.6%), hemoptysis in 6 (54.6%), low fever in 4 (36.4%), and chest pain in 3 (27.3%) of the 11 cases, respectively. The duration of symptoms before diagnosis ranged 5-36.5 years. The diagnosis of congenital bronchoesophageal fistulae was established in 9 patients by barium esophagography, in 1 patient by esophagoscopy and in 1 patient by bronchoscopy, respectively. The congenital bronchoesophageal fistulae communicated with a segmental bronchus, a main bronchus, and an intermediate bronchus in 8, 2 and 1 patients, respectively. The treatment of congenital bronchoesophageal fistulae involved excision of the fistula in 10 patients or division and suturing in 1 patient. The associated lung lesion was removed in all patients. No long-term sequelae were found during the postoperative follow-up except in 1 patient with bronchial fistula who accepted reoperation before recovery. CONCLUSION: Congenital bronchoesophageal fistula is rare in adults. Its most useful diagnostic method is esophagography. It must be treated surgically as soon as the diagnosis is established.

  15. Locally minimal topological groups

    OpenAIRE

    Außenhofer, Lydia; Chasco, María Jesús; Dikranjan, Dikran; Domínguez, Xabier

    2009-01-01

    A Hausdorff topological group $(G,\\tau)$ is called locally minimal if there exists a neighborhood $U$ of 0 in $\\tau$ such that $U$ fails to be a neighborhood of zero in any Hausdorff group topology on $G$ which is strictly coarser than $\\tau.$ Examples of locally minimal groups are all subgroups of Banach-Lie groups, all locally compact groups and all minimal groups. Motivated by the fact that locally compact NSS groups are Lie groups, we study the connection between local minimality and the ...

  16. Standardized technique for single-incision laparoscopicassisted stoma creation

    Institute of Scientific and Technical Information of China (English)

    Norikatsu Miyoshi; Shiki Fujino; Masayuki Ohue; Masayoshi Yasui; Shingo Noura; Yuma Wada; Ryuichiro Kimura; Keijiro Sugimura; Akira Tomokuni; Hirofumi Akita; Shogo Kobayashi; Hidenori Takahashi; Takeshi Omori; Yoshiyuki Fujiwara; Masahiko Yano

    2016-01-01

    To describe the procedure, efficacy, and utility of singleincision laparoscopic-assisted stoma creation(SILStoma) for transverse colostomy. Using single-incision laparoscopic surgery, we developed a standardized technique for SILStoma. Twelve consecutive patients underwent SILStoma for transverse colostomy at Osaka Medical Center for Cancer and Cardiovascular Diseases from April 2013 to March 2016. A single, intended stoma site was created with a 2.5-3.5 cm skin incision for primary access to the intra-abdominal space, and it functioned as the main port through which multi-trocars were placed. Clinical and operative factors and postoperative outcomes were evaluated. Patient demographics, including age, gender, body mass index, and surgical indications for intestinal diversion were evaluated. SILStoma was performed in nine cases without the requirement of additional ports. In the remaining three cases, 1-2 additional 5-mm ports were required for mobilization of the transverse colon and safe dissection of abdominal adhesions. No cases required conversion to open surgery. In all cases, SILStoma was completed at the initial stoma site marked preoperatively. No intraoperative or postoperative complications greater than Grade Ⅱ(the Clavien-Dindo classification) were reported in the complication survey. Surgical site infection at stoma sites was observed in four cases; however, surgical interventions were not required and all infectionswere cured completely. In all cases, the resumption of bowel movements was observed between postoperative days 1 and 2. SILStoma for transverse loop colostomy represents a feasible surgical procedure that allows the creation of a stoma at the preoperatively marked site without any additional large skin incisions.

  17. Relaxing incision for control of postoperative astigmatism following keratoplasty.

    Science.gov (United States)

    Troutman, R C; Swinger, C

    1980-02-01

    A new technique has been presented which provides a second surgical approach to correct excessive residual astigmatism following keratoplasty. The relaxing incision procedure has advantages over wedge resection in that it can be performed at the slit lamp, it gives no initial overcorrection, and it has a much shorter postoperative course while giving rapid results without suturing. Since this technique does not appear to produce significant hyperopia and may produce a tendency toward myopia, the corneal surgeon would thus have alternative techniques from which to choose, depending, in part, on the spherical component of the refraction.

  18. Conjunctival inclusion cysts following small incision cataract surgery

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    Narayanappa Shylaja

    2010-01-01

    Full Text Available The occurrence of acquired conjunctival inclusion cysts following various ophthalmic surgeries such as strabismus surgery, scleral buckling, pars plana vitrectomy, ptosis surgery and phacoemulsification has been reported. We report two cases of conjunctival inclusion cysts following manual Small Incision Cataract Surgery (SICS in two male patients aged 65 and 67 years. The cysts originated from the scleral tunnel used for manual SICS. Both were treated by excision and confirmed histopathologically. No recurrence was noted at three months follow-up. To our knowledge, conjunctival inclusion cysts following SICS have not been reported previously. Careful reflection of conjunctiva during tunnel construction and posterior chamber intraocular lens implantation may prevent their occurrence.

  19. A case of endophthalmitis associated with limbal relaxing incision

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    Aravind Haripriya

    2012-01-01

    Full Text Available Limbal relaxing incisions (LRIs are considered a relatively safe procedure with rapid stabilization and absence of infectious complications. Do we need to readdress this last impression? We report a case of nocardia endophthalmitis associated with an exudate at the site of an LRI in a patient who underwent routine cataract surgery. This case, to the best of our knowledge, is the first report of its kind, stressing the need for a cautious approach to the adoption of this method of astigmatic correction.

  20. Canyon incision, volcanic fill, and re-incision rates in southwest Peru: proxies for quantifying uplift in the Central Andes

    Science.gov (United States)

    Thouret, Jean-Claude; Gunnell, Yanni; de La Rupelle, Aude

    2010-05-01

    Using zircon and apatite fission tracks and apatite (U-Th)/He to constrain 26 rock cooling histories of Cretaceous diorites and 40Ar-39Ar to date 45 Neogene ignimbrites and lavas, we have estimated incision and topographic uplift rates of the Western Cordillera in southwest Peru. Rock cooling patterns confirm that continental denudation declined rapidly during the early Cenozoic. Topographic paleoelevations provided by 24.5 Ma forearc marine sediments now occurring at 1.8 km a.s.l. indicate that the Andean orogenic plateau did not begin to rise before Miocene time. A suite of marker horizons consisting of Huaylillas ignimbrite (14.3-12.7 Ma) on the plateau, and of Sencca ignimbrite (3.8 Ma) and Barroso lavas (2.27 Ma) near the Rio Cotahuasi and Rio Ocoña valley floors, respectively, have helped to bracket accelerated uplift between 13 Ma and 3.8-2.27 Ma. In-canyon (U-Th)/He bedrock cooling ages decrease upstream from ~13 Ma to 2-4 Ma, implying that uplift-driven valley incision began after 14 Ma and that downcutting was neither steady nor uniform along the 209 km-long canyon system. Whereas ~9 Ma Caraveli ignimbrites filled broad, shallow valleys, V-shaped downcutting occurred after 9-6 Ma. Argon-dated in-canyon lava flows and ignimbrites reveal three pulses of bedrock incision: 8.8-5.8 Ma, 5.8-3.6 Ma, 3.6-1.36 Ma, followed by post-1.36 Ma re-incision into unconsolidated valley fill. Accordingly, ample variations belie the 14 Myr-averaged incision rate of 170 m Myr-1: 130-190 m Myr-1 between 13 and 9 Ma, rising to 250-400 m/Myr-1 between 9 and 3.8 Ma and to >1000 m Myr-1 of reincision after 1.36 Ma. Rapid bedrock incision ended before 3.76 Ma in the upper, and before 2.27 Ma in the lower canyon reaches. The 3.76 to 1.36 Ma pyroclastic and mass-flow deposits filled the valley to ~75% and ~60% of its height in its upper and lower reaches, respectively. Post-1.36 Ma re-incision removed 75% of these deposits, thus exhuming most of the bedrock paleocanyon. The upper

  1. On minimal round functions

    NARCIS (Netherlands)

    Khimshiashvili, G.; Siersma, D.

    2001-01-01

    We describe the structure of minimal round functions on closed surfaces and three-folds. The minimal possible number of critical loops is determined and typical non-equisingular round function germs are interpreted in the spirit of isolated line singularities. We also discuss a version of Lusternik-

  2. Anterior ilioinguinal incision for drainage of high-located perianal abscess.

    Science.gov (United States)

    Peng, K-T; Hsieh, M-C; Hsu, W-H; Li, Y-Y; Yeh, C-H

    2013-08-01

    Most perianal abscesses originate from infected anal glands at the base of the anal crypts. Most abscesses below are usually drained through perianal incision and can be treated successfully. However, when perianal abscesses extend to the high intrapelvic cavity, it may be inadequate treatment through a single route incision through a perianal approach. The aim of this technical note is to show that combined anterior ilioinguinal and perianal incisions may provide optimal surgical field and multiple drainages. Here, we report a 56-year-old male patient with perianal-originating parapsoas abscesses. Residual abscess still remained after initial perianal incision and drainage after 1-month treatment. We presented combined anterior ilioinguinal and perianal incision technique methods for proper drainage in this complicated case. No recurrent or residual abscess remained after 2 weeks of operation. So, combined anterior ilioinguinal incision is feasible for high-located perianal abscess.

  3. Congenital Diaphragmatic Hernia

    Science.gov (United States)

    2012-01-01

    Congenital Diaphragmatic Hernia (CDH) is defined by the presence of an orifice in the diaphragm, more often left and posterolateral that permits the herniation of abdominal contents into the thorax. The lungs are hypoplastic and have abnormal vessels that cause respiratory insufficiency and persistent pulmonary hypertension with high mortality. About one third of cases have cardiovascular malformations and lesser proportions have skeletal, neural, genitourinary, gastrointestinal or other defects. CDH can be a component of Pallister-Killian, Fryns, Ghersoni-Baruch, WAGR, Denys-Drash, Brachman-De Lange, Donnai-Barrow or Wolf-Hirschhorn syndromes. Some chromosomal anomalies involve CDH as well. The incidence is < 5 in 10,000 live-births. The etiology is unknown although clinical, genetic and experimental evidence points to disturbances in the retinoid-signaling pathway during organogenesis. Antenatal diagnosis is often made and this allows prenatal management (open correction of the hernia in the past and reversible fetoscopic tracheal obstruction nowadays) that may be indicated in cases with severe lung hypoplasia and grim prognosis. Treatment after birth requires all the refinements of critical care including extracorporeal membrane oxygenation prior to surgical correction. The best hospital series report 80% survival but it remains around 50% in population-based studies. Chronic respiratory tract disease, neurodevelopmental problems, neurosensorial hearing loss and gastroesophageal reflux are common problems in survivors. Much more research on several aspects of this severe condition is warranted. PMID:22214468

  4. Congenital hypothyroidism in neonates

    Directory of Open Access Journals (Sweden)

    Aneela Anjum

    2014-01-01

    Full Text Available Context: Congenital hypothyroidism (CH is one of the most common preventable causes of mental retardation in children and it occurs in approximately 1:2,000-1:4,000 newborns. Aims and Objectives: The aim of this study is to determine the frequency of CH in neonates. Settings and Design: This cross-sectional study was conducted in neonatal units of the Department of Pediatrics Unit-I, King Edward Medical University/Mayo Hospital, Lahore and Lady Willington Hospital Lahore in 6 months (January-June 2011. Materials and Methods: Sample was collected by non-probability purposive sampling. After consent, 550 newborn were registered for the study. Demographic data and relevant history was recorded. After aseptic measures, 2-3 ml venous blood analyzed for thyroid-stimulating hormone (TSH level by immunoradiometric assay. Treatment was started according to the individual merit as per protocol. Statistical Analysis Used: Data was analyzed by SPSS 17 and Chi-square test was applied to find out the association of CH with different variables. Results: The study population consisted of 550 newborns. Among 550 newborns, 4 (0.8% newborns had elevated TSH level. CH had statistically significant association with mother′s hypothyroidism (P value 0.000 and mother′s drug intake during the pregnancy period (P value 0.013. Conclusion: CH is 0.8% in neonates. It has statistically significant association with mother′s hypothyroidism and mother′s drug intake during pregnancy.

  5. Congenital hyperthyroidism: autopsy report

    Directory of Open Access Journals (Sweden)

    Lima Marcus Aurelho de

    1999-01-01

    Full Text Available We report the autopsy of a stillborn fetus with congenital hyperthyroidism born to a mother with untreated Graves' disease, whose cause of death was congestive heart failure. The major findings concerned the skull, thyroid, heart, and placenta. The cranial sutures were closed, with overlapping skull bones. The thyroid was increased in volume and had intense blood congestion. Histological examination showed hyperactive follicles. The heart was enlarged and softened, with dilated cavities and hemorrhagic suffusions in the epicardium. The placenta had infarctions that involved at least 20% of its surface, and the vessels of the umbilical cord were fully exposed due to a decrease in Wharton 's jelly. Hyperthyroidism was confirmed by the maternal clinical data, the fetal findings of exophthalmia, craniosynostosis, and goiter with signs of follicular hyperactivity. Craniosynostosis is caused by the anabolic action of thyroid hormones in bone formation during the initial stages of development. The delayed initiation of treatment in the present case contributed to the severity of fetal hyperthyroidism and consequent fetal death.

  6. Congenital pulmonary lymphangiectasia

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    Campisi Corradino

    2006-10-01

    Full Text Available Abstract Congenital pulmonary lymphangiectasia (PL is a rare developmental disorder involving the lung, and characterized by pulmonary subpleural, interlobar, perivascular and peribronchial lymphatic dilatation. The prevalence is unknown. PL presents at birth with severe respiratory distress, tachypnea and cyanosis, with a very high mortality rate at or within a few hours of birth. Most reported cases are sporadic and the etiology is not completely understood. It has been suggested that PL lymphatic channels of the fetal lung do not undergo the normal regression process at 20 weeks of gestation. Secondary PL may be caused by a cardiac lesion. The diagnostic approach includes complete family and obstetric history, conventional radiologic studies, ultrasound and magnetic resonance studies, lymphoscintigraphy, lung functionality tests, lung biopsy, bronchoscopy, and pleural effusion examination. During the prenatal period, all causes leading to hydrops fetalis should be considered in the diagnosis of PL. Fetal ultrasound evaluation plays a key role in the antenatal diagnosis of PL. At birth, mechanical ventilation and pleural drainage are nearly always necessary to obtain a favorable outcome of respiratory distress. Home supplemental oxygen therapy and symptomatic treatment of recurrent cough and wheeze are often necessary during childhood, sometimes associated with prolonged pleural drainage. Recent advances in intensive neonatal care have changed the previously nearly fatal outcome of PL at birth. Patients affected by PL who survive infancy, present medical problems which are characteristic of chronic lung disease.

  7. Congenital Short QT Syndrome

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    Charles Antzelevitch

    2004-04-01

    Full Text Available Long QT intervals in the ECG have long been associated with sudden cardiac death. The congenital long QT syndrome was first described in individuals with structurally normal hearts in 1957.1 Little was known about the significance of a short QT interval. In 1993, after analyzing 6693 consecutive Holter recordings Algra et al concluded that an increased risk of sudden death was present not only in patients with long QT interval, but also in patients with short QT interval (<400 ms.2 Because this was a retrospective analysis, further evaluation of the data was not possible. It was not until 2000 that a short-QT syndrome (SQTS was proposed as a new inherited clinical syndrome by Gussak et al.3 The initial report was of two siblings and their mother all of whom displayed persistently short QT interval. The youngest was a 17 year old female presenting with several episodes of paroxysmal atrial fibrillation requiring electrical cardioversion.3 Her QT interval measured 280 msec at a heart rate of 69. Her 21 year old brother displayed a QT interval of 272 msec at a heart rate of 58, whereas the 51 year old mother showed a QT of 260 msec at a heart rate of 74. The authors also noted similar ECG findings in another unrelated 37 year old patient associated with sudden cardiac death.

  8. Congenital Progressive Mutilating Hemangioma

    Directory of Open Access Journals (Sweden)

    Anastasiya Chokoeva

    2017-06-01

    Full Text Available A 73-year-old male patient was admitted with symptoms of decompensated cardiac and pulmonary insufficiency with long-lasting history. A tumor-like formation was observed within the clinical examination, covering the whole skin of the nose, paranasal region of the left part of the face, as well as the upper and lower left eyelids. The lesion was with yellow to brownish surface and dark-reddish to violet discolored peripheral area, composed of nodular formations, smooth central surface and firm texture on palpation. The histopathological examination verified the diagnosis of hemangioma, which had been congenital, regarding the patient’s history, treated surgically about 50 years ago, with signs of recurrence. The presented patient had been treated surgically at the age of 20, without medical evidence of the type of the performed excision. The recurrence occurs almost 50 years later, at the age of 78. To the best of our knowledge, this is the first reported recurrence of infantile hemangioma, treated surgically almost 50 years ago.

  9. [Congenital cataract: general review].

    Science.gov (United States)

    Roche, O; Beby, F; Orssaud, C; Dupont Monod, S; Dufier, J L

    2006-04-01

    Cataract is a loss of lens transparency because of a protein alteration. Etiopathogenesis is poorly understood but new mutations of different developmental genes involved are found in 25% of cases. Frequency of onset, particularly when different ocular development anomalies occur, is related to the lens induction phenomena on the eye's anterior segment structure during embryologic development. Genetic transmission is often found on the dominant autosomal mode. Diagnosis is based on a complete and detailed examination of the eye, often with general anaesthesia. This condition predisposes children to later, sometimes serious amblyopia. Different clinical aspects can be observed: from cataract with ocular and/or systemic anomalies to polymalformative syndrome, skeletal, dermatological, neurological, metabolic, and genetic or chromosomal diseases. A general systematic pediatric examination is necessary. Congenital cataract requires first and foremost early diagnosis and a search for all etiologies. Surgical treatment is adapted case by case but it has progressed with the quality of today's intraocular lenses even if systematic implantation continues to be debated. Life-long monitoring is absolutely necessary.

  10. [Congenital aortic stenosis].

    Science.gov (United States)

    Yamaguchi, M

    2001-08-01

    Recent advances in and controversies concerning the management of children with congenital valvular aortic stenosis are discussed. In neonates with critical aortic stenosis, improved survival has recently been reported after surgical open valvotomy and balloon valvuloplasty, although it is difficult at this point to compare the results of the two procedures and determine their differential indications. Good results have also been achieved after extended aortic valvuloplasty for recurrent aortic stenosis and/or insufficiency, but the length of follow-up in these patients is still short. The technique first reported in 1991 for bilateral enlargement fo a small annulus permits the insertion of an aortic valve 3-4 sizes larger than the native annulus. It entails no risk of distorting the mitral valve, damaging the conduction system or important branches of the coronary arteries, or resulting in left ventricular dysfunction. The Ross procedure is now widely applied in the West, with reports of early mortality rates of less than 5% and event-free survival rates of 80-90% during follow-up of 4-8 years. Longer follow-up and continued careful evaluation are required to resolve the issue of possible dilatation and subsequent neoaortic valve dysfunction and pulmonary stenosis due to allograft degeneration after pulmonary autograft root replacement in children.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1997-02-01

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

  12. [Our experience with prostatic incision (TUIP) with local anesthesia].

    Science.gov (United States)

    Del Boca, C; Colloi, D; Guardamagna, A; Bolis, C; Giuberti, A C; Tzoumas, S; Ferrari, C

    1997-02-01

    The Authors present their experience in the treatment of prostatic obstruction with bladder neck incision (TUIP) performed under local anesthesia. An Hulbert 6 Fr endoscopic needle is used to infiltrate the prostatic area submitted to TUIP with 200 mg of Lidocaine 2%. The TUIP was done with a single deep incision at 7 hours using a 24 Fr Iglesias resector with Collins device. 28 patients with an age range from 69 to 85 years (mean 74) affected by IPB in an obstructed fase were submitted to this procedure. Various parameters were achieved for the selection of the patients: urodynamic diagnosis of low urinary tract obstruction, prostatic volume less than 50 ml without important prostatic median lobe, high anesthesiological risk, absence of correlated vesical complications. A clinical follow up was done at 1-6 and 12 months. The results obtained showed a good compliance of the patients treated with satisfactory urodynamic patterns. The Authors conclude that this less invasive approach, in selected cases, is the treatment of choice not only for low invasivity and morbidity rate but also for the reduced time of catheterization, hospitalization and costs.

  13. Pain-related mediators underlie incision-induced mechanical nociception in the dorsal root ganglia

    Institute of Scientific and Technical Information of China (English)

    Xiuhong Yuan; Xiangyan Liu; Qiuping Tang; Yunlong Deng

    2013-01-01

    Approximately 50-70% of patients experience incision-induced mechanical nociception after sur-gery. However, the mechanism underlying incision-induced mechanical nociception is stil unclear. Interleukin-10 and brain-derived neurotrophic factor are important pain mediators, but whether in-terleukin-10 and brain-derived neurotrophic factor are involved in incision-induced mechanical no-ciception remains uncertain. In this study, forty rats were divided randomly into the incision surgery (n=32) and sham surgery (n=8) groups. Plantar incision on the central part of left hind paw was performed under anesthesia in rats from the surgery group. Rats in the sham surgery group re-ceived anesthesia, but not an incision. Von Frey test results showed that, compared with the sham surgery group, incision surgery decreased the withdrawal threshold of rats at 0.5, 3, 6 and 24 hours after incision. Immunofluorescence staining in the dorsal root ganglia of the spinal cord (L 3-5 ) showed that interleukin-10 and brain-derived neurotrophic factor were expressed mainly on smal-and medium-sized neurons (diameter40μm) at 6 and 24 hours after incision surgery, which corresponded to the decreased mechanical withdrawal threshold of rats in the surgery group. These experimental findings suggest that expression pattern shift of interleukin-10 and brain-derived neurotrophic factor induced by inci-sion surgery in dorsal root ganglia of rats was closely involved in lowering the threshold to me-chanical stimulus in the hind paw fol owing incision surgery. Pain-related mediators induced by in-cision surgery in dorsal root ganglia of rats possibly underlie mechanical nociception in ipsilateral hind paws.

  14. Correlation between Corneal Endothelial Cell Loss and Location of Phacoemulsification Incision

    Directory of Open Access Journals (Sweden)

    Hamid Gharaee

    2011-01-01

    Full Text Available Purpose: To assess the relationship between corneal endothelial cell loss after phacoemulsification and the location of the clear corneal incision. Methods: A total of 92 patients (92 eyes with senile cataracts who met the study criteria were included in this cross sectional study and underwent phacoemulsification. The incision site was determined based on the steep corneal meridian according to preoperative keratometry. Endothelial cell density was measured using specular microscopy in the center and 3 mm from the center of the cornea in the meridian of the incisions (temporal, superior, and superotemporal. Phacoemulsification was performed by a single surgeon using the phaco chop technique through a 3.2 mm clear cornea incision. Endothelial cell loss (ECL was evaluated 1 week, and 1 and 3 months postoperatively. Results: At all time points during follow-up, ECL was comparable among the 3 incision sites, both in the central cornea and in the meridian of the incision (P > 0.05 for all comparisons. However, 3 months postoperatively, mean central ECL with superior incisions and mean sectoral ECL with temporal incisions were slightly higher. Superotemporal incisions entailed slightly less ECL than the other 2 groups. Overall, one month after surgery, mean central ECL was 10.8% and mean ECL in the sector of the incisions was 14.0%. Axial length and effective phaco time (EFT were independent predictors of postoperative central ECL (P values 0.005 and < 0.0001, respectively. Conclusion: A superotemporal phacoemulsification incision may entail less ECL as compared to other incisions (although not significantly different. The amount of central ECL may be less marked in patients with longer axial lengths and with procedures utilizing less EFT.

  15. A case of successfully managed pregnancy in a patient with complex cyanotic congenital heart disease.

    Science.gov (United States)

    Liu, J Y; Tan, W K; Tan, E L; Tan, J L; Tan, L K

    2017-06-01

    Medical advances have increased survival of patients with congenital heart disease. However, cardiac disease in pregnancy carries significant maternal and fetal risks, posing enormous challenges to obstetricians. Cyanotic congenital heart disease is associated with maternal complications such as arrhythmias, thromboembolic events and death. Fetal complications include small for gestational age, miscarriage and prematurity. Cyanotic congenital heart disease patients who continue their pregnancies require holistic multidisciplinary team care with early and coordinated planning for delivery. Management of such patients include early counseling regarding pregnancy-associated risks, close monitoring of their cardiac function and regular scanning for fetal assessment. Choice of anesthesia for these patients requires meticulous planning to achieve a favorable balance between systemic and pulmonary vascular resistance, ensuring minimal change in right-to-left shunting. We report a case of a successfully managed pregnancy in a patient with complex congenital heart disease and a single ventricle of left ventricle morphology.

  16. Shaeer’s Technique: A Minimally Invasive Procedure for Monsplasty and Revealing the Concealed Penis

    Science.gov (United States)

    2016-01-01

    Background: A concealed penis is a condition where part of the penis is invisible below the surface of the prepubic skin. Dermolipectomy can correct this condition, although it involves a long abdominal crease incision, or infrapubic incision around the base of the penis, and a possibility for genital lymphedema. This study describes Shaeer’s technique, a minimally invasive method for revealing the concealed penis. Methods: A 1- to 2-cm-long incision was cut over the anterior superior iliac spine (ASIS) on either side. A long curved blunt forceps was inserted from one incision, down to the base of the penis and then up to the contralateral ASIS. A 5-mm wide nonabsorbable tape was picked up by the forceps from 1 incision and pulled through to emerge from the other. Pulling on the tape cephalad pulled the mons pubis and revealed the penis. The tape was sutured to the periosteum overlying the ASIS on either side. Patients were followed up for 18 months for penile length, complications, and overall satisfaction. Results: Twenty patients were operated upon. Preoperatively, flaccid visible length was 3 ± 0.9 cm, and erect visible length was 8 ± 4.6 cm. Postoperatively, the flaccid visible length was 7.1 ± 2.1 cm, with a 57.9% improvement in length (P penis. PMID:27622092

  17. Rapid incision of the Colorado River in Glen Canyon - insights from channel profiles, local incision rates, and modeling of lithologic controls

    Science.gov (United States)

    Cook, K.L.; Whipple, K.X.; Heimsath, A.M.; Hanks, T.C.

    2009-01-01

    The Colorado River system in southern Utah and northern Arizona is continuing to adjust to the baselevel fall responsible for the carving of the Grand Canyon. Estimates of bedrock incision rates in this area vary widely, hinting at the transient state of the Colorado and its tributaries. In conjunction with these data, we use longitudinal profiles of the Colorado and tributaries between Marble Canyon and Cataract Canyon to investigate the incision history of the Colorado in this region. We find that almost all of the tributaries in this region steepen as they enter the Colorado River. The consistent presence of oversteepened reaches with similar elevation drops in the lower section of these channels, and their coincidence within a corridor of high local relief along the Colorado, suggest that the tributaries are steepening in response to an episode of increased incision rate on the mainstem. This analysis makes testable predictions about spatial variations in incision rates; these predictions are consistent with existing rate estimates and can be used to guide further studies. We also present cosmogenic nuclide data from the Henry Mountains of southern Utah. We measured in situ 10Be concentrations on four gravel-covered strath surfaces elevated from 1 m to 110 m above Trachyte Creek. The surfaces yield exposure ages that range from approximately 2??5 ka to 267 ka and suggest incision rates that vary between 350 and 600 m/my. These incision rates are similar to other rates determined within the high-relief corridor. Available data thus support the interpretation that tributaries of the Colorado River upstream of the Grand Canyon are responding to a recent pulse of rapid incision on the Colorado. Numerical modeling of detachment-limited bedrock incision suggests that this incision pulse is likely related to the upstream-dipping lithologic boundary at the northern edge of the Kaibab upwarp. ?? 2009 John Wiley & Sons, Ltd.

  18. In vivo and in vitro analysis of topographic changes secondary to DSAEK venting incisions.

    Science.gov (United States)

    Moshirfar, Majid; Lependu, Monette T; Church, Dane; Neuffer, Marcus C

    2011-01-01

    Descemet's stripping automated endothelial keratoplasty (DSAEK) venting incisions may induce irregular corneal astigmatism. The study examines in vivo and in vitro astigmatic effects of venting incisions. In vivo analysis examined eleven eyes of eleven patients who had received DSAEK with venting incisions. A chart review of the eleven eyes including assessment of pre and postoperative refraction and topography was performed. In vitro analysis examined three cadaver eyes which received topographic imaging followed by venting incisions at 4 mm, 6 mm, and 7 mm optical zones. Topographic imaging was then performed again after the incisions. Postoperative topographies of eleven eyes demonstrated localized flattening at incision sites and cloverleaf pattern astigmatism. There was a significant difference in corneal irregularity measurement (P = 0.03), but no significant difference in shape factor or change of topographic cylinder. The cloverleaf pattern was found in cadaver eyes with incisions placed at 4 mm and 6 mm optical zones but not at the 7 mm zone. DSAEK venting incisions can cause irregular corneal astigmatism that may affect visual outcomes. The authors recommend placement of venting incisions near the 7 mm optical zone.

  19. Thoracoscopic reoperation for recurrent pneumothorax after single-incision thoracoscopic surgery.

    Science.gov (United States)

    Sano, Atsushi; Kawashima, Mitsuaki

    2015-11-01

    An 18-year-old male patient who had undergone single-incision thoracoscopic surgery for left spontaneous pneumothorax was diagnosed with bilateral recurrent pneumothorax. We performed thoracoscopic reoperation and observed adhesions between the previous incision and the left lung. A bulla that was thought to be the cause of the recurrent left pneumothorax was found on the mediastinal side of previously ligated lesions. Longer incisions during single-incision thoracoscopic surgery may be more likely to cause adhesions. Despite the restricted view during surgery, care must be taken to identify all bullae. Use of reinforcement techniques is also important to prevent recurrence.

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

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  1. THE UNILATERAL BIG HOCKEY STICK INCISION FOR NECK DISSECTION IN THYROID CARCINOMA

    Institute of Scientific and Technical Information of China (English)

    刘宝国; 刘伟; 顾晋

    2001-01-01

    To investigate the feasibility and advantages of the unilateral big hockey stick incision in thyroid carcinoma. Method: Neck dissection using the unilateral big hockey stick incision was performed on 23 patients with thyroid carcinoma. Results: The big hockey stick incision results in a cosmetic scar which is barely visible and easily covered by hair or clothing, while it provides sufficient exposure of the operation field. A small area of marginal necrosis is occasionally seen at the apex of the skin flap due to preoperative radiotherapy. Conclusion: The unilateral big hockey stick incision has adequate surgical access, good healing of skin flaps, and a good cosmetic result.

  2. Safety of cesarean delivery through placental incision in patients with anterior placenta previa.

    Science.gov (United States)

    Hong, Deok-Ho; Kim, Eugene; Kyeong, Kyu-Sang; Hong, Seung Hwa; Jeong, Eun-Hwan

    2016-03-01

    To demonstrate the safety of fetal delivery through placental incision in a placenta previa pregnancy. We examined the medical records of 80 women with singleton pregnancy diagnosed with placenta previa who underwent cesarean section between May 2010 and May 2015 at the Department of Obstetrics and Gynecology, Chungbuk National University Hospital. Among the women with placenta previa, those who did not have the placenta in the uterine incision site gave birth via conventional uterine incision, while those with anterior placenta previa or had placenta attached to the uterine incision site gave birth via uterine incision plus placental incision. We compared the postoperative hemoglobin level and duration of hospital stay for the mother and newborn of the two groups. There was no difference between the placental incision group and non-incision group in terms of preoperative and postoperative hemoglobin change, the amount of blood transfusions required by the mother, newborns with 1-min or 5-min Apgar scores below 7 points or showing signs of acidosis on umbilical cord blood gas analysis result of pH below 7.20. Moreover, neonatal hemoglobin levels did not differ between the two groups. Fetal delivery through placental incision during cesarean section for placenta previa pregnancy does not negatively influence the prognosis of the mother or the newborn, and therefore, is considered a safe surgical technique.

  3. Brain derived neurotrophic factor (BDNF contributes to the pain hypersensitivity following surgical incision in the rats

    Directory of Open Access Journals (Sweden)

    Zhang Jian-Yi

    2008-07-01

    Full Text Available Abstract Background The pathogenic role of brain derived neurotrophic factor (BDNF in the incisional pain is poorly understood. The present study explores the role of the BDNF in the incision-induced pain hypersensitivity. Methods A longitudinal incision was made in one plantar hind paw of isoflurane-anesthetized rats. Dorsal root ganglias (DRG and spinal cords were removed at various postoperative times (1–72 h. Expression pattern of BDNF was determined by immunohistochemistry and double-labeling immunofluorescence. Lidocaine-induced blockade of sciatic nerve function was used to determine the importance of afferent nerve activity on BDNF expression in the DRG and spinal cord after incision. BDNF antibody was administered intrathecally (IT or intraperitoneal (IP to modulate the spinal BDNF or peripheral BDNF after incision. Results After hind-paw incision, the BDNF was upregulated in the ipsilateral lumbar DRG and spinal cord whereas thoracic BDNF remained unchanged in response to incision. The upregulated BDNF was mainly expressed in the large-sized neurons in DRG and the neurons and the primary nerve terminals in the spinal cord. Sciatic nerve blockade prevented the increase of BDNF in the DRG and spinal cord. IT injection of BDNF antibody greatly inhibited the mechanical allodynia induced by incision whereas IP administration had only marginal effect. Conclusion The present study showed that incision induced the segmental upregulation of BDNF in the DRG and spinal cord through somatic afferent nerve transmission, and the upregulated BDNF contributed to the pain hypersensitivity induced by surgical incision.

  4. Minimal invasive surgery in pediatric solid tumors.

    Science.gov (United States)

    Chan, Kin Wai; Lee, K H; Tam, Y H; Yeung, C K

    2007-12-01

    There is only limited experience of using the minimally invasive surgery (MIS) technique in resecting pediatric solid tumors. In this paper, we report our experience of using the MIS technique in the management of pediatric solid tumors. A retrospective review was undertaken on all children who had undergone MIS for their solid tumors between 1995 and 2005. Over a 10-year period, there were 38 patients who had undergone MIS for tumor resection. The mean age at the time of surgery was 7.5 years (range, 1 day to 15 years). There were 22 ovarian tumors, 4 sacrococcygeal tumors, 3 adrenal tumors, 3 retroperitoneal tumors, 1 kidney tumor, 1 liver mass, 1 intra-abdominal testicular tumor, and 3 intrathoracic masses. Thirty of 38 patients had undergone a successful resection using the MIS technique (78.9%). Eight patients required a conversion to the open procedure because of limited intraperitoneal space in 7 and excessive bleeding in 1. Of the 28 successfully MIS-resected intra-abdominal tumors, 18 required enlargement of the umbilical incision and 5 required an additional Pfannenstiel incision for tumor retrieval. Enlargement of the thoracic port site for specimen retrieval was required in the 2 successfully MIS-resected intrathoracic masses. The mean operation time was 171 minutes (range, 45-275). There was no postoperative complication encountered. On an average follow-up of 3.1 years, there was no recurrence observed, even in the 7 patients with malignant tumors, and all patients with successful MIS tumor excision had good cosmetic results. With the advance of laparoscopic instruments and techniques, a variety of pediatric solid tumors can be resected safely by the MIS technique. This has the potential benefit of a more rapid postoperative recovery and better cosmetic results. The role of the MIS technique in resecting malignant tumors is uncertain, as the number of cases in the current series is too small to draw any conclusion.

  5. Minimally invasive thyroidectomy (MIT): indications and results.

    Science.gov (United States)

    Docimo, Giovanni; Salvatore Tolone, Salvatore; Gili, Simona; d'Alessandro, A; Casalino, G; Brusciano, L; Ruggiero, Roberto; Docimo, Ludovico

    2013-01-01

    To establish if the indication for different approaches for thyroidectomy and the incision length provided by means of pre-operative assessment of gland volume and size of nodules resulted in safe and effective outcomes and in any notable aesthetic or quality-of-life impact on patients. Ninehundred eightytwo consecutive patients, undergoing total thyroidectomy, were enrolled. The thyroid volume and maximal nodule diameter were measured by means of ultrasounds. Based on ultrasounds findings, patients were divided into three groups: minimally invasive video assisted thyroidectomy (MIVAT), minimally invasive thyroidectomy (MIT) and conventional thyroidectomy (CT) groups. The data concerning the following parameters were collected: operative time, postoperative complications, postoperative pain and cosmetic results. The MIVAT group included 179 patients, MIT group included 592 patients and CT group included 211 patients. Incidence of complications did not differ significantly in each group. In MIVAT and MIT group, the perception of postoperative pain was less intense than CT group. The patients in the MIVAT (7±1.5) and MIT (8±2) groups were more satisfied with the cosmetic results than those in CT group (5±1.3) (p= MIT is a technique totally reproducible, and easily convertible to perform surgical procedures in respect of the patient, without additional complications, increased costs, and with better aesthetic results.

  6. Minimally invasive approach of panfacial fractures

    Directory of Open Access Journals (Sweden)

    Yudi Wijaya

    2017-08-01

    Full Text Available Background. Panfacial fractures involves fractures of several bones of face. They are associated with malocclusion, dish face deformity, enopthalmos, diplopia, cerebrospinal fluid leak and soft tissue injuries. Purpose. The purpose of this paper is to present a case of minimizing surgical wound and morbidity. Case. A 40 year old female presented with severe maxillofacial injuries caused by motor vehicle collisions about 5 days prior to admission. The assessment of the patient is mild head injury, panfacial fractures, lacerated wound at face,  rupture of globe of occular sinistra. An open reduction and internal fixation  (ORIF and enucleation of globe occular sinistra was performed.  Intraoral vestibular incision is made in the upper and lower vestibular region. Mucoperiosteal flap elevation of vestibular will exposure of the anterior maxilla and mandibular fractures. Intermaksilary fixation within 3 week and restore aesthetic with prosthesis fitting eyeball and denture. Discusion. The goal of  treatment of  panfacial fracture is to restore both the functions and pre-injury 3-dimensional facial contours. To achieve this goal two common  sequences of management of Panfacial fractures are proposed, “Bottom up and inside out” or “Top down and outside in”. Other sequences exist but there are variations of these two major approaches. Conclusion. A minimally invasive approach to  the fracture site is an alternative method  to manage panfacial fracture with a simple, effective and lower complication rate.

  7. Epicanthoplasty with modified transverse incision%改良横切口法内眦赘皮矫正术

    Institute of Scientific and Technical Information of China (English)

    李猛; 计宝辉; 王杭; 袁继龙; 谢洋春

    2011-01-01

    Objective To introduce effective and easy operating method for epicanthoplasty which is beneficial to decreasing the postoperative scar hyperplasia. Methods Epicanthoplasty was performed with a modified transverse incision and the skin flap was fixed to the new medial epicanthus. The excess area of skin flap was trimmed and the subciliary incision was closed. Totally 30 patients were treated by the operation mentioned above from June 2004 to June 2007. Results After 6 to 36 months follow-up, the palpebral fissure became longer with shorter inner canthal distance. Satisfactory results were received in all patients with nice , natural eyes shape and slight scar, postoperatively. Conclusion It is an effective and easy method to correct epicanthus minimal invasively by modified transverse incision with slight scar and optimal effect.%目的 探讨一种简单有效且能减轻切口瘢痕增生的内眦赘皮矫正方法.方法 采用改良横切口,将皮瓣悬吊于新内眦点,切除上、下方多余皮肤后缝合.自2004年6月至2007年6月,采用此改良横切口法实施内眦赘皮矫正术30例.结果 本组求美者共30例,术后随访其中28例6~36个月,睑裂变长,内眦间距缩短、眼形自然美观,切口瘢痕不明显,效果满意.结论 改良横切口法内眦赘皮矫正术操作简单,创伤小,切口瘢痕轻微,是一种可以有效矫正内眦赘皮的良好方法.

  8. Congenital Scoliosis (Mini-review).

    Science.gov (United States)

    Weiss, Hans-Rudolf; Moramarco, Marc

    2016-01-01

    Congenital scoliosis is a lateral deformity of the spine with a disturbance of the sagittal profile caused by malformations of vertebra and ribs. Typically, early surgical intervention is the suggested treatment (before three-years-old) for young patients with congenital scoliosis. While a previous study was conducted in 2011 to investigate long-term studies supporting the necessity for this recommendation and no evidence was found, this current review, is an updated search for evidence published from 2011 through March 2015. This also failed to find any prospective or randomized controlled studies to support the hypothesis that spinal fusion surgery in patients with congenital scoliosis should be considered as evidence-based treatment. Contradictory results exist on the safety of hemivertebra resection and segmental fusion using pedicle screw fixation. When using the VEPTR (vertical expandable prosthetic titanium rib) device, studies show a high rate of complications exist. It is difficult to predict the final outcome for patients with congenital scoliosis. However, it is possible that many patients with congenital scoliosis may be able to avoid spinal surgery with the application of advanced bracing technology. Therefore, it is only prudent to advocate for conservative management first before spinal surgery is considered.

  9. Comparison of administration of single dose ceftriaxone for elective caesarean section before skin incision and after cord clamping in preventing post-operative infectious morbidity.

    Science.gov (United States)

    Kalaranjini, S; Veena, P; Rani, Reddi

    2013-12-01

    To compare the efficacy of ceftriaxone before skin incision and after cord clamping in preventing post-operative infectious morbidity and neonatal outcome in elective caesarean section and to determine the effect of antibiotic prophylaxis before skin incision on neonatal outcome. Our study was a randomised controlled trial conducted among 874 women undergoing elective caesarean section from October 2010 to July 2012. These women were randomly categorised into two groups with 437 women in each group. Group 1 received single dose of ceftriaxone 1 g intravenously 15-45 min before skin incision. Group 2 received the antibiotic after cord clamping. Primary outcome measures were maternal post-operative infectious morbidities like surgical site wound infection, febrile morbidity, endometritis, urinary tract infections and neonatal sepsis. Results were analysed using Chi-square test and unpaired t test. Surgical site wound infection occurred in 3 women in group 1 (0.7%) and 6 women in group 2 (1.4%). Fever occurred in 9 women in group 1 (2.1%) and 5 in group 2 (1.1%) with the p value of 0.419, not statistically significant. Urinary tract infection occurred in 9 women in group 1 (2.1%) and 7 women in group 2 (1.6%) with the p value of 0.801. None of the women in either group developed endometritis. About 20 neonates [10 neonates (2.3%) in group 1 and 10 neonates (2.3%) in group 2] required NICU admission after caesarean delivery. The reasons for admission were respiratory distress, prematurity and congenital anomaly. About 0.9% of neonates in group 1 and 1.8% in group 2 developed neonatal sepsis with positive blood culture (p = 0.388). Timing of administration of prophylactic antibiotics for elective caesarean section either before skin incision or after cord clamping did not have significant difference in the occurrence of post-operative infectious morbidity. No adverse neonatal outcome was observed in women who received the antibiotic before skin incision.

  10. Genetics Home Reference: congenital dyserythropoietic anemia

    Science.gov (United States)

    ... Facebook Twitter Home Health Conditions CDA congenital dyserythropoietic anemia Printable PDF Open All Close All Enable Javascript ... view the expand/collapse boxes. Description Congenital dyserythropoietic anemia ( CDA ) is an inherited blood disorder that affects ...

  11. Genetics Home Reference: congenital leptin deficiency

    Science.gov (United States)

    ... Obesity? National Institute of Diabetes and Digestive and Kidney Diseases: Active at Any Size! Educational Resources (6 links) Centers for Disease Control and Prevention: Obesity and Genetics MalaCards: congenital leptin deficiency Orphanet: Obesity due to congenital leptin deficiency ...

  12. Five Facts about Congenital Heart Defects

    Science.gov (United States)

    ... Button Past Emails CDC Features Five Facts about Congenital Heart Defects Language: English Español (Spanish) Recommend on Facebook Tweet Share Compartir Congenital heart defects are the most common types of birth defects. ...

  13. Genetic Counseling for Congenital Heart Defects

    Science.gov (United States)

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More Genetic Counseling for Congenital Heart Defects Updated:Oct 26,2015 ... with congenital heart disease considers having children. Genetic counseling can help answer these questions and address your ...

  14. Minimally Invasive Cardiac Surgery Using a 3D High-Definition Endoscopic System.

    Science.gov (United States)

    Ruttkay, Tamas; Götte, Julia; Walle, Ulrike; Doll, Nicolas

    2015-01-01

    We describe a minimally invasive heart surgery application of the EinsteinVision 2.0 3D high-definition endoscopic system (Aesculap AG, Tuttlingen, Germany) in an 81-year-old man with severe tricuspid valve insufficiency. Fourteen years ago, he underwent a Ross procedure followed by a DDD pacemaker implantation 4 years later for tachy-brady-syndrome. His biventricular function was normal. We recommended minimally invasive tricuspid valve repair. The application of the aformentioned endoscopic system was simple, and the impressive 3D depth view offered an easy and precise manipulation through a minimal thoracotomy incision, avoiding the need for a rib spreading retractor.

  15. Congenital anophthalmia: A review of dealing with volume

    Directory of Open Access Journals (Sweden)

    Bernardino Robert

    2010-01-01

    Full Text Available Background : Anophthalmia in childhood whether congenital or acquired is not just a question of cosmesis. Loss of an eye can effect the maturation of the soft tissues and bony structure surrounding the affected orbit. Therefore, a comprehensive approach including medical and surgical interventions is required to rehabilitate a child early in life. Materials and Methods : A literature survey of the past 40 years on the topic of congenital anophthalmia with focus on medical and surgical volume augmentation of the orbit was conducted. Results : Newer technologies including hydrogel implants and saline-filled tissue expanders have allowed for more rapid expansion of the pediatric orbit often with minimally invasive surgical procedures. However, traditional approaches including conformer therapy are still the primary intervention in these complicated cases. Conclusion : Anophthalmia in childhood requires a close interaction between ophthalmologist and ocularist as well as a motivated patient and family. With early intervention a good cosmetic outcome with periocular symmetry is obtainable.

  16. Minimal change disease

    Science.gov (United States)

    ... get worse You develop new symptoms, including side effects from the medicines used to treat the disorder Alternative Names Minimal change nephrotic syndrome; Nil disease; Lipoid nephrosis; Idiopathic nephrotic syndrome of childhood Images ...

  17. Minimal Orderings Revisited

    Energy Technology Data Exchange (ETDEWEB)

    Peyton, B.W.

    1999-07-01

    When minimum orderings proved too difficult to deal with, Rose, Tarjan, and Leuker instead studied minimal orderings and how to compute them (Algorithmic aspects of vertex elimination on graphs, SIAM J. Comput., 5:266-283, 1976). This paper introduces an algorithm that is capable of computing much better minimal orderings much more efficiently than the algorithm in Rose et al. The new insight is a way to use certain structures and concepts from modern sparse Cholesky solvers to re-express one of the basic results in Rose et al. The new algorithm begins with any initial ordering and then refines it until a minimal ordering is obtained. it is simple to obtain high-quality low-cost minimal orderings by using fill-reducing heuristic orderings as initial orderings for the algorithm. We examine several such initial orderings in some detail.

  18. Minimal Markov Models

    CERN Document Server

    Gonzalez-Lopez, Jesus E Garcia Veronica A

    2010-01-01

    In this work we introduce a new and richer class of finite order Markov chain models and address the following model selection problem: find the Markov model with the minimal set of parameters (minimal Markov model) which is necessary to represent a source as a Markov chain of finite order. Let us call $M$ the order of the chain and $A$ the finite alphabet, to determine the minimal Markov model, we define an equivalence relation on the state space $A^{M}$, such that all the sequences of size $M$ with the same transition probabilities are put in the same category. In this way we have one set of $(|A|-1)$ transition probabilities for each category, obtaining a model with a minimal number of parameters. We show that the model can be selected consistently using the Bayesian information criterion.

  19. Ruled Laguerre minimal surfaces

    KAUST Repository

    Skopenkov, Mikhail

    2011-10-30

    A Laguerre minimal surface is an immersed surface in ℝ 3 being an extremal of the functional ∫ (H 2/K-1)dA. In the present paper, we prove that the only ruled Laguerre minimal surfaces are up to isometry the surfaces ℝ (φλ) = (Aφ, Bφ, Cφ + D cos 2φ) + λ(sin φ, cos φ, 0), where A,B,C,D ε ℝ are fixed. To achieve invariance under Laguerre transformations, we also derive all Laguerre minimal surfaces that are enveloped by a family of cones. The methodology is based on the isotropic model of Laguerre geometry. In this model a Laguerre minimal surface enveloped by a family of cones corresponds to a graph of a biharmonic function carrying a family of isotropic circles. We classify such functions by showing that the top view of the family of circles is a pencil. © 2011 Springer-Verlag.

  20. Cerebral palsy and congenital malformations

    DEFF Research Database (Denmark)

    Garne, Ester; Dolk, Helen; Krägeloh-Mann, Inge

    2007-01-01

    AIM: To determine the proportion of children with cerebral palsy (CP) who have cerebral and non-cerebral congenital malformations. METHODS: Data from 11 CP registries contributing to the European Cerebral Palsy Database (SCPE), for children born in the period 1976-1996. The malformations were...... classified as recognized syndromes, chromosomal anomalies, cerebral malformations or non-cerebral malformations. Prevalence of malformations was compared to published data on livebirths from a European database of congenital malformations (EUROCAT). RESULTS: Overall 547 out of 4584 children (11.9%) with CP...... were reported to have a congenital malformation. The majority (8.6% of all children) were diagnosed with a cerebral malformation. The most frequent types of cerebral malformations were microcephaly and hydrocephaly. Non-cerebral malformations were present in 97 CP children and in further 14 CP children...

  1. A Novel Technique for Transvaginal Retrieval of Enlarged Pelvic Viscera during Minimally Invasive Surgery

    Directory of Open Access Journals (Sweden)

    Allison Wyman

    2012-01-01

    Full Text Available Introduction. With the widespread adoption of laparoscopic and robotic surgery, more and more women are undergoing minimally invasive surgery for complex gynecological procedures. The rate-limiting step is often the delivery of an intact uterus or an unruptured adnexal mass. To avoid conversion to a minilaparotomy for specimen retrieval, we describe a novel technique using an Anchor Tissue Retrieval System bag in conjunction with a pneumo-occluder to easily retrieve large specimens through a colpotomy incision. Surgical Technique. After completion of the robotic-assisted hysterectomy, the uterus, fallopian tubes, and ovaries were too large to be retrieved intact despite multiple attempts of delivery through the colpotomy incision. Prior to resorting to a minilaparotomy or morcellation of the specimen, a 15 mm anchor retrieval bag with a pneumo-occluder was placed through the vagina and the intact specimen was easily placed inside the bag under direct visualization and removed through the colpotomy incision intact. Conclusion. We routinely utilize this technique to retrieve hysterectomy specimens that are not readily delivered through the colpotomy incision and find this technique to be safe, highly efficient, and cost effective when there is a need to remove large intact specimens during minimally invasive surgery.

  2. Paternal transmission of congenital myotonic dystrophy.

    OpenAIRE

    Bergoffen, J; Kant, J.; Sladky, J; McDonald-McGinn, D; Zackai, E H; Fischbeck, K H

    1994-01-01

    The congenital form of myotonic dystrophy is reported to be almost exclusively, if not exclusively, maternally transmitted. We present a case of congenital myotonic dystrophy which was inherited from a mildly affected father. This family illustrates that the congenital form of myotonic dystrophy can occur without intrauterine or other maternal factors related to the disease. The possibility of paternal transmission of the congenital form of myotonic dystrophy could be considered when counsell...

  3. Comparison of the incisions for the open surgical treatment of gluteal muscle contracture.

    Science.gov (United States)

    Xu, Jian; Geng, Xiang; Muhammad, Hassan; Wang, Xu; Huang, Jia-Zhang; Zhang, Chao; Ma, Xin

    2014-09-01

    Gluteal muscle contracture is not very common, but cases are still seen in China. Open surgical treatment is considered as an efficient method to treat this disease. However, the type of incision that can provide best results is yet to be determined. The authors therefore compared various incisions to determine the better one. In this retrospective study, patients who underwent surgery with a traverse straight incision, a curved incision, a longitudinal straight incision, or an 'S'-shaped incision above the greater trochanter were enrolled and divided into four groups: A, B, C, and D. In each group, the patients were divided into different levels according to a specific standard. The four groups were compared in terms of incision length, postoperative drainage amounts, wound healing rates, visual analog scale scores, and improvement in the degree of range of motion (ROM). During the follow-up period, the validity of the results, complications, and recurrent cases were evaluated. In our study, incision length and visual analog scale score of the four groups showed no significant differences (P>0.05). Wound healing rates, drainage amount, improvement in ROM, validity of the results, and recurrences in group D were significantly the best (P<0.05). No significant differences in wound healing rates, drainage amount, and improvement in ROM were found in groups A, B, and C. In terms of validity of the results and 1-year recurrence, no significant difference was observed between groups A and B; however, these factors were better than those in group C. We concluded that the 'S'-shaped incision above the greater trochanter is the most efficient among the incisions described in this study. This incision has the following advantages: clear exposure, less damage, high safety rate, excellent results, and low recurrence rate.

  4. Our First Experience With Negative Pressure Incision Management System Implemented on the Clean Surgical Incision in the Renal Transplantation Recipient: A Case Report.

    Science.gov (United States)

    Bozkurt, B; Tokac, M; Dumlu, E G; Yalcin, A; Kilic, M

    2015-06-01

    Multiple comorbidities and environmental factors increase the complications of incisional wounds in patients. It was demonstrated in previous prospective and randomized studies that negative pressure wound therapy (NPWT) reduced wound infection and other complications in clean, closed surgical incisions. In this case report, the Prevena incision management system was implemented on the clean, closed surgical incision of a 52-year-old female patient, who was given a renal transplantation from cadaver postoperatively in the operating theater. It was removed from the patient on the fifth day after the operation. Following the removal of Prevena, the wound and surrounding skin of the patient were observed. Wound healing was complete, and no skin lesion or tool-related complication was found around the wound due to NPWT. The Prevena NPWT system can be conveniently and safely implemented on the operational incision in renal transplant recipients in order to prevent surgical wound complications.

  5. Outpatient surgical treatment of female stress urinary incontinence under local anesthesia-sedation with contrasure needleless incision.

    Science.gov (United States)

    Navalón, V; Navalón, P; Pallás, Y; Ordoño, F; Monllor, E

    2014-01-01

    To evaluate the results obtained from out-patient surgical treatment of female stress urinary incontinence (SUI) with the use of trans-obturator tape (TOT) of a single Contrasure-Needleless incision (Neomedic-International). We performed an intervention with local anesthesia-sedation in outpatient regime between January 2007 to December 2011 on 96 patients affected by SUI using the placement of Needleless tension-free suburethral sling. Inclusion and discharge criteria and the results obtained as well as satisfaction grade were evaluated by a questionnaire. All the patients underwent a stress test, urodynamic study and quality of life questionnaire (ICIQ-SF) prior to and at least 3 months after the intervention. Tolerance to the procedure was good. Surgical time was less than 10 minutes and stay in the hospital up to discharge less than 2hours. The results obtained are superimposable to those reached with epidural anesthesia and hospitalization, the grade of satisfactions with the treatment received being superior to 90%. Almost all of the patients affected are candidates for inclusion in an outpatient surgery program. This noticeably improves the cost-efficacy ratio, without decreasing the health care or grade of satisfaction. Furthermore, the Contasure-Needleless system fulfills the criteria for minimally invasive surgery, providing better stability of the sling than the third generation "minibands" due to the greater length of the mesh and less post-operative pain regarding the conventional TOT as no cutaneous incisions are required. Copyright © 2012 AEU. Published by Elsevier Espana. All rights reserved.

  6. Single-Incision Multi-Port Appendectomy for a Patient with Situs Inversus Totalis; First case report

    Directory of Open Access Journals (Sweden)

    Rajkumar J. S.

    2016-05-01

    Full Text Available Situs inversus totalis (SIT is a rare autosomal recessive condition involving the complete lateral transposition of the organs. When individuals with this condition suffer from appendicitis, associated pain and symptoms are usually present on the left side, resulting in diagnostic difficulties. Moreover, the laparoscopic removal of the left-sided appendix may pose practical problems during surgery. Removal of an inflamed appendix is generally performed using a multiple-port laparoscopy. We report a 22-year-old male who presented to the Lifeline Institute of Minimal Access Surgery in Chennai, India, in April 2015 with pain in the left iliac fossa. Chest X-rays and ultrasonography confirmed SIT with an acutely inflamed appendix on the left side. The patient underwent a single-incision multi-port laparoscopic appendectomy with a successful outcome. To the best of the authors’ knowledge, this is the first report in the literature of a single-incision multi-port appendectomy in a patient with SIT.

  7. Hereditary congenital unilateral deafness : A new disorder?

    NARCIS (Netherlands)

    Dikkers, FG; Verheij, JBGM; van Mechelen, M

    2005-01-01

    Congenital unilateral deafness is a rare disorder. The prevalence rates are unknown. The prevalence of children with severe to profound hearing losses that are congenital (or acquired before the development of speech and language) is 0.5 to 3 per 1,000 live births. Evidently, congenital unilateral d

  8. Signs and Symptoms of Congenital Heart Defects

    Science.gov (United States)

    ... Twitter. What Are the Signs and Symptoms of Congenital Heart Defects? Many congenital heart defects cause few or no signs and symptoms. A ... lips, and fingernails) Fatigue (tiredness) Poor blood circulation Congenital heart defects don't cause chest pain or other painful ...

  9. Care and Treatment for Congenital Heart Defects

    Science.gov (United States)

    ... Thromboembolism Aortic Aneurysm More Care and Treatment for Congenital Heart Defects Updated:Oct 26,2015 Not all people with ... supports you in your pursuit of heart health. Congenital Heart Defects • Home • About Congenital Heart Defects • The Impact of ...

  10. [Congenital lumbar hernia and bilateral renal agenesis].

    Science.gov (United States)

    Barrero Candau, R; Garrido Morales, M

    2007-04-01

    We report a new case of congenital lumbar hernia. This is first case reported of congenital lumbar hernia and bilateral renal agenesis. We review literature and describe associated malformations reported that would be role out in every case of congenital lumbar hernia.

  11. Schinzel-Giedion syndrome and congenital megacalyces.

    Science.gov (United States)

    Herman, T E; Sweetser, D A; McAlister, W H; Dowton, S B

    1993-01-01

    The Schinzel-Giedion syndrome is a rare autosomal recessive condition with typical facies, skeletal manifestations and congenital hydronephrosis. We report an infant with characteristic findings who had bilateral congenital megacalyces. Congenital megacalyces is believed to be a developmental abnormality, occurs in other malformation syndromes and has not previously been described in the Schinzel-Giedion syndrome.

  12. MRI of congenital urethroperineal fistula

    Energy Technology Data Exchange (ETDEWEB)

    Ghadimi-Mahani, Maryam; Dillman, Jonathan R.; Pai, Deepa; DiPietro, Michael [C. S. Mott Children' s Hospital, Department of Radiology, Section of Pediatric Radiology, University of Michigan Health System, Ann Arbor, MI (United States); Park, John [C. S. Mott Children' s Hospital, Department of Pediatric Urology, University of Michigan Health System, Ann Arbor, MI (United States)

    2010-12-15

    We present the MRI features of a congenital urethroperineal fistula diagnosed in a 12-year-old boy being evaluated after a single urinary tract infection. This diagnosis was initially suggested by voiding cystourethrogram and confirmed by MRI. Imaging revealed an abnormal fluid-filled tract arising from the posterior urethra and tracking to the perineal skin surface that increased in size during micturition. Surgical resection and histopathological evaluation of the abnormal tract confirmed the diagnosis of congenital urethroperineal fistula. MRI played important roles in confirming the diagnosis and assisting surgical planning. (orig.)

  13. Single-incision laparoscopic splenectomy with innovative gastric traction suture

    Directory of Open Access Journals (Sweden)

    Srikanth G

    2011-01-01

    Full Text Available Laparoscopic splenectomy is now the gold standard for patients with idiopathic thrombocytopenic purpura (ITP undergoing splenectomy. There are a few reports in literature on single-incision laparoscopic (SIL splenectomy. Herein, we describe a patient undergoing SIL splenectomy for ITP without the use of a disposable port device. We report a 20-year-old female patient with steroid-refractory ITP having a platelet count of 14,000/cmm who underwent a SIL splenectomy. Dissection was facilitated by the use of a single articulating grasper and a gastric traction suture and splenic vessels were secured at the hilum with an endo-GIA stapler. She made an uneventful postoperative recovery and was discharged on the second postoperative day. She is doing well with no visible scar at 8-month follow-up.

  14. Nucleus management in manual small incision cataract surgery by phacosection

    Directory of Open Access Journals (Sweden)

    Ravindra M

    2009-01-01

    Full Text Available Nucleus management is critical in manual small incision cataract surgery (MSICS, as the integrity of the tunnel, endothelium and posterior capsule needs to be respected. Several techniques of nucleus management are in vogue, depending upon the specific technique of MSICS. Nucleus can be removed in toto or bisected or trisected into smaller segments. The pressure in the eye can be maintained at the desired level with the use of an anterior chamber maintainer or kept at atmospheric levels. In MSICS, unlike phacoemulsification, there is no need to limit the size of the tunnel or restrain the size of capsulorrhexis. Large well-structured tunnels and larger capsulorrhexis provide better control on the surgical maneuvers. Safety and simplicity of MSICS has made it extremely popular. The purpose of this article is to describe nucleus management by phacosection in MSICS.

  15. A case of keratitis associated with limbal relaxing incision

    Directory of Open Access Journals (Sweden)

    Aravind Haripriya

    2016-01-01

    Full Text Available We report a case of keratitis associated with limbal relaxing incision (LRI. The patient presented with progressive loss of vision with best-corrected visual acuity 20/40. Immature cataract with 1.43D against the rule astigmatism was noted. Prophylactic topical antibiotic was administered before surgery. He underwent uneventful phacoemulsification with intraocular lens implantation with LRI. On the 33rd postoperative day (POD, he presented with infiltrate along LRI site with mild iritis. Corneal scraping was positive for Staphylococcus aureus. After the treatment with topical moxifloxacin and fortified cefazolin, the infiltrate started to resolve. On the 50th POD, the corneal infection was resolved with marked thinning at LRI site.

  16. A case of keratitis associated with limbal relaxing incision

    Science.gov (United States)

    Haripriya, Aravind; Smita, Anand

    2016-01-01

    We report a case of keratitis associated with limbal relaxing incision (LRI). The patient presented with progressive loss of vision with best-corrected visual acuity 20/40. Immature cataract with 1.43D against the rule astigmatism was noted. Prophylactic topical antibiotic was administered before surgery. He underwent uneventful phacoemulsification with intraocular lens implantation with LRI. On the 33rd postoperative day (POD), he presented with infiltrate along LRI site with mild iritis. Corneal scraping was positive for Staphylococcus aureus. After the treatment with topical moxifloxacin and fortified cefazolin, the infiltrate started to resolve. On the 50th POD, the corneal infection was resolved with marked thinning at LRI site. PMID:28112139

  17. Transcriptomic analysis of incised leaf-shape determination in birch.

    Science.gov (United States)

    Mu, Huaizhi; Lin, Lin; Liu, Guifeng; Jiang, Jing

    2013-12-01

    Plant researchers have focused much attention on leaf shape because of its importance in the identification. To evaluate the impact of intraspecies leaf-shape variation on the transcriptome, a series of Betula pendula 'Dalecarlica' and B. pendula saplings were generated through tissue culture. The leaf shapes and transcriptomes of B. pendula 'Dalecarlica' clones were compared with those of B. pendula clones. The leaf shape of B. pendula 'Dalecarlica' was incised and that of B. pendula was ovate. Transcriptome data revealed numerous changes in gene expression between B. pendula 'Dalecarlica' and B. pendula, including upregulation of 8767 unigenes and downregulation of 8379 unigenes in B. pendula 'Dalecarlica'. A pathway analysis revealed that the transport and signal transduction of auxin were altered in 'Dalecarlica', which may have contributed to its altered leaf shape. These results shed light on variation in birch leaf shape and help identify important genes for the genetic engineering of birch trees. © 2013.

  18. Overnight urethral stenting after tubularized incised plate urethroplasty for distal hypospadias.

    Science.gov (United States)

    Ritch, Chad R; Murphy, Alana M; Woldu, Solomon L; Reiley, Elizabeth A; Hensle, Terry W

    2010-06-01

    The duration of urethral stenting after tubularized incised plate (TIP) urethroplasty for hypospadias varies among surgeons. Typically the catheter is left for up to 7 days with the goal of minimizing post-operative complications. We describe our experience with overnight stenting for distal TIP hypospadias repair. A retrospective chart review was performed on patients who underwent TIP hypospadias repair from 2003 to 2008. Patients who had their urethral catheter overnight were included in this analysis. Outcomes analyzed were the rates of: urethrocutaneous fistula, meatal stenosis, urethral stricture and urinary tract infections. A total of 64 patients underwent outpatient TIP hypospadias repair. Forty-nine patients had overnight urethral stenting with at least 12 months follow-up and were included in the analysis. Five of the 49 patients (10.2%) developed urethrocutaneous fistula. Of these five patients, two had undergone re-do hypospadias repair. The fistula rate in primary repairs was 3/45 (6.7%). There were no incidences of meatal stenosis, urinary tract infections or urethral strictures. In our experience, overnight urethral stenting for TIP hypospadias repair does not significantly affect the rates of urethrocutaneous fistula, meatal stenosis and urinary tract infections. Patients who have had a primary TIP hypospadias repair may have their urethral catheter removed safely on post-operative day one.

  19. On the control of riverbed incision induced by run-of-river power plant

    Science.gov (United States)

    Bizzi, Simone; Dinh, Quang; Bernardi, Dario; Denaro, Simona; Schippa, Leonardo; Soncini-Sessa, Rodolfo

    2015-07-01

    Water resource management (WRM) through dams or reservoirs is worldwide necessary to support key human-related activities, ranging from hydropower production to water allocation and flood risk mitigation. Designing of reservoir operations aims primarily to fulfill the main purpose (or purposes) for which the structure has been built. However, it is well known that reservoirs strongly influence river geomorphic processes, causing sediment deficits downstream, altering water, and sediment fluxes, leading to riverbed incision and causing infrastructure instability and ecological degradation. We propose a framework that, by combining physically based modeling, surrogate modeling techniques, and multiobjective (MO) optimization, allows to include fluvial geomorphology into MO optimization whose main objectives are the maximization of hydropower revenue and the minimization of riverbed degradation. The case study is a run-of-the-river power plant on the River Po (Italy). A 1-D mobile-bed hydro-morphological model simulated the riverbed evolution over a 10 year horizon for alternatives operation rules of the power plant. The knowledge provided by such a physically based model is integrated into a MO optimization routine via surrogate modeling using the response surface methodology. Hence, this framework overcomes the high computational costs that so far hindered the integration of river geomorphology into WRM. We provided numerical proof that river morphologic processes and hydropower production are indeed in conflict but that the conflict may be mitigated with appropriate control strategies.

  20. A new incision for unilateral cleft lip repair developed using animated simulation of repair on computer

    Directory of Open Access Journals (Sweden)

    Sahay A

    2007-01-01

    Full Text Available Background: Unilateral cleft lip repair continues to leave behind some amount of dissatisfaction, as a scope for further improvement is always felt. Most surgeons do not like to deviate from the standard Millard′s/ triangular techniques, or their minor modifications, as no one likes to experiment on the face for fear of unfavourable outcomes. The computer can be utilized as a useful tool in the analysis and planning of surgery and new methods can be developed and attempted subsequently with greater confidence. Aim: We decided to see if an improved lip repair could be developed with the use of computers. Materials and Methods: Analysis of previous lip repairs was done to determine where an improvement was required. Movement of tissues, by simulating an ideal repair, using image warping software, on digital images of cleft lip was studied in animation sequences. A repair which could reproduce these movements was planned. A new incision emerged, which had combined the principles of Millard′s and Randall / Tennyson repairs, with additional features. The new method was performed on 30 cases. Conclusions: The results were encouraging as the shortcomings of these methods were minimized, and the advantages maximized.

  1. Single-incision retroperitoneoscopic adrenalectomy: a North American experience.

    Science.gov (United States)

    Sho, Shonan; Yeh, Michael W; Li, Ning; Livhits, Masha J

    2017-07-01

    Endoscopic adrenalectomy is currently performed using multiple ports placed either transabdominally or retroperitoneally. We report our initial experience with single-incision retroperitoneoscopic adrenalectomy (SIRA). A prospective database of patients undergoing adrenalectomy from December 2013 through March 2016 was analyzed. We adopted conventional retroperitoneoscopic adrenalectomy (CORA) in December 2013 and transitioned to SIRA in March 2015. SIRA was performed using three trocars placed through a single 2-cm incision below the 12th rib. Clinical characteristics and outcomes were compared between patients undergoing SIRA and CORA. One hundred and five adrenalectomies were performed in 102 patients: 34 laparoscopic transperitoneal, 24 CORA, 37 SIRA and 7 open. The SIRA and CORA groups were similar with respect to clinical characteristics (SIRA vs. CORA: mean BMI 27.0 vs. 28.8 kg/m(2), maximum BMI 38.9 vs. 44.3 kg/m(2); mean nodule size 3.2 vs. 3.2 cm, maximum nodule size 8.0 vs. 6.0 cm). One patient undergoing SIRA required placement of an additional 5-mm port because of extensive adhesions. No patients who underwent SIRA or CORA required conversion to open adrenalectomy. There were no deaths, and blood loss remained CORA (105 vs. 92 min, P = 0.26). In multivariable linear regression analysis, nodule size > 5 cm (effect = 1.75, P CORA and may be applied to technically challenging cases involving obese patients or large nodules. The use of three ports allows for two-handed dissection, which may shorten the learning curve for many surgeons.

  2. Congenital syphilis surveillance

    Directory of Open Access Journals (Sweden)

    Antonella Marangoni

    2011-06-01

    Full Text Available Congenital syphilis (CS is mainly a consequence of the lack of antenatal care and control of sexually transmitted infections.The bedrock of the prevention of CS is syphilis diagnosis by serological screening during pregnancy.Current Italian guidelines suggest that all the pregnant women should be tested in the first trimester. Due to the frequently absence of specific signs of infection at birth, laboratory tests are often the only method for a correct CS diagnosis. The aim of this study was to evaluate the usefulness of Treponema pallidum IgM Western Blot (WB and Polymerase Chain Reaction (PCR on cerebrospinal fluid (CSF as an aid in the diagnosis of CS during a prospective surveillance study carried out at St. Orsola Hospital in Bologna, Italy, from November 2000 through June 2010. All pregnant women during pregnancy and at delivery were screened for syphilis by ARCHITECT® Syphilis TP, Abbott. Positive samples were further analysed by Treponema Pallidum Hemagglutination Test (TPHA and Rapid Plasma Reagin (RPR tests, Radim.An in-house Western Blot (WB was also performed. Infants born to syphilis seropositive mothers were enrolled in a prospective follow up. At birth, tests were performed (including IgM WB. Infants with positive RPR tests at birth born to mothers not adequately treated received also a long bone radiograph as well as a complete CSF analysis, including Veneral Disease Research Laboratori (VDRL (Siemens Healthcare Diagnostics and PCR testing. All seroreactive infants received careful follow up examinations and serological testing at 0, 3, 6, 9, 12 months or until the tests became negative. In this study, positive syphilis serology was noted in 151 pregnant women delivering in our hospital. Fifteen women had never been adequately treated, and 9 out 15 gave birth to infected newborns.All these 9 infants had positive IgM WB results on serum samples. Two babies had characteristic long bone lesions at X-ray examination and 3 were born

  3. Congenital anomalies in Primorsky region.

    Science.gov (United States)

    Kiku, P; Voronin, S; Golokhvast, K

    2015-01-01

    According to WHO hereditary diseases and congenital malformations contribute significantly to the health of population. Thus, the problems of epidemiology, clinical presentation, diagnosis and treatment of congenital abnormalities are of interest for many researchers [2]. In addition, the dynamic accounting for the incidence of congenital malformations and hereditary diseases allows the researchers to assess the ecological situation in the region [1]. The occurrence of congenital anomalies in the world varies; it depends heavily on how carefully the data is collected [4]. Multifactorial or polygenic diseases develop under the influence of environmental factors in the presence of defective genes. They can constitute up to 90% of all chronic pathology [2-5]. To determine the incidence of congenital anomalies under the influence of environmental factors. The study used the methodology of system evaluation of congenital anomalies incidence in Primorsky region, depending on bio-climatic and environmental conditions. The authors used health statistics for the period from 2000 to 2014, F.12 class for congenital abnormalities in adolescents and children that were compared in geographical and temporal aspects with environmental factors of 33 settlements in Primorsky region. The environment is represented by nature and climate (6 factor modules) and sanitation (7 factor modules) blocks of factors. When formalizing the information database of the environment a specially developed 10-point assessment scale was used. Statistical processing of the information was carried out using Pearson's chi-squared test and multiple regression method from SSPS application program package. The study found that over the 15-year period the level of congenital abnormalities in children increased by 27.5% and in adolescents - by 35.1%, and in 2014 it amounted to 1687.6 and 839.3 per 100 000 people, respectively. The predictive model shows a steady further growth of this pathology. The incidence

  4. [Minimally invasive approaches to hip and knee joints for total joint replacement].

    Science.gov (United States)

    Rittmeister, M; König, D P; Eysel, P; Kerschbaumer, F

    2004-11-01

    The manuscript features the different minimally invasive approaches to the hip for joint replacement. These include medial, anterior, anterolateral, and posterior approaches. The concept of minimally invasive hip arthroplasty makes sense if it is an integral part of a larger concept to lower postoperative morbidity. Besides minimal soft tissue trauma, this concept involves preoperative patient education, preemptive analgesia, and postoperative physiotherapy. It is our belief that minimal incision techniques for the hip are not suited for all patients and all surgeons. The different minimally invasive approaches to the knee joint for implantation of a knee arthroplasty are described and discussed. There have been no studies published yet that fulfill EBM criteria. The data so far show that minimally invasive approaches and implantation techniques for total knee replacements lead to quicker rehabilitation of patients.

  5. 小切口非超声乳化白内障摘出术的改进%The improvement of small incision non-phacoemulsification cataract extraction

    Institute of Scientific and Technical Information of China (English)

    杨本诚; 王君; 胡军

    2012-01-01

    目的 评价利用改进的小切口无缝线非超声乳化白内障摘出+人工晶状体植入手术治疗白内障的临床效果.方法 对白内障5126例(6819眼)用剃须刀片完成隧道切口及侧切口,弧形截囊,自然娩核,随访3个月~9年.结果 术后散光轻,葡萄膜炎症反应轻微,继发性青光眼、后发性白内障及视网膜脱离等并发症发生少,且伤口愈合快,视力提高快.结论 此手术由于切口小,无需缝线,设备简单易于掌握,便于在基层开展.%Objective To evaluate the clinical effects of cataract surgery through small incision non-phacoemulsification cataract extraction (SICS) and intraocular lens (IOL) implantation (SICS + IOL).Methods Indeatifying 6819 eyes of 5126 patients congenital cataracts,we used razor-blade to complete surgery steps such as the tunnel and incision,capsulorhexis arc.After surgery,the following-up from three months to nine years was carried out.Results After SICS + IOL,all of the eyes had slight uveitis,and few after-cataract,secondary glaucoma,retinal detachment and other complications.Conclusion This type of surgery has the advantages of small incision,sutureless,non-Sophisticated equipment needed and easily grasped,so it shoud be easily opened in the grassroots.

  6. Systematic review: open, small-incision or laparoscopic cholecystectomy for symptomatic cholecystolithiasis.

    NARCIS (Netherlands)

    Keus, F.; Gooszen, H.G.; Laarhoven, C.J.H.M. van

    2009-01-01

    BACKGROUND: Laparoscopic cholecystectomy has become the method of choice for gallbladder removal, although evidence of superiority over open and small-incision cholecystectomy is lacking. AIM: To compare the effects of open, small-incision and laparoscopic cholecystectomy techniques for patients wit

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

    NARCIS (Netherlands)

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

    2009-01-01

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

  8. Systematic review: open, small-incision or laparoscopic cholecystectomy for symptomatic cholecystolithiasis

    DEFF Research Database (Denmark)

    Keus, F; Gooszen, H G; Van Laarhoven, C J H M

    2009-01-01

    Laparoscopic cholecystectomy has become the method of choice for gallbladder removal, although evidence of superiority over open and small-incision cholecystectomy is lacking.......Laparoscopic cholecystectomy has become the method of choice for gallbladder removal, although evidence of superiority over open and small-incision cholecystectomy is lacking....

  9. Systematic review : open, small-incision or laparoscopic cholecystectomy for symptomatic cholecystolithiasis

    NARCIS (Netherlands)

    Keus, F.; Gooszen, H. G.; Van Laarhoven, C. J. H. M.

    2009-01-01

    Laparoscopic cholecystectomy has become the method of choice for gallbladder removal, although evidence of superiority over open and small-incision cholecystectomy is lacking. To compare the effects of open, small-incision and laparoscopic cholecystectomy techniques for patients with symptomatic cho

  10. Randomized clinical trial of single- versus multi-incision laparoscopic cholecystectomy

    DEFF Research Database (Denmark)

    Jørgensen, Lars Nannestad; Rosenberg, J; Al-Tayar, H;

    2014-01-01

    BACKGROUND: There are no randomized studies that compare outcomes after single-incision (SLC) and conventional multi-incision (MLC) laparoscopic cholecystectomy under an optimized perioperative analgesic regimen. METHODS: This patient- and assessor-blinded randomized three-centre clinical trial c...

  11. Double incision wound healing bioassay using Hamelia patens from El Salvador.

    Science.gov (United States)

    Gomez-Beloz, Alfredo; Rucinski, James C; Balick, Michael J; Tipton, Camille

    2003-10-01

    Hamelia patens Jacq. (Rubiaceae) has received little attention in the laboratory for its wound healing ability even though it is commonly used as a treatment for wounds throughout Central America. A double incision wound healing bioassay was carried out with a crude extract of Hamelia patens collected from El Salvador. Animals were divided into three groups. Group I (n = 14) had the left incision treated with 5% (w/w) Hamelia patens and the contralateral side with petroleum jelly (PJ). Group II (n = 14) had the left incision treated with 10% (w/w) ointment and the contralateral side with petroleum jelly. Group III (n = 10) had the left incision treated with petroleum jelly and the contralateral side left untreated. Breaking strength of the incisions was measured on day 7 and day 12. For Groups I and II, there was no significant difference between treatment and control incisions at day 7. On day 12, there was a significant difference between the treated and control incisions for Groups I and II. There was no significant difference between petroleum jelly and untreated incisions for Group III on day 7 and day 12. Hamelia patens does increase breaking strength of wounds significantly more than the control group. Further wound healing studies of this plant are warranted.

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

    DEFF Research Database (Denmark)

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

    2017-01-01

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

  13. Two different techniques for frontalis suspension using Gore-Tex to treat severe congenital ptosis.

    Science.gov (United States)

    Zaky, Adel Galal; Mandour, Sameh Saad; Zaky, Marwa Aly; Ebrahem, Asmaa Mohamed

    2017-04-01

    Severe congenital ptosis is commonly associated with poor levator function. This study compares the functional and cosmetic outcomes of open versus closed frontalis sling using Gore-Tex in the treatment of such conditions. Randomized interventional comparative case series of 20 eyes of 13 patients with severe congenital ptosis with levator excursion Gore-Tex string sutures either through a skin crease incision (group 1) or supraciliary incisions (group II). Mean age was 5.10 ± 3.10 years in group I and 7.30 ± 4.47 years in group II. Ptosis was unilateral in six patients and bilateral in seven patients. Following surgery, there was a statistically significant improvement in the palpebral fissure width (PFW) and marginal reflex distance (MRD) in both groups (p value 0.001) with better functional outcome in group II (closed approach). The cosmetic results were better in group I (open approach). The mean operative time in group II was 18.1 ± 2.4 min, which was significantly shorter than group I (30.2 ± 3.1 min). No recurrence or grave complications were encountered during follow-up. Gore-Tex is a useful sling material for correction of severe congenital ptosis due to poor frontalis action. Open transcrease approach is recommended in absence of lid crease whereas closed approach is better used in cases with preserved crease due to its superior functional outcome.

  14. Locally minimal topological groups

    CERN Document Server

    enhofer, Lydia Au\\ss; Dikranjan, Dikran; Domínguez, Xabier

    2009-01-01

    A Hausdorff topological group $(G,\\tau)$ is called locally minimal if there exists a neighborhood $U$ of 0 in $\\tau$ such that $U$ fails to be a neighborhood of zero in any Hausdorff group topology on $G$ which is strictly coarser than $\\tau.$ Examples of locally minimal groups are all subgroups of Banach-Lie groups, all locally compact groups and all minimal groups. Motivated by the fact that locally compact NSS groups are Lie groups, we study the connection between local minimality and the NSS property, establishing that under certain conditions, locally minimal NSS groups are metrizable. A symmetric subset of an abelian group containing zero is said to be a GTG set if it generates a group topology in an analogous way as convex and symmetric subsets are unit balls for pseudonorms on a vector space. We consider topological groups which have a neighborhood basis at zero consisting of GTG sets. Examples of these locally GTG groups are: locally pseudo--convex spaces, groups uniformly free from small subgroups (...

  15. Vertical intra-areolar incision in dual-plane breastaugmentation mammaplasty

    Institute of Scientific and Technical Information of China (English)

    LONG Xiao; ZENG Ang; ZHANG Hai-lin; QIAO Qun

    2011-01-01

    Objective To investigate the use of vertical intra-areolar incision in dual plane breast augmentation.Methods Fifteen cases received dual plane breast augmentation with vertical intra-areola incision in our hospital from January 2008 to December 2008.Breast gland was cut vertically in the upper part and pectoralis major muscle was separated according to the direction of the muscle fiber.Then the pectoralis major muscle was partially amputated at the starting point.Finally the implant was placed partially under the breast gland and partially under the pectoralis major muscle.Results The follow-up of more than one year showed all cases healed well and the incisions were concealed except one case who suffered delayed healing of the wound and depigmentation of the incision.Conclusion Vertical intra-areolar incision in dual plane breast augmentation is an easily-performed and feasible method and leaves less scar post operation.

  16. The lazy lateral incision: an innovative approach to the skin-sparing mastectomy.

    Science.gov (United States)

    Dutton, Walter; Ghareeb, Paul A; McClellan, W Thomas

    2013-01-01

    The skin-sparing mastectomy has many advantages over a simple mastectomy, including preservation of the native breast skin, inframammary fold, and improved aesthetics for immediate reconstruction. The traditional transverse elliptical access incision is anterior on the breast mound, requires a second incision for previous biopsy sites, and provides restricted access to the axilla. We describe a novel mastectomy incision that improves scar appearance, improves access to the axillary contents, and reduces skin flap retraction. This incision starts at the nipple-areolar complex and extends laterally in a curvilinear fashion toward the axilla incorporating the biopsy scar along the way. This simple sinusoidal design results in an aesthetically superior alternative to the traditional linear mastectomy incision.

  17. Oral pathology case: congenital epulides

    OpenAIRE

    Amorim, J.

    2010-01-01

    A one month-old girl was referred to our department due a neoformation of the mandible. The excisional biopsy of the lesion revealed a congenital epulides of the newborn. This is an uncommon lesion, easy to diagnose, as it has a typical appearance and localisation. Surgical treatment is the option, namely when it impairs feeding, swallowing or breathing.

  18. [Genetics of congenital heart diseases].

    Science.gov (United States)

    Bonnet, Damien

    2017-06-01

    Developmental genetics of congenital heart diseases has evolved from analysis of serial slices in embryos towards molecular genetics of cardiac morphogenesis with a dynamic view of cardiac development. Genetics of congenital heart diseases has also changed from formal genetic analysis of familial recurrences or population-based analysis to screening for mutations in candidates genes identified in animal models. Close cooperation between molecular embryologists, pathologists involved in heart development and pediatric cardiologists is crucial for further increase of knowledge in the field of cardiac morphogenesis and genetics of cardiac defects. The genetic model for congenital heart disease has to be revised to favor a polygenic origin rather than a monogenic one. The main mechanism is altered genic dosage that can account for heart diseases in chromosomal anomalies as well as in point mutations in syndromic and isolated congenital heart diseases. The use of big data grouping information from cardiac development, interactions between genes and proteins, epigenetic factors such as chromatin remodeling or DNA methylation is the current source for improving our knowledge in the field and to give clues for future therapies. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  19. Oral pathology case: congenital epulides

    OpenAIRE

    Amorim, J

    2010-01-01

    A one month-old girl was referred to our department due a neoformation of the mandible. The excisional biopsy of the lesion revealed a congenital epulides of the newborn. This is an uncommon lesion, easy to diagnose, as it has a typical appearance and localisation. Surgical treatment is the option, namely when it impairs feeding, swallowing or breathing.

  20. Prenatal diagnosis of congenital diseases

    NARCIS (Netherlands)

    M.F. Niermeijer (Martinus)

    1975-01-01

    textabstractPrenatal diagnosis of a number of congenital diseases is possible by amniocentesis in the 14th - 16th week of pregnancy and subsequent analysis of cultured amniotic fluid cells or amniotic fluid supernatant. Parents at risk for a child with a chromosomal disorder, an X-linked disease, a

  1. Congenital dacryocystocele: prenatal MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Yazici, Zeynep [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Uludag University, Department of Radiology, Faculty of Medicine, Bursa (Turkey); Kline-Fath, Beth M.; Rubio, Eva I.; Calvo-Garcia, Maria A.; Linam, Leann E. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Yazici, Bulent [Uludag University, Department of Ophthalmology, Faculty of Medicine, Bursa (Turkey)

    2010-12-15

    Congenital dacryocystocele can be diagnosed prenatally by imaging. Prenatal MRI is increasingly utilized for fetal diagnosis. To present the radiological and clinical features of seven fetuses with congenital dacryocystocele diagnosed with prenatal MRI. The institutional database of 1,028 consecutive prenatal MR examinations performed during a period of 4 years was reviewed retrospectively. The cases of congenital dacryocystocele were identified by reading the report of each MRI study. The incidence of dacryocystocele diagnosed with prenatal MRI was 0.7% (n=7/1,028). The dacryocystocele was bilateral in three fetuses. Mean gestational age at the time of diagnosis was 31 weeks. The indication for prenatal MRI was the presence or the suspicion of central nervous system abnormality in six fetuses and diaphragmatic hernia in one. Dacryocystocele was associated with an intranasal cyst in six of ten eyes. Prenatal sonography revealed dacryocystocele in only two of seven fetuses. Of eight eyes with postnatal follow-up, four did not have any lacrimal symptoms. Prenatal MRI can delineate congenital dacryocystocele more clearly and in a more detailed fashion than ultrasonography. Presence of dacryocystocele was symptomatic in only 50% of our patients, supporting that prenatal diagnosis of dacryocystocele might follow a benign course. (orig.)

  2. Embryology of congenital diaphragmatic hernia.

    Science.gov (United States)

    Kluth, D; Keijzer, R; Hertl, M; Tibboel, D

    1996-11-01

    It is still generally believed that the defect in congenital diaphragmatic hernia results from failure of the so-called pleuroperitoneal canals (PPCs) to close at the end of the embryonic period (8th gestational week). Furthermore, it is assumed that gut could enter the thoracic cavity through this defect, causing compression and finally hypoplasia of the lung. However, this sequence of embryological events has never been studied, and many details even of normal diaphragmatic development are still unknown. Using scanning electron microscopy and a new animal model of congenital diaphragmatic hernia (CDH), the nitrofen rat model, the normal embryology of the diaphragm was reinvestigated and, for the first time, the crucial developmental steps of congenital diaphragmatic hernia formation were studied. The basic results were: (1) In normal development, the PPCs are never wide enough to allow herniation of gut loops. (2) The formation of the defect happens in an early embryonic period. (3) The early ingrowth of liver through the defect is of major importance for the formation of CDH. In another set of experiments, the nitrofen rat model of congenital diaphragmatic hernias was used to study the cellular mechanisms involved during epithelial and mesenchymal growth and differentiation in normal and in abnormal lungs. These results, combined with selected culture techniques (eg, branching morphogenesis and epithelio-mesenchymal interaction) probably open new ways to a better understanding of the mechanisms that finally lead to an abnormal lung in CDH.

  3. Congenital Chagas disease: an update.

    Science.gov (United States)

    Carlier, Yves; Sosa-Estani, Sergio; Luquetti, Alejandro O; Buekens, Pierre

    2015-05-01

    Congenital infection with Trypanosoma cruzi is a global problem, occurring on average in 5% of children born from chronically infected mothers in endemic areas, with variations depending on the region. This presentation aims to focus on and update epidemiological data, research methods, involved factors, control strategy and possible prevention of congenital infection with T. cruzi. Considering that etiological treatment of the child is always effective if performed before one year of age, the diagnosis of infection in pregnant women and their newborns has to become the standard of care and integrated into the surveillance programs of syphilis and human immunodeficiency virus. In addition to the standard tests, polymerase chain reaction performed on blood of neonates of infected mothers one month after birth might improve the diagnosis of congenital infection. Recent data bring out that its transmission can be prevented through treatment of infected women before they become pregnant. The role of parasite genotypes and host genetic factors in parasite transmission and development of infection in foetuses/neonates has to be more investigated in order to better estimate the risk factors and impact on health of congenital infection with T. cruzi.

  4. Congenital Chagas disease: an update

    Directory of Open Access Journals (Sweden)

    Yves Carlier

    2015-05-01

    Full Text Available Congenital infection with Trypanosoma cruzi is a global problem, occurring on average in 5% of children born from chronically infected mothers in endemic areas, with variations depending on the region. This presentation aims to focus on and update epidemiological data, research methods, involved factors, control strategy and possible prevention of congenital infection with T. cruzi. Considering that etiological treatment of the child is always effective if performed before one year of age, the diagnosis of infection in pregnant women and their newborns has to become the standard of care and integrated into the surveillance programs of syphilis and human immunodeficiency virus. In addition to the standard tests, polymerase chain reaction performed on blood of neonates of infected mothers one month after birth might improve the diagnosis of congenital infection. Recent data bring out that its transmission can be prevented through treatment of infected women before they become pregnant. The role of parasite genotypes and host genetic factors in parasite transmission and development of infection in foetuses/neonates has to be more investigated in order to better estimate the risk factors and impact on health of congenital infection with T. cruzi.

  5. Adaptive Alternating Minimization Algorithms

    CERN Document Server

    Niesen, Urs; Wornell, Gregory

    2007-01-01

    The classical alternating minimization (or projection) algorithm has been successful in the context of solving optimization problems over two variables or equivalently of finding a point in the intersection of two sets. The iterative nature and simplicity of the algorithm has led to its application to many areas such as signal processing, information theory, control, and finance. A general set of sufficient conditions for the convergence and correctness of the algorithm is quite well-known when the underlying problem parameters are fixed. In many practical situations, however, the underlying problem parameters are changing over time, and the use of an adaptive algorithm is more appropriate. In this paper, we study such an adaptive version of the alternating minimization algorithm. As a main result of this paper, we provide a general set of sufficient conditions for the convergence and correctness of the adaptive algorithm. Perhaps surprisingly, these conditions seem to be the minimal ones one would expect in ...

  6. Minimal E$_{0}$-semigroups

    CERN Document Server

    Arveson, W

    1995-01-01

    It is known that every semigroup of normal completely positive maps of a von Neumann can be ``dilated" in a particular way to an E_0-semigroup acting on a larger von Neumann algebra. The E_0-semigroup is not uniquely determined by the completely positive semigroup; however, it is unique (up to conjugacy) provided that certain conditions of {\\it minimality} are met. Minimality is a subtle property, and it is often not obvious if it is satisfied for specific examples even in the simplest case where the von Neumann algebra is \\Cal B(H). In this paper we clarify these issues by giving a new characterization of minimality in terms projective cocycles and their limits. Our results are valid for semigroups of endomorphisms acting on arbitrary von Neumann algebras with separable predual.

  7. Sialendoscopy and Combined Minimally Invasive Treatment for Large Parotid Stones

    Science.gov (United States)

    Zavázalová, Šárka; Vorobiov, Olexii; Astl, Jaromír

    2016-01-01

    Sialendoscopy (SE) represents nowadays one of the standard diagnostic and therapeutic procedures in the treatment of major salivary glands lithiasis. We know from experience that it is successful only in small percentage of patients, when used in monotherapy. However, it represents an indispensable part of all of the combined minimally invasive gland-preserving treatment techniques, the success rate of which is around 90%. In this work, we focused on the role of sialendoscopy in the treatment of patients with larger inflamed fixed stones in glandula parotis. We conducted a total of 364 sialendoscopy procedures in 332 patients on our site. We have confirmed lithiasis as a cause of salivary gland obstruction in 246 (74%) patients. In 9 patients there was larger, single, or multiple inflamed fixed lithiasis of glandula parotis. In this subgroup of patients endoscopically assisted sialolithectomy from external mini-incision has become the method of choice. In 9 of the 9 (100%) cases we have achieved complete elimination of stones, and in 8 of the 9 (89%) cases we have achieved complete elimination of complaints. Sialoendoscopically assisted sialolithectomy of glandula parotis from external mini-incision has proved to be highly effective technique to eliminate stones with minimal complications. PMID:27882318

  8. Crystalloid-based cardioplegia for minimally invasive cardiac surgery.

    Science.gov (United States)

    Misfeld, Martin; Davierwala, Piroze

    2012-01-01

    With the ever-increasing popularity of minimally invasive (MI) cardiac surgery, procedures like aortic valve replacement, with or without concomitant aortic surgery, and mitral and tricuspid valve procedures are now routinely performed through a minimal-access partial upper sternotomy and right anterolateral small thoracotomy, respectively, in our institution. To have optimal visualization through a small incision, it is extremely important to reduce the number of instruments, retractors, and cannulae passing through the incision to a bare minimum and to avoid repeated manipulation of the operative field. Repeated use of blood cardioplegia to maintain myocardial protection can sometimes prevent the surgeon from executing the aforementioned measures. However, if adequate myocardial protection can be achieved and maintained by administering a single dose of crystalloid cardioplegia, it would help expedite the operation with greater ease. At our institution, myocardial protection during aortic valve surgery is achieved using either blood or crystalloid cardioplegia according to surgeon preference. However, crystalloid cardioplegia has become the standard myocardial protection strategy for performing MI mitral valve surgery. Our experience with crystalloid cardioplegia for MI mitral valve surgery is the focus of this article.

  9. Corneal tissue welding with infrared laser irradiation after clear corneal incision.

    Science.gov (United States)

    Rasier, Rfat; Ozeren, Mediha; Artunay, Ozgür; Bahçecioğlu, Halil; Seçkin, Ismail; Kalaycoğlu, Hamit; Kurt, Adnan; Sennaroğlu, Alphan; Gülsoy, Murat

    2010-09-01

    The aim of this study was to investigate the potential of infrared lasers for corneal welding to seal corneal cuts done in an experimental animal model. Full-thickness corneal cuts on freshly enucleated bovine eyes were irradiated with infrared (809-nm diode, 980-nm diode, 1070-nm YLF, and 1980-nm Tm:YAP) lasers to get immediate laser welding. An 809-nm laser was used with the topical application of indocyanine green to enhance the photothermal interaction at the weld site. In total, 60 bovine eyes were used in this study; 40 eyes were used in the first part of the study for the determination of optimal welding parameters (15 eyes were excluded because of macroscopic carbonization, opacification, or corneal shrinkage; 2 eyes were used for control), and 20 eyes were used for further investigation of more promising lasers (YLF and Tm:YAP). Laser wavelength, irradiating power, exposure time, and spot size were the dose parameters, and optimal dose for immediate closure with minimal thermal damage was estimated through histological examination of welded samples. In the first part of the study, results showed that none of the applications was satisfactory. Full-thickness success rates were 28% (2 of 7) for 809-nm and for 980-nm diode lasers and 67% (2 of 3) for 1070-nm YLF and (4 of 6) for 1980-nm Tm:YAP lasers. In the second part of the study, YLF and Tm:YAP lasers were investigated with bigger sample size. Results were not conclusive but promising again. Five corneal incisions were full-thickness welded out of 10 corneas with 1070-nm laser, and 4 corneal incisions were partially welded out of 10 corneas with 1980-nm laser in the second part of the study. Results showed that noteworthy corneal welding could be obtained with 1070-nm YLF laser and 1980-nm Tm:YAP laser wavelengths. Furthermore, in vitro and in vivo studies will shed light on the potential usage of corneal laser welding technique.

  10. Comparison of Modifications in Flap Anastomosis Patterns and Skin Incision Types for External Dacryocystorhinostomy: Anterior-Only Flap Anastomosis with W Skin Incision versus Anterior and Posterior Flap Anastomosis with Linear Skin Incision

    Directory of Open Access Journals (Sweden)

    Burcu Dirim

    2015-01-01

    Full Text Available Purpose. To compare the outcomes of external dacryocystorhinostomy (E-DCR by using two different flap anastomosis patterns and skin incision types. Methods. This study included 79 patients (88 eyes with lacrimal drainage system disorders who underwent E-DCR surgery. Fifty eyes of 44 patients (group A underwent E-DCR by suturing anterior and posterior flaps (H-flap of the lacrimal sac with curvilinear skin incision whereas in 38 eyes of 35 patients (group B DCR was performed by suturing only anterior flaps (U-flap with W skin incision. Results. The success rate was evaluated according to lacrimal patency and scar assessment scores. Patency was achieved in 78 patients (88.6%. In terms of groups, patency was 44 eyes (88.0% in group A and 34 eyes (89.5% in group B. There was no statistically significant difference in the success rates of lacrimal patency between the two groups. Further, there was no statistically significant difference concerning cutaneous scar scores. Conclusion. Our study suggests that anastomoses of only anterior flaps or both anterior and posterior flaps have similar success rates; suturing only anterior flaps is easier to perform and shortens the operative time. In addition, W skin incision is a reasonable alternative to curvilinear incision for reducing scar formation.

  11. Minimally invasive plate internal fixation for calcaneal fractures

    Institute of Scientific and Technical Information of China (English)

    SHAN Shu-lan; XU Jun-ling; YAO Shu-zhang; YU Guo-sheng; LIU Yu-qin

    2010-01-01

    Objective: To assess the clinical efficacy of minimally invasive plate internal fixation for the treatment of calcaneal fractures.Methods: Manual reduction, rectification of deformity,and cold compress with traditional Chinese medicine were used preoperatively to relieve swelling and pain. A small incision was made to expose the articular facet and to perform anatomic reduction and plate fixation. Self-made traditional Chinese pharmaceutics were applied postoperatively on the surface of the wound to accelerate bony union.Results: All the 40 patients were followed up for at least 1 year postoperatively. According to the Maryland scoring system, the excellent and good rate was 87.5%.Conclusion: Minimally invasive plate internal fixation has the advantages of relatively mild injury, reliable fixation,good recovery, and rare complications in the treatment of intraarticular fractures.

  12. Minimally invasive surgical treatment of valvular heart disease.

    Science.gov (United States)

    Goldstone, Andrew B; Joseph Woo, Y

    2014-01-01

    Cardiac surgery is in the midst of a practice revolution. Traditionally, surgery for valvular heart disease consisted of valve replacement via conventional sternotomy using cardiopulmonary bypass. However, over the past 20 years, the increasing popularity of less-invasive procedures, accompanied by advancements in imaging, surgical instrumentation, and robotic technology, has motivated and enabled surgeons to develop and perform complex cardiac surgical procedures through small incisions, often eliminating the need for sternotomy or cardiopulmonary bypass. In addition to the benefits of improved cosmesis, minimally invasive mitral valve surgery was pioneered with the intent of reducing morbidity, postoperative pain, blood loss, hospital length of stay, and time to return to normal activity. This article reviews the current state-of-the-art of minimally invasive approaches to the surgical treatment of valvular heart disease.

  13. Application of minimally invasive surgery in traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Liu Baiyun

    2014-12-01

    Full Text Available This article aims to expound the essence of minimally invasive surgery as well as when and how to use it in craniocerebral trauma surgery according to the characteristics of the disease. In neurosurgery, the importance of tissue protection should be from the inside to the outside, i.e. brain→dura→skull→scalp. In this article, I want to share my opinion and our team’s experience in terms of selecting surgical approaches and incision, surgical treatment of the skull, dura handling, intracranial operation and placement of drainage based on the above theory. I hope this will be helpful for trauma surgeons. Key words: Traumatic brain injuries; Large craniectomy; Surgical procedures, minimally invasive

  14. Minimal constrained supergravity

    Directory of Open Access Journals (Sweden)

    N. Cribiori

    2017-01-01

    Full Text Available We describe minimal supergravity models where supersymmetry is non-linearly realized via constrained superfields. We show that the resulting actions differ from the so called “de Sitter” supergravities because we consider constraints eliminating directly the auxiliary fields of the gravity multiplet.

  15. Minimally invasive periodontal therapy.

    Science.gov (United States)

    Dannan, Aous

    2011-10-01

    Minimally invasive dentistry is a concept that preserves dentition and supporting structures. However, minimally invasive procedures in periodontal treatment are supposed to be limited within periodontal surgery, the aim of which is to represent alternative approaches developed to allow less extensive manipulation of surrounding tissues than conventional procedures, while accomplishing the same objectives. In this review, the concept of minimally invasive periodontal surgery (MIPS) is firstly explained. An electronic search for all studies regarding efficacy and effectiveness of MIPS between 2001 and 2009 was conducted. For this purpose, suitable key words from Medical Subject Headings on PubMed were used to extract the required studies. All studies are demonstrated and important results are concluded. Preliminary data from case cohorts and from many studies reveal that the microsurgical access flap, in terms of MIPS, has a high potential to seal the healing wound from the contaminated oral environment by achieving and maintaining primary closure. Soft tissues are mostly preserved and minimal gingival recession is observed, an important feature to meet the demands of the patient and the clinician in the esthetic zone. However, although the potential efficacy of MIPS in the treatment of deep intrabony defects has been proved, larger studies are required to confirm and extend the reported positive preliminary outcomes.

  16. Logarithmic Superconformal Minimal Models

    CERN Document Server

    Pearce, Paul A; Tartaglia, Elena

    2013-01-01

    The higher fusion level logarithmic minimal models LM(P,P';n) have recently been constructed as the diagonal GKO cosets (A_1^{(1)})_k oplus (A_1^{(1)})_n / (A_1^{(1)})_{k+n} where n>0 is an integer fusion level and k=nP/(P'-P)-2 is a fractional level. For n=1, these are the logarithmic minimal models LM(P,P'). For n>1, we argue that these critical theories are realized on the lattice by n x n fusion of the n=1 models. For n=2, we call them logarithmic superconformal minimal models LSM(p,p') where P=|2p-p'|, P'=p' and p,p' are coprime, and they share the central charges of the rational superconformal minimal models SM(P,P'). Their mathematical description entails the fused planar Temperley-Lieb algebra which is a spin-1 BMW tangle algebra with loop fugacity beta_2=x^2+1+x^{-2} and twist omega=x^4 where x=e^{i(p'-p)pi/p'}. Examples are superconformal dense polymers LSM(2,3) with c=-5/2, beta_2=0 and superconformal percolation LSM(3,4) with c=0, beta_2=1. We calculate the free energies analytically. By numerical...

  17. Prostate resection - minimally invasive

    Science.gov (United States)

    ... invasive URL of this page: //medlineplus.gov/ency/article/007415.htm Prostate resection - minimally invasive To use ... into your bladder instead of out through the urethra ( retrograde ... on New Developments in Prostate Cancer and Prostate Diseases. Evaluation and treatment of lower ...

  18. Single transverse extended incision for radical neck dissection.

    Science.gov (United States)

    Chagas, José Francisco Sales; Pascoal, Maria Beatriz Nogueira; Aquino, José Luís Braga; Brandi, Luís Antônio; Previtale, Evandro Von Zuben; Trillo, Ana Sofia Pontes; Curioni, Otávio Alberto; Rapoport, Abrão; Dedivitis, Rogério Aparecido

    2016-01-01

    to assess the efficacy of the single transverse extended cervical incision in radical neck dissection. we conducted a prospective study, from January 2008 to January 2009, with 18 patients undergoing surgical treatment of malignant tumors of the upper aero-digestive tract. The primary lesion was located in the oral cavity in eight cases, in the oropharynx in three, in the hypopharynx in three, in the larynx in two, in the maxillary sinus, and in one case, the primary injury was hidden. There were 29 neck dissections, eight bilateral and 10 unilateral (26 radical and three selective). Staging revealed nine patients with T4 tumor, one T3, six T2, one T1 and one Tx. Five patients were N0, nine N2b, one N2c and three N3. The average number of dissected lymph nodes was 34.25. We performed the neck dissection through a single incision located in the middle neck, coincident with the skinfold, with a length of about 2 to 3 cm behind the anterior edge of the trapezius muscle and 3 to 4 cm from the midline for the unilateral neck dissections. as complications, there were myocutaneous flap necrosis in one patient with prior radiation therapy, one lymphatic fistula, one dehiscence of the tracheostomy, one cervical abscess, one salivary fistula and one suture dehiscence. the single extended incision provides adequate exposure of the neck structures, without compromising surgical time, even in bilateral dissections. It does not compromise the resection of all cervical lymph nodes; it has excellent aesthetic and functional results and is easily associated with other approaches to resection of the primary tumor. verificar a eficácia da incisão cervical única, transversa e estendida, para o esvaziamento cervical radical. estudo prospectivo, de janeiro de 2008 a janeiro de 2009, de 18 pacientes submetidos a tratamento cirúrgico de tumores malignos da via aero-digestiva superior. A lesão primária se situava na cavidade oral em oito casos, na orofaringe em três, no seio

  19. Minimizing incisional dehiscence following 2-stage prosthetic breast reconstruction in the setting of radiation therapy

    OpenAIRE

    Nahabedian, Maurice Y.

    2013-01-01

    Incisional dehiscence is a potential complication following prosthetic breast reconstruction. This is exacerbated in the setting of previous radiation therapy (RT) at the time of exchange of the tissue expander to a permanent implant. A technical modification is described that has successfully minimized this adverse event. Twenty-nine patients that had tissue expanders and RT underwent exchange of the device through a laterally based incision along the inframammary fold (IMF) rather than thro...

  20. Virtual cardiotomy based on 3-D MRI for preoperative planning in congenital heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Soerensen, Thomas Sangild [University of Aarhus, Department of Computer Science, Aarhus N (Denmark); University of Aarhus, Institute of Clinical Medicine, Aarhus (Denmark); Beerbaum, Philipp; Razavi, Reza; Greil, Gerald Franz [King' s College London School of Medicine, Division of Imaging Sciences, London (United Kingdom); Guy' s and St. Thomas' Hospital, Department of Paediatric Cardiology, London (United Kingdom); Mosegaard, Jesper [Alexandra Institute, Aarhus (Denmark); Rasmusson, Allan [University of Aarhus, Department of Computer Science, Aarhus N (Denmark); Schaeffter, Tobias [King' s College London School of Medicine, Division of Imaging Sciences, London (United Kingdom); Austin, Conal [Guy' s and St. Thomas' Hospital, Department of Cardiothoracic Surgery, London (United Kingdom)

    2008-12-15

    Patient-specific preoperative planning in complex congenital heart disease may be greatly facilitated by virtual cardiotomy. Surgeons can perform an unlimited number of surgical incisions on a virtual 3-D reconstruction to evaluate the feasibility of different surgical strategies. To quantitatively evaluate the quality of the underlying imaging data and the accuracy of the corresponding segmentation, and to qualitatively evaluate the feasibility of virtual cardiotomy. A whole-heart MRI sequence was applied in 42 children with congenital heart disease (age 3{+-}3 years, weight 13{+-}9 kg, heart rate 96{+-} 21 bpm). Image quality was graded 1-4 (diagnostic image quality {>=}2) by two independent blinded observers. In patients with diagnostic image quality the segmentation quality was also graded 1-4 (4 no discrepancies, 1 misleading error). The average image quality score was 2.7 - sufficient for virtual reconstruction in 35 of 38 patients (92%) older than 1 month. Segmentation time was 59{+-}10 min (average quality score 3.5). Virtual cardiotomy was performed in 19 patients. Accurate virtual reconstructions of patient-specific cardiac anatomy can be produced in less than 1 h from 3-D MRI. The presented work thus introduces a new, clinically feasible noninvasive technique for improved preoperative planning in complex cases of congenital heart disease. (orig.)

  1. Anoftalmia associada à catarata congênita: relato de caso Anophthalmia and congenital cataract: case report

    Directory of Open Access Journals (Sweden)

    Alessandro Santana

    2005-06-01

    Full Text Available Apresentação de um caso de anoftalmia e catarata congênita associada a malformações sistêmicas. Paciente, 6 meses, do sexo masculino, com anoftalmia à esquerda e catarata congênita polar posterior à direita. Instituiu-se terapêutica cirúrgica por meio de aspiração do núcleo e córtex com pequena incisão sem implante de lente intra-ocular, e capsulorrexe posterior com vitrectomia. A associação entre anoftalmia e catarata congênita é condição rara em que o diagnóstico e tratamento precoces são fundamentais para adequada reabilitação do paciente.The authors report a case of anophthalmia, congenital cataract and systemic malformations. Male patient, 6 months old, left anophthalmia and congenital posterior polar cataract in the right eye. The patient was treated with manual aspiration of the crystalline lens, with no intraocular lens implantation with primary posterior capsulorhexis and anterior vitrectomy through a small incision. The association of anophthalmia and congenital cataract is rare. The early diagnosis and management in these cases is very important for the best visual rehabilitation.

  2. Dental stigmata and enamel thickness in a probable case of congenital syphilis from XVI century Croatia.

    Science.gov (United States)

    Lauc, Tomislav; Fornai, Cinzia; Premužić, Zrinka; Vodanović, Marin; Weber, Gerhard W; Mašić, Boris; Rajić Šikanjić, Petra

    2015-10-01

    To analyse the dental remains of an individual with signs of congenital syphilis by using macroscopic observation, CBCT and micro-CT images, and the analysis of the enamel thickness. Anthropological analysis of human skeletal remains from the 16th century archaeological site Park Grič in Zagreb, Croatia discovered a female, 17-20 years old at the time of death, with dental signs supportive of congenital syphilis: mulberry molars and canine defects, as well as non-specific hypoplastic changes on incisors. The focus of the analysis was on three aspects: gross morphology, hypoplastic defects of the molars, canines and incisors, as well as enamel thickness of the upper first and second molars. The observed morphology of the first molars corresponds to the typical aspect of mulberry molars, while that of the canines is characterised by hypomineralisation. Hypoplastic grooves were observed on the incisal edges of all incisors. The enamel of the first molars is underdeveloped while in the second molars a thick-enamelled condition is observed. Our observations for the dental and skeletal evidence are supportive to a diagnosis of congenital syphilis for this specimen from XVI century Croatia. The use of CT imaging helped documenting the diagnostic features and quantifying the effect of the dental stigmata on first molars. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. [Retrospective analysis of the treatment of recurrent congenital fistula or cyst in lateral cervical part].

    Science.gov (United States)

    Yuan, Yongyi; Zhang, Guozheng; Wang, Guojian; Huang, Deliang; Liu, Liangfa; Wu, Wenming; Wang, Jialing

    2011-12-01

    To analysis the therapeutic procedure on the recurrent congenital fistula or cyst in lateral cervical part. Thirty-nine cases with recurrent congenital fistula or cyst in lateral cervical part were enrolled in this study including 12 cases from the first branchial cleft, 6 from the second branchial cleft and 21 from the third branchial cleft. All the cases underwent fistula or cyst excision for 2 to 5 times in their whole therapeutic process, not counting the incision and drainage. During 9 months to 17 years follow-up, fistula or cyst in 6 cases relapsed,including 1 fistula from the first branchial cleft,3 fistulae from the second branchial cleft, 1 fistula and 1 cyst from the third branchial cleft, respectively. One case with recurrent fistula from the first branchial cleft was diagnosed temporal verrucous carcinoma six months after the third fistula excision operation and died one year after the forth operation probably due to the intracranial metastasis of temporal bone verrucous carcinoma. In two cases, the fistulae went through the thyroid gland to the piriform fossa and both the fistulae and part of the thyroid glands were resected. In the patients whose inner orificium fistulae were found and ligated effectively,no recurrence occurred during the followed-up period. The key point to cure the recurrent congenital fistula or cyst in lateral cervical part lies in proper occasion of operation, stain tracing in operation and reasonable program of operation.

  4. Extensive adipose tissue necrosis following pfannenstiel incision for endometrial cancer.

    Science.gov (United States)

    Lavoie, Maryse Céline; Plante, Marie; Lemieux, Marie-Carine; Roberge, Céline; Renaud, Marie-Claude; Grégoire, Jean; Roy, Michel; Sebastianelli, Alexandra

    2014-03-01

    Contexte : Les hématomes sont des complications postopératoires qui peuvent en venir à se manifester à la suite du recours à des incisions de Pfannenstiel. Habituellement, ils se résorbent de façon spontanée ou font l’objet d’un drainage (en fonction de leur ampleur). Des facteurs de risque importants (comme l’obésité et le diabète) pourraient mener à des complications surajoutées et aggraver davantage l’issue. Cas : Dix jours après avoir subi une hystérectomie abdominale totale par incision de Pfannenstiel en raison d’un cancer de l’endomètre, une femme de 73 ans a présenté un gros hématome sous-cutané. L’hématome en question a évolué et a mené à une nécrose étendue du tissu adipeux sous-cutané. La mise en œuvre d’un débridement de grande envergure s’est avérée nécessaire et la plaie a été traitée par pression négative au moyen de gaze afin de permettre une cicatrisation par deuxième intention. Une guérison satisfaisante a été constatée après 82 jours de traitement, sans greffe cutanée. Conclusion : Ce cas souligne l’utilité du traitement de plaie par pression négative au moyen de gaze, ainsi que la nécessité d’avoir recours à une approche multidisciplinaire au moment d’assurer la prise en charge de complications de plaie d’une telle complexité.

  5. [Minimally invasive cardiac surgery for aortic valve disease].

    Science.gov (United States)

    Fujimura, Y; Katoh, T; Hamano, K; Gohra, H; Tsuboi, H; Esato, K

    1998-12-01

    Recent surgical advances leading to good operative results have contributed to the trend to useminimally invasive approaches, even in cardiac surgery. Smaller incisions are clearly more cosmetically acceptable to patients. When using a minimally invasive approach, it is most important to maintain surgical quality without jeopardizing patients. A good operative visual field leads to good surgical results. In the parasternal approach, we use a retractor to harvest an internal thoracic artery in coronary artery bypass surgery. Retracting the sternum upward allows for a good surgical view and permits the use of an arch cannula rather than femoral cannulation. When reoperating for aortic valve repair, the j-sternotomy approach requires less adhesiolysis compared with the traditional full sternotomy. No special technique is necessary to perform aortic valve surgery using the j-sternotomy approach. However, meticulous attention must be paid to avoiding left ventricular air embolisms to prevent postoperative stroke or neurocognitive deficits, especially when utilizing a minimally invasive approach. Transesophageal echo is useful not only for monitoring cardiac function but also for monitoring the persence of air in the left ventricle and atrium. This paper compare as the degree of invasion of minimally invasive cardiac surgery and the traditional full sternotomy. No differences were found in the occurrence of systemic inflammatory response syndrome between patients undergoing minimally invasive cardiac surgery and the traditional technique. Therefore it is concluded that minimally invasive surgery for patients with aortic valve disease may become the standard approach in the near future.

  6. Development of a New Type of Incisal Table for Prosthetic Articulators

    Directory of Open Access Journals (Sweden)

    Alessandro Tasora

    2010-01-01

    Full Text Available This study illustrates the effectiveness of an advanced incisal table surface, featuring adjustable curvature, in the sake of more accurate articulator kinematics in anterior teeth reconstruction. Prosthetic articulators, used by dental technicians in reconstructive dentistry, are adjustable instruments that simulate the motion of mastication between dental casts: usually, the forward motion (protrusion of the mandible is guided by sliding a pin over a flat table in order to recreate those movements when incisal teeth are missing. However, such protrusion is an approximation of the exact motion, since flat incisal tables have a limited set of adjustments. Customized software has been developed in order to simulate the kinematics of articulators in three-dimensional space: animations and measures of the envelope of teeth profiles show the unfeasibility of reconstructing with good approximation the profile of incisive teeth, when a simple ‘flat’ incisal table is used. A new incisal table with an adjustable curvature has been proposed, simulated, and built, and computer simulations demonstrated the superior precision of the new design when compared to a conventional articulator which uses a flat incisal table.

  7. Percutaneous bone-anchored hearing implant surgery: dermatome versus linear incision technique.

    Science.gov (United States)

    Strijbos, Ruben M; Bom, Steven J H; Zwerver, Stefan; Hol, Myrthe K S

    2017-01-01

    The objective of this historical cohort study is to identify if there are differences in soft tissue reactions and skin thickening between implantation of the percutaneous bone-anchored hearing implant (BAHI) using the dermatome or linear incision technique. All adult patients who received a BAHI between August 2005 and January 2013 were selected. One surgeon performed all procedures and only the dermatome and linear incision technique were used. A total of 132 patients/implants were included and significantly more patients with risk factors were seen in the linear incision cohort. A soft tissue reaction Holgers ≥1 was present in 18 patients (40.9 %) in the dermatome compared to 36 patients (40.9 %) in the linear incision group. A Holgers ≥2 was noticed in 9 (20.5 %) and 19 (21.6 %) patients, respectively. Skin thickening was described in 14 (31.8 %) and 11 patients (12.5 %) in, respectively, the dermatome and linear incision cohort, which was a significant difference (p = 0.001). Nevertheless, therapeutic interventions were effective. In conclusion, there was no significant difference in (adverse) soft tissue reactions; however, skin thickening was more present in the dermatome technique. In addition, significantly more patients with risk factors were allocated to the linear incision technique. Based on these results, the linear incision is advocated as preferred technique.

  8. [Dentascan computed tomography of the mandibular incisive canal. Its radiologic anatomy and the therapeutic implications].

    Science.gov (United States)

    Calgaro, A; Bison, L; Bellis, G B; Pozzi Mucelli, R

    1999-11-01

    To stress the importance of CT depiction of the mandibular incisive canal. This anatomical structure contains a major neurovascular bundle and is thus very important in the planning of mandibular implants in the canine-incisive area. January through December 1998, sixty patients unselected by age and gender were submitted to mandibular CT. Axial slices were acquired with 1-1.5 mm thickness and 1 mm table feed, and the images were then reformatted with a dedicated dental software. Both the conventional and the Helical techniques were used. The incisive canal appears on Dentascan transverse reconstructions as a round low-density area within mandibular trabecular bone, which is surrounded by a higher-density rim representing the canal walls. This anatomical structure originates from the mental foramen and continues mesially to the mental symphysis. The mandibular canal was visualized in 95% of cases bilaterally (57/60); the incisive canal was depicted on the left side in 41.6% of cases (25/60) and on the right side in 51.6% (31/60). The importance of careful assessment of the mandibular canal course before implantology is now widely recognized. The same holds true for the canine-incisive region in the jaw, to detect the incisive canal if present and prevent any complications from its accidental damage. CT with a dedicated software showed the incisive canal in a large number of patients, which calls for precise reporting of its presence, course, and relationships with teeth.

  9. Incision properties and thermal effects of CO2 lasers in soft tissue

    Science.gov (United States)

    Wilder-Smith, Petra B. B.; Arrastia-Jitosho, Anna-Marie A.; Liaw, Lih-Huei L.; Berns, Michael W.

    1995-05-01

    Thermal and histological events resulting from soft tissue incision using CO2 lasers at 9.3 (mu) or 10.6 (mu) , fitted with a hollow wave guide or an articulated arm delivery system respectively, were investigated. In 9 fresh pigs' mandibles, standardized incisions 3 cm in length were made in the oral mucosa. Incisions were performed in the cw mode at 1 W, 4 W, and 12 W. Thermal events were measured in adjacent soft tissues using thermocouples. Incisions were dissected out, fixed, embedded in paraffin wax, sectioned and stained with Serius Red. The Students' t-test for paired data was used to compare zones of necrosis, zones of collagen damage and thermal events. No significant temperature rise was measured during irradiation at any timepoints or power settings (p < 0.05). Results were very similar for the two lasers with significantly different results obtained only at the 12 W setting (p < 0.05). Vertical incision depths and horizontal incision widths did not differ significantly (p < 0.0001) at 12 W and 4 W. Horizontal and vertical zones of necrosis did not differ significantly (p < 0.0001) either between the two lasers at 12 W and 4 W. Thus the thermal and histological events occurring during soft tissue incision were similar using these two lasers, despite the difference in wavelength and delivery system.

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

    Directory of Open Access Journals (Sweden)

    Bhattacharya Debasish

    2009-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Arefah Dehghani Tafti

    2011-03-01

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

  12. Scar Assessment After Breast Augmentation Surgery with Axillary Incision versus Inframammary Fold Incision: Long-Term Follow-Up in Chinese Patients.

    Science.gov (United States)

    Sun, Jingjing; Mu, Dali; Liu, Chunjun; Ji, Kai; Chen, Lin; Liu, Wenyue; Luan, Jie

    2016-10-01

    The inframammary fold (IMF) incision is widely used in Western countries for breast augmentation surgery, whereas the axillary incision is the dominant approach used in China, because many Chinese surgeons believe that the Asian population has a higher risk of developing hypertrophic scars. However, comparative data of scar assessment through different incisions in Chinese patients are scarce. The aims of the study were as follows: (1) to evaluate the outcomes of scar assessment using the Vancouver scar scale (VSS), combined with patient satisfaction scoring, in the scar assessment after breast augmentation surgery; (2) to compare the long-term cosmetic effects of surgical scars between axillary and IMF incisions. Consecutive patients coming to our department for follow-up care at least 1 year after primary breast augmentation surgeries with axillary and IMF incisions between January 1, 2014 and December 31, 2014 were included in the research. Internal consistency, inter-rater reliability, and convergent validity were examined for the VSS and patient satisfaction scoring. The baseline characteristics and scar scores were tested using the Mann-Whitney U-test and Student's t test between the two groups. Sixty-one patients underwent implantation surgeries through the axillary incisions, and 17 patients through the IMF incisions. There were no significant differences in age, follow-up time, body mass index, implant volume, or implant projection between groups. Reliability and validity of the VSS and patient satisfaction scoring were satisfactory. The scores of pigmentation were higher in the IMF group than those in the axilla group with statistical significance (P IMF group (P IMF can achieve comparable cosmetic effects and patient satisfaction in Chinese women. Chinese patients with proper indications can receive breast augmentation surgery through the IMF incision, with fewer risks and less trauma, and get satisfactory scar appearance as through the axillary

  13. Experience in using three different minimally invasive approaches in cardiac operations.

    Science.gov (United States)

    Wang, Wen Lin; Cai, Kai Can; Zeng, Wei Sheng; Jiang, Ren Chao

    2003-03-01

    In order to reach a clear understanding of minimally invasive approaches in cardiac operations, the authors review clinical experience in using three such approaches: inferior partial median sternotomy, right anterolateral minor thoracotomy, and the right parasternal approach. Sternotomy and the three different minimally invasive approaches were applied in and 2431 and 323 patients respectively. The approaches were selected according to the circumstances of the individual case. Both external and internal cardiac structures were observed during the operations. The length of the incision, the postoperative drainage, operative time, and cardiopulmonary bypass time were investigated. The postoperative complications occurring after minimally invasive approaches were observed. In inferior partial median sternotomy, all structures except for the ascending aorta could be exposed well. In right anterolateral minor thoracotomy, only the structures on the right side of the heart could be exposed, but the mitral valve could also be exposed well. The exposure of the right parasternal approach was similar to that of right anterolateral minor thoracotomy. There were statistically significant differences between sternotomy and the minimally invasive approaches in terms of incision length and postoperative drainage, but no difference in operative time and cardiopulmonary bypass time. The postoperative complications of MIAs included air embolism (n = 3), chest pain (n = 9), chest wall malacia (n = 1), rib fracture (n = 2), and sternum fracture (n = 2). The total incidence of complications in minimally invasive approaches was 5.3%. The minimally invasive approaches can have satisfactory clinical results if the approaches are correctly chosen and performed.

  14. Neuro-imaging and positron emission tomography of congenital homonymous hemianopsia.

    Science.gov (United States)

    Bosley, T M; Kiyosawa, M; Moster, M; Harbour, R; Zimmerman, R; Savino, P J; Sergott, R C; Alavi, A; Reivich, M

    1991-04-15

    Congenital homonymous hemianopsia is an uncommon asymptomatic visual field defect discovered typically in young adult life that is caused by a diverse group of insults to the retrochiasmal afferent visual system occurring prenatally, at birth, or during early childhood. We treated eight patients with congenital homonymous hemianopsia; seven with damage involving the optic radiations and one with an abnormality of the optic tract. We performed positron emission tomography using 18F-fluoro-2-deoxyglucose on two patients with dense homonymous hemianopsias, lesions of the contralateral optic radiations, and largely intact occipital cortex. These studies showed minimal abnormalities in resting visual cortex glucose metabolism of the affected visual cortex.

  15. Management of labour and delivery in congenitally corrected transposition of great arteries.

    Science.gov (United States)

    Dhir, S; Racine, J; Gratton, R; Bergin, L; de Vrijer, B

    2015-11-01

    A descriptive case report of the labour and delivery management of a 28-year-old woman who presented with congenitally corrected transposition of great arteries, dextrocardia, systemic ventricular dysfunction and junctional tachycardia. Patients with congenitally corrected transposition have a thin-walled morphological right ventricle as the systemic circulatory pump. The stress of increased cardiac output can lead to congestive heart failure, systemic atrioventricular valve regurgitation and arrhythmias. We used minimally invasive continuous cardiac output monitoring, fluid balance optimization and good maternal pain control to prevent decompensation and achieve vaginal delivery with a good maternal and neonatal outcome. © 2015 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  16. Single-Incision Laparoscopic Sterilization of the Cheetah (Acinonyx jubatus).

    Science.gov (United States)

    Hartman, Marthinus J; Monnet, Eric; Kirberger, Robert M; Schmidt-Küntzel, Anne; Schulman, Martin L; Stander, Jana A; Stegmann, George F; Schoeman, Johan P

    2015-07-01

    To describe laparoscopic ovariectomy and salpingectomy in the cheetah (Acinonyx jubatus) using single-incision laparoscopic surgery (SILS). Prospective cohort. Female cheetahs (Acinonyx jubatus) (n = 21). Cheetahs were randomly divided to receive either ovariectomy (n = 11) or salpingectomy (n = 10). The use and complications of a SILS port was evaluated in all of cheetahs. Surgery duration and insufflation volumes of carbon dioxide (CO2 ) were recorded and compared across procedures. Laparoscopic ovariectomy and salpingectomy were performed without complications using a SILS port. The poorly-developed mesosalpinx and ovarian bursa facilitated access to the uterine tube for salpingectomy in the cheetah. The median surgery duration for ovariectomy was 24 minutes (interquartile range 3) and for salpingectomy was 19.5 minutes (interquartile range 3) (P = .005). The median volume of CO2 used for ovariectomy was 11.25 L (interquartile range 3.08) and for salpingectomy was 4.90 L (interquartile range 2.52), (P = .001) CONCLUSIONS: Laparoscopic ovariectomy and salpingectomy can be performed in the cheetah using SILS without perioperative complications. Salpingectomy is faster than ovariectomy and requires less total CO2 for insufflation. © Copyright 2015 by The American College of Veterinary Surgeons.

  17. [Intraocular pressure decrease after manual small incision cataract surgery].

    Science.gov (United States)

    Nganga Ngabou, C G F; Makita, C; Ndalla, S S; Nkokolo, F; Madzou, M

    2017-05-01

    We decided to evaluate the decrease in intraocular pressure six months after cataract surgery. We evaluated patients' IOP using an applanation tonometer. The patients then underwent cataract surgery. Six months after cataract surgery, we reevaluated the IOP by the same method, and we determined the post-operative change. Among the 147 operated eyes, 123 eyes or 83.67% exhibited a decrease in IOP. The mean preoperative IOP for the operative eye was 15.61±4.5mmHg; the mean post-operative IOP was 12.57±3.5mmHg; the mean IOP decrease after surgery was 3.16±4mmHg, for a mean decrease of 20%. This decrease is statistically significant, Pdecrease in IOP varies proportionally to the initial IOP. In glaucomatous patients, the mean preoperative IOP was 23.16±5.68mmHg and mean post-operative IOP was 14.5±2.7mmHg, a decrease of 37.39%. The decrease in IOP after cataract surgery was generally moderate. However, this IOP decreased proportionally to the initial IOP, thus giving significant decreases for higher IOPs. This decrease in IOP, well known after phacoemulsification, was also obtained after Manual Small Incision Cataract Surgery, a surgical technique which is increasingly employed in developing countries. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  18. Reproductive Outcome of Transcervical Uterine Incision in Unicornuate Uterus

    Science.gov (United States)

    Xia, En-Lan; Li, Tin-Chiu; Choi, Sze-Ngar Sylvia; Zhou, Qiao-Yun

    2017-01-01

    Background: The pregnancy outcome of the unicornuate uterus is associated with an increased risk of miscarriage, cervical incompetence, and a number of obstetric complications. However, at present, there is no accepted treatment method for women with unicornuate uterus, other than expectant measures. The aim of this study was to evaluate the reproductive outcome of transcervical uterine incision (TCUI) in patients with unicornuate uterus. Methods: Thirty-three patients with unicornuate uterus presented to our tertiary center for infertility or miscarriage. All 33 patients underwent TCUI and were followed up for 10–52 months. The pregnancy outcomes (first-trimester miscarriage, second-trimester miscarriage, preterm, term, intrauterine death, ongoing pregnancy, and live birth) before and after TCUI were compared by t-test. Results: Among 31 patients who attempted to conceive after TCUI, twenty conceived including one termination of pregnancy, one second-trimester miscarriage, one ectopic pregnancy, five preterm deliveries, 11 term delivery, and one ongoing pregnancy. There were 16 live births in total. There was significant reduction in the first-trimester miscarriage rate (t = 4.890; P pregnancy outcome in women with unicornuate uterus presenting with infertility or miscarriage. PMID:28139506

  19. Corneal relaxing incision combined with phacoemulsification and IOL implantation

    Institute of Scientific and Technical Information of China (English)

    沈晔; 童剑萍; 李毓敏

    2004-01-01

    Objective: To analyze the effectiveness and safety of corneal relaxing incisions (CRI) in correcting keratometric astigmatism during cataract surgery. Methods: A prospective study of two groups: control group and treatment group. A treatment group included 25 eyes of 25 patients who had combined clear corneal phacoemulsification, IOL implantation and CRI. A control group included 25 eyes of 25 patients who had clear corneal phacoemulsification and IOL implantation.Postoperative keratometric astigmatism was measured at 1 week, 1 month, 3 months and 6 months. Results: CRI signifi-cantly decreased keratometric astigmatism in patients with preexisting astigmatism compared with astigmatic changes in the control group. In eyes with CRI, the mean keratometric astigmatism was 0.29±0.17 D(range 0 to 0.5 D) at 1 week, 0.41±0.21 D (range 0 to 0.82 D) at 1 month, respectively reduced by 2.42 D and 2.30 D at 1 week and 1 month postoperatively (P=0.000, P=0.000), and postoperative astigmatism was stable until 6 months follow-up. The keratometric astigmatism of all patients decreased to less than 1.00 D postoperatively. Conclusions: CRI is a practical, simple, safe and effective method to reduce preexisting astigmatism during cataract surgery. A modified nomogram is proposed. The long-term effect of CRI should be investigated.

  20. Treatment and prevention of poor wound healing of scar incision cesarean section again%瘢痕切口再次剖宫产术切口愈合不良的处理及防范

    Institute of Scientific and Technical Information of China (English)

    陶芳; 骆骏

    2014-01-01

    目的:探讨瘢痕切口再次剖宫产术,术后发生切口愈合不良的处理及防范措施。方法:收治瘢痕切口再次剖宫产术发生切口愈合不良患者12例。切口愈合不良分为切口感染和切口脂肪液化两种,根据渗液的多少采取不同的处理方法。结果:仅3例经换药后,渗液减少后进行了Ⅱ期缝合,其他9例均经换药后,达到Ⅰ期愈合,收效良好。结论:加强防范,积极处理,尽量减少瘢痕切口再次手术后切口愈合不良的发生,以促进切口的早期愈合。%Objective:To investigate the treatment and prevention of poor wound healing of scar incision cesarean section again. Methods:12 patients with poor wound healing of scar incision cesarean section again were selected.The poor wound healing was divided into two kinds of incision infection and incision fat liquefaction,we took a different approach according to how much fluid. Results:Only 3 cases were given Ⅱ period suture when the drainage decrease after dressing change,the other 9 cases achieve Ⅰperiod healing after dressing change,with good results.Conclusion:If we want to promote the early healing of incision,we must strengthen the prevention,active treatment,and minimize to occur poor wound healing of scar incision cesarean section again.