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Sample records for neural elements percutaneous

  1. High-density percutaneous chronic connector for neural prosthetics

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    Shah, Kedar G.; Bennett, William J.; Pannu, Satinderpall S.

    2015-09-22

    A high density percutaneous chronic connector, having first and second connector structures each having an array of magnets surrounding a mounting cavity. A first electrical feedthrough array is seated in the mounting cavity of the first connector structure and a second electrical feedthrough array is seated in the mounting cavity of the second connector structure, with a feedthrough interconnect matrix positioned between a top side of the first electrical feedthrough array and a bottom side of the second electrical feedthrough array to electrically connect the first electrical feedthrough array to the second electrical feedthrough array. The two arrays of magnets are arranged to attract in a first angular position which connects the first and second connector structures together and electrically connects the percutaneously connected device to the external electronics, and to repel in a second angular position to facilitate removal of the second connector structure from the first connector structure.

  2. Equivalence of Conventional and Modified Network of Generalized Neural Elements

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    E. V. Konovalov

    2016-01-01

    Full Text Available The article is devoted to the analysis of neural networks consisting of generalized neural elements. The first part of the article proposes a new neural network model — a modified network of generalized neural elements (MGNE-network. This network developes the model of generalized neural element, whose formal description contains some flaws. In the model of the MGNE-network these drawbacks are overcome. A neural network is introduced all at once, without preliminary description of the model of a single neural element and method of such elements interaction. The description of neural network mathematical model is simplified and makes it relatively easy to construct on its basis a simulation model to conduct numerical experiments. The model of the MGNE-network is universal, uniting properties of networks consisting of neurons-oscillators and neurons-detectors. In the second part of the article we prove the equivalence of the dynamics of the two considered neural networks: the network, consisting of classical generalized neural elements, and MGNE-network. We introduce the definition of equivalence in the functioning of the generalized neural element and the MGNE-network consisting of a single element. Then we introduce the definition of the equivalence of the dynamics of the two neural networks in general. It is determined the correlation of different parameters of the two considered neural network models. We discuss the issue of matching the initial conditions of the two considered neural network models. We prove the theorem about the equivalence of the dynamics of the two considered neural networks. This theorem allows us to apply all previously obtained results for the networks, consisting of classical generalized neural elements, to the MGNE-network.

  3. Numerical simulation with finite element and artificial neural network ...

    Indian Academy of Sciences (India)

    Further, this database after the neural network training; is used to analyse measured material properties of different test pieces. The ANN predictions are reconfirmed with contact type finite element analysis for an arbitrary selected test sample. The methodology evolved in this work can be extended to predict material ...

  4. Finite element strategies to satisfy clinical and engineering requirements in the field of percutaneous valves.

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    Capelli, Claudio; Biglino, Giovanni; Petrini, Lorenza; Migliavacca, Francesco; Cosentino, Daria; Bonhoeffer, Philipp; Taylor, Andrew M; Schievano, Silvia

    2012-12-01

    Finite element (FE) modelling can be a very resourceful tool in the field of cardiovascular devices. To ensure result reliability, FE models must be validated experimentally against physical data. Their clinical application (e.g., patients' suitability, morphological evaluation) also requires fast simulation process and access to results, while engineering applications need highly accurate results. This study shows how FE models with different mesh discretisations can suit clinical and engineering requirements for studying a novel device designed for percutaneous valve implantation. Following sensitivity analysis and experimental characterisation of the materials, the stent-graft was first studied in a simplified geometry (i.e., compliant cylinder) and validated against in vitro data, and then in a patient-specific implantation site (i.e., distensible right ventricular outflow tract). Different meshing strategies using solid, beam and shell elements were tested. Results showed excellent agreement between computational and experimental data in the simplified implantation site. Beam elements were found to be convenient for clinical applications, providing reliable results in less than one hour in a patient-specific anatomical model. Solid elements remain the FE choice for engineering applications, albeit more computationally expensive (>100 times). This work also showed how information on device mechanical behaviour differs when acquired in a simplified model as opposed to a patient-specific model.

  5. Artificial Neural Network System to Predict the Postoperative Outcome of Percutaneous Nephrolithotomy.

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    Aminsharifi, Alireza; Irani, Dariush; Pooyesh, Shima; Parvin, Hamid; Dehghani, Sakineh; Yousofi, Khalilolah; Fazel, Ebrahim; Zibaie, Fatemeh

    2017-05-01

    To construct, train, and apply an artificial neural network (ANN) system for prediction of different outcome variables of percutaneous nephrolithotomy (PCNL). We calculated predictive accuracy, sensitivity, and precision for each outcome variable. During the study period, all adult patients who underwent PCNL at our institute were enrolled in the study. Preoperative and postoperative variables were recorded, and stone-free status was assessed perioperatively with computed tomography scans. MATLAB software was used to design and train the network in a feed forward back-propagation error adjustment scheme. Preoperative and postoperative data from 200 patients (training set) were used to analyze the effect and relative relevance of preoperative values on postoperative parameters. The validated adequately trained ANN was used to predict postoperative outcomes in the subsequent 254 adult patients (test set) whose preoperative values were serially fed into the system. To evaluate system accuracy in predicting each postoperative variable, predicted values were compared with actual outcomes. Two hundred fifty-four patients (155 [61%] males) were considered the test set. Mean stone burden was 6702.86 ± 381.6 mm3. Overall stone-free rate was 76.4%. Fifty-four out of 254 patients (21.3%) required ancillary procedures (shockwave lithotripsy 5.9%, transureteral lithotripsy 10.6%, and repeat PCNL 4.7%). The accuracy and sensitivity of the system in predicting different postoperative variables ranged from 81.0% to 98.2%. As a complex nonlinear mathematical model, our ANN system is an interconnected data mining tool, which prospectively analyzes and "learns" the relationships between variables. The accuracy and sensitivity of the system for predicting the stone-free rate, the need for blood transfusion, and post-PCNL ancillary procedures ranged from 81.0% to 98.2%.The stone burden and the stone morphometry were among the most significant preoperative characteristics that

  6. Simulating dynamic plastic continuous neural networks by finite elements.

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    Joghataie, Abdolreza; Torghabehi, Omid Oliyan

    2014-08-01

    We introduce dynamic plastic continuous neural network (DPCNN), which is comprised of neurons distributed in a nonlinear plastic medium where wire-like connections of neural networks are replaced with the continuous medium. We use finite element method to model the dynamic phenomenon of information processing within the DPCNNs. During the training, instead of weights, the properties of the continuous material at its different locations and some properties of neurons are modified. Input and output can be vectors and/or continuous functions over lines and/or areas. Delay and feedback from neurons to themselves and from outputs occur in the DPCNNs. We model a simple form of the DPCNN where the medium is a rectangular plate of bilinear material, and the neurons continuously fire a signal, which is a function of the horizontal displacement.

  7. Neural network applied to elemental archaeological Marajoara ceramic compositions

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    Toyota, Rosimeiri G.; Munita, Casimiro S., E-mail: rosimeiritoy@yahoo.com.b, E-mail: camunita@ipen.b [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil); Boscarioli, Clodis, E-mail: boscarioli@gmail.co [Universidade Estadual do Oeste do Parana, Cascavel, PR (Brazil). Centro de Ciencias Exatas e Tecnologicas. Colegiado de Informatica; Hernandez, Emilio D.M., E-mail: boscarioli@gmail.co [Universidade de Sao Paulo (USP), SP (Brazil). Escola Politecnica; Neves, Eduardo G.; Demartini, Celia C., E-mail: eduardo@pq.cnpq.b [Museu de Arqueologia e Etnologia (MAE/USP), Sao Paulo, SP (Brazil)

    2009-07-01

    In the last decades several analytical techniques have been used in archaeological ceramics studies. However, instrumental neutron activation analysis, INAA, employing gamma-ray spectrometry seems to be the most suitable technique because it is a simple analytical method in its purely instrumental form. The purpose of this work was to determine the concentration of Ce, Co, Cr, Cs, Eu, Fe, Hf, K, La, Lu, Na, Nd, Rb, Sb, Sc, Sm, Ta, Tb, Th, U, Yb, and Zn in 160 original marajoara ceramic fragments by INAA. Marajoara ceramics culture was sophisticated and well developed. This culture reached its peak during the V and XIV centuries in Marajo Island located on the Amazon River delta area in Brazil. The purpose of the quantitative data was to identify compositionally homogeneous groups within the database. Having this in mind, the data set was first converted to base-10 logarithms to compensate for the differences in magnitude between major elements and trace elements, and also to yield a closer to normal distribution for several trace elements. After that, the data were analyzed using the Mahalanobis distance and using the lambda Wilks as critical value to identify the outliers. The similarities among the samples were studied by means of cluster analysis, principal components analysis and discriminant analysis. Additional confirmation of these groups was made by using elemental concentration bivariate plots. The results showed that there were two very well defined groups in the data set. In addition, the database was studied using artificial neural network with unsupervised learning strategy known as self-organizing maps to classify the marajoara ceramics. The experiments carried out showed that self-organizing maps artificial neural network is capable of discriminating ceramic fragments like multivariate statistical methods, and, again the results showed that the database was formed by two groups. (author)

  8. Galanin-like immunoreactive neural elements in domestic ruminant pancreas.

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    Baltazar, E T; Kitamura, N; Sasaki, M; Cottrell, D F; Boloron, H M; Yamada, J

    2001-08-01

    The distribution and ontogeny of the galanin-like immunoreactive (Gal-IR) neural structures in the pancreas of cattle, sheep and goat were investigated immunohistochemically. The present study confirmed the previous findings on the immunolocalization of galanin both in the neural elements and endocrine cells of cattle, and reported for the first time its exclusive localization in the neural elements of sheep and goat. The frequency of Gal-IR nerve fibers and nerve cell bodies was high in cattle and low in sheep and goat. Their first detection was at the first fetal trimester in cattle and third trimester in sheep and goat. In cattle, a marked increase in the frequency of Gal-IR nerve fibers was observed from the third trimester to early neonatal stage followed by a decrease after three months postnatal. In contrast to the non-preferential distribution pattem in sheep, the Gal-IR nerve fibers in cattle and goat pancreas were predominantly associated with the acini, excretory ducts and blood vessels, but rarely detected in the pancreatic islets. The Gal-IR nerve cell bodies were observed as isolated bodies in the intra- and interlobular connective tissues and as a group within the intrapancreatic ganglia. At the vicinity of the nerve cell bodies, Gal-IR nerve fibers were observed. The present findings may suggest that: (1) galanin regulates pancreatic function as neurotransmitter/neuromodulator in ruminants; (2) galanin plays a more important role in large than in small ruminants; and (3) particularly in cattle, it exerts its most dramatic effect during perinatal development.

  9. Percutaneous Mitral Valve Dilatation: Single Balloon versus Double Balloon - A Finite Element Study

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    Schievano, Silvia; Kunzelman, Karyn; Nicosia, Mark; Cochran, R. P.; Einstein, Daniel R.; Khambadkone, Sachin; Bonheoffer, Philipp

    2009-01-01

    Background: Percutaneous mitral valve (MV) dilatation is performed with either a single balloon (SB) or double balloon (DB) technique. The aim of this study was to compare the two balloon system results using the finite element (FE) method. Methods and Results: An established FE model of the MV was modified by fusing the MV leaflet edges at commissure level to simulate a stenotic valve (orifice area=180mm2). A FE model of a 30mm SB (low-pressure, elastomeric balloon) and an 18mm DB system (high-pressure, non-elastic balloon) was created. Both SB and DB simulations resulted in splitting of the commissures and subsequent stenosis dilatation (final MV area=610mm2 and 560mm2 respectively). Stresses induced by the two balloon systems varied across the valve. At the end of inflation, SB showed higher stresses in the central part of the leaflets and at the commissures compared to DB simulation, which demonstrated a more uniform stress distribution. The higher stresses in the SB analysis were due to the mismatch of the round balloon shape with the oval mitral orifice. The commissural split was not easily accomplished with the SB due to its high compliance. The high pressure applied to the DB guaranteed the commissural split even when high forces were required to break the commissure welds. Conclusions: The FE model demonstrated that MV dilatation can be accomplished by both SB and DB techniques. However, the DB method resulted in higher probability of splitting of the fused commissures and less damage caused to the MV leaflets by overstretching.

  10. Vacuum-actuated percutaneous insertion/implantation tool for flexible neural probes and interfaces

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    Sheth, Heeral; Bennett, William J.; Pannu, Satinderpall S.; Tooker, Angela C.

    2017-03-07

    A flexible device insertion tool including an elongated stiffener with one or more suction ports, and a vacuum connector for interfacing the stiffener to a vacuum source, for attaching the flexible device such as a flexible neural probe to the stiffener during insertion by a suction force exerted through the suction ports to, and to release the flexible device by removing the suction force.

  11. A Novel Combination of Percutaneous Endoscopic Lumbar Discectomy and Epiduroscopic Laser Neural Decompression for Down-migrated Disc Herniation.

    Science.gov (United States)

    Choi, Kyung-Chul; Lee, Dong Chan; Park, Choon-Keun

    2017-05-01

    Although percutaneous endoscopic lumbar discectomy (PELD) is an effective treatment for herniated discs, its application in a disc with extensive migration is still challenging. As such, epiduroscopic laser neural decompression (ELND) provides a new view of the epidural space as well as an alternative treatment for a herniated disc and epidural fibrosis. In this paper the authors introduce the novel combination of PELD and ELND for high grade down-migrated disc herniation.An 87-year old woman presented with severe pain radiating down her leg due to high grade down-migrated disc herniation at L4-5. The therapeutic plan was organized into 3 steps. First, the patient underwent PELD to remove the paracentral extruded disc and open the epidural space between the traversing nerve root and disc space. Second, ELND was performed to remove the down-migrated disc and simultaneously push the free fragment to the L4-5 disc space. Lastly, repetitive free fragments were picked up and streamed upward using ELND. The patient reported significant reduction of pain after surgery. Postoperative magnetic resonance imaging (MRI) showed complete removal of the ruptured disc fragment. A combination of PELD and ELND may be an option of treatments for down-migrated disc herniation.

  12. Role of lumbar interspinous distraction on the neural elements.

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    Alfieri, Alex; Gazzeri, Roberto; Prell, Julian; Scheller, Christian; Rachinger, Jens; Strauss, Christian; Schwarz, Andreas

    2012-10-01

    The interspinous distraction devices are used to treat variable pathologies ranging from facet syndrome, diskogenic low back pain, degenerative spinal stenosis, diskopathy, spondylolisthesis, and instability. The insertion of a posterior element with an interspinous device (ISD) is commonly judged responsive to a relative kyphosis of a lumbar segment with a moderate but persistent increase of the spinal canal and of the foraminal width and area, and without influence on low-grade spondylolisthesis. The consequence is the need of shared specific biomechanical concepts to give for each degenerative problem the right indication through a critical analysis of all available experimental and clinical biomechanical data. We reviewed systematically the available clinical and experimental data about kyphosis, enlargement of the spinal canal, distraction of the interspinous distance, increase of the neural foramina, ligamentous structures, load of the posterior annulus, intradiskal pressure, strength of the spinous processes, degeneration of the adjacent segment, complications, and cost-effectiveness of the ISD. The existing literature does not provide actual scientific evidence over the superiority of the ISD strategy, but most of the experimental and clinical data show a challenging potential. These considerations are applicable with different types of ISD with only few differences between the different categories. Despite--or because of--the low invasiveness of the surgical implantation of the ISD, this technique promises to play a major role in the future degenerative lumbar microsurgery. The main indications for ISD remain lumbar spinal stenoses and painful facet arthroses. A clear documented contraindication is the presence of an anterolisthesis. Nevertheless, the existing literature does not provide evidence of superiority of outcome and cost-effectiveness of the ISD strategy over laminectomy or other surgical procedures. At this time, the devices should be used in

  13. Controlling the elements: an optogenetic approach to understanding the neural circuits of fear.

    Science.gov (United States)

    Johansen, Joshua P; Wolff, Steffen B E; Lüthi, Andreas; LeDoux, Joseph E

    2012-06-15

    Neural circuits underlie our ability to interact in the world and to learn adaptively from experience. Understanding neural circuits and how circuit structure gives rise to neural firing patterns or computations is fundamental to our understanding of human experience and behavior. Fear conditioning is a powerful model system in which to study neural circuits and information processing and relate them to learning and behavior. Until recently, technological limitations have made it difficult to study the causal role of specific circuit elements during fear conditioning. However, newly developed optogenetic tools allow researchers to manipulate individual circuit components such as anatomically or molecularly defined cell populations, with high temporal precision. Applying these tools to the study of fear conditioning to control specific neural subpopulations in the fear circuit will facilitate a causal analysis of the role of these circuit elements in fear learning and memory. By combining this approach with in vivo electrophysiological recordings in awake, behaving animals, it will also be possible to determine the functional contribution of specific cell populations to neural processing in the fear circuit. As a result, the application of optogenetics to fear conditioning could shed light on how specific circuit elements contribute to neural coding and to fear learning and memory. Furthermore, this approach may reveal general rules for how circuit structure and neural coding within circuits gives rise to sensory experience and behavior. Copyright © 2012 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  14. Multiscale methodology for bone remodelling simulation using coupled finite element and neural network computation.

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    Hambli, Ridha; Katerchi, Houda; Benhamou, Claude-Laurent

    2011-02-01

    The aim of this paper is to develop a multiscale hierarchical hybrid model based on finite element analysis and neural network computation to link mesoscopic scale (trabecular network level) and macroscopic (whole bone level) to simulate the process of bone remodelling. As whole bone simulation, including the 3D reconstruction of trabecular level bone, is time consuming, finite element calculation is only performed at the macroscopic level, whilst trained neural networks are employed as numerical substitutes for the finite element code needed for the mesoscale prediction. The bone mechanical properties are updated at the macroscopic scale depending on the morphological and mechanical adaptation at the mesoscopic scale computed by the trained neural network. The digital image-based modelling technique using μ-CT and voxel finite element analysis is used to capture volume elements representative of 2 mm³ at the mesoscale level of the femoral head. The input data for the artificial neural network are a set of bone material parameters, boundary conditions and the applied stress. The output data are the updated bone properties and some trabecular bone factors. The current approach is the first model, to our knowledge, that incorporates both finite element analysis and neural network computation to rapidly simulate multilevel bone adaptation.

  15. Research on quasi-dynamic calibration model of plastic sensitive element based on neural networks

    Science.gov (United States)

    Wang, Fang; Kong, Deren; Yang, Lixia; Zhang, Zouzou

    2017-08-01

    Quasi-dynamic calibration accuracy of the plastic sensitive element depends on the accuracy of the fitting model between pressure and deformation. By using the excellent nonlinear mapping ability of RBF (Radial Basis Function) neural network, a calibration model is established which use the peak pressure as the input and use the deformation of the plastic sensitive element as the output in this paper. The calibration experiments of a batch of copper cylinders are carried out on the quasi-dynamic pressure calibration device, which pressure range is within the range of 200MPa to 700MPa. The experiment data are acquired according to the standard pressure monitoring system. The network train and study are done to quasi dynamic calibration model based on neural network by using MATLAB neural network toolbox. Taking the testing samples as the research object, the prediction accuracy of neural network model is compared with the exponential fitting model and the second-order polynomial fitting model. The results show that prediction of the neural network model is most close to the testing samples, and the accuracy of prediction model based on neural network is better than 0.5%, respectively one order higher than the second-order polynomial fitting model and two orders higher than the exponential fitting model. The quasi-dynamic calibration model between pressure peak and deformation of plastic sensitive element, which is based on neural network, provides important basis for creating higher accuracy quasi-dynamic calibration table.

  16. A Method for Assessing the Retention of Trace Elements in Human Body Using Neural Network Technology.

    Science.gov (United States)

    Tunakova, Yulia; Novikova, Svetlana; Ragimov, Aligejdar; Faizullin, Rashat; Valiev, Vsevolod

    2017-01-01

    Models that describe the trace element status formation in the human organism are essential for a correction of micromineral (trace elements) deficiency. A direct trace element retention assessment in the body is difficult due to the many internal mechanisms. The trace element retention is determined by the amount and the ratio of incoming and excreted substance. So, the concentration of trace elements in drinking water characterizes the intake, whereas the element concentration in urine characterizes the excretion. This system can be interpreted as three interrelated elements that are in equilibrium. Since many relationships in the system are not known, the use of standard mathematical models is difficult. The artificial neural network use is suitable for constructing a model in the best way because it can take into account all dependencies in the system implicitly and process inaccurate and incomplete data. We created several neural network models to describe the retentions of trace elements in the human body. On the model basis, we can calculate the microelement levels in the body, knowing the trace element levels in drinking water and urine. These results can be used in health care to provide the population with safe drinking water.

  17. Artificial neural networks applied to quantitative elemental analysis of organic material using PIXE

    Energy Technology Data Exchange (ETDEWEB)

    Correa, R. [Universidad Tecnologica Metropolitana, Departamento de Fisica, Av. Jose Pedro Alessandri 1242, Nunoa, Santiago (Chile)]. E-mail: rcorrea@utem.cl; Chesta, M.A. [Universidad Nacional de Cordoba, Facultad de Matematica, Astronomia y Fisica, Medina Allende s/n Ciudad Universitaria, 5000 Cordoba (Argentina)]. E-mail: chesta@famaf.unc.edu.ar; Morales, J.R. [Universidad de Chile, Facultad de Ciencias, Departamento de Fisica, Las Palmeras 3425, Nunoa, Santiago (Chile)]. E-mail: rmorales@uchile.cl; Dinator, M.I. [Universidad de Chile, Facultad de Ciencias, Departamento de Fisica, Las Palmeras 3425, Nunoa, Santiago (Chile)]. E-mail: mdinator@uchile.cl; Requena, I. [Universidad de Granada, Departamento de Ciencias de la Computacion e Inteligencia Artificial, Daniel Saucedo Aranda s/n, 18071 Granada (Spain)]. E-mail: requena@decsai.ugr.es; Vila, I. [Universidad de Chile, Facultad de Ciencias, Departamento de Ecologia, Las Palmeras 3425, Nunoa, Santiago (Chile)]. E-mail: limnolog@uchile.cl

    2006-08-15

    An artificial neural network (ANN) has been trained with real-sample PIXE (particle X-ray induced emission) spectra of organic substances. Following the training stage ANN was applied to a subset of similar samples thus obtaining the elemental concentrations in muscle, liver and gills of Cyprinus carpio. Concentrations obtained with the ANN method are in full agreement with results from one standard analytical procedure, showing the high potentiality of ANN in PIXE quantitative analyses.

  18. High-Lift Optimization Design Using Neural Networks on a Multi-Element Airfoil

    Science.gov (United States)

    Greenman, Roxana M.; Roth, Karlin R.; Smith, Charles A. (Technical Monitor)

    1998-01-01

    The high-lift performance of a multi-element airfoil was optimized by using neural-net predictions that were trained using a computational data set. The numerical data was generated using a two-dimensional, incompressible, Navier-Stokes algorithm with the Spalart-Allmaras turbulence model. Because it is difficult to predict maximum lift for high-lift systems, an empirically-based maximum lift criteria was used in this study to determine both the maximum lift and the angle at which it occurs. Multiple input, single output networks were trained using the NASA Ames variation of the Levenberg-Marquardt algorithm for each of the aerodynamic coefficients (lift, drag, and moment). The artificial neural networks were integrated with a gradient-based optimizer. Using independent numerical simulations and experimental data for this high-lift configuration, it was shown that this design process successfully optimized flap deflection, gap, overlap, and angle of attack to maximize lift. Once the neural networks were trained and integrated with the optimizer, minimal additional computer resources were required to perform optimization runs with different initial conditions and parameters. Applying the neural networks within the high-lift rigging optimization process reduced the amount of computational time and resources by 83% compared with traditional gradient-based optimization procedures for multiple optimization runs.

  19. Discover regulatory DNA elements using chromatin signatures and artificial neural network.

    Science.gov (United States)

    Firpi, Hiram A; Ucar, Duygu; Tan, Kai

    2010-07-01

    Recent large-scale chromatin states mapping efforts have revealed characteristic chromatin modification signatures for various types of functional DNA elements. Given the important influence of chromatin states on gene regulation and the rapid accumulation of genome-wide chromatin modification data, there is a pressing need for computational methods to analyze these data in order to identify functional DNA elements. However, existing computational tools do not exploit data transformation and feature extraction as a means to achieve a more accurate prediction. We introduce a new computational framework for identifying functional DNA elements using chromatin signatures. The framework consists of a data transformation and a feature extraction step followed by a classification step using time-delay neural network. We implemented our framework in a software tool CSI-ANN (chromatin signature identification by artificial neural network). When applied to predict transcriptional enhancers in the ENCODE region, CSI-ANN achieved a 65.5% sensitivity and 66.3% positive predictive value, a 5.9% and 11.6% improvement, respectively, over the previously best approach. CSI-ANN is implemented in Matlab. The source code is freely available at http://www.medicine.uiowa.edu/Labs/tan/CSIANNsoft.zip kai-tan@uiowa.edu Supplementary Materials are available at Bioinformatics online.

  20. Case report: Percutaneous electrical neural field stimulation in two cases of sympathetically-mediated pain [version 1; referees: 1 approved, 2 approved with reservations

    Directory of Open Access Journals (Sweden)

    Lynn Fraser

    2017-06-01

    Full Text Available Background: Fibromyalgia and complex regional pain syndrome (CRPS are both chronic pain syndromes with pathophysiologic mechanisms related to autonomic nervous system dysregulation and central sensitization.  Both syndromes are considered difficult to treat with conventional pain therapies. Case presentations: Here we describe a female veteran with fibromyalgia and a male veteran with CRPS, both of whom failed multiple pharmacologic, physical and psychological therapies for pain, but responded to percutaneous electrical neural field stimulation (PENFS targeted at the auricular branches of the cranial nerves. Discussion: While PENFS applied to the body has been previously described for treatment of localized pain, PENFS effects on cranial nerve branches of the ear is not well-known, particularly when used for regional and full-body pain syndromes such as those described here. PENFS of the ear is a minimally-invasive, non-pharmacologic therapy that could lead to improved quality of life and decreased reliance on medication. However, further research is needed to guide clinical application, particularly in complex pain patients.

  1. Neural networks-based damage detection for bridges considering errors in baseline finite element models

    Science.gov (United States)

    Lee, Jong Jae; Lee, Jong Won; Yi, Jin Hak; Yun, Chung Bang; Jung, Hie Young

    2005-02-01

    Structural health monitoring has become an important research topic in conjunction with damage assessment and safety evaluation of structures. The use of system identification approaches for damage detection has been expanded in recent years owing to the advancements in signal analysis and information processing techniques. Soft computing techniques such as neural networks and genetic algorithm have been utilized increasingly for this end due to their excellent pattern recognition capability. In this study, a neural networks-based damage detection method using the modal properties is presented, which can effectively consider the modelling errors in the baseline finite element model from which the training patterns are to be generated. The differences or the ratios of the mode shape components between before and after damage are used as the input to the neural networks in this method, since they are found to be less sensitive to the modelling errors than the mode shapes themselves. Two numerical example analyses on a simple beam and a multi-girder bridge are presented to demonstrate the effectiveness of the proposed method. Results of laboratory test on a simply supported bridge model and field test on a bridge with multiple girders confirm the applicability of the present method.

  2. Failure Diagnosis and Prognosis of Rolling - Element Bearings using Artificial Neural Networks: A Critical Overview

    Science.gov (United States)

    Rao, B. K. N.; Srinivasa Pai, P.; Nagabhushana, T. N.

    2012-05-01

    Rolling - Element Bearings are extensively used in almost all global industries. Any critical failures in these vitally important components would not only affect the overall systems performance but also its reliability, safety, availability and cost-effectiveness. Proactive strategies do exist to minimise impending failures in real time and at a minimum cost. Continuous innovative developments are taking place in the field of Artificial Neural Networks (ANNs) technology. Significant research and development are taking place in many universities, private and public organizations and a wealth of published literature is available highlighting the potential benefits of employing ANNs in intelligently monitoring, diagnosing, prognosing and managing rolling-element bearing failures. This paper attempts to critically review the recent trends in this topical area of interest.

  3. Biomechanical study of four kinds of percutaneous screw fixation in two types of unilateral sacroiliac joint dislocation: a finite element analysis.

    Science.gov (United States)

    Zhang, Lihai; Peng, Ye; Du, Chengfei; Tang, Peifu

    2014-12-01

    To compare the biomechanical stability of four different kinds of percutaneous screw fixation in two types of unilateral sacroiliac joint dislocation. Finite element models of unstable Tile type B and type C pelvic ring injuries were created in this study. Modelling was based on fixation with a single S1 screw (S1-1), single S2 screw (S2-1), two S1 screws (S1-2) and a combination of a single S1 and a single S2 screw (S1–S2). The biomechanical test of two types of pelvic instability (rotational or vertical) with four types of percutaneous fixation were compared. Displacement, flexion and lateral bend (in bilateral stance) were recorded and analyzed. Maximal inferior translation (displacement) was found in the S2-1 group in type B and C dislocations which were 1.58 mm and 1.90 mm, respectively. Maximal flexion was found in the S2-1 group in type B and C dislocations which were 1.55° and 1.95°, respectively. The results show that the flexion from most significant angulation to least is S2-1, S1-1, S1-2, and S1–S2 in type B and C dislocations. All the fixations have minimal lateral bend. Our findings suggest single screw S1 fixation should be adequate fixation for a type B dislocation. For type C dislocations, one might consider a two screw construct (S1–S2) to give added biomechanical stability if clinically indicated.

  4. Inclusion mechanical property estimation using tactile images, finite element method, and artificial neural network.

    Science.gov (United States)

    Lee, Jong-Ha; Won, Chang-Hee

    2011-01-01

    In this paper, we developed a methodology for estimating three parameters of tissue inclusion: size, depth, and Young's modulus from the tactile data obtained at the tissue surface with the tactile sensation imaging system. The estimation method consists of the forward algorithm using finite element method, and inversion algorithm using artificial neural network. The forward algorithm is designed to comprehensively predict the tactile data based on the mechanical properties of the tissue inclusion. This forward information is used to develop an inversion algorithm that will be used to extract the size, depth, and Young's modulus of a tissue inclusion from the tactile image. The proposed method is then validated with custom made tissue phantoms with matching elasticities of typical human breast tissues. The experimental results showed that the proposed estimation method estimates the size, depth, and Young's modulus of tissue inclusions with root mean squared errors of 1.25 mm, 2.09 mm, and 28.65 kPa, respectively.

  5. Are concentrations of alkaline earth elements in maternal hair associated with risk of neural tube defects?

    Science.gov (United States)

    Li, Zhenjiang; Wang, Bin; Huo, Wenhua; Liu, Yingying; Zhu, Yibing; Xie, Jing; Li, Zhiwen; Ren, Aiguo

    2017-12-31

    The relationship between maternal intake of alkaline earth elements (AEEs) during the period of neural tube closure and the risk of neural tube defects (NTDs) is still unclear. We propose that AEE deficiency during the early period of pregnancy is associated with an elevated risk of NTDs in the offspring. In this study, we recruited 191 women with NTD-affected pregnancies (cases) and 261 women who delivered healthy infants (controls). The concentrations of four AEEs (Ca, Mg, Sr, Ba) in maternal hair sections that grew during early pregnancy were analyzed. Information on the dietary habits of the mothers was also collected by questionnaire. Higher concentrations of the four AEEs in hair had protective effects against the risk of total NTDs, with odds ratios with 95% confidence interval (comparing groups separated by each median level) of 0.44 (0.28-0.68) for Mg, 0.56 (0.36-0.87) for Ca, 0.45 (0.28-0.70) for Sr, and 0.41 (0.26-0.65) for Ba. Significant negative dose-response trends were identified for the relationships between the four AEE concentrations in maternal hair and the risks of anencephaly and spina bifida, but not for encephalocele. The frequencies of maternal consumption of fresh green vegetables, fresh fruit, and meat or fish were positively correlated with the concentrations of AEEs in hair. We concluded that the maternal intake of AEEs may play an important role in preventing NTD formation in offspring, and that this intake is related to maternal dietary habits of consuming fresh green vegetables, fresh fruit, and fish or meat. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. A multiscale modelling of bone ultrastructure elastic proprieties using finite elements simulation and neural network method.

    Science.gov (United States)

    Barkaoui, Abdelwahed; Tlili, Brahim; Vercher-Martínez, Ana; Hambli, Ridha

    2016-10-01

    Bone is a living material with a complex hierarchical structure which entails exceptional mechanical properties, including high fracture toughness, specific stiffness and strength. Bone tissue is essentially composed by two phases distributed in approximately 30-70%: an organic phase (mainly type I collagen and cells) and an inorganic phase (hydroxyapatite-HA-and water). The nanostructure of bone can be represented throughout three scale levels where different repetitive structural units or building blocks are found: at the first level, collagen molecules are arranged in a pentameric structure where mineral crystals grow in specific sites. This primary bone structure constitutes the mineralized collagen microfibril. A structural organization of inter-digitating microfibrils forms the mineralized collagen fibril which represents the second scale level. The third scale level corresponds to the mineralized collagen fibre which is composed by the binding of fibrils. The hierarchical nature of the bone tissue is largely responsible of their significant mechanical properties; consequently, this is a current outstanding research topic. Scarce works in literature correlates the elastic properties in the three scale levels at the bone nanoscale. The main goal of this work is to estimate the elastic properties of the bone tissue in a multiscale approach including a sensitivity analysis of the elastic behaviour at each length scale. This proposal is achieved by means of a novel hybrid multiscale modelling that involves neural network (NN) computations and finite elements method (FEM) analysis. The elastic properties are estimated using a neural network simulation that previously has been trained with the database results of the finite element models. In the results of this work, parametric analysis and averaged elastic constants for each length scale are provided. Likewise, the influence of the elastic constants of the tissue constituents is also depicted. Results highlight

  7. Behavioral deficits and neural damage of Caenorhabditis elegans induced by three rare earth elements.

    Science.gov (United States)

    Xu, Tiantian; Zhang, Manke; Hu, Jiani; Li, Zihan; Wu, Taipu; Bao, Jianing; Wu, Siyu; Lei, Lili; He, Defu

    2017-08-01

    Rare earth elements (REEs) are widely used in industry, agriculture, medicine and daily life in recent years. However, environmental and health risks of REEs are still poorly understood. In this study, neurotoxicity of trichloride neodymium, praseodymium and scandium were evaluated using nematode Caenorhabditis elegans as the assay system. Median lethal concentrations (48 h) were 99.9, 157.2 and 106.4 mg/L for NdCl3, PrCl3 and ScCl3, respectively. Sublethal dose (10-30 mg/L) of these trichloride salts significantly inhibited body length of nematodes. Three REEs resulted in significant declines in locomotor frequency of body bending, head thrashing and pharyngeal pumping. In addition, mean speed and wavelength of crawling movement were significantly reduced after chronic exposure. Using transgenic nematodes, we found NdCl3, PrCl3 and ScCl3 resulted in loss of dendrite and soma of neurons, and induced down-expression of dat-1::GFP and unc-47::GFP. It indicates that REEs can lead to damage of dopaminergic and GABAergic neurons. Our data suggest that exposure to REEs may cause neurotoxicity of inducing behavioral deficits and neural damage. These findings provide useful information for understanding health risk of REE materials. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Artificial Neural Network Based Fault Diagnostics of Rolling Element Bearings Using Time-Domain Features

    Science.gov (United States)

    Samanta, B.; Al-Balushi, K. R.

    2003-03-01

    A procedure is presented for fault diagnosis of rolling element bearings through artificial neural network (ANN). The characteristic features of time-domain vibration signals of the rotating machinery with normal and defective bearings have been used as inputs to the ANN consisting of input, hidden and output layers. The features are obtained from direct processing of the signal segments using very simple preprocessing. The input layer consists of five nodes, one each for root mean square, variance, skewness, kurtosis and normalised sixth central moment of the time-domain vibration signals. The inputs are normalised in the range of 0.0 and 1.0 except for the skewness which is normalised between -1.0 and 1.0. The output layer consists of two binary nodes indicating the status of the machine—normal or defective bearings. Two hidden layers with different number of neurons have been used. The ANN is trained using backpropagation algorithm with a subset of the experimental data for known machine conditions. The ANN is tested using the remaining set of data. The effects of some preprocessing techniques like high-pass, band-pass filtration, envelope detection (demodulation) and wavelet transform of the vibration signals, prior to feature extraction, are also studied. The results show the effectiveness of the ANN in diagnosis of the machine condition. The proposed procedure requires only a few features extracted from the measured vibration data either directly or with simple preprocessing. The reduced number of inputs leads to faster training requiring far less iterations making the procedure suitable for on-line condition monitoring and diagnostics of machines.

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

    Science.gov (United States)

    Hu, Xin-Jia; Wang, Hua

    2017-01-01

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

  10. CONCEPTION OF USE VIBROACOUSTIC SIGNALS AND NEURAL NETWORKS FOR DIAGNOSING OF CHOSEN ELEMENTS OF INTERNAL COMBUSTION ENGINES IN CAR VEHICLES

    Directory of Open Access Journals (Sweden)

    Piotr CZECH

    2014-03-01

    Full Text Available Currently used diagnostics systems are not always efficient and do not give straightforward results which allow for the assessment of the technological condition of the engine or for the identification of the possible damages in their early stages of development. Growing requirements concerning durability, reliability, reduction of costs to minimum and decrease of negative influence on the natural environment are the reasons why there is a need to acquire information about the technological condition of each of the elements of a vehicle during its exploitation. One of the possibilities to achieve information about technological condition of a vehicle are vibroacoustic phenomena. Symptoms of defects, achieved as a result of advanced methods of vibroacoustic signals processing can serve as models which can be used during construction of intelligent diagnostic system based on artificial neural networks. The work presents conception of use artificial neural networks in the task of combustion engines diagnosis.

  11. Application of artificial neural network in precise prediction of cement elements percentages based on the neutron activation analysis

    Science.gov (United States)

    Eftekhari Zadeh, E.; Feghhi, S. A. H.; Roshani, G. H.; Rezaei, A.

    2016-05-01

    Due to variation of neutron energy spectrum in the target sample during the activation process and to peak overlapping caused by the Compton effect with gamma radiations emitted from activated elements, which results in background changes and consequently complex gamma spectrum during the measurement process, quantitative analysis will ultimately be problematic. Since there is no simple analytical correlation between peaks' counts with elements' concentrations, an artificial neural network for analyzing spectra can be a helpful tool. This work describes a study on the application of a neural network to determine the percentages of cement elements (mainly Ca, Si, Al, and Fe) using the neutron capture delayed gamma-ray spectra of the substance emitted by the activated nuclei as patterns which were simulated via the Monte Carlo N-particle transport code, version 2.7. The Radial Basis Function (RBF) network is developed with four specific peaks related to Ca, Si, Al and Fe, which were extracted as inputs. The proposed RBF model is developed and trained with MATLAB 7.8 software. To obtain the optimal RBF model, several structures have been constructed and tested. The comparison between simulated and predicted values using the proposed RBF model shows that there is a good agreement between them.

  12. Periodic Table of the Elements in the Perspective of Artificial Neural Networks

    Science.gov (United States)

    Lemes, Mauricio R.; Dal Pino, Arnaldo

    2011-01-01

    Although several chemical elements were not known by end of the 19th century, Mendeleev came up with an astonishing achievement, the periodic table of elements. He was not only able to predict the existence of (then) new elements, but also to provide accurate estimates of their chemical and physical properties. This is a profound example of the…

  13. A two-dimensional flow sensor with integrated micro thermal sensing elements and a back propagation neural network.

    Science.gov (United States)

    Que, Ruiyi; Zhu, Rong

    2013-12-31

    This paper demonstrates a novel flow sensor with two-dimensional 360° direction sensitivity achieved with a simple structure and a novel data fusion algorithm. Four sensing elements with roundabout wires distributed in four quadrants of a circle compose the sensor probe, and work in constant temperature difference (CTD) mode as both Joule heaters and temperature detectors. The magnitude and direction of a fluid flow are measured by detecting flow-induced temperature differences among the four elements. The probe is made of Ti/Au thin-film with a diameter of 2 mm, and is fabricated using micromachining techniques. When a flow goes through the sensor, the flow-induced temperature differences are detected by the sensing elements that also serve as the heaters of the sensor. By measuring the temperature differences among the four sensing elements symmetrically distributed in the sensing area, a full 360° direction sensitivity can be obtained. By using a BP neural network to model the relationship between the readouts of the four sensor elements and flow parameters and execute data fusion, the magnitude and direction of the flow can be deduced. Validity of the sensor design was proven through both simulations and experiments. Wind tunnel experimental results show that the measurement accuracy of the airflow speed reaches 0.72 m/s in the range of 3 m/s-30 m/s and the measurement accuracy of flow direction angle reaches 1.9° in the range of 360°.

  14. Percutaneous cholecystostomy

    Energy Technology Data Exchange (ETDEWEB)

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

    2002-09-01

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

  15. Elements of an algorithm for optimizing a parameter-structural neural network

    Directory of Open Access Journals (Sweden)

    Mrówczyńska Maria

    2016-06-01

    Full Text Available The field of processing information provided by measurement results is one of the most important components of geodetic technologies. The dynamic development of this field improves classic algorithms for numerical calculations in the aspect of analytical solutions that are difficult to achieve. Algorithms based on artificial intelligence in the form of artificial neural networks, including the topology of connections between neurons have become an important instrument connected to the problem of processing and modelling processes. This concept results from the integration of neural networks and parameter optimization methods and makes it possible to avoid the necessity to arbitrarily define the structure of a network. This kind of extension of the training process is exemplified by the algorithm called the Group Method of Data Handling (GMDH, which belongs to the class of evolutionary algorithms. The article presents a GMDH type network, used for modelling deformations of the geometrical axis of a steel chimney during its operation.

  16. Effect of exposure to trace elements in the soil on the prevalence of neural tube defects in a high-risk area of China.

    Science.gov (United States)

    Huang, Jing; Wu, Jilei; Li, Tiejun; Song, Xinming; Zhang, Bingzi; Zhang, Pingwen; Zheng, Xiaoying

    2011-04-01

    Our objective is to build a model that explains the association between the exposure to trace elements in the soil and the risk of neural tube defects. We built a function with different parameters to describe the effects of trace elements on neural tube defects. The association between neural tube defects and trace element levels was transformed into an optimization problem using the maximum likelihood method. Tin, lead, nickel, iron, copper, and aluminum had typical layered effects (dosage effects) on the prevalence of neural tube defects. Arsenic, selenium, zinc, strontium, and vanadium had no effect, and molybdenum had one threshold value that affected the prevalence of birth defects. As an exploratory research work, our model can be used to determine the direction of the effect of the trace element content of cultivated soil on the risk of neural tube defects, which shows the clues by the dosage effect of their toxicological characteristics. Based on our findings, future biogeochemical research should focus on the direct effects of trace elements on human health. Copyright © 2011 The Editorial Board of Biomedical and Environmental Sciences. Published by Elsevier B.V. All rights reserved.

  17. Determination of penetration depth at high velocity impact using finite element method and artificial neural network tools

    Directory of Open Access Journals (Sweden)

    Namık KılıÇ

    2015-06-01

    Full Text Available Determination of ballistic performance of an armor solution is a complicated task and evolved significantly with the application of finite element methods (FEM in this research field. The traditional armor design studies performed with FEM requires sophisticated procedures and intensive computational effort, therefore simpler and accurate numerical approaches are always worthwhile to decrease armor development time. This study aims to apply a hybrid method using FEM simulation and artificial neural network (ANN analysis to approximate ballistic limit thickness for armor steels. To achieve this objective, a predictive model based on the artificial neural networks is developed to determine ballistic resistance of high hardness armor steels against 7.62 mm armor piercing ammunition. In this methodology, the FEM simulations are used to create training cases for Multilayer Perceptron (MLP three layer networks. In order to validate FE simulation methodology, ballistic shot tests on 20 mm thickness target were performed according to standard Stanag 4569. Afterwards, the successfully trained ANN(s is used to predict the ballistic limit thickness of 500 HB high hardness steel armor. Results show that even with limited number of data, FEM-ANN approach can be used to predict ballistic penetration depth with adequate accuracy.

  18. Percutaneous Coronary Intervention

    Science.gov (United States)

    ... page from the NHLBI on Twitter. Percutaneous Coronary Intervention Also known as coronary angioplasty. Percutaneous coronary intervention ( ... heart for more information about this topic. Related reading Angina Arrhythmia Atherosclerosis Blood Tests Cardiac Catheterization Cardiac ...

  19. A DWT and SVM based method for rolling element bearing fault diagnosis and its comparison with Artificial Neural Networks

    Directory of Open Access Journals (Sweden)

    Sunil Tyagi

    2017-04-01

    Full Text Available A classification technique using Support Vector Machine (SVM classifier for detection of rolling element bearing fault is presented here.  The SVM was fed from features that were extracted from of vibration signals obtained from experimental setup consisting of rotating driveline that was mounted on rolling element bearings which were run in normal and with artificially faults induced conditions. The time-domain vibration signals were divided into 40 segments and simple features such as peaks in time domain and spectrum along with statistical features such as standard deviation, skewness, kurtosis etc. were extracted. Effectiveness of SVM classifier was compared with the performance of Artificial Neural Network (ANN classifier and it was found that the performance of SVM classifier is superior to that of ANN. The effect of pre-processing of the vibration signal by Discreet Wavelet Transform (DWT prior to feature extraction is also studied and it is shown that pre-processing of vibration signal with DWT enhances the effectiveness of both ANN and SVM classifiers. It has been demonstrated from experiment results that performance of SVM classifier is better than ANN in detection of bearing condition and pre-processing the vibration signal with DWT improves the performance of SVM classifier.

  20. Determination of the mechanical and physical properties of cartilage by coupling poroelastic-based finite element models of indentation with artificial neural networks.

    Science.gov (United States)

    Arbabi, Vahid; Pouran, Behdad; Campoli, Gianni; Weinans, Harrie; Zadpoor, Amir A

    2016-03-21

    One of the most widely used techniques to determine the mechanical properties of cartilage is based on indentation tests and interpretation of the obtained force-time or displacement-time data. In the current computational approaches, one needs to simulate the indentation test with finite element models and use an optimization algorithm to estimate the mechanical properties of cartilage. The modeling procedure is cumbersome, and the simulations need to be repeated for every new experiment. For the first time, we propose a method for fast and accurate estimation of the mechanical and physical properties of cartilage as a poroelastic material with the aid of artificial neural networks. In our study, we used finite element models to simulate the indentation for poroelastic materials with wide combinations of mechanical and physical properties. The obtained force-time curves are then divided into three parts: the first two parts of the data is used for training and validation of an artificial neural network, while the third part is used for testing the trained network. The trained neural network receives the force-time curves as the input and provides the properties of cartilage as the output. We observed that the trained network could accurately predict the properties of cartilage within the range of properties for which it was trained. The mechanical and physical properties of cartilage could therefore be estimated very fast, since no additional finite element modeling is required once the neural network is trained. The robustness of the trained artificial neural network in determining the properties of cartilage based on noisy force-time data was assessed by introducing noise to the simulated force-time data. We found that the training procedure could be optimized so as to maximize the robustness of the neural network against noisy force-time data. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Optimizing finite element predictions of local subchondral bone structural stiffness using neural network-derived density-modulus relationships for proximal tibial subchondral cortical and trabecular bone.

    Science.gov (United States)

    Nazemi, S Majid; Amini, Morteza; Kontulainen, Saija A; Milner, Jaques S; Holdsworth, David W; Masri, Bassam A; Wilson, David R; Johnston, James D

    2017-01-01

    Quantitative computed tomography based subject-specific finite element modeling has potential to clarify the role of subchondral bone alterations in knee osteoarthritis initiation, progression, and pain. However, it is unclear what density-modulus equation(s) should be applied with subchondral cortical and subchondral trabecular bone when constructing finite element models of the tibia. Using a novel approach applying neural networks, optimization, and back-calculation against in situ experimental testing results, the objective of this study was to identify subchondral-specific equations that optimized finite element predictions of local structural stiffness at the proximal tibial subchondral surface. Thirteen proximal tibial compartments were imaged via quantitative computed tomography. Imaged bone mineral density was converted to elastic moduli using multiple density-modulus equations (93 total variations) then mapped to corresponding finite element models. For each variation, root mean squared error was calculated between finite element prediction and in situ measured stiffness at 47 indentation sites. Resulting errors were used to train an artificial neural network, which provided an unlimited number of model variations, with corresponding error, for predicting stiffness at the subchondral bone surface. Nelder-Mead optimization was used to identify optimum density-modulus equations for predicting stiffness. Finite element modeling predicted 81% of experimental stiffness variance (with 10.5% error) using optimized equations for subchondral cortical and trabecular bone differentiated with a 0.5g/cm(3) density. In comparison with published density-modulus relationships, optimized equations offered improved predictions of local subchondral structural stiffness. Further research is needed with anisotropy inclusion, a smaller voxel size and de-blurring algorithms to improve predictions. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Percutaneous Abscess Drainage

    Science.gov (United States)

    ... and devices that monitor your heart beat and blood pressure. top of page How is the procedure performed? Image-guided, minimally invasive procedures such as percutaneous abscess drainage are most ...

  3. New Frontiers in Percutaneous Interventions

    NARCIS (Netherlands)

    E. Meliga (Emanuele)

    2009-01-01

    markdownabstract__Abstract__ In 1977 Andreas Gruntzig introduced a catheter-based therapy for the percutaneous management of patients with coronary artery disease. This became known as percutaneous transluminal coronary angioplasty (PTCA). Initially there were many skeptics and pessimists. The

  4. The radiographic results and neurologic complications of instrumented reduction and fusion of high-grade spondylolisthesis without decompression of the neural elements: a retrospective review of 44 patients.

    Science.gov (United States)

    Sailhan, Frederic; Gollogly, Sohrab; Roussouly, Pierre

    2006-01-15

    A retrospective review of all cases of high-grade spondylolisthesis treated by 1 surgeon between the years 1991 and 2003. To report the radiographic results and neurologic complications following instrumented posterior reduction and fusion without decompression of the neural elements. Despite a large number of published reviews of the clinical results of operative intervention, controversy remains about the surgical treatment of high-grade spondylolisthesis. A retrospective review of the clinical charts and radiographs of all patients with L5-S1 spondylolisthesis and more than 50% anterior displacement of L5 on S1 who were treated by the same surgical team at 1 institution. With this technique, an average reduction in the displacement of L5 on S1 from 64% to 38% was achieved. At a minimum 2-year follow-up (41 patients), we have detected 5 cases with evidence of pseudarthrosis or loss of reduction (11.4%). Overall, a neurologic complication rate of 9.1% occurred in this series, with a 2.3% chance of a persistent motor deficit. We did not detect any loss of bowel or bladder function after surgery. At last follow-up, and after revision procedures, we were able to achieve good or fair clinical results in 40 (90.9%) of 44 patients. These data suggest that a posterior instrumented reduction and fusion of high-grade spondylolisthesis without decompression of the neural elements can be accomplished with acceptable radiographic and clinical results.

  5. Percutaneous Transhepatic Cholangiography

    African Journals Online (AJOL)

    1974-03-30

    Mar 30, 1974 ... Our experience with percutaneous transhepatic cholangio- graphy in 46 cases is presented and compared with other series. The technique is safe, simple and accurate and can play a major role in the early diagnosis of ob- ... tube and television monitor. The lateral approach described by Varela Fuentes et ...

  6. Dorsal arthrodesis in prepubertal New Zealand white rabbits followed to skeletal maturity: Effect on thoracic dimensions, spine growth and neural elements

    Directory of Open Access Journals (Sweden)

    Canavese Federico

    2010-01-01

    Full Text Available Background: Several studies have shown that severe spinal deformity and early arthrodesis can adversely affect the development of the spine and thorax by changing their shape and reducing their normal function. This article analyzes the consequences of posterior fusion on the growth of spine, thorax and neural elements in New Zealand white rabbits and compares with similar human data. Materials and Methods : The first section of the article analyzes the consequences of T1-T6 dorsal arthrodesis on the growth of the spine, sternum, thorax volume and neural elements in 12 prepubertal female New Zealand white rabbits, through a study of CT scans and histology specimens. The second part, evaluates thoracic dimensions in 21 children with spinal arthrodesis for treatment of deformity performed prior to nine years of age. Results: Dorsal arthrodesis in prepubertal rabbits changes thoracic growth patterns. In operated rabbits thoracic depth grows more slowly than thoracic width. The sternum as well as length of thoracic vertebral bodies in the spinal segment T1-T6 show reduced growth. Children undergoing spinal arthrodesis before nine years of age were noted to have shortened height, short trunk and disproportionate body habitus at skeletal maturity. Observed spine height and chest dimension values were reduced compared to the expected norms. The ratio between chest width and chest depth was below normal values. Conclusions: The first part of the study shows that thoracic dorsal arthrodesis in prepubertal New Zealand white rabbit influences thoracic, spine growth and affects the shape of pseudo unipolar neurons of the dorsal root ganglia. The second part demonstrates that children treated before nine years of age have significantly reduced spine height and thoracic dimensions. The thorax becomes elliptical as chest depth grows less than chest width. Both experimental and clinical findings contribute to explain reduced chest growth and subsequent thoracic

  7. Neural responses to nostalgia-evoking music modeled by elements of dynamic musical structure and individual differences in affective traits.

    Science.gov (United States)

    Barrett, Frederick S; Janata, Petr

    2016-10-01

    Nostalgia is an emotion that is most commonly associated with personally and socially relevant memories. It is primarily positive in valence and is readily evoked by music. It is also an idiosyncratic experience that varies between individuals based on affective traits. We identified frontal, limbic, paralimbic, and midbrain brain regions in which the strength of the relationship between ratings of nostalgia evoked by music and blood-oxygen-level-dependent (BOLD) signal was predicted by affective personality measures (nostalgia proneness and the sadness scale of the Affective Neuroscience Personality Scales) that are known to modulate the strength of nostalgic experiences. We also identified brain areas including the inferior frontal gyrus, substantia nigra, cerebellum, and insula in which time-varying BOLD activity correlated more strongly with the time-varying tonal structure of nostalgia-evoking music than with music that evoked no or little nostalgia. These findings illustrate one way in which the reward and emotion regulation networks of the brain are recruited during the experiencing of complex emotional experiences triggered by music. These findings also highlight the importance of considering individual differences when examining the neural responses to strong and idiosyncratic emotional experiences. Finally, these findings provide a further demonstration of the use of time-varying stimulus-specific information in the investigation of music-evoked experiences. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Transforaminal Percutaneous Endoscopic Lumbar Diskectomy with Percutaneous Epidural Neuroplasty in Lumbar Disk Herniation: Technical Note.

    Science.gov (United States)

    Lee, Hyeong-Jin; Kim, Jin-Sung; Ryu, Kyeong-Sik

    2017-02-01

    Percutaneous endoscopic lumbar diskectomy and percutaneous epidural neuroplasty is a commonly used minimally invasive spinal surgery in lumbar disk herniation. But to our knowledge, there is no report about the results of percutaneous endoscopic lumbar diskectomy with percutaneous epidural neuroplasty. We did this study to evaluate the effect of percutaneous endoscopic lumbar diskectomy with percutaneous epidural neuroplasty in lumbar disk herniation. We report a series of cases about techniques and results of percutaneous endoscopic lumbar diskectomy with percutaneous epidural neuroplasty in lumbar disk herniation, as well as introduce technical procedures and advantages. Seven patients improved axial back pain with percutaneous endoscopic lumbar diskectomy with percutaneous epidural neuroplasty and had no complications. The percutaneous endoscopic lumbar diskectomy with percutaneous epidural neuroplasty has many advantages with removing lumbar disk herniation in procedures. Percutaneous endoscopic lumbar diskectomy with percutaneous epidural neuroplasty is a safe and effective surgical method in lumbar disk herniation. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Elemental distribution in reproductive and neural organs of the Epilachna nylanderi (Coleoptera: Coccinellidae), a phytophage of nickel hyperaccumulator Berkheya coddii (Asterales: Asteraceae) by micro-PIXE.

    Science.gov (United States)

    Mesjasz-Przybyłowicz, Jolanta; Orłowska, Elżbieta; Augustyniak, Maria; Nakonieczny, Mirosław; Tarnawska, Monika; Przybyłowicz, Wojciech; Migula, Paweł

    2014-01-01

    The phenomenon of metal hyperaccumulation by plants is often explained by a pathogen or herbivore defense hypothesis. However, some insects feeding on metal hyperaccumulating plants are adapted to the high level of metals in plant tissues. Former studies on species that feed on the leaves of Berkheya coddii Roessler 1958 (Asteraceae), a nickel-hyperaccumulating plant, demonstrated several protective mechanisms involved in internal distribution, immobilization, and elimination of Ni from the midgut and Malpighian tubules. These species are mainly coleopterans, including the lady beetle, Epilachna nylanderi (Mulsant 1850) (Coleoptera: Coccinellidae), collected from the ultramafic ecosystem near Barberton in South Africa. By performing particle-induced X-ray emission microanalysis elemental microanalysis (PIXE), this study examined whether Ni may be harmful to internal body systems that decide on insect reactivity (central nervous system [CNS]), their reproduction, and the relationships between Ni and other micronutrients. Data on elemental distribution of nine selected elements in target organs of E. nylanderi were compared with the existing data for other insect species adapted to the excess of metals. Micro-PIXE maps of seven regions of the CNS showed Ni mainly in the neural connectives, while cerebral ganglia were better protected. Concentrations of other bivalent metals were lower than those of Ni. Testis, compared with other reproductive organs, showed low amounts of Ni. Zn was effectively regulated at physiological dietary levels. In insects exposed to excess dietary Zn, it was also accumulated in the reproductive organs. Comparison of E. nylanderii with other insects that ingest hyperaccumulating plants, especially chrysomelid Chrysolina clathrata (Clark) (Coleoptera: Chrysomelidae), showed lower protection of the CNS and reproductive organs. © The Author 2014. Published by Oxford University Press on behalf of the Entomological Society of America.

  10. Percutaneous vertebroplasty; Perkutane Vertebroplastie

    Energy Technology Data Exchange (ETDEWEB)

    Hierholzer, J.; Fuchs, H. [Kliniken fuer Diagnostische und Interventionelle Radiologie, Klinikum Ernst von Bergmann, Potsdam (Germany); Depriester, C. [Strahlenklinik und Poliklinik, Charite, Humboldt-Univ. Berlin (Germany); Clinique du Bois, Lille (France); Venz, S. [Strahlenklinik und Poliklinik, Charite, Humboldt-Univ. Berlin (Germany); Maier-Hauff, K. [Neurochirurgische Klinik, Bundeswehrkrankenhaus, Berlin (Germany); Schulz, R. [Unfall- und Wiederherstellungschirurgie, Klinikum Ernst von Bergmann, Potsdam (Germany); Koch, K. [Strahlentherapie, Klinikum Ernst von Bergmann, Potsdam (Germany)

    2002-03-01

    Purpose: To describe the procedure of percutaneous vertebroplasty and to present our first clinical results of patients treated for benign or malignant painful vertebral body disease. Material and Methods: We performed percutaneous vertebroplasty in 31 painful lesions of the spine. Liquid bone cement was injected into the affected vertebral body using fluoroscopic guidance through a bilateral transpedicular approach. Etiology of the bone disease was assessed by biopsy. Pain intensity was assessed before and 1 week after the procedure by standardized catalogue. Results: Percutaneous vertebroplasty was performed in 17 thoracic and in 14 lumbar spine bodies of benign (n = 23) or malignant (n = 8) disease; no clinically relevant complications occurred. All patients reported significant pain relief 1 week after the intervention. One week after treatment, patients were pain-free in 15/31 vertebral bodies, and reported mild residual pain not necessitating narcotic medication in 16/31 cases. Conclusion: In accordance with the literature, percutaneous vertebroplasty proved to be a highly effective, minimal invasive interventional procedure to treat severely painful bone lesions of benign and malignant origin. (orig.) [German] Ziel der Arbeit ist es, die Methodik der perkutanen Vertebroplastie zu beschreiben und die eigenen Ergebnisse bei Patienten mit schmerzhaften Knochenlaesionen vorzustellen. Material und Methoden: 31 schmerzhafte Wirbelkoerperlaesionen wurden durch radiologisch gestuetzte perkutane Injektion von fluessigem Knochenzement (perkutane Vertebroplastie) behandelt. In allen Faellen wurde der bilaterale transpedikulaere Zugan zum Wirbelkoerper gewaehlt. Die Genese der zugrunde liegenden Erkrankung wurde durch Knochenbiopsie gesichert, die in koaxialer Technik durch die Vertebroplastiekanuele moeglich wurde. Die Schmerzintensitaet wurde vor und eine Woche nach der Intervention standardisiert erhoben. Ergebnisse: Bei allen Patienten gelang die Intervention ohne

  11. Tissue-Specific Methylation of Long Interspersed Nucleotide Element-1 of Homo Sapiens (L1Hs) During Human Embryogenesis and Roles in Neural Tube Defects.

    Science.gov (United States)

    Wang, L; Chang, S; Guan, J; Shangguan, S; Lu, X; Wang, Z; Wu, L; Zou, J; Zhao, H; Bao, Y; Qiu, Z; Niu, B; Zhang, T

    2015-01-01

    Epigenetic regulation of long interspersed nucleotide element-1 (LINE-1) retrotransposition events plays crucial roles during early development. Previously we showed that LINE-1 hypomethylation in neuronal tissues is associated with pathogenesis of neural tube defect (NTD). Herein, we further evaluated LINE-1 Homo sapiens (L1Hs) methylation in tissues derived from three germ layers of stillborn NTD fetuses, to define patterns of tissue specific methylation and site-specific hypomethylation at CpG sites within an L1Hs promoter region. Stable, tissue-specific L1Hs methylation patterns throughout three germ layer lineages of the fetus, placenta, and maternal peripheral blood were observed. Samples from maternal peripheral blood exhibited the highest level of L1Hs methylation (64.95%) and that from placenta showed the lowest (26.82%). Between samples from NTDs and controls, decrease in L1Hs methylation was only significant in NTD-affected brain tissue at 7.35%, especially in females (8.98%). L1Hs hypomethylation in NTDs was also associated with a significant increase in expression level of an L1Hs-encoded transcript in females (r = -0.846, p = 0.004). This could be due to genomic DNA instability and alternation in chromatins accessibility resulted from abnormal L1Hs hypomethylation, as showed in this study with HCT-15 cells treated with methylation inhibitor 5-Aza.

  12. A pilot study on the association between rare earth elements in maternal hair and the risk of neural tube defects in north China.

    Science.gov (United States)

    Huo, Wenhua; Zhu, Yibing; Li, Zhenjiang; Pang, Yiming; Wang, Bin; Li, Zhiwen

    2017-07-01

    Rare earth elements (REEs) have many applications in industry, agriculture, and medicine, resulting in occupational and environmental exposure and concerns regarding REE-associated health effects. However, few epidemiological studies have examined the adverse effects of REEs on pregnancy outcomes. Therefore, this study examined the relationship between the REE concentrations in maternal hair growing during early pregnancy and the risk of neural tube defects (NTDs) in offspring. We included 191 women with NTD-affected pregnancies (cases) and 261 women delivering healthy infants (controls). The cases were divided into three subtypes: anencephaly, spina bifida, and encephalocele. Four REEs in maternal hair were analyzed by inductively coupled plasma-mass spectrometry: lanthanum (La), cerium (Ce), praseodymium (Pr), and neodymium (Nd). A questionnaire was used to collect information about maternal sociodemographic characteristics and dietary habits. The median concentrations of Ce and Pr in the NTD group were higher than those in the control group, whereas there were no significant differences for La and Nd. The adjusted odds ratios (ORs) for the four REE concentrations above the median in the case groups were not significantly > 1. An increasing frequency of the consumption of beans or bean products and fresh fruit was negatively correlated with the four REE concentrations. Our results did not suggest that the concentrations of REEs in maternal hair were associated with the risk of NTDs or any subtype of NTDs in the general population. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Orthopedic surgical analyzer for percutaneous vertebroplasty

    Science.gov (United States)

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

    2001-05-01

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

  14. [Ultrasound guided percutaneous nephrolithotripsy].

    Science.gov (United States)

    Guliev, B G

    2014-01-01

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

  15. Percutaneous Penetration - Methodological Considerations

    DEFF Research Database (Denmark)

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

    2014-01-01

    Studies on percutaneous penetration are needed to assess the hazards after unintended occupational skin exposures to industrial products as well as the efficacy after intended consumer exposure to topically applied medicinal or cosmetic products. During recent decades, a number of methods have been...... to the vehicles and solvents used in donor and sampling fluids so that it reflects in-use conditions as closely as possible. Based on available experimental data, mathematical models have been developed to aid predictions of skin penetration. The authors question the general use of the present mathematical models...... in hazard assessment, as they seem to ignore outliers among chemicals as well as the heterogeneity of skin barrier properties and skin conditions within the exposed populations....

  16. Percutaneous dilatational tracheostomy

    DEFF Research Database (Denmark)

    Johnsen, R.

    2015-01-01

    Introduction Since the introduction and development of percutaneous dilatational tracheostomy (PDT), this procedure is accepted and incorporated in ICUs worldwide. In spite of obvious benefits for the patients, who obtain more comfort and mobility and less use of sedatives, the procedure also...... implies the risk of several complications, some of which may be lethal. Severe complications include hemorrhage, displacement and pneumothorax. Different methods of PDT are described in the literature, each with disadvantages and benefits. The aim of this study was to analyze complications due to PDTs...... noted within 7 days. In addition we registered patients' age, sex, BMI, SOFA score, methods used in procedures and experience of operators. Results A total of 136 patients admitted to the UCI had undergone a PDT between 2007 and 2014. Of these, two were excluded due to the PDT being performed in another...

  17. Percutaneous Nephrolithotomy in Children

    Directory of Open Access Journals (Sweden)

    Romano T. DeMarco

    2011-01-01

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

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

    African Journals Online (AJOL)

    2011-06-15

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

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

    African Journals Online (AJOL)

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

  20. Percutaneous transbiliary biopsy.

    Science.gov (United States)

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

    2017-01-01

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

  1. Percutaneous vertebroplasty in tumoral osteolysis

    Energy Technology Data Exchange (ETDEWEB)

    Jakobs, T.F.; Trumm, C.; Reiser, M.; Hoffmann, R.T. [University of Munich - Campus Grosshadern, Department of Radiology, Munich (Germany)

    2007-08-15

    Percutaneous vertebroplasty is a minimally invasive, radiologically guided procedure in which bone cement is injected into structurally weakened or destructed vertebrae in order to achieve additional biomechanical stability. In addition to treating osteoporotic vertebral fractures, this technique gains popularity to relieve pain by stabilizing vertebrae compromised by, for example, metastases, aggressive hemangiomas or multiple myeloma that are at risk of pathologic fracture. Since conservative treatment with narcotic analgesics, bed rest, biphosphonates and back bracing for several weeks is often ineffective and the analgesic effect of radiation therapy is delayed, percutaneous vertebroplasty may play a beneficial role in the management of metastases to the spine. (orig.)

  2. Percutaneous nephrolithotomy and its legacy

    NARCIS (Netherlands)

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

    2005-01-01

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

  3. Percutaneous injuries during surgical procedures.

    Science.gov (United States)

    Tokars, J I; Bell, D M; Culver, D H; Marcus, R; Mendelson, M H; Sloan, E P; Farber, B F; Fligner, D; Chamberland, M E; McKibben, P S

    1992-06-03

    To study the numbers and circumstances of percutaneous injuries (eg, needle sticks, cuts) that occur during surgical procedures. Surgical personnel risk infection with blood-borne pathogens from percutaneous injuries; some injuries might also place patients at risk by exposing them to a health care worker's blood. Observers present at 1382 surgical procedures recorded information about the procedure, the personnel present, and percutaneous injuries that occurred. Four US teaching hospitals during 1990. Operating room personnel in five surgical specialties. Numbers and circumstances of percutaneous injuries among surgical personnel and instances in which surgical instruments that had injured a worker recontacted the patient's surgical wound. Ninety-nine injuries occurred during 95 (6.9%) of the 1382 procedures. Seventy-six injuries (77%) were caused by suture needles and affected the nondominant hand (62 injuries [63%]), especially the distal forefinger. The risk of injury adjusted for confounding variables by logistic regression was higher during vaginal hysterectomy (odds ratio [OR], 3.5; 95% confidence interval [CI], 1.6 to 7.5) and lower during certain orthopedic procedures (OR, 0.2; CI, 0.1 to 0.7) than during 11 other types of procedures (reference group; OR, 1.0). Use of fingers rather than an instrument to hold the tissue being sutured was associated with 35 injuries (35%). Eighty-eight injuries (89%) were sustained by resident or attending surgeons; in 28 (32%) of the 88 injuries in surgeons, the sharp object that caused the injury recontacted the patient. Percutaneous injuries occur regularly during surgery, placing surgical personnel and, to a lesser extent, patients at risk for infection with blood-borne pathogens. Many such injuries may be preventable with changes in devices, techniques, or protective equipment; all such measures require careful evaluation to determine their efficacy in reducing injury and their effect on patient care.

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

    Directory of Open Access Journals (Sweden)

    Miran Jeromel

    2014-04-01

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

  5. Validation of artificial neural network models for predicting biochemical markers associated with male infertility.

    Science.gov (United States)

    Vickram, A S; Kamini, A Rao; Das, Raja; Pathy, M Ramesh; Parameswari, R; Archana, K; Sridharan, T B

    2016-08-01

    Seminal fluid is the secretion from many glands comprised of several organic and inorganic compounds including free amino acids, proteins, fructose, glucosidase, zinc, and other scavenging elements like Mg(2+), Ca(2+), K(+), and Na(+). Therefore, in the view of development of novel approaches and proper diagnosis to male infertility, overall understanding of the biochemical and molecular composition and its role in regulation of sperm quality is highly desirable. Perhaps this can be achieved through artificial intelligence. This study was aimed to elucidate and predict various biochemical markers present in human seminal plasma with three different neural network models. A total of 177 semen samples were collected for this research (both fertile and infertile samples) and immediately processed to prepare a semen analysis report, based on the protocol of the World Health Organization (WHO [2010]). The semen samples were then categorized into oligoasthenospermia (n=35), asthenospermia (n=35), azoospermia (n=22), normospermia (n=34), oligospermia (n=34), and control (n=17). The major biochemical parameters like total protein content, fructose, glucosidase, and zinc content were elucidated by standard protocols. All the biochemical markers were predicted by using three different artificial neural network (ANN) models with semen parameters as inputs. Of the three models, the back propagation neural network model (BPNN) yielded the best results with mean absolute error 0.025, -0.080, 0.166, and -0.057 for protein, fructose, glucosidase, and zinc, respectively. This suggests that BPNN can be used to predict biochemical parameters for the proper diagnosis of male infertility in assisted reproductive technology (ART) centres. AAS: absorption spectroscopy; AI: artificial intelligence; ANN: artificial neural networks; ART: assisted reproductive technology; BPNN: back propagation neural network model; DT: decision tress; MLP: multilayer perceptron; PESA: percutaneous

  6. [Current options for percutaneous endoscopic access to the digestive tract

    NARCIS (Netherlands)

    Romkens, T.E.H.; Jong, D.J. de; Kristinsson, J.O.; Wanten, G.J.A.

    2008-01-01

    Four patients, aged 67, 52, 56 and 64 years, respectively, undergoing percutaneous colostomy or jejunostomy are presented to illustrate current options for percutaneous endoscopic access to the digestive tract. The first patient had Parkinson's disease and required percutaneous jejunostomy for

  7. Percutaneous Cementoplasty for Kienbock's Disease.

    Science.gov (United States)

    Vallejo, Eduardo Crespo; Martinez-Galdámez, Mario; Martin, Ernesto Santos; de Gregorio, Arturo Perera; Gallego, Miriam Gamo; Escobar, Angeles Ramirez

    2017-05-01

    Kienböck disease typically presents with wrist pain, swelling, restricted range of motion, and difficulty in performing activities of daily living. Because the etiology and evolution of disease remain unclear, broad ranges of treatments have been designed. Percutaneous cementoplasty is expanding its role for managing painful bone metastases outside the spine. We can draw a parallel between lytic tumoral lesions and Kienbock's disease. Increasing the strength and rigidity of lunate with cementoplasty can prevent it from collapse, relieve the symptoms associated with the process of avascular necrosis, and increase the wrist range of motion. We report the case of 30-year-old man with a painful stage IIIA Kienböck disease who underwent percutaneous cementoplasty and experienced immediate effective pain relief and recovery of wrist mobility.

  8. Percutaneous cryoablation for hepatocellular carcinoma

    Directory of Open Access Journals (Sweden)

    Kyoung Doo Song

    2016-12-01

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

  9. Percutaneous Fixation of Displaced Calcaneal Fracture

    Directory of Open Access Journals (Sweden)

    Yeung Yip-Kan

    2011-06-01

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

  10. Percutaneous approaches to mitral valve disease

    National Research Council Canada - National Science Library

    Fassa, A-A; Himbert, D; Brochet, E; Bouleti, C; Vahanian, A

    2015-01-01

    Percutaneous approaches to mitral valve disease consist in modifications of existing surgical techniques, aiming to replicate the favourable outcomes of surgery, with less procedure-related risk, due...

  11. ORIGINAL PAPER ORIG ORIG Percutaneous stone removal

    African Journals Online (AJOL)

    The percutaneous tract was made by the interven- tional radiologist under ultrasound combined with. Percutaneous stone removal. M N van der Ness, MB ChB, DA (SA),. DRCOG (UK). C S de Vries, MB ChB, MMed (Rad). Department of Diagnostic Radiology, Universitas Hospital, University of the Free State, Bloemfontein.

  12. Original Article Evaluation of Percutaneous Suprapubic

    African Journals Online (AJOL)

    Objective: To evaluate the feasibility and effectiveness of percutaneous cystolithotripsy under local anesthesia. Patients and Methods: In this prospective study we analyzed the results of percutaneous cystolithotripsy under local anesthesia performed in 42 patients (36 men and 6 women). Suprapubic access was obtained ...

  13. Percutaneous lung biopsy: technique, efficacy, and complications.

    Science.gov (United States)

    Winokur, Ronald S; Pua, Bradley B; Sullivan, Brian W; Madoff, David C

    2013-06-01

    Computed tomography-guided percutaneous needle biopsy of the lung is an indispensable tool in the evaluation of pulmonary abnormalities due to its high diagnostic accuracy in the detection of malignancy. Percutaneous biopsy in the lung plays a critical role in obtaining pathologic proof of malignancy, guiding staging and planning treatment. This article reviews biopsy techniques and their related efficacy and complications.

  14. Percutaneous balloon dilatation for benign hepaticojejunostomy strictures

    NARCIS (Netherlands)

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

    2000-01-01

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

  15. Recent Advances in Percutaneous Nephrolithotomy

    Directory of Open Access Journals (Sweden)

    Erem Kaan Basok

    2014-05-01

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

  16. The use of artificial neural network for modelling of phycoremediation of toxic elements As(III) and As(V) from wastewater using Botryococcus braunii.

    Science.gov (United States)

    Podder, M S; Majumder, C B

    2016-02-15

    In the present study, a thorough investigation has been done on the removal efficiency of both As(III) and As (V) from synthetic wastewater by phycoremediation of Botryococcus braunii algal biomass. Artificial neural networks (ANNs) are practised for predicting % phycoremediation efficiency of both As(III) and As(V) ions. The influence of several parameters for example initial pH, inoculum size, contact time and initial arsenic concentration (either As(III) or As(V)) was examined systematically. The maximum phycoremediation of As(III) and As(V) was found to be 85.22% and 88.15% at pH9.0, equilibrium time of 144h by using algal inoculum size of 10% (v/v) and initial arsenic concentration of 50mg/L. The data acquired from laboratory scale experimental set up was utilized for training a three-layer feed-forward back propagation (BP) with Levenberg-Marquardt (LM) training algorithm having 4:5:1 architecture. A comparison between the experimental data and model outputs provided a high correlation coefficient (R(2)all_ANN equal to 0.9998) and exhibited that the model was capable for predicting the phycoremediation of both As(III) and As(V) from wastewater. The network topology was optimized by changing number of neurons in hidden layers. ANNs are efficient to model and simulate highly non-liner multivariable relationships. Absolute error and Standard deviation (SD) with respect to experimental output were calculated for ANN model outputs. The comparison of phycoremediation efficiencies of both As(III) and As(V) between experimental results and ANN model outputs exhibited that ANN model can determine the behaviour of As(III) and As(V) elimination process under various circumstances. Copyright © 2015 Elsevier B.V. All rights reserved.

  17. Should anyone perform percutaneous endoscopic laser diskectomy and percutaneous lumbar disc decompressions?

    OpenAIRE

    Epstein, Nancy E.

    2016-01-01

    Background: Increasingly, pain management specialists (P-S) (e.g., anesthesiologists, radiologists, or physiatrists), who are not spinal surgeons, are performing percutaneous endoscopic laser diskectomy (PELD), percutaneous lumbar disc decompression (PLDD), and target percutaneous laser disc decompression (T-PLDD) in patients with minimal/mild disc herniations. Here, theoretically, the laser vaporizes/shrinks a small portion of disc tissue that lowers intradiscal pressure/volume, and thereby ...

  18. Direct percutaneous endoscopic jejunostomy performed with gastroscope

    Directory of Open Access Journals (Sweden)

    Ajay P Choksi

    2013-01-01

    Full Text Available While percutaneous endoscopic gastrostomy (PEG is a well-known approach for achieving enteral feeding, direct percutaneous endoscopic jejunostomy (DPEJ is a technique that allows endoscopic placement of percutaneous/transabdominal feeding tube directly into the jejunum. It offers a non-surgical alternative for postpyloric enteral feeding for long-term nutritional support when gastric feeding is not technically possible or is inappriopriate. Conventionally DPEJ is done with pediatric colonoscope or small bowel enteroscope. Here, we report a case where DPEJ was accomplished with gastroscope.

  19. [Percutaneous approaches in valvular heart diseases].

    Science.gov (United States)

    Aydin, Mustafa; Cetiner, Mehmet Ali

    2009-07-01

    Valvular heart diseases still continue to be an important health problem. Surgical replacement of cardiac valves keeps a widely used treatment method for the present. However, the efficiency of minimal invasive and percutaneous methods targeted to repair and replacement of the diseased valves has been searched for nowadays. The first clinical experiences and early stage outcomes on the applicability of these methods are encouraging. Nevertheless, it should be kept in mind that percutaneous valvular interventions are at their development stages. Long term confidence and efficiency studies of these treatment modalities are needed. The present review emphasizes the studies on percutaneous techniques initiated in the treatment of valvular heart diseases.

  20. A comparison of the techniques of secondary ion mass spectrometry and resonance ionization mass spectrometry for the analysis of potentially toxic element accumulation in neural tissue.

    Science.gov (United States)

    Jones, O R; Perks, R M; Abraham, C J; Telle, H H; Oakley, A E

    1997-01-01

    A comparison is made of the techniques of secondary ion mass spectrometry (SIMS) and resonance ionization mass spectrometry (RIMS) for the detection of the neuro-toxic element aluminium in cortical tissue. Experiments were performed using a reflectron-type time-of-flight mass spectrometer (TOFMS) in conjunction with an Ar+ source for target sputtering and a pulsed tuneable dye laser system for resonance ionization. It is shown how isobaric interference of species such as CNH and C2H3 in the case of aluminium greatly affect the quantitative accuracy and the detection limit of aluminium in biological samples when analysed using SIMS. In contrast the use of RIMS virtually eliminates this problem, so allowing easier quantification and much lower detection limits to be achieved. Detection limits of approximately 3 ppm for aluminium in brain tissue homogenates were achieved using RIMS, with a spatial resolution of less than 100 microns.

  1. Percutaneous penetration studies for risk assessment

    DEFF Research Database (Denmark)

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

    2000-01-01

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

  2. complementary techniques of percutaneous closure of ductus ...

    African Journals Online (AJOL)

    2013-07-07

    Jul 7, 2013 ... We report this single centre experience of percutaneous. PDA closure in a ... Design: A descriptive retrospective cohort study. ... Three of the subjects in the coil group had the ducts embolised using the double technique while ...

  3. Percutanous vertebroplasty for vertebral compression fracture in ...

    African Journals Online (AJOL)

    ; a report of two cases. ... Background: Osteoporotic vertebral fractures are common in the geriatric age group. ... Conclusion: Percutanous vertebroplasty offers effective, immediate and sustained pain relief in osteoporotic vertebral fractures.

  4. Laparoscopic-assisted percutaneous endoscopic transgastrostomy jejunostomy

    National Research Council Canada - National Science Library

    Dimofte, Mihail-Gabriel; Porumb, Vlad; Nicolescu, Simona; Ristescu, Irina; Lunca, Sorinel

    2014-01-01

    .... The typical approach involves a percutaneous endoscopic transgastrostomy jejunostomy (PEG-J), which requires a combination of procedures designed to ensure that no organ is interposed between the abdominal wall and the gastric surface...

  5. Prediction of postoperative pain after percutaneous nephrolithotomy

    DEFF Research Database (Denmark)

    Pedersen, Katja Venborg; Olesen, Anne Estrup; Osther, Palle Jørn Sloth

    2013-01-01

    an improvement in rehabilitation. This study evaluates the relationship between preoperative experimental pain assessment and postoperative pain and opioid consumption. Forty-four patients with uni- or bilateral kidney stone disease scheduled for percutaneous nephrolithotomy were included. The preoperative pain...

  6. The percutaneous nephrolithotomy global study

    DEFF Research Database (Denmark)

    Labate, Gaston; Modi, Pranjal; Timoney, Anthony

    2011-01-01

    or more complications. The most frequent complications were fever and bleeding. Urinary leakage, hydrothorax, hematuria, urinary tract infection, pelvic perforation, and urinary fistula also occurred in ≥20 patients in each group. The majority of complications (n=634, 54.0%) were classified as Clavien......PURPOSE: This study evaluated postoperative complications of percutaneous nephrolithotomy (PCNL) and the influence of selected factors on the risk of complications using the Clinical Research Office of the Endourological Society (CROES) PCNL Global Study database. PATIENTS AND METHODS: The CROES...... PCNL Global Study collected prospective data for consecutive patients who were treated with PCNL at centers around the world for 1 year. Complications were evaluated by the modified Clavien classification system. RESULTS: Of 5724 patients with Clavien scores, 1175 (20.5%) patients experienced one...

  7. An update on percutaneous nephrolithotomy

    DEFF Research Database (Denmark)

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

    2013-01-01

    Since its introduction in late 1970's, percutaneous nephrolithotomy (PNL) has undergone an evolution in both equipment and technique. This evolution still continues today in the era of minimally invasive treatment options, and is evidenced by the numerous publications. PNL is generally advantageous...... in the management of large renal stones (>1.5-2 cm) with high stone-free rates and considerable complication rates. However this technique is especially competing with retrograde intrarenal surgery and laparoscopic techniques. Therefore the CROES Global PNL Study Group prospectively collected data of over 5800...... patients managed with PNL worldwide and analyzed the data in detail, producing more than 25 scientific papers. And this update focuses on the lessons learned from the CROES PCNL Global Study....

  8. Bivalirudin in percutaneous coronary intervention

    Directory of Open Access Journals (Sweden)

    Sam J Lehman

    2006-12-01

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

  9. Pulmonary Cement Embolism following Percutaneous Vertebroplasty

    Directory of Open Access Journals (Sweden)

    Ümran Toru

    2014-01-01

    Full Text Available Percutaneous vertebroplasty is a minimal invasive procedure that is applied for the treatment of osteoporotic vertebral fractures. During vertebroplasty, the leakage of bone cement outside the vertebral body leads to pulmonary cement embolism, which is a serious complication of this procedure. Here we report a 48-year-old man who was admitted to our hospital with dyspnea after percutaneous vertebroplasty and diagnosed as pulmonary cement embolism.

  10. Infective endocarditis following percutaneous pulmonary valve replacement

    DEFF Research Database (Denmark)

    Cheung, Gary; Vejlstrup, Niels; Ihlemann, Nikolaj

    2013-01-01

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

  11. Tip Deflection Determination of a Barrel for the Effect of an Accelerating Projectile Before Firing Using Finite Element and Artificial Neural Network Combined Algorithm

    Directory of Open Access Journals (Sweden)

    Mehmet Akif Koç

    Full Text Available Abstract For realistic applications, design and control engineers have limited modelling options in dealing with some vibration problems that hold many nonlinearity such as non-uniform geometry, variable velocity loadings, indefinite damping cases, etc. For these reasons numerous time consuming experimental studies at high costs must be done for determining the actual behaviour such nonlinear systems. However, using advantages of multiple computational methods like Finite Element Method (FEM together with an Artificial Intelligence (ANN, many complicated engineering problems can be handled and solved to some extent. This study, proposes a new collective method to deal with the nonlinear vibrations of the barrels in order to fulfil accurate shooting expectancy. Using known analytical methods, in practical, to determine dynamic behaviour of the barrel beam is not possible for all conditions of firing that include numerous varieties of ammunition for different purposes, and each projectile of different ammunition has different mass and exit velocity. In order to cover all cases this study proposes a new method that combines a precise FEM with ANN, and can be used for determining the exact dynamic behaviour of a barrel for some cases and then for precisely predicting the behaviour for all other possible cases of firing. In this study, the whole nonlinear behaviour of an antiaircraft barrel were obtained with 3.5% accuracy errors by ANN trained by FEM using calculated analysis results of ammunitions for a particular range. The proposed FEM-ANN combined method can be very useful for design and control engineers in design and control of barrels in order to compensate the effect of nonlinear vibrations of a barrel for achieving a higher shooting accuracy; and can reduce high-cost experimental works.

  12. Neural-like growing networks

    Science.gov (United States)

    Yashchenko, Vitaliy A.

    2000-03-01

    On the basis of the analysis of scientific ideas reflecting the law in the structure and functioning the biological structures of a brain, and analysis and synthesis of knowledge, developed by various directions in Computer Science, also there were developed the bases of the theory of a new class neural-like growing networks, not having the analogue in world practice. In a base of neural-like growing networks the synthesis of knowledge developed by classical theories - semantic and neural of networks is. The first of them enable to form sense, as objects and connections between them in accordance with construction of the network. With thus each sense gets a separate a component of a network as top, connected to other tops. In common it quite corresponds to structure reflected in a brain, where each obvious concept is presented by certain structure and has designating symbol. Secondly, this network gets increased semantic clearness at the expense owing to formation not only connections between neural by elements, but also themselves of elements as such, i.e. here has a place not simply construction of a network by accommodation sense structures in environment neural of elements, and purely creation of most this environment, as of an equivalent of environment of memory. Thus neural-like growing networks are represented by the convenient apparatus for modeling of mechanisms of teleological thinking, as a fulfillment of certain psychophysiological of functions.

  13. Percutaneous radiofrequency thermal lumbar sympathectomy and its clinical use

    NARCIS (Netherlands)

    J. Pernak (Jamina)

    1988-01-01

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

  14. Training in Percutaneous Nephrolithotomy-A Critical Review

    NARCIS (Netherlands)

    de La Rosette, Jean J. M. C. H.; Laguna, Maria P.; Rassweiler, Jens J.; Conort, Pierre

    2008-01-01

    Aim: To study factors influencing training and maintaining skills in performing percutaneous nephrolithotomy (PCNL). Methods: We matched key words, throughout Medline, MeSH, and Cochrane databases including: renal stone, percutaneous, nephrostomy, endourology, educational, training, learning curve,

  15. [Second neoplasms after percutaneous radiotherapy].

    Science.gov (United States)

    Haidl, F; Pfister, D; Semrau, R; Heidenreich, A

    2017-03-01

    Radiation therapy represents an alternative treatment to radical prostatectomy in the management of clinically localized prostate cancer. Radiation-induced second neoplasms are defined by a latency period of at least 5 years, location within the field of radiation therapy, and a histology which differs from the primary tumor. Based on the data in the literature, there is a consistently increased risk of bladder cancer (HR: 1.67, 95% CI 1.55-1.80), rectal cancer (HR: 1.79, 95% CI 1.34-2.38), and colorectal cancer (HR: 1.79, 95% CI 1.34-23.8) following percutaneous radiation therapy. Following brachytherapy only an increased for the development of bladder cancer (HR: 2.14, 95% CI 1.03-3.94) has been observed. The incidence of second neoplasms increases significantly and continuously with the posttreatment time interval. Although bladder cancers following RT of the prostate are usually more locally advanced and of high grade, no negative impact in terms of overall survival and cancer-specific survival has been observed. Symptoms or findings of microhematuria need to be examined thoroughly after radiation therapy to identify bladder cancer quite early.

  16. Percutaneous nephrolithotomy for pediatric urolithiasis

    Directory of Open Access Journals (Sweden)

    Arvind P Ganpule

    2010-01-01

    Full Text Available Pediatric urolithiasis is a management dilemma as a number of treatment options are available such as shock wave lithotripsy (SWL, percutaneous nephrolithotomy (PCNL, and retrograde intrarenal surgery (RIRS. PCNL offers good clearance rates in a single hospital stay. The concerns with PCNL include the use of large instrument in pediatric kidneys, parenchymal damage and the associated effects on renal function, radiation exposure with fluoroscopy, and the risk of major complications including sepsis and bleeding. Evolution of pediatric PCNL technique such as miniaturization of instruments, limitation of tract size and advanced intracorporeal lithotripters have resulted in this technique being widely utilized for achieving stone-free status in appropriate patients. Many of the patients in our country come from remote areas thereby requiring special considerations during treatment. This also necessitates complete clearance in a single shorter hospital stay. PCNL appears to be the optimal option available in this scenario. The literature suggests that even complex and staghorn calculi can be tackled with this approach. The choice of the method to gain access is a matter of experience and personal preference. Ultrasound offers the advantage of visualization of spleen, liver and avoids injury. Miniaturization of instruments, particularly smaller nephroscopes and the potential to use lasers will decrease the morbidity and improve the clearance rates further. In this article, we analyze the management of pediatric urolithiasis with PCNL. We discuss our technique and analyze the results, complications and technique mentioned in the contemporary literature.

  17. Infective complication following percutaneous nephrolithotomy

    Directory of Open Access Journals (Sweden)

    Bannakij Lojanapiwat

    2016-03-01

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

  18. Percutaneous extraction of stented device leads.

    Science.gov (United States)

    Baranowski, Bryan; Wazni, Oussama; Chung, Roy; Martin, David O; Rickard, John; Tanaka-Esposito, Christine; Bassiouny, Mohammed; Wilkoff, Bruce L

    2012-05-01

    There are limited published data regarding the percutaneous extraction of device leads jailed by a venous stent. In this study we assessed the feasibility and safety of percutaneous extraction of stented device leads. We reviewed our experience percutaneously extracting 7 chronically implanted device leads jailed to the wall of the left innominate and/or subclavian veins by a previously placed stent. All leads were successfully extracted by using a percutaneous approach. Both pacing leads and defibrillator leads were extracted. The oldest pacing lead extracted was 14 years old. The oldest defibrillator lead extracted was 6 years old. Three of the leads were extracted with simple manual traction alone. The 4 remaining leads required a more complex, femoral extraction approach for successful removal. In our experience extracting 7 stented device leads, complete percutaneous removal was feasible 100% of the time using a combination of simple manual traction and a femoral approach. No major complications were associated with the extraction procedures. Copyright © 2012 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  19. Percutaneous epidural drainage through a burr hole

    Directory of Open Access Journals (Sweden)

    Priscila M Falsarella

    2016-01-01

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

  20. Current Considerations in Direct Percutaneous Endoscopic Jejunostomy

    Directory of Open Access Journals (Sweden)

    Yanfei Zhu

    2012-01-01

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

  1. PERCUTANEOUS ENDOSCOPIC ELECTRORESECTION OF RENAL PELVIC TUMORS

    Directory of Open Access Journals (Sweden)

    B. K. Komyakov

    2014-07-01

    Full Text Available The paper gives the results of percutaneous electroresection of the renal pelvic wall with a tumor in 4 patients. The operation has been made for absolute indications: 3 patients had a single kidney and the fourth patient had a single functioning left kidney (the right pelvic dystopic kidney failed to function. In all the patients, the primary symptom of the disease was macrohematuria, the examination for which revealed a renal pelvic tumor measuring 1.2 to 2.5 cm in size. There were no complications after percutaneous electroresection of the renal pelvic wall with a tumor. Intrarenal BCG therapy was performed in the postoperative period. Percutaneous electroresection is indicated for tumors of the renal pelvis and the upper third of the ureter of the single kidney.

  2. Evolvable synthetic neural system

    Science.gov (United States)

    Curtis, Steven A. (Inventor)

    2009-01-01

    An evolvable synthetic neural system includes an evolvable neural interface operably coupled to at least one neural basis function. Each neural basis function includes an evolvable neural interface operably coupled to a heuristic neural system to perform high-level functions and an autonomic neural system to perform low-level functions. In some embodiments, the evolvable synthetic neural system is operably coupled to one or more evolvable synthetic neural systems in a hierarchy.

  3. Neural elements in dental pulp and dentin.

    OpenAIRE

    Nair, P N R

    1995-01-01

    This article addresses the structural and quantitative aspects of human tooth innervation and briefly considers the functions and clinical relevance of tooth axons. The classification of peripheral axons, the pulpal and dentinal innervation, and the theories of dentin sensitivity are discussed. Quantitative studies on tooth innervation are also reviewed. Human premolars receive about 2300 axons at the root-apex of which about 13% are myelinated and 87% are nonmyelinated fibers. Most apical my...

  4. Percutaneous Cryotherapy of Vascular Malformation: Initial Experience

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-06-15

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

  5. Memristor-based neural networks

    Science.gov (United States)

    Thomas, Andy

    2013-03-01

    The synapse is a crucial element in biological neural networks, but a simple electronic equivalent has been absent. This complicates the development of hardware that imitates biological architectures in the nervous system. Now, the recent progress in the experimental realization of memristive devices has renewed interest in artificial neural networks. The resistance of a memristive system depends on its past states and exactly this functionality can be used to mimic the synaptic connections in a (human) brain. After a short introduction to memristors, we present and explain the relevant mechanisms in a biological neural network, such as long-term potentiation and spike time-dependent plasticity, and determine the minimal requirements for an artificial neural network. We review the implementations of these processes using basic electric circuits and more complex mechanisms that either imitate biological systems or could act as a model system for them.

  6. Neural tube defects

    Directory of Open Access Journals (Sweden)

    M.E. Marshall

    1981-09-01

    Full Text Available Neural tube defects refer to any defect in the morphogenesis of the neural tube, the most common types being spina bifida and anencephaly. Spina bifida has been recognised in skeletons found in north-eastern Morocco and estimated to have an age of almost 12 000 years. It was also known to the ancient Greek and Arabian physicians who thought that the bony defect was due to the tumour. The term spina bifida was first used by Professor Nicolai Tulp of Amsterdam in 1652. Many other terms have been used to describe this defect, but spina bifida remains the most useful general term, as it describes the separation of the vertebral elements in the midline.

  7. Percutaneous tension band wiring for patellar fractures.

    Science.gov (United States)

    Rathi, Akhilesh; Swamy, M K S; Prasantha, I; Consul, Ashu; Bansal, Abhishek; Bahl, Vibhu

    2012-08-01

    To evaluate outcome of percutaneous tension band wiring for transverse fractures of the patella. 16 men and 7 women aged 27 to 65 (mean, 40) years underwent percutaneous tension band wiring for transverse fractures of the patella with a displacement of >3 mm. Pain, operating time, mobility, functional score, and complications were evaluated. 20 patients underwent successful percutaneous tension band wiring. The remaining 3 patients in whom closed reduction failed underwent open reduction and tension band wiring. The mean operating time was 46 (range, 28-62) minutes. The mean follow-up period was 20 (range, 15-30) months. At the latest follow-up, all patients had regained full extension. The objective score was excellent in 20 patients and good in 3, whereas the subjective score was excellent in 17, good in 5, and fair in one. All patients had radiological union at week 8. One patient had patellofemoral arthritis (secondary to a postoperative articular step). Two patients developed superficial infections, which resolved after antibiotic therapy. Mean thigh muscle wasting was 0.7 (range, 0.4-1) cm. Three patients encountered hardware problems (impingement/irritation of the skin over the knee) necessitating implant removal. Percutaneous tension band wiring is a viable option for transverse fractures of the patella.

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

    African Journals Online (AJOL)

    A. Bansal

    2016-06-03

    Jun 3, 2016 ... www.ees.elsevier.com/afju · www.sciencedirect.com. Case report. Duodenal perforation during percutaneous nephrolithotomy (PCNL) in a pediatric patient: A case report. A. Bansal. ∗. , V. Singh, R. Sinha. King George Medical University, Lucknow, Uttar Pradesh 226003, India. Received 13 September ...

  9. Gastrostomie percutanée endoscopique

    National Research Council Canada - National Science Library

    Le Sidaner, Anne

    2002-01-01

    La gastrostomie percutanée endoscopique est actuellement la voie d’abord de référence pour l’alimentation entérale prolongée. La simplicité et la rapidité de la technique, l’évolution du matériel font que les gastro...

  10. Percutaneous Injuries in Nigerian Dentists | Utomi | Nigerian ...

    African Journals Online (AJOL)

    Objective: The purpose of this study is to assess the frequency of percutaneous injuries among Nigerian dentists and to describe the factors associated with the injuries. Materials and Methods: A questionnaire survey of 160 practicing dentists in Lagos, Ibadan, Ife and Benin. Result: A total of 208 injuries were reported by ...

  11. Reported incidences and factors associated with percutaneous ...

    African Journals Online (AJOL)

    Background: Percutaneous injuries and mucocutaneous blood and other body fluids exposure are among the common hospital hazards affecting health care workers (HCWs) worldwide. These exposures pose risks of contracting infections such as Hepatitis B and C and Human Immunodeficiency viruses. This study aimed ...

  12. Ethical challenges of percutaneous endoscopic gastrostomy.

    Science.gov (United States)

    Morgenstern, L; Laquer, M; Treyzon, L

    2005-03-01

    Percutaneous endoscopic gastrostomy (PEG) is a widely used procedure for patients who cannot swallow. Although it is mostly performed for valid indications, its use in terminally ill patients is questionable. In this study, more than 30% of patients died in hospital after PEG placement and 16% died less than 30 days after placement. Strict guidelines and oversight or PEG placement are recommended.

  13. Percutaneous Radiofrequency Ablation of Renal Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Yi-You Chiou

    2005-05-01

    Conclusion: Percutaneous RFA is effective in the treatment of RCC. It is most successful for tumors not larger than 3 cm in diameter, and has a satisfactory success rate in tumors of 3-5 cm in diameter. The rate of serious complications of RFA is low. Further studies are necessary to determine the long-term efficacy of RFA in RCC.

  14. The effect of volatility on percutaneous absorption.

    Science.gov (United States)

    Rouse, Nicole C; Maibach, Howard I

    2016-01-01

    Topically applied chemicals may volatilize, or evaporate, from skin leaving behind a chemical residue with new percutaneous absorptive capabilities. Understanding volatilization of topical medications, such as sunscreens, fragrances, insect repellants, cosmetics and other commonly applied topicals may have implications for their safety and efficacy. A systematic review of English language articles from 1979 to 2014 was performed using key search terms. Articles were evaluated to assess the relationship between volatility and percutaneous absorption. A total of 12 articles were selected and reviewed. Key findings were that absorption is enhanced when coupled with a volatile substance, occlusion prevents evaporation and increases absorption, high ventilation increases volatilization and reduces absorption, and pH of skin has an affect on a chemical's volatility. The articles also brought to light that different methods may have an affect on volatility: different body regions; in vivo vs. in vitro; human vs. Data suggest that volatility is crucial for determining safety and efficacy of cutaneous exposures and therapies. Few articles have been documented reporting evaporation in the context of percutaneous absorption, and of those published, great variability exists in methods. Further investigation of volatility is needed to properly evaluate its role in percutaneous absorption.

  15. Percutaneous penetration through slightly damaged skin

    DEFF Research Database (Denmark)

    Nielsen, Jesper B

    2005-01-01

    Guidelines for experimental studies of percutaneous penetration prescribe optimal barrier integrity of the skin. The barrier integrity of the skin exposed in occupational or household situations is, however, not always ideal, and skin problems are among the most dominant reasons for absence from ...

  16. Current considerations of direct percutaneous endoscopic jejunostomy.

    Science.gov (United States)

    Zhu, Yanfei; Shi, Liping; Tang, Hao; Tao, Guoqing

    2012-02-01

    BACKGROUOND: Direct percutaneous endoscopic jejunostomy (DPEJ) is a well-known approach to deliver postpyloric enteral nutritional support to individuals who cannot tolerate gastric feeding. However, it is technically difficult, and some case series have reported significant procedural failure rates. The present article describes current indications, successes and complications of DPEJ placement. A MEDLINE database search was performed to identify relevant articles using the key words "direct percutaneous endoscopic jejunostomy", "percutaneous endoscopic gastrostomy", and "percutaneous endoscopic gastrostomy with a jejunal extension tube". Additional articles were identified by a manual search of the references cited in the key articles obtained in the primary search. DPEJ is gradually becoming more common in the treatment of patients who cannot tolerate gastric feeding. Differences in patient selection and technique modifications may contribute to the various success rates reported. Failure is most often due to inadequate transillumination or gastroduodenal obstruction. Currently, there are limited data to evaluate the safety and effectiveness of DPEJ. The clinical use of DPEJ is increasing. With appropriate care and expertise, DPEJ may prove to be reliable and safe.

  17. Current considerations in direct percutaneous endoscopic jejunostomy

    Science.gov (United States)

    Zhu, Yanfei; Shi, Liping; Tang, Hao; Tao, Guoqing

    2012-01-01

    BACKGROUND: Direct percutaneous endoscopic jejunostomy (DPEJ) is a well-known approach to deliver postpyloric enteral nutritional support to individuals who cannot tolerate gastric feeding. However, it is technically difficult, and some case series have reported significant procedural failure rates. The present article describes current indications, successes and complications of DPEJ placement METHODS: A MEDLINE database search was performed to identify relevant articles using the key words “direct percutaneous endoscopic jejunostomy”, “percutaneous endoscopic gastrostomy”, and “percutaneous endoscopic gastrostomy with a jejunal extension tube”. Additional articles were identified by a manual search of the references cited in the key articles obtained in the primary search. RESULTS: DPEJ is gradually becoming more common in the treatment of patients who cannot tolerate gastric feeding. Differences in patient selection and technique modifications may contribute to the various success rates reported. Failure is most often due to inadequate transillumination or gastroduodenal obstruction. Currently, there are limited data to evaluate the safety and effectiveness of DPEJ. CONCLUSION: The clinical use of DPEJ is increasing. With appropriate care and expertise, DPEJ may prove to be reliable and safe. PMID:22312608

  18. Percutaneous penetration studies for risk assessment

    NARCIS (Netherlands)

    Sartorelli, P.; Andersen, H.R.; Angerer, J.; Corish, J.; Drexler, H.; Göen, T.; Griffin, P.; Hotchkiss, S.A.M.; Larese, F.; Montomoli, L.; Perkins, J.; Schmelz, M.; Sandt, J. van de; Williams, F.

    2000-01-01

    During the last few years the general interest in the percutaneous absorption of chemicals has increased. It is generally accepted that there is very few reliable quantitative and qualitative data on dermal exposure to chemicals in the general population and in occupationally exposed workers. In

  19. Percutaneous transvenous mitral commissurotomy in juvenile mitral ...

    African Journals Online (AJOL)

    Objective: To determine the efficacy and safety of percutaneous transvenous mitral commissurotomy(PTMC), using multi-track double balloon technique in juvenile mitral stenosis. Design: Open non-randomised intervention. Setting: Cardiac catheterisation laboratories of The Mater Hospital, The Nairobi Hospital and ...

  20. PERCUTANEOUS CALYCEAL IRRIGATION FOR SMALL CALYCEAL

    African Journals Online (AJOL)

    and has a variable success rate, while multiple tracks increase the risk of complications of. PNL, especially bleeding. We herein describe a technique of intra- operative percutaneous calyceal irrigation us- ing fluoroscopic and endoscopic guide. This helps to increase the stone clearance rate dur- ing PNL without the need ...

  1. [Percutaneous treatment of valvular heart diseases].

    Science.gov (United States)

    Ettori, Federica; Fiorina, Claudia; Lipartiti, Felicia; Maffeo, Diego; Curello, Salvatore; Chizzola, Giuliano; Curnis, Antonio; Chiari, Ermanna; Dei Cas, Livio

    2012-10-01

    Surgical valve replacement represents the treatment of choice for symptomatic and severe valvular heart disease. However, the operative risk is increased in presence of advanced age and comorbidities, therefore such patients are often not deemed suitable for surgical treatment. Recently, percutaneous valve replacement has emerged as an optional treatment for such patients, particularly for treating severe aortic stenosis and severe mitral regurgitation.

  2. Complementary techniques of percutaneous closure of ductus ...

    African Journals Online (AJOL)

    East African Medical Journal ... Device closure of the ductus was first performed at the Mater hospital in 1999 in a ten year old male using a five millilitre detachable cook coil. In 2000 the ... We report this single centre experience of percutaneous PDA closure in a resource-limited setting; utilising the two techniques.

  3. Neural Networks

    Directory of Open Access Journals (Sweden)

    Schwindling Jerome

    2010-04-01

    Full Text Available This course presents an overview of the concepts of the neural networks and their aplication in the framework of High energy physics analyses. After a brief introduction on the concept of neural networks, the concept is explained in the frame of neuro-biology, introducing the concept of multi-layer perceptron, learning and their use as data classifer. The concept is then presented in a second part using in more details the mathematical approach focussing on typical use cases faced in particle physics. Finally, the last part presents the best way to use such statistical tools in view of event classifers, putting the emphasis on the setup of the multi-layer perceptron. The full article (15 p. corresponding to this lecture is written in french and is provided in the proceedings of the book SOS 2008.

  4. Postoperative seizure following transforaminal percutaneous endoscopic lumbar discectomy

    OpenAIRE

    Kertmen, Hayri; G?rer, Bora; YILMAZ, Erdal Resit; Sekerci, Zeki

    2016-01-01

    Endoscopic surgery for lumbar disc herniation has been available for more than 30 years. Transforaminal percutaneous endoscopic lumbar discectomy is a well-known, safe, and effective method used for the treatment of the lumbar disc herniation. The published complications of the transforaminal percutaneous endoscopic lumbar discectomy consist of infections, thrombophlebitis, dysesthesia, dural tear, vascular injury, and death. Seizure after transforaminal percutaneous endoscopic lumbar discect...

  5. Percutaneous Cementoplasty for Kienbock’s Disease

    Energy Technology Data Exchange (ETDEWEB)

    Vallejo, Eduardo Crespo, E-mail: dreduardocrespo@gmail.com [Hospital Príncipe de Asturias, Vascular and Interventional Radiology Unit (Spain); Martinez-Galdámez, Mario [Fundación Jimenez Diaz, Neurointerventional Radiology Unit (Spain); Martin, Ernesto Santos [Memorial Sloan-Kettering Center, Vascular and Interventional Radiology Unit (United States); Gregorio, Arturo Perera de [Hospital Príncipe de Asturias, Department of Orthopedic Surgery (Spain); Gallego, Miriam Gamo [Hospital Príncipe de Asturias, Vascular and Interventional Radiology Unit (Spain); Escobar, Angeles Ramirez [Hospital Príncipe de Asturias, Radiology Unit (Spain)

    2017-05-15

    Kienböck disease typically presents with wrist pain, swelling, restricted range of motion, and difficulty in performing activities of daily living. Because the etiology and evolution of disease remain unclear, broad ranges of treatments have been designed. Percutaneous cementoplasty is expanding its role for managing painful bone metastases outside the spine. We can draw a parallel between lytic tumoral lesions and Kienbock’s disease. Increasing the strength and rigidity of lunate with cementoplasty can prevent it from collapse, relieve the symptoms associated with the process of avascular necrosis, and increase the wrist range of motion. We report the case of 30-year-old man with a painful stage IIIA Kienböck disease who underwent percutaneous cementoplasty and experienced immediate effective pain relief and recovery of wrist mobility.

  6. Nefopam Reduces Dysesthesia after Percutaneous Endoscopic Lumbar Discectomy

    National Research Council Canada - National Science Library

    Ok, Young Min; Cheon, Ji Hyun; Choi, Eun Ji; Chang, Eun Jung; Lee, Ho Myung; Kim, Kyung Hoon

    2016-01-01

    Neuropathic pain, including paresthesia/dysesthesia in the lower extremities, always develops and remains for at least one month, to variable degrees, after percutaneous endoscopic lumbar discectomy (PELD...

  7. Ultrasound Guided Percutaneous Nephrostomy For Obstructive Uropathy

    Directory of Open Access Journals (Sweden)

    Abdullah Gedik

    2008-01-01

    Full Text Available We retrospectively evaluated the indications and complications in our patients that were performed of percutaneous nephrostomy applications with ultrasonography guidance.We evaluated 371 all patients whom applied percutaneous nephrostomy with ultrasonography guidance between January 2002 and December 2005 were evaluated retrospectively. The demographic data, cause of the obstruction, minor and major complications of patients were discussed.In this period, totally 455 Percutaneous nephrostomies (84 bilaterally, 287 unilaterally in 371 patients (were placed in 113 females (30.45 % and 258 males were placed. The male (69.55% patients whom mean age of the patients were 32.17 year (range 5 months to 85 years. In 17 of 371 (3.73% patients, it was determined with antegrade pyelography that nephro stomy catheters were not in the kidney. Total success ratio was 96.37%. Causes of the obstructions were malignant diseases in for 76 patients (20.48% and were benign diseases in for 295 patients (79.52%. The major complications were determined twenty-four of patients (6.46%. Major complications included macroscopic hematuria which needs transfusion (7 patients, septicemia (14 patients, and retroperitoneal colon perforation with needle (3 patients were observed in 24 of the 371 patients. Minor complications were observed in 51 of the 371 patients (13.74 %. All of the minor complications were macroscopic hematuria that resolved in less than 24 hours. In conclusion, percutaneous nephrostomy with ultrasonography guidance were found as an effective and, safe and successful method for the drainage of upper urinary tract in the obstructive uropaty.

  8. CIRSE Guidelines on Percutaneous Vertebral Augmentation

    Energy Technology Data Exchange (ETDEWEB)

    Tsoumakidou, Georgia, E-mail: gtsoumakidou@yahoo.com; Too, Chow Wei, E-mail: spyder55@gmail.com; Koch, Guillaume, E-mail: guillaume.koch@gmail.com; Caudrelier, Jean, E-mail: jean.caudrelier@chru-strasbourg.fr; Cazzato, Roberto Luigi, E-mail: gigicazzato@hotmail.it; Garnon, Julien, E-mail: juliengarnon@gmail.com; Gangi, Afshin, E-mail: gangi@unistra.fr [Strasbourg University Hospital, Interventional Radiology Department (France)

    2017-03-15

    Vertebral compression fracture (VCF) is an important cause of severe debilitating back pain, adversely affecting quality of life, physical function, psychosocial performance, mental health and survival. Different vertebral augmentation procedures (VAPs) are used in order to consolidate the VCFs, relief pain,and whenever posible achieve vertebral body height restoration. In the present review we give the indications, contraindications, safety profile and outcomes of the existing percutaneous VAPs.

  9. Promising results after percutaneous mitral valve repair

    DEFF Research Database (Denmark)

    Ihlemann, Nikolaj; Franzen, Olaf; Jørgensen, Erik

    2011-01-01

    Mitral valve regurgitation (MR) is the secondmost frequent valve disease in Europe. Untreated MR causes considerable morbidity and mortality. In the elderly, as many as half of these patients are denied surgery because of an estimated high surgical risk. Percutaneous mitral valve repair...... with the MitraClip system resembles the Alfieristitch where a clip is used to connect the tip of the mitral valve leaflets....

  10. Percutaneous hallux valgus treatment: Unilaterally or bilaterally.

    Science.gov (United States)

    Carvalho, Paulo; Viana, G; Flora, M; Emanuel, P; Diniz, P

    2016-12-01

    Currently there is no consensus regarding the use of bilateral simultaneous percutaneous surgery for Hallux valgus treatment. Although the technique described in M. Prado's book, recommends operating only one foot at a time there are no published studies confirming it. The aim of this study was to evaluate whether there is a difference between the results of patients that have been percutaneously operated on one foot and those operated on both feet at the same surgical time for mild to moderate Hallux valgus correction. We did a retrospective single centre evaluation of 93 feet (61 patients) with Hallux valgus operated percutaneously. 29 patients were operated unilaterally (group I) and 32 bilaterally simultaneously (group II) between 2005 and 2009. The Metatarsophalangeal angle (MPA), Intermetatarsal angle (IMA) and Distal metatarsal articular angle (DMAA) were evaluated pre- and postoperatively. The AOFAS score, the degree of patients' satisfaction and the complications were evaluated postoperatively. The mean follow-up was 24.0 months in group I, and 28.0 in group II. The average postoperative AOFAS score was 86.8, 82.9 in group I and 88.6 in group II (p>0.05). 90.6% were satisfied or very satisfied in group I, and 89.7% in group II (p>0.05). There was no statistically significant difference (p>0.05) in the average correction of MPA, DMAA, and IMA. The complications rate was similar in both groups. The similar results obtained in both groups suggest that the simultaneous bilateral percutaneous surgery gives equivalent results to the unilateral, which has an important socioeconomic impact since there is only one recovery time for both feet. Further research is needed. Copyright © 2015 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

  11. Percutaneous Cryoablation for Renal Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Tsitskari Maria

    2015-06-01

    Full Text Available Renal cell carcinoma (RCC is the most common type of kidney cancer in adults. Nephron sparing resection (partial nephrectomy has been the “gold standard” for the treatment of resectable disease. With the widespread use of cross sectional imaging techniques, more cases of renal cell cancers are detected at an early stage, i.e. stage 1A or 1B.  This has provided an impetus for expanding the nephron sparing options and especially, percutaneous ablative techniques.  Percutaneous ablation for RCC is now performed as a standard therapeutic nephron-sparing option in patients who are poor candidates for resection or when there is a need to preserve renal function due to comorbid conditions, multiple renal cell carcinomas, and/or heritable renal cancer syndromes. During the last few years, percutaneous cryoablation has been gaining acceptance as a curative treatment option for small renal cancers. Clinical studies to date indicate that cryoablation is a safe and effective therapeutic method with acceptable short and long term outcomes and with a low risk, in the appropriate setting.  In addition it seems to offer some advantages over radio frequency ablation (RFA and other thermal ablation techniques for renal masses.

  12. Imaging in percutaneous ablation for atrial fibrillation

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-11-15

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

  13. Post-cardiac injury syndrome: an atypical case following percutaneous coronary intervention.

    Science.gov (United States)

    Paiardi, Silvia; Cannata, Francesco; Ciccarelli, Michele; Voza, Antonio

    2017-12-01

    Post-cardiac injury syndrome (PCIS) is a syndrome characterized by pericardial and/or pleural effusion, triggered by a cardiac injury, usually a myocardial infarction or cardiac surgery, rarely a minor cardiovascular percutaneous procedure. Nowadays, the post-cardiac injury syndrome, is regaining importance and interest as an emerging cause of pericarditis, especially in developed countries, due to a great and continuous increase in the number and complexity of percutaneous cardiologic procedures. The etiopathogenesis seems mediated by the immunitary system producing immune complexes, which deposit in the pericardium and pleura and trigger an inflammatory response. We present the atypical case of a 76-year-old man presenting with a hydro-pneumothorax, low-grade fever and elevated inflammation markers, after two complex percutaneous coronary interventions, executed 30 and 75 days prior. The clinical features of our case are consistent with the diagnostic criteria of PCIS: prior injury of the pericardium and/or myocardium, fever, leucocytosis, elevated inflammatory markers, remarkable steroid responsiveness and latency period. Only one element does not fit with this diagnosis and does not find any further explanation: the air accompanying the pleural effusion, determining a hydro-pneumothorax and requiring a pleural drainage catheter positioning. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Neural Tube Defects

    Science.gov (United States)

    ... vitamin, before and during pregnancy prevents most neural tube defects. Neural tube defects are usually diagnosed before the infant is ... or imaging tests. There is no cure for neural tube defects. The nerve damage and loss of function ...

  15. A tabela periódica dos elementos químicos prevista por redes neurais artificiais de Kohonen Periodic table of the elements in the perspective of artificial neural networks

    Directory of Open Access Journals (Sweden)

    Maurício Ruv Lemes

    2008-01-01

    Full Text Available Although several chemical elements were not known by end of the 18th century, Mendeleyev came up with an astonishing achievement: the periodic table of elements. He was not only able to predict the existence of (then new elements but also to provide accurate estimates of their chemical and physical properties. This is certainly a relevant example of the human intelligence. Here, we intend to shed some light on the following question: Can an artificial intelligence system yield a classification of the elements that resembles, in some sense, the periodic table? To achieve our goal, we have fed a self-organized map (SOM with information available at Mendeleyev's time. Our results show that similar elements tend to form individual clusters. Thus, SOM generates clusters of halogens, alkaline metals and transition metals that show a similarity with the periodic table of elements.

  16. CT guided percutaneous needle biopsy of the chest: initial experience

    African Journals Online (AJOL)

    The objective of this article is to report our first experience of CT guided percutaneous thoracic biopsy and to demonstrate the accuracy and safety of this procedure. This was a retrospective study of 28 CT-Guided Percutaneous Needle Biopsies of the Chest performed on 24 patients between November 2014 and April 2015.

  17. Percutaneous central venous catheterization in children, is it efficient ...

    African Journals Online (AJOL)

    Objective To evaluate the frequent use of percutaneous central venous catheters (CVCs) in pediatric agegroup. Methods Retrospectively we reviewed the records of all children that had percutaneous CVCs in the pediatric surgical ward and pediatric intensive care unit at King Hussein Medical Center between January

  18. Experience of Percutaneous Trigger Finger Release under Local ...

    African Journals Online (AJOL)

    the results of percutaneous trigger finger release under local anesthesia. Subjects and Methods. This prospective study was carried out at Orthopedics department of M. M. Medical College from July 2005 to July 2010. It. Experience of Percutaneous Trigger Finger Release under Local Anesthesia in the Medical College of.

  19. Percutaneous endoscopic gastrostomy placement: Caregiver decision making in Taiwan

    Directory of Open Access Journals (Sweden)

    Lily Yeh

    2013-02-01

    Conclusion: Caregivers' decisions to proceed with a percutaneous endoscopic gastrostomy procedure were mediated by desires to relieve patients' suffering. To empower caregivers to make enteral feeding decisions, nurses must provide sufficient information about percutaneous gastrostomy tubes and their care, support decision making and help to identify an opportunity for gastrostomy tube placement.

  20. Renal lymphangiomatosis during pregnancy: management with percutaneous drainage

    Energy Technology Data Exchange (ETDEWEB)

    Oezmen, M.; Akata, D.; Akhan, O. [Hacettepe Univ., Ankara (Turkey). Dept. of Radiology; Deren, Oe.; Durukan, T. [Hacettepe Univ., Ankara (Turkey). Dept. of Obstetrics and Gynecology; Oezen, H. [Hacettepe Univ., Ankara (Turkey). Dept. of Urology

    2001-01-01

    We report a unique case of exacerbation of renal lymphangiomatosis during pregnancy which was managed percutaneously until delivery. Renal lymphangiomatosis is a very rare benign disorder that might cause abdominal pain and rarely hypertension and hematuria. Surgical treatment options may result in nephrectomy. Percutaneous drainage of symptomatic renal lymphangiomas should be viewed as an efficient therapeutic option particularly when surgery is contraindicated. (orig.)

  1. Malfunctioning Plastic Biliary Endoprosthesis: Percutaneous Transhepatic Balloon Pulling Technique

    Science.gov (United States)

    Rossi, Umberto G.; Rigamonti, Paolo; Cariati, Maurizio

    2013-01-01

    Percutaneous transhepatic removal techniques for malfunctioning plastic biliary endoprosthesis are considered safe and efficient second-line strategies, when endoscopic procedures are not feasible. We describe the percutaneous transhepatic balloon pulling technique in a patient with an unresectable malignant hilar cholangiocarcinoma. PMID:23984158

  2. Malfunctioning Plastic Biliary Endoprosthesis: Percutaneous Transhepatic Balloon Pulling Technique

    Directory of Open Access Journals (Sweden)

    Umberto G. Rossi

    2013-01-01

    Full Text Available Percutaneous transhepatic removal techniques for malfunctioning plastic biliary endoprosthesis are considered safe and efficient second-line strategies, when endoscopic procedures are not feasible. We describe the percutaneous transhepatic balloon pulling technique in a patient with an unresectable malignant hilar cholangiocarcinoma.

  3. Percutaneous transhepatic biliary drainage in malignant extrahepatic cholestasis

    Energy Technology Data Exchange (ETDEWEB)

    Hoevels, J.

    1985-03-01

    The technique of non-surgical percutaneous transhepatic biliary drainage has been improved recently. Combined internal and external drainage of bile was enabled by manipulation of a guide wire and a drainage catheter through the stenosed or obstructed section of the extrahepatic biliary ducts. Experience have been gained concerning internal drainage of bile by percutaneous transhepatic insertion of an endoprosthesis for some years now.

  4. Case Report Percutaneous Dilational Tracheostomy A bed side ...

    African Journals Online (AJOL)

    Introduction: Tracheostomy is one of the most commonly performed procedures in critically ill patients. Percutaneous dilatational tracheostomy (PDT), according to ciaglias technique described in 1985, has become the most popular technique for percutaneous tracheostomy and is demonstrably as safe as surgical.

  5. Percutaneous management of tumoral biliary obstruction in children

    Energy Technology Data Exchange (ETDEWEB)

    Akinci, Devrim; Gumus, Burcak; Ozkan, Orhan S.; Ozmen, Mustafa N.; Akhan, Okan [Hacettepe School of Medicine, Department of Radiology, Sihhiye, Ankara (Turkey); Ekinci, Saniye [Hacettepe School of Medicine, Department of Paediatric Surgery, Sihhiye, Ankara (Turkey); Akcoren, Zuhal [Hacettepe School of Medicine, Department of Paediatric Pathology, Sihhiye, Ankara (Turkey); Kutluk, Tezer [Hacettepe School of Medicine, Department of Paediatric Oncology, Sihhiye, Ankara (Turkey)

    2007-10-15

    There is limited experience of percutaneous biliary interventions in children although they are safe and effective procedures. To evaluate the efficacy and safety of percutaneous management of tumoral biliary obstruction in children. Percutaneous biliary interventions were performed in eight children (six boys, two girls) with a mean age of 10.5 years (range 4-17 years). The interventions included percutaneous biliary drainage (five patients), percutaneous biliary drainage and placement of a self-expanding metallic stent (two patients), and percutaneous cholecystostomy (one patient). All patients had signs of obstructive jaundice and two had cholangitis. All procedures were successful. No procedure-related mortality was observed. Bilirubin levels returned to normal in four of the eight patients. Findings of cholangitis resolved in the two affected patients after the procedure and antibiotic treatment. Two patients underwent surgery after percutaneous biliary drainage procedures. A self-expanding metallic stent was placed in two patients with malignancy and the stents remained patent until death. Percutaneous biliary interventions can be performed safely for the management of tumoral biliary obstruction in children. (orig.)

  6. Percutaneous reduction and fixation of intraarticular calcaneal fractures

    NARCIS (Netherlands)

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

    2008-01-01

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

  7. Morphine versus oxycodone analgesia after percutaneous kidney stone surgery

    DEFF Research Database (Denmark)

    Pedersen, Katja Venborg; Olesen, Anne Estrup; Drewes, Asbjørn Mohr

    2013-01-01

    According to previous studies oxycodone might have some advantages over morphine in the treatment of visceral pain. This study investigated the opioid consumption (primary outcome), pain relief and side effects (secondary outcomes) of morphine versus oxycodone after percutaneous nephrolithotomy u...... after percutaneous kidney stone operation was not confirmed....

  8. Percutaneous Image-Guided Ablation of Breast Tumors: An Overview

    OpenAIRE

    Sag, Alan A.; Maybody, Majid; Comstock, Christopher; Solomon, Stephen B.

    2014-01-01

    Percutaneous non-surgical image-guided ablation is emerging as an adjunct or alternative to surgery in the management of benign and malignant breast tumors. This review covers the current state of the literature regarding percutaneous image-guided ablation modalities, clinical factors regarding patient selection, and future directions for research.

  9. Percutaneous image-guided ablation of breast tumors: an overview.

    Science.gov (United States)

    Sag, Alan A; Maybody, Majid; Comstock, Christopher; Solomon, Stephen B

    2014-06-01

    Percutaneous non-surgical image-guided ablation is emerging as an adjunct or alternative to surgery in the management of benign and malignant breast tumors. This review covers the current state of the literature regarding percutaneous image-guided ablation modalities, clinical factors regarding patient selection, and future directions for research.

  10. Targeting the Neural Microenvironment in Prostate Cancer

    Science.gov (United States)

    2017-10-01

    Award Number: W81XWH-14-1-0505 TITLE: Targeting the Neural Microenvironment in Prostate Cancer PRINCIPAL INVESTIGATOR: Michael Ittmann MD PhD...CONTRACT NUMBER Targeting the Neural Microenvironment in Prostate Cancer 5b. GRANT NUMBER W81XWH-14-1-0505 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d...ABSTRACT Prostate cancer (PCa) remains the most common malignancy and the second leading cause of cancer -related death for men in the United States. Recent

  11. Toxic Elements

    DEFF Research Database (Denmark)

    Hajeb, Parvaneh; Shakibazadeh, Shahram; Sloth, Jens Jørgen

    2016-01-01

    Food is considered the main source of toxic element (arsenic, cadmium, lead, and mercury) exposure to humans, and they can cause major public health effects. In this chapter, we discuss the most important sources for toxic element in food and the foodstuffs which are significant contributors...... to human exposure. The occurrence of each element in food classes from different regions is presented. Some of the current toxicological risk assessments on toxic elements, the human health effect of each toxic element, and their contents in the food legislations are presented. An overview of analytical...... techniques and challenges for determination of toxic elements in food is also given....

  12. Percutaneous management of prosthetic valve thrombosis.

    Science.gov (United States)

    Hariram, Vuppaladadhiam

    2014-01-01

    Thrombosis of a prosthetic valve is a serious complication in patients with prosthetic heart valves. Thrombolysis is the initial choice of treatment. Patients who do not respond to thrombolysis are subjected to surgery which carries a high risk. We report a case series of 5 patients with prosthetic mitral valve thrombosis who did not respond to thrombolysis and were subjected to percutaneous manipulation of the prosthetic valves successfully and improved. Five patients who were diagnosed to have prosthetic mitral valve thrombosis and failed to respond to a minimum of 36 h of thrombolysis (persistent symptoms with increased gradients, abnormal findings on fluoroscopy),were subjected to percutaneous treatment after receiving proper consent. None of them had a visible thrombus on transthoracic echocardiogram. All patients underwent transseptal puncture following which a 6F JR4 guiding catheter was passed into the left atrium. The valve leaflets were repeatedly hit gently under fluoroscopic guidance till they regained their normal mobility. Mean age was 38.8 years. Average peak and mean gradients prior to the procedure were 38 and 25 and after the procedure were 12 and 6 mm of Hg respectively. All patients had successful recovery of valve motion on fluoroscopy with normalization of gradients and complete resolution of symptoms. None of the patients had any focal neurological deficits, embolic manifestations or bleeding complications. Percutaneous manipulation of prosthetic valves in selected patients with prosthetic valve thrombosis who do not respond to thrombolytic therapy is feasible and can be used as an alternative to surgery. Copyright © 2014 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

  13. Emergency percutaneous needle decompression for tension pneumoperitoneum

    Directory of Open Access Journals (Sweden)

    Körner Markus

    2011-05-01

    Full Text Available Abstract Background Tension pneumoperitoneum as a complication of iatrogenic bowel perforation during endoscopy is a dramatic condition in which intraperitoneal air under pressure causes hemodynamic and ventilatory compromise. Like tension pneumothorax, urgent intervention is required. Immediate surgical decompression though is not always possible due to the limitations of the preclinical management and sometimes to capacity constraints of medical staff and equipment in the clinic. Methods This is a retrospective analysis of cases of pneumoperitoneum and tension pneumoperitoneum due to iatrogenic bowel perforation. All patients admitted to our surgical department between January 2005 and October 2010 were included. Tension pneumoperitoneum was diagnosed in those patients presenting signs of hemodynamic and ventilatory compromise in addition to abdominal distension. Results Between January 2005 and October 2010 eleven patients with iatrogenic bowel perforation were admitted to our surgical department. The mean time between perforation and admission was 36 ± 14 hrs (range 30 min - 130 hrs, between ER admission and begin of the operation 3 hrs and 15 min ± 47 min (range 60 min - 9 hrs. Three out of eleven patients had clinical signs of tension pneumoperitoneum. In those patients emergency percutaneous needle decompression was performed with a 16G venous catheter. This improved significantly the patients' condition (stabilization of vital signs, reducing jugular vein congestion, bridging the time to the start of the operation. Conclusions Hemodynamical and respiratory compromise in addition to abdominal distension shortly after endoscopy are strongly suggestive of tension pneumoperitoneum due to iatrogenic bowel perforation. This is a rare but life threatening condition and it can be managed in a preclinical and clinical setting with emergency percutaneous needle decompression like tension pneumothorax. Emergency percutaneous decompression is no

  14. Percutaneous needle fasciotomy for recurrent Dupuytren disease.

    Science.gov (United States)

    van Rijssen, Annet L; Werker, Paul M N

    2012-09-01

    Increasing options to treat Dupuytren disease include percutaneous needle fasciotomy (PNF), a minimally invasive technique that has proven to be effective for the treatment of primary disease. However, its effect on recurrent disease is not clear. We studied 30 patients with recurrent Dupuytren disease in 40 fingers, with a mean follow-up of 4.4 years. Primary outcome measures were total passive extension deficit reduction and interval to a second recurrence, defined as an increase of more than 30° compared with the result at the end of the previous treatment. We noted complications. Total passive extension reduction was 76%. Percutaneous needle fasciotomy was especially effective for the metacarpophalangeal joint, with an average reduction of 93%, whereas the average reduction in the proximal interphalangeal joint was 57%. A total of 50% of patients did not develop a secondary recurrence during follow-up. The other 50% did, and we treated recurrence within an average of 1.4 years after PNF. By means of PNF, we postponed tertiary treatment an average of 2.9 years starting from the initial treatment for Dupuytren disease. We successfully treated all secondary recurrences by limited fasciectomy, according to patients' wishes. We noted no major adverse effects. Percutaneous needle fasciotomy can be applied effectively for recurrent disease; 50% of patients remain free of recurrence for a mean of 4.4 years. If a secondary recurrence occurs, it does so relatively early after treatment. Patients must therefore be willing to accept this uncertainty in the context of the advantages of PNF, such as fast recovery, low complication rate, and minimal invasiveness. Copyright © 2012 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  15. Percutaneous treatment of lumbar disc herniation

    Energy Technology Data Exchange (ETDEWEB)

    Leonardi, M.; Resta, F.; Bettinelli, A. [Ospedale Maggiore di Milano (Italy); Lavaroni, A.; Fabris, G. [Ospedale Civile di Udine (Italy); Abelli, F. [Fondazione Clinica del Lavorno, Pavia (Italy)

    1994-12-31

    918 patients were subjected to percutaneous treatment of lumbar herniated disc. 733 of these were treated through enzymatic nucleolysis with chymopapain, for a total 883 levels. Chemonucleolysis was carried out on 733 patients (79.8%). Automated discectomy has been carried out in 185 cases (20.1%). Chemonucleolysis has led to the resolution of the symptoms in a high percentage of cases (82.2%). Nucleotomy has proved to be an effective method in 74.6% of cases. (author). 7 refs, 6 figs, 1 tab.

  16. Percutaneous vertebroplasty: history, technique and current perspectives

    Energy Technology Data Exchange (ETDEWEB)

    Hide, I.G. E-mail: geoff.hide@nuth.nhs.uk; Gangi, A

    2004-06-01

    Percutaneous vertebroplasty is a safe and efficacious technique for the treatment of persistent pain from a fractured vertebral body. Injection of cement into the vertebral body is made after insertion of a large-bore needle, frequently by a trans-pedicular approach. Vertebroplasty is most commonly used to treat painful osteoporotic fracture resistant to conservative therapy, but may be helpful in other conditions such as malignant collapse. NICE guidelines are now available for this procedure, which is relatively new in the UK, but has been performed for more than 15 years in continental Europe.

  17. Adverse events associated with percutaneous enteral access.

    Science.gov (United States)

    Singh, Ajaypal; Gelrud, Andres

    2015-01-01

    Placement of percutaneous endoscopic gastrostomy or jejunostomy is a safe procedure with low periprocedural mortality, but overall mortality rates are high because of underlying disease conditions. These procedures are also associated with postprocedure complications. The clinically significant adverse events related to the procedures include infection (at tube site and peritonitis), bleeding, and aspiration. More rare associated events include buried bumpers, injury to adjacent viscera with subsequent fistula formation, and tumor seeding. There is a lack of guidelines about these procedures other than those concerning the use of antibiotics and the management of antithrombotics and anticoagulation before the procedure. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. A New Technique for Percutaneous Tracheotomy.

    Science.gov (United States)

    Margolin, Gregori; Ullman, Johan; Karling, Jonas

    2017-05-01

    The objective of this study was to investigate a new technique for tracheal puncture during percutaneous dilatational tracheotomy (PDT). A new invention, known as SafeTrach, was used: this instrument allows exact localization of the puncture site with built-in protection of the posterior tracheal wall. Surgery was performed on 17 patients with this technique, and our experience is described in this report. The results showed that this new technique minimizes known risk factors compared with existing PDT techniques, including patients with disadvantageous anatomy.

  19. [Neural repair].

    Science.gov (United States)

    Kitada, Masaaki; Dezawa, Mari

    2008-05-01

    Recent progress of stem cell biology gives us the hope for neural repair. We have established methods to specifically induce functional Schwann cells and neurons from bone marrow stromal cells (MSCs). The effectiveness of these induced cells was evaluated by grafting them either into peripheral nerve injury, spinal cord injury, or Parkinson' s disease animal models. MSCs-derived Schwann cells supported axonal regeneration and re-constructed myelin to facilitate the functional recovery in peripheral and spinal cord injury. MSCs-derived dopaminergic neurons integrated into host striatum and contributed to behavioral repair. In this review, we introduce the differentiation potential of MSCs and finally discuss about their benefits and drawbacks of these induction systems for cell-based therapy in neuro-traumatic and neuro-degenerative diseases.

  20. Cortical neural prosthetics.

    Science.gov (United States)

    Schwartz, Andrew B

    2004-01-01

    Control of prostheses using cortical signals is based on three elements: chronic microelectrode arrays, extraction algorithms, and prosthetic effectors. Arrays of microelectrodes are permanently implanted in cerebral cortex. These arrays must record populations of single- and multiunit activity indefinitely. Information containing position and velocity correlates of animate movement needs to be extracted continuously in real time from the recorded activity. Prosthetic arms, the current effectors used in this work, need to have the agility and configuration of natural arms. Demonstrations using closed-loop control show that subjects change their neural activity to improve performance with these devices. Adaptive-learning algorithms that capitalize on these improvements show that this technology has the capability of restoring much of the arm movement lost with immobilizing deficits.

  1. SAFETY AND EFFICACY OF TUBELESS PERCUTANEOUS NEPHROLITHOTOMY

    Directory of Open Access Journals (Sweden)

    S Falahatkar

    2008-11-01

    Full Text Available "nPercutaneous nephrolithotomy (PNL is commonly used to treat patients with complex renal calculi. Placing a nephrostomy tube is the last step after completing PNL. Significant early postoperative discomfort after percutaneous procedure is usually secondary to nephrostomy tubes. The goal of this study is to evaluate the safety of tubeless PNL. A total of 45 patients with mean age of 46.6 years entered the study. Tubeless PNL was performed in 28 patients and 17 patients were treated with standard PNL. The results of 2 groups were compared with t test. In both groups, PNL was performed successfully without any significant complication. Postoperative hospitalization in standard group was 3.71 day and in tubeless group was 1.65 day that significant statistical difference was observed (P < 0.05. Analgesic dose using in standard group was 101.56 mg (pethidine vs 99.07 mg (pethidine in tubeless group, with no significant statistical difference. There wasn't any organ trauma. Rate of complications, including hematuria, extravasation, fever, UTI and urosepsis, didn't have any significant statistical difference in two groups. It seems that tubeless PNL may be an effective and safe method in renal stone treatment in selected patients. In comparison with standard PNL, tubeless PNL has some benefits including reduction the length of hospitalization. Further studies on more patients are needed to determine the advantages of this technique.

  2. Percutaneous alcohol sclerotherapy for symptomatic congenital cysts

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Chong Soo; Chung, Gyung Ho; Lee, Sang Young; Lee, Jeung Min; Son, Myung Hee; Song, Ho Young; Choi, Ki Chul [College of Medicine, Chonbuk National University, Jeonju (Korea, Republic of)

    1992-01-15

    Twenty patients with symptomatic congenital cysts in the liver, kidney, thyroid, and lower neck underwent, ultrasound guided percutaneous aspiration through a drainage catheter with temporary instillation of 95% ethanol into the cyst. Our procedure was based on the method as described by Bean and Rodan(16) in 1985. Additionally, two other steps were added to prevent the dilutional effect of residual cyst fluid. One was the preliminary washing of the cyst with alcohol. The other was to treat with 30% replacement of alcohol every 10 minutes during the treatment secession. Minor complications of transient temperature elevation and haziness occurred, but no major complications were encountered. After the alcohol treatment follow up examinations were performed with computed tomography or ultrasonography at 6 weeks, 6 months, 9 months and 15 months. Although there was diminished size, recurrence was noted in 6 of twenty patients(30%) at 6 weeks and one of twenty patients(5%) at 6 months. There was no recurrence at 9 months and 15 months. The results indicated that percutaneous aspiration and alcohol sclerotherapy are safe and effective therapy for symptomatic congenital cysts.

  3. Percutaneous cryotherapy for inoperable lung malignancy

    Energy Technology Data Exchange (ETDEWEB)

    Park, Eun Hae; Jin, Gong Yong; Han, Young Min; Lee, Yong Chul; Kwon, Keun Sang [Chonbuk National Univ. Medical School and Hospital, Jeonju, (Korea, Republic of)

    2012-05-15

    To evaluate the therapeutic efficacy of percutaneous cryotherapy for inoperable patients with malignant pulmonary nodules. We enrolled 14 patients (7 males, 7 females, average age 68.8 years) who had inoperable lung malignancy in this study from August 2006 through July 2009. We evaluated the therapeutic efficacy of cryotherapy for complete or incomplete ablation by follow up chest CT. Using Kaplan Meier statistical methods, we estimated the survival of patients who had undergone cryotherapy and we investigated post cryotherapy complications. Five of the 14 patients underwent complete ablation (35.7%), while 9 of 14 patients underwent incomplete ablation (64.3%). The change in mean size before procedure and at last follow up CT in the complete and incomplete ablation were as follows: 13.2 {+-} 7.6 mm {yields} 3.8 {+-} 2.7 mm, and 18.1 {+-} 6.2 mm {yields} 33.7 {+-} 17.9 mm, respectively. The median survival of patients in the complete and the incomplete groups were 51.5 months and 24 months, respectively. One patient developed a small pneumothorax, which resolved spontaneously. Two patients developed hemoptysis after the procedure, which was controlled within a day. Percutaneous cryotherapy may be an effective and safe therapeutic method for inoperable patients with malignant pulmonary nodules.

  4. Laparoscopic-assisted percutaneous endoscopic transgastrostomy jejunostomy.

    Science.gov (United States)

    Dimofte, Mihail-Gabriel; Porumb, Vlad; Nicolescu, Simona; Ristescu, Irina; Lunca, Sorinel

    2014-01-01

    New therapeutic protocols for patients with end-stage Parkinson disease include a carbidopa/levodopa combination using continuous, modulated enteral administration via a portable pump. The typical approach involves a percutaneous endoscopic transgastrostomy jejunostomy (PEG-J), which requires a combination of procedures designed to ensure that no organ is interposed between the abdominal wall and the gastric surface. Lack of transillumination in maximal endoscopic light settings is a major contraindication for PEG-J, and we decided to use a different approach to establish enteric access for long-term medication delivery via pump, using a minimally invasive procedure. In all patients, we performed a laparoscopic-assisted percutaneous transgastrostomy jejunostomy (LAPEG-J) after an unsuccessful endoscopic transillumination. Five patients with end-stage Parkinson disease were referred to our department after successful therapeutic testing with administration of levodopa/carbidopa via naso-jejunal tube. All patients failed the endoscopic transillumination during the endoscopic procedure and were considered for LAPEG-J. In all patients, the LAPEG-J procedure was uneventful. The most common reason identified for failed transillumination was a high position of the stomach, followed by interposition of the liver or colon between the stomach and anterior abdominal wall. There were no complications regarding the LAPEG-J procedure, and all patients were discharged during the second postprocedural day. LAPEG-J provides a simple and safe option for placing a jejunostomy after an unsuccessful PEG-J attempt.

  5. [Percutaneous tracheostomy in the ventilated patient].

    Science.gov (United States)

    Añón, J M; Araujo, J B; Escuela, M P; González-Higueras, E

    2014-04-01

    The medical indications of tracheostomy comprise the alleviation of upper airway obstruction; the prevention of laryngeal and upper airway damage due to prolonged translaryngeal intubation in patients subjected to prolonged mechanical ventilation; and the facilitation of airway access for the removal of secretions. Since 1985, percutaneous tracheostomy (PT) has gained widespread acceptance as a method for creating a surgical airway in patients requiring long-term mechanical ventilation. Since then, several comparative trials of PT and surgical tracheostomy have been conducted, and new techniques for PT have been developed. The use of percutaneous dilatation techniques under bronchoscopic control are now increasingly popular throughout the world. Tracheostomy should be performed as soon as the need for prolonged intubation is identified. However a validated model for the prediction of prolonged mechanical ventilation is not available, and the timing of tracheostomy should be individualized. The present review analyzes the state of the art of PT in mechanically ventilated patients--this being regarded by many as the technique of choice in performing tracheostomy in critically ill patients. Copyright © 2012 Elsevier España, S.L. and SEMICYUC. All rights reserved.

  6. Percutaneous nephrolithotomy in children: A preliminary report.

    Science.gov (United States)

    Elderwy, Ahmad A; Gadelmoula, Mohamed; Elgammal, Mohamed A; Osama, Ehab; Al-Hazmi, Hamdan; Hammouda, H; Osman, Esam; Abdullah, Medhat A; Neel, Khalid Fouda

    2014-07-01

    The recurrence of pediatric nephrolithiasis, the morbidity of repeated open surgical treatment as well as our experience in percutaneous nephrolithotomy (PNL) in adult patients, all derived us to shift to PNL for managing renal stones >1.5 cm in pediatric patients. Our aim of this study is to evaluate the safety and efficacy of PNL in pediatric patients. During the period of the month between May 2011 and April 2013, 38 children (47 renal units) underwent PNL for renal stones 1.5-5 cm in length. Patient demographics, stone characteristics, and clinical outcome were prospectively studied. Data of those who underwent conventional and tubeless PNL were compared. Median follow-up period was 12 months (range: 6-24). The median age at presentation was 8-year (range: 3-12). The operative time ranged from 30 to 120 min (median 90). Overall stone clearance rate was 91.5% after single PNL. The median hospital stay was 3 days. Auxiliary procedures were successful for the remaining 4 patients (nephroscopic clearance in one and shockwave lithotripsy in 3). Tubeless PNL was performed in 17 renal units with a comparable outcome to conventional ones. The perioperative complications were noted in 5/47 (10.6%) of all procedures (Clavien Grade II in 4 and Clavien Grade IIIa in 1) and were managed conservatively. Percutaneous nephrolithotomy for renal stones in pediatric patients is safe and feasible if performed by a well-experienced endourologist. Tubeless PNL is a better choice for children.

  7. Complications of Percutaneous Nephrolithotomy and their Management

    Directory of Open Access Journals (Sweden)

    Neeraj Thapa

    2016-11-01

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

  8. Radiologic imaging and percutaneous treatment of pelvic lymphocele

    Energy Technology Data Exchange (ETDEWEB)

    Karcaaltincaba, Musturay [Department of Radiology, Division of Abdominal and Interventional Radiology, Hacettepe University School of Medicine, Sihhiye, Ankara 06100 (Turkey); Akhan, Okan [Department of Radiology, Division of Abdominal and Interventional Radiology, Hacettepe University School of Medicine, Sihhiye, Ankara 06100 (Turkey)]. E-mail: oakhan@hacettepe.edu.tr

    2005-09-01

    Pelvic lymphocele, also known as lymphocyst, is a cystic structure caused by lymphatic injury usually secondary to pelvic lymphadenectomy and renal transplantation. Lymphoceles can cause morbidity and rarely mortality by compression of adjacent structures and infectious complications. This review discusses etiology and treatment options for pelvic lymphoceles including surgical and percutaneous methods with emphasis on percutaneous techniques particularly in conjunction with sclerotherapy. Percutaneous catheter drainage with sclerotherapy procedure with various sclerosing agents is described in detail. Ethanol, povidone-iodine, tetracycline, doxycycline, bleomycin, talc and fibrin glue can be used as sclerosing agents. Combination of sclerosing agents to percutaneous catheter drainage significantly improves success rate in the treatment of pelvic lymphoceles. Infected lymphoceles are usually treated solely with percutaneous catheter drainage. Percutaneous treatment can be tailored according to volume of lymphoceles. We generally prefer single session sclerotherapy and 1 day catheter drainage in lymphoceles less than 150 mL, and larger ones are treated by multi-session sclerotherapy until daily drainage decreases below 10 mL. Percutaneous treatment preferably with sclerotherapy should be considered as the first-line treatment modality for pelvic lymphoceles due to its effectiveness, widespread applicability on an outpatient basis, ease of procedure and low complication rate.

  9. Accuracy of percutaneous lung biopsy for invasive pulmonary aspergillosis

    Energy Technology Data Exchange (ETDEWEB)

    Hoffer, F.A. [Dept. of Diagnostic Imaging, St. Jude Children' s Research Hospital, Memphis, TN (United States); Gow, K.; Davidoff, A. [Dept. of Surgery, St. Jude Children' s Research Hospital, Memphis, TN (United States); Flynn, P.M. [Dept. of Infectious Diseases, St. Jude Children' s Research Hospital, Memphis, TN (United States)

    2001-03-01

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

  10. Animal models for percutaneous-device-related infections: a review.

    Science.gov (United States)

    Shao, Jinlong; Kolwijck, Eva; Jansen, John A; Yang, Fang; Walboomers, X Frank

    2017-06-01

    This review focuses on the construction of animal models for percutaneous-device-related infections, and specifically the role of inoculation of bacteria in such models. Infections around percutaneous devices, such as catheters, dental implants and limb prostheses, are a recurrent and persistent clinical problem. To promote the research on this clinical problem, the establishment of a reliable and validated animal model would be of keen interest. In this review, literature related to percutaneous devices was evaluated, and particular attention was paid to studies involving the use of bacteria. The design of percutaneous devices, susceptibility of various animal species, bacterial strains, amounts of bacteria, method of inoculation and methods for subsequent evaluation of the infection are discussed in detail. Given that an ideal animal model for study of percutaneous-device-related infection is still not existent, this article presents the basis for the construction of such a standardized animal model for percutaneous-device-related infection studies. The inoculation of bacteria is critical to obtain an animal model for standardized studies for percutaneous-device-related infections. Copyright © 2017. Published by Elsevier B.V.

  11. Percutaneous embolization of varicocele: technique, indications, relative contraindications, and complications

    Directory of Open Access Journals (Sweden)

    Joshua Halpern

    2016-01-01

    Full Text Available There are several options for the treatment of varicocele, including surgical repair either by open or microsurgical approach, laparoscopy, or through percutaneous embolization of the internal spermatic vein. The ultimate goal of varicocele treatment relies on the occlusion of the dilated veins that drain the testis. Percutaneous embolization offers a rapid recovery and can be successfully accomplished in approximately 90% of attempts. However, the technique demands interventional radiologic expertise and has potential serious complications, including vascular perforation, coil migration, and thrombosis of pampiniform plexus. This review discusses the common indications, relative contraindications, technical details, and risks associated with percutaneous embolization of varicocele.

  12. CT-guided percutaneous treatment of solitary pyogenic splenic abscesses

    Energy Technology Data Exchange (ETDEWEB)

    Pombo, F. [Dept. of Radiology, Hospital Juan Canalejo, La Coruna (Spain); Suarez, I. [Dept. of Radiology, Hospital Juan Canalejo, La Coruna (Spain); Marini, M. [Dept. of Radiology, Hospital Juan Canalejo, La Coruna (Spain); Arrojo, L. [Dept. of Radiology, Hospital Juan Canalejo, La Coruna (Spain); Echaniz, A. [Dept. of Internal Medicine, Hospital Juan Canalejo, La Coruna (Spain)

    1991-08-01

    Six patients with solitary pyogenic splenic abscesses treated by CT-guided percutaneous drainage (by catheter or needle), are presented. There were 3 unilocular, purely intrasplenic abscesses and 3 complex lesions with loculations and perisplenic involvement. Percutaneous drainage and intravenous antibiotics were curative in 4 patients. In the other 2, who had multiloculated abscesses, despite initially successful drainage, splenectomy was performed because of intractable left upper quadrant pain in one case and persistent fever and drainage of pus after 30 days in the other. These patients also developed large, sterile left pleural effusions. Solitary pyogenic splenic abscesses - particularly if uniloculated - can be effectively treated by CT-guided percutaneous drainage. (orig.)

  13. Percutaneous Microwave Ablation of Renal Angiomyolipomas

    Energy Technology Data Exchange (ETDEWEB)

    Cristescu, Mircea, E-mail: mcristescu@uwhealth.org [University of Wisconsin, Department of Radiology (United States); Abel, E. Jason, E-mail: abel@urology.wisc.edu [University of Wisconsin, Department of Urology (United States); Wells, Shane, E-mail: swells@uwhealth.org; Ziemlewicz, Timothy J., E-mail: tziemlewicz@uwhealth.org [University of Wisconsin, Department of Radiology (United States); Hedican, Sean P., E-mail: hedican@surgery.wisc.edu [University of Wisconsin, Department of Urology (United States); Lubner, Megan G., E-mail: mlubner@uwhealth.org; Hinshaw, J. Louis, E-mail: jhinshaw@uwhealth.org; Brace, Christopher L., E-mail: cbrace@uwhealth.org; Lee, Fred T., E-mail: flee@uwhealth.org [University of Wisconsin, Department of Radiology (United States)

    2016-03-15

    PurposeTo evaluate the safety and efficacy of US-guided percutaneous microwave (MW) ablation in the treatment of renal angiomyolipoma (AML).Materials and MethodsFrom January 2011 to April 2014, seven patients (5 females and 2 males; mean age 51.4) with 11 renal AMLs (9 sporadic type and 2 tuberous sclerosis associated) with a mean size of 3.4 ± 0.7 cm (range 2.4–4.9 cm) were treated with high-powered, gas-cooled percutaneous MW ablation under US guidance. Tumoral diameter, volume, and CT/MR enhancement were measured on pre-treatment, immediate post-ablation, and delayed post-ablation imaging. Clinical symptoms and creatinine were assessed on follow-up visits.ResultsAll ablations were technically successful and no major complications were encountered. Mean ablation parameters were ablation power of 65 W (range 60–70 W), using 456 mL of hydrodissection fluid per patient, over 4.7 min (range 3–8 min). Immediate post-ablation imaging demonstrated mean tumor diameter and volume decreases of 1.8 % (3.4–3.3 cm) and 1.7 % (27.5–26.3 cm{sup 3}), respectively. Delayed imaging follow-up obtained at a mean interval of 23.1 months (median 17.6; range 9–47) demonstrated mean tumor diameter and volume decreases of 29 % (3.4–2.4 cm) and 47 % (27.5–12.1 cm{sup 3}), respectively. Tumoral enhancement decreased on immediate post-procedure and delayed imaging by CT/MR parameters, indicating decreased tumor vascularity. No patients required additional intervention and no patients experienced spontaneous bleeding post-ablation.ConclusionOur early experience with high-powered, gas-cooled percutaneous MW ablation demonstrates it to be a safe and effective modality to devascularize and decrease the size of renal AMLs.

  14. Successful Treatment of Uterine Arteriovenous Malformation with Percutaneous Embolization

    Directory of Open Access Journals (Sweden)

    An-Chi Lin

    2007-03-01

    Conclusion: AVM can be diagnosed at an early stage with the aid of history taking and ultrasound. Percutaneous embolotherapy is a safe and effective treatment for AVM, especially when fertility preservation is desired.

  15. Age-related percutaneous penetration part 1: skin factors.

    Science.gov (United States)

    Konda, S; Meier-Davis, S R; Cayme, B; Shudo, J; Maibach, H I

    2012-05-01

    Changes in the skin that occur in the elderly may put them at increased risk for altered percutaneous penetration from pharmacotherapy along with potential adverse effects. Skin factors that may have a role in age-related percutaneous penetration include blood flow, pH, skin thickness, hair and pore density, and the content and structure of proteins, glycosaminoglycans (GAGs), water, and lipids. Each factor is examined as a function of increasing age along with its potential impact on percutaneous penetration. Additionally, topical drugs that successfully overcome the barrier function of the skin can still fall victim to cutaneous metabolism, thereby producing metabolites that may have increased or decreased activity. This overview discusses the current data and highlights the importance of further studies to evaluate the impact of skin factors in age-related percutaneous penetration.

  16. Biliary-pleural fistulas without biliary obstruction: percutaneous catheter management

    National Research Council Canada - National Science Library

    Feld, R; Wechsler, RJ; Bonn, J

    1997-01-01

    ...: Our purpose was to report the use of percutaneous catheter drainage as a therapeutic option in the management of three patients with biliary-pleural fistulas without biliary obstructions. CONCLUSION...

  17. Biliary duct obstruction treatment with aid of percutaneous ...

    African Journals Online (AJOL)

    Biliary duct obstruction treatment with aid of percutaneous transhepatic biliary drainage. Daniel Knap, Natalia Orlecka, Renata Judka, Aleksandra Juza, Michał Drabek, Maciej Honkowicz, Tomasz Kirmes, Bartosz Kadłubicki, Dominik Sieron, Jan Baron ...

  18. Percutaneous portal vein access and transhepatic tract hemostasis.

    Science.gov (United States)

    Saad, Wael E A; Madoff, David C

    2012-06-01

    Percutaneous portal vein interventions require minimally invasive access to the portal venous system. Common approaches to the portal vein include transjugular hepatic vein to portal vein access and direct transhepatic portal vein access. A major concern of the transhepatic route is the risk of postprocedural bleeding, which is increased when patients are anticoagulated or receiving pharmaceutical thrombolytic therapy. Thus percutaneous portal vein access and subsequent closure are important technical parts of percutaneous portal vein procedures. At present, various techniques have been used for either portal access or subsequent transhepatic tract closure and hemostasis. Regardless of the method used, meticulous technique is required to achieve the overall safety and effectiveness of portal venous procedures. This article reviews the various techniques of percutaneous transhepatic portal vein access and the various closure and hemostatic methods used to reduce the risk of postprocedural bleeding.

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

    National Research Council Canada - National Science Library

    Kanthila Mahesha

    2017-01-01

      Background: Lumbar disc herniation is a major cause of back pain and sciatica. The surgical management of lumbar disc prolapse has evolved from exploratory laminectomy to percutaneous endoscopic discectomy...

  20. IMPLANTATION METASTASIS OF LARYNGEAL CANCER AFTER PERCUTANEOUS ENDOSCOPIC GASTROSTOMY

    Directory of Open Access Journals (Sweden)

    A. O. Guz

    2017-01-01

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

  1. Percutaneous planter fasciitis release under local anesthesia: A prospective study

    Directory of Open Access Journals (Sweden)

    Ramji Lal Sahu

    2017-04-01

    Conclusion: Percutaneous planter fasciitis release under local anesthesia is a minimally invasive procedure that can be performed in the outpatient setting. It is easy, quick, effective and moreover with few complications.

  2. 1-year rehospitalization after percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Hansen, Kirstine Nørregaard; Bendix, Kristoffer; Antonsen, Lisbeth

    2018-01-01

    AIMS: To evaluate the incidence and causes of rehospitalization within 1-year after percutaneous coronary intervention (PCI) in a country where the National Health Service provides universal tax-supported health care, guaranteeing residents free hospital access. METHODS AND RESULTS: Between January.......26-1.34) and Charlson Comorbidity Index ≥ 3 (OR 3.03;95% CI 2.71-3.27) Conclusions: In an unselected patient cohort treated with PCI, half of the patients were rehospitalized within 1-year, illuminating the impact of comorbidity in patients with ischemic heart disease....... 2010 and September 2014, 17,111 patients were treated with PCI in two University Hospitals in Western Denmark. Patients who were readmitted within 1-year after PCI were identified. Overall 1-year readmission rate was 50.4%. The cause was angina/myocardial infarction (MI) in 4,282 patients (49...

  3. Technical problems during percutaneous transhepatic biliary drainage

    Energy Technology Data Exchange (ETDEWEB)

    Weber, J.; Hoever, S.

    1985-11-01

    Technical problems are repeatedly encountered during percutaneous transhepatic drainage by catheter or endo-prosthesis which are caused by the position, extent and tightness of the stenosis in the biliary ducts. All means of overcoming these problems must be used, otherwise technical failure or complications become inevitable. The methods to be adopted if catheters break and endo-prostheses become displaced or occluded, and for haemorrhage, are described, as well as methods for draining multiple, proximal or intrahepatic stenoses. This is based on an experience with 74 patients on whom 130 drainage procedures have been perforemd (80 catheters, 50 endo-prostheses). All complications and mortality (five patients, 3.8%) were due to problems which could not be solved. Internal biliary drainage by means of an endoprosthesis is markedly superior to catheter drainage. (orig.).

  4. Percutaneous Nephrolithotomy and Chronic Kidney Disease

    DEFF Research Database (Denmark)

    Sairam, Krish; Scoffone, Cesare M; Alken, Peter

    2012-01-01

    by glomerular filtration rate, including chronic kidney disease stages 0/I/II-greater than 60, stage III-30 to 59 and stages IV/V-less than 30 ml/minute/1.73 m(2). Patient characteristics, operative characteristics, outcomes and morbidity were assessed. RESULTS: Estimated glomerular filtration rate data were...... available on 5,644 patients, including 4,436 with chronic kidney disease stages 0/I/II, 994 with stage III and 214 with stages IV/V. A clinically significant minority of patients with nephrolithiasis presented with severe chronic kidney disease. A greater number of patients with stages IV/V previously...... underwent percutaneous nephrolithotomy, ureteroscopy or nephrostomy and had positive urine cultures than less severely affected patients, consistent with the higher incidence of staghorn stones in these patients. Patients with chronic kidney disease stages IV/V had statistically significantly worse...

  5. Percutaneous spine injection: considerations for improving treatment

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Joon Woo; Kim, Sung Hyun; Lee, In Sook; Choi, Jung Ah; Yoon, Chang Jin; Hwang, Sung Il; Kang, Heung Sik [Seoul National University Bundang Hospital, Bundang (Korea, Republic of); Choi, Ja Young; Koh, Young Hwan; Hong, Sung Hwan [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2005-07-15

    To discuss the causes of treatment failure in percutaneous spine injections for low back pain or radiculopathy by analyzing patients who have experienced negative treatment effect on their first visit and a positive treatment effect on their second visit. The authors reviewed the cases of 24 patients who visited the pain intervention outpatient department in our hospital due to back pain or radiculopathy. All patients reviewed experienced a negative treatment effect following their first spine injection, but a positive treatment effect following the second injection. The dates of the cases range from June 2003 to May 2004. Two radiologists analyzed the possible causes of the negative treatment effect following the first injection therapies by considering clinical aspects as well as reviewing radiological images. The most common condition was the presence of the change in the level of the second selective nerve root block (n=13). In seven cases, the methods for administering the injections were changed to facet block (n=2), midline epidural block (n=1), selective nerve root block (n=3) and caudal epidural block (n=1). In four cases, there were no changes in the methods for administering the injections nor were there any changes in the level of the selective nerve root block between first and second visit. In those cases, after reviewing spot radiographs performed during injection, we attributed the causes of failure of injection therapy to an inappropriate distribution of drugs. We can improve the effect of percutaneous spine injections for low back pain or radioculopathy by determining the exact level of perineural root block, trying alternative methods, and insuring a good distribution of the injected drugs.

  6. [Pull percutaneous endoscopic gastrostomy: personal experience].

    Science.gov (United States)

    Geraci, G; Sciumè, C; Pisello, F; Li Volsi, F; Facella, T; Tinaglia, D; Modica, G

    2007-04-01

    To review the indications, complications, and outcomes of percutaneous endoscopic gastrostomy (PEG), that are placed routinely in patients unable to obtain adequate nutrition from oral feeding for swallowing disorders (neurological diseases, head and neck cancer, oesophageal cancer, psychological disorders). Retrospective review of patients referred for PEG placement from 2003 to 2005. Endoscopic Surgery in Section of General and Thoracic Surgery, Faculty of Medicine and Surgery, Palermo, Italy. A total of 50 patients, 11 women and 39 men, referred our Section for PEG placement. Indications for PEG placement included various neurologic impairment (82%), oesophageal non-operable cancer (6%), cardia non-operable cancer (4%), cerebrovascular accident (2%), anorexia (2%), pharyngeal esophageal obstruction (2%), head and neck cancer (2%). All patients received preoperative antibiotics as short-term profilaxis. 51 PEGs were positioned in 50 patients. No major complications were registered; 45 patients (90%) were alive at 1 year follow-up and no mortality procedure-related was registered. Percutaneous endoscopic gastrotomy removal had been performed on 2 patients as end-point of treatment, and 43 patients continued to have PEGs in use at 2006. Outpatients PEG placement using conscious sedation is a safe and effective method for providing enteral nutrition. This technique constitutes the gold standard treatment for enteral nutrition in patients with neurologic impairment or as prophylactic in patients affected by head and neck cancer who needs demolitive surgery. Patients should be carefully assessed, and discussion with the patient and their families should be held to determine that the patient is an appropriate candidate. The Authors feel prophylactic antibiotics lessened the incidence of cutaneous perigastrostomy infection.

  7. Percutaneous treatment of benign bile duct strictures

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-05-15

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

  8. Percutaneous nephrolithotomy in children: A preliminary report

    Directory of Open Access Journals (Sweden)

    Ahmad A. Elderwy

    2014-01-01

    Full Text Available Objectives: The recurrence of pediatric nephrolithiasis, the morbidity of repeated open surgical treatment as well as our experience in percutaneous nephrolithotomy (PNL in adult patients, all derived us to shift to PNL for managing renal stones >1.5 cm in pediatric patients. Our aim of this study is to evaluate the safety and efficacy of PNL in pediatric patients. Materials and Methods: During the period of the month between May 2011 and April 2013, 38 children (47 renal units underwent PNL for renal stones 1.5-5 cm in length. Patient demographics, stone characteristics, and clinical outcome were prospectively studied. Data of those who underwent conventional and tubeless PNL were compared. Median follow-up period was 12 months (range: 6-24. Results: The median age at presentation was 8-year (range: 3-12. The operative time ranged from 30 to 120 min (median 90. Overall stone clearance rate was 91.5% after single PNL. The median hospital stay was 3 days. Auxiliary procedures were successful for the remaining 4 patients (nephroscopic clearance in one and shockwave lithotripsy in 3. Tubeless PNL was performed in 17 renal units with a comparable outcome to conventional ones. The perioperative complications were noted in 5/47 (10.6% of all procedures (Clavien Grade II in 4 and Clavien Grade IIIa in 1 and were managed conservatively. Conclusions: Percutaneous nephrolithotomy for renal stones in pediatric patients is safe and feasible if performed by a well-experienced endourologist. Tubeless PNL is a better choice for children.

  9. Percutaneous plating of distal tibial fractures.

    Science.gov (United States)

    Khoury, Amal; Liebergall, Meir; London, Eli; Mosheiff, Rami

    2002-09-01

    This article presents our experience with 24 patients who had distal tibial fractures and were treated by percutaneous plate fixation. Distribution of the fractures according to the AO/OTA classification was as follows: five patients suffered from a 43 A type fracture, six from a 43 B type fracture, and 13 from a 43 C type fractures. Four of the fractures were open. Exclusion criteria included 43 C3 fractures and Gustilo III open fractures. All fractures showed radiographic signs of union enough to enable full weightbearing within an average time of 12.3 weeks. All patients showed a good range of motion (average dorsiflexion 12 degrees and average plantiflexion 18 degrees). Two fractures united with mal-union: one with an 8 degrees valgus deformity and another with a 7 degrees varus deformity. Both cases, which had a metaphyseal component, were treated by means of a "soft" (flexible and manually adjustable) AO 3.5 mm reconstruction plate. Except for one case of superficial infection, no infections were detected in any of the patients. The biological percutaneous plate fixation of distal tibial fractures with no extensive intra-articular involvement is a good soft tissue preserving technique. It provides a rigid and anatomical fixation in most cases. We conclude that type B fractures with one intact column can be fixed with either "soft" or "rigid" plates, and type A and C fractures with a metaphyseal component should be fixed with "rigid" plates (AO 4.5 mm Dynamic Compression Plate). In these fractures the reduction should be performed cautiously due to the tendency of sagittal plane mal-reduction.

  10. Biliary-pleural fistulas without biliary obstruction: percutaneous catheter management.

    Science.gov (United States)

    Feld, R; Wechsler, R J; Bonn, J

    1997-08-01

    Our purpose was to report the use of percutaneous catheter drainage as a therapeutic option in the management of three patients with biliary-pleural fistulas without biliary obstructions. In the proper clinical setting, the CT findings of liver dome laceration or abscess, diaphragm disruption, and pleural effusion should suggest biliary-pleural fistula. Percutaneous catheter management can be curative or serve a temporizing function before surgery.

  11. Postoperative complications following percutaneous endoscopic gastrostomy are common in children

    DEFF Research Database (Denmark)

    Halvard Hansen, Erik Sören; Qvist, N.; Rasmussen, L.

    2017-01-01

    Aim: Inserting a feeding tube using percutaneous endoscopic gastrostomy may be necessary to ensure that children with eating problems receive sufficient enteral nutrition. The aim of this study was to investigate the perioperative and postoperative complications of percutaneous endoscopic...... were grade 3b complications. No gastrostomy-related deaths were observed, and no single preoperative risk factor was identified. Perioperative complications were experienced by 2.6% of the patients. Conclusion: Gastrostomy feeding tube placement was associated with a high rate of postoperative...

  12. Colon Perforation: A Rare Complication During Percutaneous Nephrolithotomy

    Directory of Open Access Journals (Sweden)

    Chun-Hsiung Huang

    2006-02-01

    Full Text Available Only a few cases of colon perforation during percutaneous nephrolithotomy (PCNL have been reported. We present here a case of colon perforation during PCNL that was managed conservatively by stenting the urinary tract, using the percutaneous catheter as the colostomy tube, and giving broad-spectrum antibiotics. This report also reviews the anatomic and technical access to the kidney and reminds the urologist about this rare but serious complication of PCNL.

  13. Percutaneous radiofrequency thermal lumbar sympathectomy and its clinical use

    OpenAIRE

    Pernak, Jamina

    1988-01-01

    textabstractPercutaneous radiofrequency thermolesion techniques are commonly used in the treatment of chronic pain in different pain syndromes. There are many reports describing techniques of percutaneous radiofrequency thermolesion for denervation of central & spinal nerves (Mullan 1963), 1965, 1971; Rosomoff, 1966, Sweet 1974, Uematsu, 1974). Apart from the report by Pernak (1985) no other clinical studies concerning the use of the radiofrequency electrocoagulation technique for denervation...

  14. Training for percutaneous renal access on a virtual reality simulator.

    Science.gov (United States)

    Zhang, Yi; Yu, Cheng-fan; Liu, Jin-shun; Wang, Gang; Zhu, He; Na, Yan-qun

    2013-01-01

    The need to develop new methods of surgical training combined with advances in computing has led to the development of virtual reality surgical simulators. The PERC Mentor(TM) is designed to train the user in percutaneous renal collecting system access puncture. This study aimed to validate the use of this kind of simulator, in percutaneous renal access training. Twenty-one urologists were enrolled as trainees to learn a fluoroscopy-guided percutaneous renal accessing technique. An assigned percutaneous renal access procedure was immediately performed on the PERC Mentor(TM) after watching instruction video and an analog operation. Objective parameters were recorded by the simulator and subjective global rating scale (GRS) score were determined. Simulation training followed and consisted of 2 hours daily training sessions for 2 consecutive days. Twenty-four hours after the training session, trainees were evaluated performing the same procedure. The post-training evaluation was compared to the evaluation of the initial attempt. During the initial attempt, none of the trainees could complete the appointed procedure due to the lack of experience in fluoroscopy-guided percutaneous renal access. After the short-term training, all trainees were able to independently complete the procedure. Of the 21 trainees, 10 had primitive experience in ultrasound-guided percutaneous nephrolithotomy. Trainees were thus categorized into the group of primitive experience and inexperience. The total operating time and amount of contrast material used were significantly lower in the group of primitive experience versus the inexperience group (P = 0.03 and 0.02, respectively). The training on the virtual reality simulator, PERC Mentor(TM), can help trainees with no previous experience of fluoroscopy-guided percutaneous renal access to complete the virtual manipulation of the procedure independently. This virtual reality simulator may become an important training and evaluation tool in

  15. Percutaneous absorption of chlorhexidine in neonatal cord care.

    OpenAIRE

    Aggett, P J; Cooper, L. V.; Ellis, S H; McAinsh, J

    1981-01-01

    The percutaneous absorption of chlorhexidine during its routine use in topical antiseptic preparations used in umbilical cord care was investigated by determining plasma chlorhexidine concentrations at ages 5 and 9 days. These showed that percutaneous absorption of chlorhexidine occurred in preterm neonates treated with a 1% solution of chlorhexidine in ethanol, but not in term infants similarly treated, or in preterm infants treated only with a dusting powder containing 1% chlorhexidine and ...

  16. Sedation Monitoring and Management during Percutaneous Endoscopic Lumbar Discectomy

    OpenAIRE

    Menekse Oksar; Tulin Gumus; Orhan Kanbak

    2016-01-01

    Percutaneous endoscopic laser discectomy (PELD) is a painful intervention that requires deep sedation and analgesia. However, sedation should be light at some point because cooperation by the patient during the procedure is required for successful surgical treatment. Light sedation poses a problem for endotracheal intubation, while patients placed in the prone position during percutaneous endoscopic discectomy pose a problem for airway management. Therefore, under these conditions, sedation s...

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

    OpenAIRE

    Kanthila Mahesha

    2017-01-01

    Background: Lumbar disc herniation is a major cause of back pain and sciatica. The surgical management of lumbar disc prolapse has evolved from exploratory laminectomy to percutaneous endoscopic discectomy. Percutaneous endoscopic discectomy is the least invasive procedure for lumbar disc prolapse. The aim of this study was to analyze the clinical outcome, quality of life, neurologic function, and complications. Materials and Methods: One hundred patients with lumbar disc prolapse who wer...

  18. IMPLANTATION METASTASIS OF LARYNGEAL CANCER AFTER PERCUTANEOUS ENDOSCOPIC GASTROSTOMY

    OpenAIRE

    Guz, A. O.; A. S. Zakharov; A. V. Garev

    2017-01-01

    Squamous cell head and neck carcinoma is frequently associated with dysphagia. An adequate enteral nutrition is the key to successful treatment and rehabilitation of these patients. Percutaneous endoscopic gastrostomy is the preferred route of feeding and nutritional support in head and neck cancer patients with dysphagia. We report a rare case of implantation metastasis of laryngeal cancer following percutaneous endoscopic gastrostomy. Our experience in treating this complication has been de...

  19. Minimal Invasive Percutaneous Fixation of Thoracic and Lumbar Spine Fractures

    Directory of Open Access Journals (Sweden)

    Federico De Iure

    2012-01-01

    Full Text Available We studied 122 patients with 163 fractures of the thoracic and lumbar spine undergoing the surgical treatment by percutaneous transpedicular fixation and stabilization with minimally invasive technique. Patient followup ranged from 6 to 72 months (mean 38 months, and the patients were assessed by clinical and radiographic evaluation. The results show that percutaneous transpedicular fixation and stabilization with minimally invasive technique is an adequate and satisfactory procedure to be used in specific type of the thoracolumbar and lumbar spine fractures.

  20. [The biological aftereffects of preoperative and palliative percutaneous biliary drainage].

    Science.gov (United States)

    Arévalo, A; Hebrero, J; Arconada, J A; Fernández, M; Elexpuru, J I; Escudero, B; Lalinde, J; Pinillos, E

    1992-01-01

    Biological repercussions in 78 patients with malignant obstructive jaundice in whom percutaneous biliary drainage was performed, are reported. In 37 cases drainage was done during operation while 41 were palliative. Biochemistry, proteinogram, hematological studies, renal function and immunology were assessed 15.7 +/- 3.4 days postoperatively and 25.2 +/- 4.7 days in palliative drainage. Results show a significant improvement of all parameters, more important in preoperative drainages especially in those combining percutaneous and internal drainage techniques.

  1. Prevalence of percutaneous injuries and associated factors among dental surgeons

    OpenAIRE

    Ferreira, Fabiana Vargas; Santana, Bianca Palma; Tarquinio, Sandra Beatriz Chaves; DEMARCO, Flávio Fernando

    2012-01-01

    Purpose: The practice of dentistry usually involves contact with secretions from the oral cavity through percutaneous injuries, which is a risk factor for the transmission of infections, especially hepatitis B, between the professional and patients. This study aimed to assess the prevalence of percutaneous injuries and associated factors among dental surgeons. Methods: A total of 187 dental surgeons from the city of Pelotas, Brazil, participated in this study. Data concerning the socio-demogr...

  2. Neural entrainment to speech modulates speech intelligibility

    NARCIS (Netherlands)

    Riecke, Lars; Formisano, Elia; Sorger, Bettina; Başkent, Deniz; Gaudrain, Etienne

    2018-01-01

    Speech is crucial for communication in everyday life. Speech-brain entrainment, the alignment of neural activity to the slow temporal fluctuations (envelope) of acoustic speech input, is a ubiquitous element of current theories of speech processing. Associations between speech-brain entrainment and

  3. drinking water treatment using artificial neural network

    African Journals Online (AJOL)

    ogwueleka

    synaptic weights are used to store the knowledge.” The neural network approach is a branch of artificial intelligence. The ANN is based on a model of the human neurological system that consists of basic computing elements (called neurons) interconnected together (Figure 1). The model used for all classification attempts.

  4. Cognitive And Neural Sciences Division 1992 Programs

    Science.gov (United States)

    1992-08-01

    Neuronal Micronets as Nodal Elements PRINCIPAL INVESTIGATOR: Thomas H. Brown Yale University Department of Psychology (203) 432-7008 R&T PROJECT CODE...of neural nets, and to develop a micronet architecture which captures the computations in neurons. Approach: Simulations will be conducted of the

  5. Neural networks and applications tutorial

    Science.gov (United States)

    Guyon, I.

    1991-09-01

    The importance of neural networks has grown dramatically during this decade. While only a few years ago they were primarily of academic interest, now dozens of companies and many universities are investigating the potential use of these systems and products are beginning to appear. The idea of building a machine whose architecture is inspired by that of the brain has roots which go far back in history. Nowadays, technological advances of computers and the availability of custom integrated circuits, permit simulations of hundreds or even thousands of neurons. In conjunction, the growing interest in learning machines, non-linear dynamics and parallel computation spurred renewed attention in artificial neural networks. Many tentative applications have been proposed, including decision systems (associative memories, classifiers, data compressors and optimizers), or parametric models for signal processing purposes (system identification, automatic control, noise canceling, etc.). While they do not always outperform standard methods, neural network approaches are already used in some real world applications for pattern recognition and signal processing tasks. The tutorial is divided into six lectures, that where presented at the Third Graduate Summer Course on Computational Physics (September 3-7, 1990) on Parallel Architectures and Applications, organized by the European Physical Society: (1) Introduction: machine learning and biological computation. (2) Adaptive artificial neurons (perceptron, ADALINE, sigmoid units, etc.): learning rules and implementations. (3) Neural network systems: architectures, learning algorithms. (4) Applications: pattern recognition, signal processing, etc. (5) Elements of learning theory: how to build networks which generalize. (6) A case study: a neural network for on-line recognition of handwritten alphanumeric characters.

  6. Robustness of the ATLAS pixel clustering neural network algorithm

    CERN Document Server

    AUTHOR|(INSPIRE)INSPIRE-00407780; The ATLAS collaboration

    2016-01-01

    Proton-proton collisions at the energy frontier puts strong constraints on track reconstruction algorithms. In the ATLAS track reconstruction algorithm, an artificial neural network is utilised to identify and split clusters of neighbouring read-out elements in the ATLAS pixel detector created by multiple charged particles. The robustness of the neural network algorithm is presented, probing its sensitivity to uncertainties in the detector conditions. The robustness is studied by evaluating the stability of the algorithm's performance under a range of variations in the inputs to the neural networks. Within reasonable variation magnitudes, the neural networks prove to be robust to most variation types.

  7. Neural Schematics as a unified formal graphical representation of large-scale Neural Network Structures

    Directory of Open Access Journals (Sweden)

    Matthias eEhrlich

    2013-10-01

    Full Text Available One of the major outcomes of neuroscientific research are models of Neural Network Structures. Descriptions of these models usually consist of a non-standardized mixture of text, figures, and other means of visual information communication in print media. However, as neuroscience is an interdisciplinary domain by nature, a standardized way of consistently representing models of Neural Network Structures is required. While generic descriptions of such models in textual form have recently been developed, a formalized way of schematically expressing them does not exist to date. Hence, in this paper we present Neural Schematics as a concept inspired by similar approaches from other disciplines for a generic two dimensional representation of said structures. After introducing Neural Network Structures in general, a set of current visualizations of models of Neural Network Structures is reviewed and analyzed for what information they convey and how their elements are rendered. This analysis then allows for the definition of general items and symbols to consistently represent these models as Neural Schematics on a two dimensional plane. We will illustrate the possibilities an agreed upon standard can yield on sampled diagrams transformed into Neural Schematics and an example application for the design and modeling of large-scale Neural Network Structures.

  8. Introduction to neural networks

    CERN Document Server

    James, Frederick E

    1994-02-02

    1. Introduction and overview of Artificial Neural Networks. 2,3. The Feed-forward Network as an inverse Problem, and results on the computational complexity of network training. 4.Physics applications of neural networks.

  9. Morphological neural networks

    Energy Technology Data Exchange (ETDEWEB)

    Ritter, G.X.; Sussner, P. [Univ. of Florida, Gainesville, FL (United States)

    1996-12-31

    The theory of artificial neural networks has been successfully applied to a wide variety of pattern recognition problems. In this theory, the first step in computing the next state of a neuron or in performing the next layer neural network computation involves the linear operation of multiplying neural values by their synaptic strengths and adding the results. Thresholding usually follows the linear operation in order to provide for nonlinearity of the network. In this paper we introduce a novel class of neural networks, called morphological neural networks, in which the operations of multiplication and addition are replaced by addition and maximum (or minimum), respectively. By taking the maximum (or minimum) of sums instead of the sum of products, morphological network computation is nonlinear before thresholding. As a consequence, the properties of morphological neural networks are drastically different than those of traditional neural network models. In this paper we consider some of these differences and provide some particular examples of morphological neural network.

  10. A Prospective Randomized Study Comparing Mini-surgical Percutaneous Dilatational Tracheostomy With Surgical and Classical Percutaneous Tracheostomy

    OpenAIRE

    Hashemian, Seyed Mohammad-Reza; Digaleh, Hadi

    2015-01-01

    Abstract Although percutaneous dilatational tracheostomy (PDT) is more accessible and less time-demanding compared with surgical tracheostomy (ST), it has its own limitations. We introduced a modified PDT technique and brought some surgical knowledge to the bedside to overcome some standard percutaneous dilatational tracheostomy relative contraindications. PDT uses a blind route of tracheal access that usually requires perioperational imaging guidance to protect accidental injuries. Moreover,...

  11. Extrapedicular Infiltration Anesthesia as an Improved Method of Local Anesthesia for Unipedicular Percutaneous Vertebroplasty or Percutaneous Kyphoplasty

    Directory of Open Access Journals (Sweden)

    Liehua Liu

    2016-01-01

    Full Text Available Aim. This report introduces extrapedicular infiltration anesthesia as an improved method of local anesthesia for unipedicular percutaneous vertebroplasty or percutaneous kyphoplasty. Method. From March 2015 to March 2016, 44 patients (11 males and 33 females with osteoporotic vertebral compression fractures with a mean age of 71.4±8.8 years (range: 60 to 89 received percutaneous vertebroplasty or percutaneous kyphoplasty. 24 patients were managed with conventional local infiltration anesthesia (CLIA and 20 patients with both CLIA and extrapedicular infiltration anesthesia (EPIA. Patients evaluated intraoperative pain by means of the visual analogue score and were monitored during the procedure for additional sedative analgesia needs and for adverse nerve root effects. Results. VAS of CLIA + EPIA and CLIA group was 2.5±0.7 and 4.3±1.0, respectively, and there was significant difference (P=0.001. In CLIA group, 1 patient required additional sedative analgesia, but in CLIA + EPIA group, no patients required that. In the two groups, no adverse nerve root effects were noted. Summary. Extrapedicular infiltration anesthesia provided good local anesthetic effects without significant complications. This method deserves further consideration for use in unipedicular percutaneous vertebroplasty and percutaneous kyphoplasty.

  12. Should anyone perform percutaneous endoscopic laser diskectomy and percutaneous lumbar disc decompressions?

    Science.gov (United States)

    Epstein, Nancy E

    2016-01-01

    Increasingly, pain management specialists (P-S) (e.g., anesthesiologists, radiologists, or physiatrists), who are not spinal surgeons, are performing percutaneous endoscopic laser diskectomy (PELD), percutaneous lumbar disc decompression (PLDD), and target percutaneous laser disc decompression (T-PLDD) in patients with minimal/mild disc herniations. Here, theoretically, the laser vaporizes/shrinks a small portion of disc tissue that lowers intradiscal pressure/volume, and thereby provides "symptomatic relief" (e.g., low back pain/radiculopathy). Nevertheless, the vast majority of these patients experience spontaneous relief of their complaints over several months without any intervention. A literature review revealed that P-S specialists are performing PELD/PLDD/T-PLDD to address minimal/mild disc herniations. However, multiple well-designed studies confirmed that PELD/PLDD/T-PLDD were ineffective for managing acute/chronic pain in these patients. Several randomized clinical trials documented the lack of clinical efficacy of PELD/PLDD/T-PLLD procedures over microdiskectomy. PELD/PLDD/T-PLDD correlated with only 60-70% success rates with higher reoperation rates (e.g., up to 38%) vs. 90% success rates for routine microdiskectomy (e.g., with faster recovery and only 16% reoperation rates). Nevertheless, without surgical training, P-S are performing these procedures and are, therefore, unable to adddress perioperative/postoperative PELD/PLDD/T-PLDD surgical complications. Pain management specialists, who are not trained spinal surgeons, should not perform PELD/PLDD/T-PLDD surgery to treat minimal/mild disc herniations. Not only do most of these discs resolve spontaneously over several months but also they are largely ineffective. Furthermore, there is no evidence to support the superiority of PELD/PLDD/T-PLDD procedures over microdiskectomy even if performed by spinal specialists.

  13. Peritonitis following percutaneous gastrostomy tube insertions in children

    Energy Technology Data Exchange (ETDEWEB)

    Dookhoo, Leema [The Hospital for Sick Children, Department of Diagnostic Imaging, Toronto, ON (Canada); University of Toronto, Faculty of Medicine, Toronto, ON (Canada); Mahant, Sanjay [The Hospital for Sick Children, Department of Pediatrics, Toronto, ON (Canada); Parra, Dimitri A.; John, Philip R.; Amaral, Joao G.; Connolly, Bairbre L. [The Hospital for Sick Children, Department of Diagnostic Imaging, Toronto, ON (Canada)

    2016-09-15

    Percutaneous retrograde gastrostomy has a high success rate, low morbidity, and can be performed under different levels of sedation or local anesthesia in children. Despite its favourable safety profile, major complications can occur. Few studies have examined peritonitis following percutaneous retrograde gastrostomy in children. To identify potential risk factors and variables influencing the development and early diagnosis of peritonitis following percutaneous retrograde gastrostomy. We conducted a retrospective case-control study of children who developed peritonitis within 7 days of percutaneous retrograde gastrostomy between 2003 and 2012. From the 1,504 patients who underwent percutaneous retrograde gastrostomy, patients who developed peritonitis (group 1) were matched by closest date of procedure to those without peritonitis (group 2). Peritonitis was defined according to recognized clinical criteria. Demographic, clinical, procedural, management and outcomes data were collected. Thirty-eight of 1,504 children (2.5%; 95% confidence interval, 1.8-3.5) who underwent percutaneous retrograde gastrostomy developed peritonitis ≤7 days post procedure (group 1). Fever (89%), irritability (63%) and abdominal pain (55%) occurred on presentation of peritonitis. Group 1 patients were all treated with antibiotics; 41% underwent additional interventions: tube readjustments (8%), aspiration of pneumoperitoneum (23%), laparotomy (10%) and intensive care unit admission (10%). In group 1, enteral feeds started on average 3 days later and patients were discharged 5 days later than patients in group 2. There were two deaths not directly related to peritonitis. Neither age, gender, weight, underlying diagnoses nor operator was identified as a risk factor. Peritonitis following percutaneous retrograde gastrostomy in children occurs in approximately 2.5% of cases. No risk factors for its development were identified. Medical management is usually sufficient for a good outcome

  14. Facet violation with the placement of percutaneous pedicle screws.

    Science.gov (United States)

    Patel, Rakesh D; Graziano, Gregory P; Vanderhave, Kelly L; Patel, Alpesh A; Gerling, Michael C

    2011-12-15

    Independent review and classification of therapeutic procedures performed on cadavers by surgeons blinded to purpose of study. The objective of this study is to determine the rate of facet violation with the placement of percutaneous pedicle screws. Improvements in percutaneous instrumentation and fluoroscopic imaging have led to a resurgence of percutaneous pedicle screw insertion in lumbar spine surgery in an attempt to minimize many of the complications associated with open techniques of pedicle screw placement. Rates of pedicle breech and neurologic injury resulting from percutaneous insertion are reportedly similar to those of open techniques. Postoperative pain because of impingement and instability is believed to result from violation of the facet capsule or facet joint. To the authors' knowledge, however, the rate of facet injury associated with the placement of percutaneous pedicle screws is unreported in the literature. Percutaneous pedicle screw placement was performed on 4 cadaveric specimens by 4 certified orthopedic surgeons who had clinical experience in the procedure and who were blinded to the study's purpose. The surgeons were instructed to place pedicle screws from L1-S1 using their preferred clinical techniques and a 5.5-mm screw system with which they were all familiar. All surgeons utilized 1 OEC C-arm for fluoroscopic imaging. After insertion, 2 independent spine surgeons each reviewed and classified the placement of all facet screws. A total of 48 screws were inserted and classified. The placement of 28 screws (58%) resulted in violation of facet articulation, with 8 of these screws being intra-articular. Interobserver reliability of the classification system was 100%. Percutaneous pedicle screw placement may result in a high rate of facet violation. Facet injury can be reliability classified and therefore, perhaps, easily prevented.

  15. Superior articulating facet violation: percutaneous versus open techniques.

    Science.gov (United States)

    Jones-Quaidoo, Sean M; Djurasovic, Mladen; Owens, R Kirk; Carreon, Leah Y

    2013-06-01

    Recent studies have reported the incidence of superior facet joint violation using percutaneous techniques. These techniques have not been compared with the open midline approach. An increased incidence of superior facet violation may lead to adjacent-segment disease. In this paper, the authors' goal is to compare the rate of superior facet violation with the use of percutaneously placed pedicle screws versus midline approach open placement. Patients who underwent a single-level fusion using a percutaneous approach from L-1 to S-1 who had undergone CT scanning within 1 year after surgery were identified. A cohort who underwent open fusion matched by level of surgery was identified. All CT scans were reviewed by 3 fellowship-trained spine surgeons to determine the degree of facet violation. The final categorization for each screw was based on the most frequent reading among the 6 evaluations. The Fisher test was used to determine the association of facet violation with approach. There were 66 patients in each group. Patients in the Percutaneous group were younger (mean 42.5 years) than those in the Open group (mean 57.8 years, p = 0.000). There was no statistically significant difference in sex distribution, surgical levels fused, or time between surgery and CT scan between the groups. Thirty-six (13.6%) of 264 screws in the percutaneous and 16 (6%) of 263 screws in the Open group were in the facet joint (p = 0.005). Of these, 17 (12%) of the 132 proximal screws in the percutaneous and 7 (5%) of the 131 proximal screws in the Open group were in the facet joint (p = 0.052). The use of a percutaneous method to insert pedicle screws results in a statistically significantly higher incidence of facet joint violation, even if only proximal screws are considered. Further studies are needed to determine if this leads to a higher incidence of symptomatic adjacent-level disease.

  16. Peritonitis following percutaneous gastrostomy tube insertions in children.

    Science.gov (United States)

    Dookhoo, Leema; Mahant, Sanjay; Parra, Dimitri A; John, Philip R; Amaral, Joao G; Connolly, Bairbre L

    2016-09-01

    Percutaneous retrograde gastrostomy has a high success rate, low morbidity, and can be performed under different levels of sedation or local anesthesia in children. Despite its favourable safety profile, major complications can occur. Few studies have examined peritonitis following percutaneous retrograde gastrostomy in children. To identify potential risk factors and variables influencing the development and early diagnosis of peritonitis following percutaneous retrograde gastrostomy. We conducted a retrospective case-control study of children who developed peritonitis within 7 days of percutaneous retrograde gastrostomy between 2003 and 2012. From the 1,504 patients who underwent percutaneous retrograde gastrostomy, patients who developed peritonitis (group 1) were matched by closest date of procedure to those without peritonitis (group 2). Peritonitis was defined according to recognized clinical criteria. Demographic, clinical, procedural, management and outcomes data were collected. Thirty-eight of 1,504 children (2.5%; 95% confidence interval, 1.8-3.5) who underwent percutaneous retrograde gastrostomy developed peritonitis ≤7 days post procedure (group 1). Fever (89%), irritability (63%) and abdominal pain (55%) occurred on presentation of peritonitis. Group 1 patients were all treated with antibiotics; 41% underwent additional interventions: tube readjustments (8%), aspiration of pneumoperitoneum (23%), laparotomy (10%) and intensive care unit admission (10%). In group 1, enteral feeds started on average 3 days later and patients were discharged 5 days later than patients in group 2. There were two deaths not directly related to peritonitis. Neither age, gender, weight, underlying diagnoses nor operator was identified as a risk factor. Peritonitis following percutaneous retrograde gastrostomy in children occurs in approximately 2.5% of cases. No risk factors for its development were identified. Medical management is usually sufficient for a good outcome

  17. Interactions of skin thickness and physicochemical properties of test compounds in percutaneous penetration studies

    NARCIS (Netherlands)

    Wilkinson, S.C.; Maas, W.J.M.; Nielsen, J.B.; Greaves, L.C.; Sandt, J.J.M. van de; Williams, F.M.

    2006-01-01

    Objectives: To determine the effect of skin thickness on the percutaneous penetration and distribution of test compounds with varying physicochemical properties using in vitro systems. Studies were carried out in accordance with OECD guidelines on skin absorption tests. Methods: Percutaneous

  18. Percutaneous dilatational tracheostomy without fiber optic bronchoscopy-Evaluation of 80 intensive care units cases

    NARCIS (Netherlands)

    J.A. Calvache (Jose Andrés); R.A. Molina García (Rodrigo); A.L. Trochez (Adolfo); J. Benitez (Javier); L.A. Flga (Lucía Arroyo)

    2013-01-01

    textabstractBackground: The development of percutaneous dilatational tracheostomy techniques (PDT) has facilitated the procedure in Intensive Care Units (ICU). Objective: To describe the early intra and post-operative complications in ICU patients requiring percutaneous dilatational tracheostomy

  19. Clinical and Angiographic Factors Associated With Asymptomatic Restenosis After Percutaneous Coronary Intervention

    NARCIS (Netherlands)

    P.N. Ruygrok (Peter); M.W.I. Webster (Mark); V. de Valk (Vincent); G.A. van Es (Gerrit Anne); J.A. Ormiston (John); M-A.M. Morel (Marie-Angèle); P.W.J.C. Serruys (Patrick)

    2001-01-01

    textabstractBACKGROUND: Angiographic restenosis after percutaneous coronary interventional procedures is more common than recurrent angina. Clinical and angiographic factors associated with asymptomatic versus symptomatic restenosis after percutaneous coronary intervention were compared. METHODS AND

  20. Percutaneous cholecystostomy for patients with acute cholecystitis and an increased surgical risk

    NARCIS (Netherlands)

    H. van Overhagen (H.); H. Meyers (Hjalmar); H.W. Tilanus (Hugo); J. Jeekel (Hans); J.S. Laméris (Johan )

    1996-01-01

    textabstractPurpose: To evaluate percutaneous cholecystostomy in patients with acute cholecystitis and an increased surgical risk. Methods: Thirty-three patients with acute cholecystitis (calculous, n = 22; acalculous, n = 11) underwent percutaneous cholecystostomy by means of a transhepatic (n =

  1. Element 115

    OpenAIRE

    Forsberg, Ulrika

    2016-01-01

    This thesis is devoted to detailed studies of element 115 decay chains using the highly efficient multi-coincidence alpha, electron, gamma and X-ray detector setup TASISpec at the gas-filled separator TASCA at GSI, Darmstadt, Germany. In a three-week long experiment thirty new decay chains assumed to stem from element 115 isotopes were observed together with the very first detections of gamma rays and potential X-rays from these nuclei. Paper I describes preparations in terms of optimisations...

  2. The Laplacian spectrum of neural networks

    Science.gov (United States)

    de Lange, Siemon C.; de Reus, Marcel A.; van den Heuvel, Martijn P.

    2014-01-01

    The brain is a complex network of neural interactions, both at the microscopic and macroscopic level. Graph theory is well suited to examine the global network architecture of these neural networks. Many popular graph metrics, however, encode average properties of individual network elements. Complementing these “conventional” graph metrics, the eigenvalue spectrum of the normalized Laplacian describes a network's structure directly at a systems level, without referring to individual nodes or connections. In this paper, the Laplacian spectra of the macroscopic anatomical neuronal networks of the macaque and cat, and the microscopic network of the Caenorhabditis elegans were examined. Consistent with conventional graph metrics, analysis of the Laplacian spectra revealed an integrative community structure in neural brain networks. Extending previous findings of overlap of network attributes across species, similarity of the Laplacian spectra across the cat, macaque and C. elegans neural networks suggests a certain level of consistency in the overall architecture of the anatomical neural networks of these species. Our results further suggest a specific network class for neural networks, distinct from conceptual small-world and scale-free models as well as several empirical networks. PMID:24454286

  3. Aging affects neural precision of speech encoding.

    Science.gov (United States)

    Anderson, Samira; Parbery-Clark, Alexandra; White-Schwoch, Travis; Kraus, Nina

    2012-10-10

    Older adults frequently report they can hear what is said but cannot understand the meaning, especially in noise. This difficulty may arise from the inability to process rapidly changing elements of speech. Aging is accompanied by a general slowing of neural processing and decreased neural inhibition, both of which likely interfere with temporal processing in auditory and other sensory domains. Age-related reductions in inhibitory neurotransmitter levels and delayed neural recovery can contribute to decreases in the temporal precision of the auditory system. Decreased precision may lead to neural timing delays, reductions in neural response magnitude, and a disadvantage in processing the rapid acoustic changes in speech. The auditory brainstem response (ABR), a scalp-recorded electrical potential, is known for its ability to capture precise neural synchrony within subcortical auditory nuclei; therefore, we hypothesized that a loss of temporal precision results in subcortical timing delays and decreases in response consistency and magnitude. To assess this hypothesis, we recorded ABRs to the speech syllable /da/ in normal hearing younger (18-30 years old) and older (60-67 years old) adult humans. Older adults had delayed ABRs, especially in response to the rapidly changing formant transition, and greater response variability. We also found that older adults had decreased phase locking and smaller response magnitudes than younger adults. Together, our results support the theory that older adults have a loss of temporal precision in the subcortical encoding of sound, which may account, at least in part, for their difficulties with speech perception.

  4. The CROES percutaneous nephrolithotomy global study: the influence of body mass index on outcome

    DEFF Research Database (Denmark)

    Fuller, Andrew; Razvi, Hassan; Denstedt, John D

    2012-01-01

    In addition to more commonly forming stones, obese patients present a number of challenges when undergoing percutaneous nephrolithotomy. We evaluated percutaneous nephrolithotomy outcomes in 3,709 patients stratified by body mass index.......In addition to more commonly forming stones, obese patients present a number of challenges when undergoing percutaneous nephrolithotomy. We evaluated percutaneous nephrolithotomy outcomes in 3,709 patients stratified by body mass index....

  5. [Local anesthesia after percutaneous administration. I].

    Science.gov (United States)

    Ziegenmeyer, J; Meyer, F

    1976-11-01

    Local anesthesia of the intact skin is difficult because of the skin barrier to epicutaneous penetration. Using solutions of local anesthetics in organic agents, which have the ability of penetrating the skin without causing irreversible damage and enhancing the percutaneous absorption of all materials dissolved therein, topical anesthesia seems to be attainable. A satisfactory method for determining pain threshold in uninjured skin of animals has been set up. Measurments of the pricking pain threshold have been made by exposing the skin of guinea-pigs to defined mechanical and electrical stimuli. A nociceptive muscle reflex (twitch) has been taken as the index of pain sensation. The suppression of this twitch has been used as an indicator of anesthetic potency. Two methods have been applied with varying parameters: stimulation at a fixed intensity until the pain threshold was reached (duration of anesthetic effect) and stimulation with increasing stimulus strenght until the cutaneous reflex was elicited (intensity or "depth" of anesthesia). The local anesthetic effects of lidocaine, fomocaine and procaine bases were studied, after dissolving them in dimethyl sulfoxide (DMSO), a wellknown carrier for transmembranal application. The duration of local anesthesia measured by electrical stimuli was longer than that obtained with mechanical ones. Differences are discussed. All results indicate that fomocaine (5%) has a greater local anesthetic potency than procaine (5%) but both are less active than lidocaine (5%). No effect could be seen after application of DMSO alone.

  6. [Percutaneous endoscopic gastrostomy in childhood and adolescence].

    Science.gov (United States)

    Behrens, R; Muschweck, H; Richter, T

    1996-01-01

    Nasogastric tube-feeding often is necessary in the treatment of chronically ill patients. The disadvantage (irritation of the hypopharynx, dislocation, stigma) can be avoided by the percutaneous endoscopic gastrostomy (PEG). In childhood there is only limited experience with this techniques. We report about 89 children with PEG. Indications were central dysphagia (67), dystrophy caused by chronic renal failure or congenital heart disease (15), application of special diets (6) and gastric volvulus (1). The endoscopy was done in sedation. The PEG was placed in the stomach (73) or duodenum (16). 14 Complications were observed: inflammation at the insertion site (2), perforation (2, healing under conservative treatment), dislocation of the duodenal part into the stomach or occlusion (6) and distraction of the retention disk (4). There were no procedures-related deaths. The mean duration of the PEG was more than 1 year. The affected persons were very pleased with the efficacy of this treatment. In all patients (including infants) requiring long-term tube-feeding the option of a PEG should be taken into consideration. In our experience the PEG is associated with a low rate of complications and provides a major improvement for children who are dependent on tube feeding.

  7. Percutaneous Ethibloc injection in aneurysmal bone cysts

    Energy Technology Data Exchange (ETDEWEB)

    Garg, N.K.; Walsh, H.P.J.; Dorgan, J.C.; Bruce, C.E. [Dept. of Orthopaedics, Royal Liverpool Children' s Hospital (United Kingdom); Carty, H. [Dept. of Radiodiagnosis, Royal Liverpool Children' s Hospital (United Kingdom)

    2000-04-01

    Objective. To investigate whether the injection of Ethibloc into aneurysmal bone cysts can be an effective treatment modality.Design and patients. Ethibloc is an alcoholic solution of zein (corn protein) which has thrombogenic and fibrogenic properties. Ten patients with aneurysmal bone cysts were treated with CT-guided percutaneous injection of Ethibloc into the cyst cavity. Ethibloc injection was the primary treatment in five patients. Four patients had recurrence following previous curettage and bone grafting and one patient had not responded to injection into the lesion of autologous iliac crest bone marrow aspirate. Three patients needed a second injection. The median follow-up was 27 (6-60) months.Results and conclusion. Symptoms were relieved in all patients. At imaging, seven patients had resolution of the lesion and three had partial response at the most recent follow-up. Complications consisted of a local transitory inflammatory reaction in two patients and an aseptic abscess in one patient. This relatively simple, minimally invasive procedure makes an operation unnecessary by stopping the expansion of the cyst and inducing endosteal new bone formation. This technique may be used as the primary management of aneurysmal bone cysts excluding spinal lesions. (orig.)

  8. Is percutaneous nephrolithotomy in solitary kidneys safe?

    Science.gov (United States)

    Wong, Kathie Alexina; Sahai, Arun; Patel, Amit; Thomas, Kay; Bultitude, Matthew; Glass, Jonathan

    2013-11-01

    To review our experience from a high volume stone center with a focus on efficacy, safety, and renal function. Stones requiring percutaneous nephrolithotomy (PCNL) in patients with solitary kidneys can pose significant anxiety to the urologist. Limited data are available in published reports in this setting. A comprehensive retrospective review of medical records was performed on patients who underwent PCNL and had a solitary kidney or a single functioning renal unit. Data were collected on patient demographics, stone burden, outcomes, complications, and renal function. Of 378 PCNLs performed between January 2003 and September 2011, 22 were performed in 17 patients with a single functioning kidney. Three procedures were performed in a transplanted kidney. In those with solitary calculus, the longest mean length and stone surface area were 37 mm and 825 mm(2), respectively. Stone-free rate was 59%. Auxiliary procedures were required in 6 cases, resulting in a stone-free rate of 77%. Median inpatient stay was 4 days. Serum creatinine values improved from 144 to 126 umol/L before and after the procedure and mean estimated glomerular filtration rate improved similarly from 51 to 59 mls/minute, respectively. Blood transfusion was required in 1 patient, sepsis developed in 3, and 2 patients required a stent for obstruction. PCNL in solitary kidneys is safe with an acceptable complication rate if performed in a high volume center. Outcomes are good, although auxiliary procedures may be necessary. Renal function remains stable or improves after procedure. Copyright © 2013 Elsevier Inc. All rights reserved.

  9. Sedation for Percutaneous Endoscopic Lumbar Discectomy

    Directory of Open Access Journals (Sweden)

    Menekse Oksar

    2016-01-01

    Full Text Available Although anesthetic requirements for minimally invasive neurosurgical techniques have been described in detail and applied successfully since the early 2000s, most of the literature on this subject has dealt with cranial cases that were operated on in the supine or sitting positions. However, spinal surgery has also used minimally invasive techniques that were performed in prone position for more than 30 years to date. Although procedures in both these neurosurgical techniques require the patient to be awake for a certain period of time, the main surgical difference with minimally invasive spinal surgery is that the patients are in the prone position, which may result in increased requirement of airway management because of deep sedation. In addition, although minimally invasive spinal surgery progresses slowly and different techniques are used with no agreement on the terminology used to describe these techniques thus far, the anesthetist needs to understand the surgical and anesthetic requirements for each type of intervention in order to take necessary precautions. This paper reviews the literature on this topic and discusses the anesthetic necessities for percutaneous endoscopic laser surgery.

  10. Sedation for Percutaneous Endoscopic Lumbar Discectomy

    Science.gov (United States)

    2016-01-01

    Although anesthetic requirements for minimally invasive neurosurgical techniques have been described in detail and applied successfully since the early 2000s, most of the literature on this subject has dealt with cranial cases that were operated on in the supine or sitting positions. However, spinal surgery has also used minimally invasive techniques that were performed in prone position for more than 30 years to date. Although procedures in both these neurosurgical techniques require the patient to be awake for a certain period of time, the main surgical difference with minimally invasive spinal surgery is that the patients are in the prone position, which may result in increased requirement of airway management because of deep sedation. In addition, although minimally invasive spinal surgery progresses slowly and different techniques are used with no agreement on the terminology used to describe these techniques thus far, the anesthetist needs to understand the surgical and anesthetic requirements for each type of intervention in order to take necessary precautions. This paper reviews the literature on this topic and discusses the anesthetic necessities for percutaneous endoscopic laser surgery. PMID:27738652

  11. Percutaneous Nephrolithotomy for Paediatric Stone Disease

    Directory of Open Access Journals (Sweden)

    Hüseyin Çelik

    2015-06-01

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

  12. Incidence of retrorenal colon during percutaneous nephrolithotomy

    Directory of Open Access Journals (Sweden)

    Mehmet Balasar

    2015-04-01

    Full Text Available Objective The aim of this study was to investigate retrorenal colon incidence in percutaneous nephrolithotomy (PNL interventions made in our clinic. Materials and Methods Clinical data of 804 PNL patients, accumulated over a 7 year period (2006-2012, was surveyed. The patient files were reviewed retrospectively, and only those who had abdominal computed tomography (CT images before PNL intervention were included in the study. In the CT images, the position of both the ascending and descending colon in relation to the right and left kidneys were evaluated. Results According to our hospital reports, 394 patients with CT images were included in the present study 27 patients (6.9% had retrorenal colon, of which 18 (4.6% were on the left side, 4 (1.0% on the right side and 5 (1.3% had bilateral retrorenal colons. Colonic perforation complication was seen only in two patients and the colonic perforation rate was 0.3%. These two cases had no CT images. Conclusions PNL, in the process of becoming the standard treatment modality, is a safe and reliable technique for renal stone treatment. Colonic injury should be taken into consideration during PNL interventions of the lower pole of the kidney (especially on the left side due to the location of retrorenal colon.

  13. Minimizing radiation exposure during percutaneous nephrolithotomy.

    Science.gov (United States)

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

    2015-12-01

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

  14. Percutaneous necrosectomy in patients with acute, necrotizing pancreatitis

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-08-15

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

  15. Percutaneous drainage with ultrasound guidance in the intensive care unit

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Doo Kyung; Won, Je Hwan; Kim, Jai Keun [College of Medicine, Ajou Univ., Suwon (Korea, Republic of); Lee, Kwang Hun [College of Medicine, Yonsei Univ., Seoul (Korea, Republic of); Kim, Ji Hyung [College of Medicine, Keonyang Univ., Daejeon (Korea, Republic of)

    2004-03-01

    To determine the efficacy and safety of bedside percutaneous drainage procedures with ultrasound guidance in critically ill patients in the intensive care unit (ICU). Sixty five percutaneous drainage procedures performed at the bedside, in 39 ICU patients, were evaluated. All of the procedures were performed with ultrasound guidance alone. The procedures consisted of percutaneous drainage of abdominal (n=35) and pleural (n=27) fluids, percutaneous cholecystostomy (n=2) and percutaneous nephrostomy (n=1). The clinical responses were classified as 'complete response', 'partial response', 'failure' or 'undetermined'. The medical records were reviewed retrospectively to evaluate the clinical response. Technical success was achieved in 64 of the 65 procedures (98.5%). The complication rate was 13.8% (9 cases). There was no immediate procedure-related death or worsening of the clinical condition of the patients. The clinical responses after drainage were 'complete response' in 39 cases (60.9%). 'partial response' in 14 (21.9%), 'failure' in 3 (4.7%), and 'undetermined' in 8 (12.5%). Bedside drainage procedures with ultrasound guidance are effective and safe to perform when patients are too critically ill to be moved from the ICU to the angiography room.

  16. Postoperative seizure following transforaminal percutaneous endoscopic lumbar discectomy

    Science.gov (United States)

    Kertmen, Hayri; Gürer, Bora; Yilmaz, Erdal Resit; Sekerci, Zeki

    2016-01-01

    Endoscopic surgery for lumbar disc herniation has been available for more than 30 years. Transforaminal percutaneous endoscopic lumbar discectomy is a well-known, safe, and effective method used for the treatment of the lumbar disc herniation. The published complications of the transforaminal percutaneous endoscopic lumbar discectomy consist of infections, thrombophlebitis, dysesthesia, dural tear, vascular injury, and death. Seizure after transforaminal percutaneous endoscopic lumbar discectomy is an extremely rare complication. A 20-year-old patient applied at our department who had undergone transforaminal percutaneous endoscopic lumbar. During the procedure, while performing the discography, non-ionic contrast media was administered into the thecal sac inadvertently. Two hours after surgery, the patient developed generalized tonic-clonic seizure of 5-min duration. Diagnosis of iohexol-induced seizure was made and the patient was treated supportively without anti-epileptics. Here we present the first case of seizure after transforaminal percutaneous endoscopic lumbar discectomy, which was caused by inadvertent administration of the contrast media into the thecal sac. PMID:27695562

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-03-15

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

  18. Quality of canine spermatozoa retrieved by percutaneous epididymal sperm aspiration.

    Science.gov (United States)

    Varesi, S; Vernocchi, V; Faustini, M; Luvoni, G C

    2013-02-01

    To investigate the feasibility of percutaneous epididymal sperm aspiration in dogs and whether it might provide a population of epididymal spermatozoa similar to the population that can be obtained by processing isolated epididymis caudae. Concentration and total sperm number, motility, morphology and acrosomal integrity of spermatozoa retrieved by percutaneous epididymal sperm aspiration, in vitro aspiration and mincing of the cauda of the epididymis were compared. Percutaneous epididymal sperm aspiration is a feasible procedure to retrieve a population of spermatozoa in dogs. Quality is similar to that of spermatozoa collected in vitro, although a wide variation amongst animals was observed. In case of ejaculation failure due to pathological conditions in dogs, the collection of spermatozoa from the cauda of the epididymis could be an option for providing gametes for assisted reproductive technologies. Percutaneous epididymal sperm aspiration can be used in dogs with compromised reproductive performance, in which orchiectomy cannot be performed for medical or owner reasons. Further studies aimed to investigate whether the percutaneous epididymal sperm aspiration technique might be feasible for repeated semen collection and to accurately evaluate side effects are required. © 2013 British Small Animal Veterinary Association.

  19. Current status of percutaneous vertebroplasty and percutaneous kyphoplasty – a review

    Science.gov (United States)

    Yimin, Yang; Zhiwei, Ren; Wei, Ma; Jha, Rajiv

    2013-01-01

    Percutaneous vertebroplasty (PV) and kyphoplasty (PK) are the 2 vertebral augmentation procedures that have emerged as minimally invasive surgical options to treat painful vertebral compression fractures (VCF) during the last 2 decades. VCF may either be osteoporotic or tumor-associated. Two hundred million women are affected by osteoporosis globally. Vertebral fracture may result in acute pain around the fracture site, loss of vertebral height due to vertebral collapse, spinal instability, and kyphotic deformity. The main goal of the PV and PK procedures is to give immediate pain relief to patients and restore the vertebral height lost due to fracture. In percutaneous vertebroplasty, bone cement is injected through a minimal incision into the fractured site. Kyphoplasty involves insertion of a balloon into the fractured site, followed by inflation-deflation to create a cavity into which the filler material is injected, and the balloon is taken out prior to cement injection. This literature review presents a qualitative overview on the current status of vertebral augmentation procedures, especially PV and PK, and compares the efficacy and safety of these 2 procedures. The review consists of a brief history of the development of these 2 techniques, a discussion on the current research on the bone cement, clinical outcome of the 2 procedures, and it also sheds light on ongoing and future research to maximize the efficacy and safety of vertebral augmentation procedures. PMID:24097261

  20. Percutaneous Aspiration Thrombectomy for the Treatment of Arterial Thromboembolic Occlusions Following Percutaneous Transluminal Angioplasty

    Energy Technology Data Exchange (ETDEWEB)

    Schleder, Stephan, E-mail: stephan.schleder@ukr.de [University Hospital Regensburg, Department of Radiology (Germany); Diekmann, Matthias [Radiology Center Rahlstedt (Germany); Manke, Christoph [General Hospital Fulda, Department of Radiology (Germany); Heiss, Peter [University Hospital Regensburg, Department of Radiology (Germany)

    2015-02-15

    PurposeThis study was designed to evaluate the technical success and the early clinical outcome of patients undergoing percutaneous aspiration thrombectomy (PAT) for the treatment of arterial thromboembolism following percutaneous infrainguinal transluminal angioplasty (PTA).MethodsIn this single-center study, during a period of 7 years retrospectively, 47 patients (22 male, 47 %) with a mean age of 73 (range 53–96) years were identified in whom PAT was performed for the treatment of thromboembolic complications of infrainguinal PTA. Primary technical success was defined as residual stenosis of <50 % in diameter after sole PAT, whereas secondary technical success was defined as residual stenosis of <50 % in diameter after PAT and additional PTA and/or stenting. Clinical outcome parameters (e.g., need for further intervention, minor/major amputation) were evaluated for the 30-day postinterventional period.ResultsPrimary technical success was achieved in 64 % of patients (30/47); secondary technical success was obtained in 96 % of patients (45/47). Clinical outcome data were available in 38 patients. In 87 % of patients (33/38), there was no need for further intervention within the 30-day postinterventional period. In three patients, minor amputations were conducted due to preexisting ulcerations (Rutherford Category 5 respectively).ConclusionsPAT enables endovascular treatment of iatrogenic thromboembolic complications after PTA with good technical and early clinical results and minimal morbidity.

  1. 21 CFR 880.5970 - Percutaneous, implanted, long-term intravascular catheter.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Percutaneous, implanted, long-term intravascular... and Personal Use Therapeutic Devices § 880.5970 Percutaneous, implanted, long-term intravascular catheter. (a) Identification. A percutaneous, implanted, long-term intravascular catheter is a device that...

  2. Evolvable Neural Software System

    Science.gov (United States)

    Curtis, Steven A.

    2009-01-01

    The Evolvable Neural Software System (ENSS) is composed of sets of Neural Basis Functions (NBFs), which can be totally autonomously created and removed according to the changing needs and requirements of the software system. The resulting structure is both hierarchical and self-similar in that a given set of NBFs may have a ruler NBF, which in turn communicates with other sets of NBFs. These sets of NBFs may function as nodes to a ruler node, which are also NBF constructs. In this manner, the synthetic neural system can exhibit the complexity, three-dimensional connectivity, and adaptability of biological neural systems. An added advantage of ENSS over a natural neural system is its ability to modify its core genetic code in response to environmental changes as reflected in needs and requirements. The neural system is fully adaptive and evolvable and is trainable before release. It continues to rewire itself while on the job. The NBF is a unique, bilevel intelligence neural system composed of a higher-level heuristic neural system (HNS) and a lower-level, autonomic neural system (ANS). Taken together, the HNS and the ANS give each NBF the complete capabilities of a biological neural system to match sensory inputs to actions. Another feature of the NBF is the Evolvable Neural Interface (ENI), which links the HNS and ANS. The ENI solves the interface problem between these two systems by actively adapting and evolving from a primitive initial state (a Neural Thread) to a complicated, operational ENI and successfully adapting to a training sequence of sensory input. This simulates the adaptation of a biological neural system in a developmental phase. Within the greater multi-NBF and multi-node ENSS, self-similar ENI s provide the basis for inter-NBF and inter-node connectivity.

  3. Percutaneous dilatational tracheostomy following total artificial heart implantation.

    Science.gov (United States)

    Spiliopoulos, Sotirios; Dimitriou, Alexandros Merkourios; Serrano, Maria Rosario; Guersoy, Dilek; Autschbach, Ruediger; Goetzenich, Andreas; Koerfer, Reiner; Tenderich, Gero

    2015-07-01

    Coagulation disorders and an immune-altered state are common among total artificial heart patients. In this context, we sought to evaluate the safety of percutaneous dilatational tracheostomy in cases of prolonged need for mechanical ventilatory support. We retrospectively analysed the charts of 11 total artificial heart patients who received percutaneous dilatational tracheostomy. We focused on early and late complications. We observed no major complications and no procedure-related deaths. Early minor complications included venous oozing (45.4%) and one case of local infection. Late complications, including subglottic stenosis, stomal infection or infections of the lower respiratory tract, were not observed. In conclusion, percutaneous dilatational tracheostomy in total artificial heart patients is safe. Considering the well-known benefits of early tracheotomy over prolonged translaryngeal intubation, we advocate early timing of therapy in cases of prolonged mechanical ventilation. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  4. Percutaneous peritoneovenous shunt positioning: technique and preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Orsi, Franco; Grasso, Rosario Francesco; Bonomo, Guido; Marinucci, Irene [Division of Radiology, European Institute of Oncology, Milan (Italy); Monti, Cinzia [Institute of Radiology, University of Milan (Italy); Bellomi, Massimo [Division of Radiology, European Institute of Oncology, Milan (Italy); Institute of Radiology, University of Milan (Italy)

    2002-05-01

    Nine peritoneovenous shunts were positioned by percutaneous technique in seven patients with advanced malignancy causing severe refractory ascites, and in two patients with hepatic cirrhosis (one with hepatocarcinoma). In all patients the shunts were percutaneously placed through the subclavian vein in the angiographic suite under digital fluoroscopic guide. No complications directly related to the procedure occurred. The shunt was successfully positioned in all patients in 60 min average time. No patient showed symptoms related to pulmonary overload or to disseminated intravascular coagulation. All patients had a significant improvement of the objective symptoms related to ascites such as respiratory symptoms, dyspepsia, and functional impairment to evacuation describing an improvement of their quality of life. Maximum shunt patency was 273 days. Percutaneous placement of peritoneovenous shunt is a safe, fast, and inexpensive procedure, extremely useful in resolution of refractory ascites, reducing symptoms, and allowing effective palliation, with a great improvement in quality of life. (orig.)

  5. Recurrence of primary aldosteronism after percutaneous ethanol injection

    Directory of Open Access Journals (Sweden)

    Fan-Chi Chang

    2012-03-01

    Full Text Available Adrenalectomy is the definite treatment for aldosterone-producing adenoma (APA. Percutaneous ethanol or acetic acid injection with computed tomography (CT guidance has been described as a safe, noninvasive, and effective alternative treatment modality in patients with high surgical risk. We report on a man who was 49 years of age and presented with treatment-resistant hypertension and was later diagnosed with APA. CT-guided percutaneous ethanol injection (PEI was performed for this high surgical risk patient. He had aldosteronism recurrence 4 years after the ethanol injection, so a second PEI was performed. The tumor size was reduced and his blood pressure was normalized. Therefore, we suggest that clinicians should closely check aldosterone to renin ration and potassium level if percutaneous chemical ablation is considered in functioning adrenal adenomas.

  6. Percutaneous radiofrequency thermocoagulation of osteoid osteomas: factors affecting therapeutic outcome

    Energy Technology Data Exchange (ETDEWEB)

    Cribb, G.L.; Goude, W.H.; Cool, P.; Tins, B.; Cassar-Pullicino, V.N.; Mangham, D.C. [Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry (United Kingdom)

    2005-11-01

    To examine factors which affect local recurrence of osteoid osteomas treated with percutaneous CT-guided radiofrequency thermocoagulation. A prospective study was carried out on 45 patients with osteoid osteoma who underwent percutaneous radiofrequency thermocoagulation with a minimum follow-up of 12 months There were seven local recurrences (16%); all occurred within the first year. Local recurrence was significantly related to a non-diaphyseal location (P<0.01). There was no significant relationship (P=0.05) between local recurrence and age of the patient, duration of symptoms, previous treatment, size of the lesion, positive biopsy, radiofrequency generator used or the number of needle positions. There were no complications. Osteoid osteomas in a non-diaphyseal location are statistically more likely to recur than those in a diaphyseal location when treated with CT-guided percutaneous radiofrequency thermocoagulation. This relationship between local recurrence and location has not been previously reported. (orig.)

  7. Percutaneous paravalvular leak closure- imaging, techniques and outcomes.

    Science.gov (United States)

    Krishnaswamy, Amar; Kapadia, Samir R; Tuzcu, E Murat

    2013-01-01

    Paravalvular leak (PVL) is a known complication of surgical and transcatheter valve replacement procedures. Patients most commonly present with congestive heart failure and/or hemolysis, and repeat surgical procedures to correct the PVL carries increased risk with reduced likelihood of success. As a result, percutaneous approaches to PVL closure have been developed, with a considerable emphasis on multimodality imaging for both diagnosis and procedural guidance in the cardiac catheterization laboratory. Several large series of percutaneous PVL closure have been recently published, with encouraging results with respect to both procedural success and clinical outcomes. Here, we give a comprehensive review of imaging and procedural techniques for percutaneous PVL closure and present the data supporting this novel treatment strategy.

  8. [Early complications of Griggs percutaneous tracheotomy in own material].

    Science.gov (United States)

    Pietkiewicz, Piotr; Machała, Waldemar; Kuśmierczyk, Krzysztof; Miłoński, Jarosław; Wiśniewski, Tomasz; Urbaniak, Joanna; Olszewski, Jurek

    2012-01-01

    The aim of the work was to assess early complications of Griggs percutaneous tracheotomy in the own material. The study covered 155 patients aged 17-88, including 36 women and 119 men. The patients were treated at the Department of Anaesthesiology and Intensive Therapy between 2006-2010. They underwent Griggs percutaneous tracheostomy by a laryngologist or a trained anaesthesiologist. Each surgical procedure was conducted with the use of Portex Blue Line Ultra Percutaneous Tracheotomy Kit (Smiths Medical Co., USA), the trachea was intubated while the patient was under general anaesthesia with propofol, fentanyl and relaxation with atracurium. The studied material revealed Griggs percutaneous tracheotomy complications in 26 patients (16.8%), in which 11 patients (7.1%) presented complications within the perioperative period while 15 patients (9.7%) reported early complications. Haemorrhage, usually not very profuse, occurred 7 times (4.6%), mainly in tracheopunction, and was the most often perioperative complication. Moreover, in the perioperative period, 3 patients (1.9%) had trachea identifications difficulties, which required tracheopunction many a time, and 1 patient (0.65%) encountered sudden circulatory arrest with asystolia and effective CPR. In the early postoperative period after Griggs percutaneous tracheotomy, the most common complication was haemorrhage in the operative twenty-four hours, which was noted in 10 patients (6.5%). Among other adverse complications were found: infection of the tissues near the tracheostomal region in 3 patients (1.9%), subcutaneous oedema in 1 patient (0.65%), accidental removing the tube from an unformed tracheostoma in 1 patient (0.65%). In the studied material, complications after Griggs percutaneous tracheotomy amounted to 16.8%, of which 7.1% occurred in the perioperative period while 9.7% were early complications, mainly light bleeding. This may prove good preparation of the surgical team for the surgical procedures

  9. Consciousness and neural plasticity

    DEFF Research Database (Denmark)

    In contemporary consciousness studies the phenomenon of neural plasticity has received little attention despite the fact that neural plasticity is of still increased interest in neuroscience. We will, however, argue that neural plasticity could be of great importance to consciousness studies....... If consciousness is related to neural processes it seems, at least prima facie, that the ability of the neural structures to change should be reflected in a theory of this relationship "Neural plasticity" refers to the fact that the brain can change due to its own activity. The brain is not static but rather...... a dynamic entity, which physical structure changes according to its use and environment. This change may take the form of growth of new neurons, the creation of new networks and structures, and change within network structures, that is, changes in synaptic strengths. Plasticity raises questions about...

  10. Tubeless percutaneous nephrolithotomy: call of the day.

    Science.gov (United States)

    Rana, Abdul Majid; Mithani, Shoaib

    2007-02-01

    We challenge the routine placement of nephrostomy tube after percutaneous nephrolithotomy (PCNL) without taking into consideration the size, burden, and multiplicity of the stones; the degree of obstruction of the pelvicaliceal system, or any anatomic variations of the kidney in shape or position. Between January 2005 to March 2006, 110 patients underwent PCNL, 77% of whom had multiple stones. The mean size of the single stones was 4.3 cm (range 2.8-6.5 cm), and the mean single-stone burden was 7.2 cm2 (range 5.6-14.3 cm2). The mean burden of multiple stones was 11.4 cm2 (range 8-23 cm2). Among the patients, 18 had had previous renal surgery, 12 had renal insufficiency, and 7 had a solitary functioning kidney. One patient each had horseshoe kidney and malrotated kidney. In 106 patients, no nephrostomy drain was placed, only an externalized 5F ureteral catheter for 16 to 20 hours. Two patients had simultaneous bilateral tubeless PCNL. The outcome was evaluated prospectively. The frequency of complications, length of hospital stay, and stone-free status were assessed. A stone-free rate of 80% was achieved using PCNL as monotherapy. The mean postoperative hospital stay was 16 to 20 hours. Three patients required placement of a nephrostomy tube because of significant bleeding and one because of purulent renal discharge. In four patients, a ureteral catheter was replaced by a stent because of significant residual stone burdens. The initial 18 patients underwent ultrasound examination on the first postoperative day, and none demonstrated any extrarenal collection, so routine ultrasound examination was omitted in succeeding patients. One patient required exploration because of a retroperitoneal hematoma. Omission of a nephrostomy tube after PCNL while retaining an externalized ureteral catheter for 16 to 20 hours is sufficient and safe irrespective of the stone characteristics. Shape, position, and function of the kidneys are also irrelevant with regard to tubeless PCNL.

  11. Percutaneous radiofrequency ablation in painful bone metastases

    Directory of Open Access Journals (Sweden)

    German Garabano

    2015-09-01

    Full Text Available Backgraund There are different treatment for painful bone metastases (mtts, with different results. CT-guided Percutaneous Radiofrequency Ablation (CT-PRA is one of them. The pupose of this retrospective study was to assess the initial results using this methods, focusing on pain relief, showing details of the surgical technique. Methods 18 patients with an average age of 59.2 years and 15 months follow-up were treated. Nine mtts were located in the femur, 4 dorsal / lumbar spine, 3 in scapula and 2 in Iliac. The Mtts origin were Breast Ca 7 cases, lung in 4, Kidney in 4 and 3 in Thyroid. The rachis mtts were found at more than 10mm of the medullary cavity and mtts of long bones showed low risk of fracture. Lesions >3cm were treated whit CT-PRA  using Valleylab Rita needle and these <3cm with CoolTip needle. Pain was assessed by Visual Analog Scale (VAS preoperatively, at 2, 7 and 30 days, and then at 3 and 6 months. Results Preoperative pain score was 8.33 on average. At 7 days of ablatión de VAS score was 5 on average and at 30 days was 2 points. After at 3 and 6 months de VAS average was 1. This method had excellent patients tolerance and no complications. There were two recurrences which underwent endoprosthesis unconventional proximal femur and knee respectively, evolving favorably. Conclusion CT-guided APRF impresses a promising, simple and effective tool in the treatment of painfull bone mtts, achieving excellent pain control with good tolerance by the patient.

  12. Percutaneous epicardial ablation in ventricular arrhythmias.

    Science.gov (United States)

    Galvão Santos, Pedro; Cavaco, Diogo; Adragão, Pedro; Scanavacca, Mauricio; Reis Santos, Katya; Belo Morgado, Francisco; Carmo, Pedro; Costa, Francisco; Bernardo, Ricardo; Nunes, Manuela; Abecasis, Miguel; Neves, José; Mendes, Miguel

    2014-05-01

    Reentrant circuits of ventricular tachycardia may involve not only the endocardium but also the epicardium. Epicardial ablation can be useful in these situations. The aim of this study was to assess efficacy, safety and complications in a series of consecutive patients who underwent ablation of ventricular tachycardia with epicardial mapping. The study included all patients undergoing ventricular tachycardia ablation with epicardial mapping from 2004 to 2012. Of a total of 95 ablations, an epicardial approach was attempted in nine patients, eight male, mean age 58±12 years. Endocardial mapping was performed in all patients previously or simultaneously. The etiology of the arrhythmia was non-ischemic in eight patients and ischemic in one. We compared the number of events in the six months prior to the epicardial procedure and six months after. Percutaneous epicardial access was achieved in eight patients. In one case it was not possible due to the presence of adhesions. In none of the patients was the procedure repeated and there were no major complications during hospitalization. In a mean follow-up of 3.5±1.2 years, one patient suffered stroke; there were no other medium-to-long-term complications and the number of ventricular tachycardia episodes was reduced in all patients after ablation. Epicardial radiofrequency ablation of ventricular tachycardia was effective in reducing morbidity in eight patients, with a low risk of complications in the short and medium-to-long term. Copyright © 2012 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

  13. Third-generation percutaneous vertebral augmentation systems.

    Science.gov (United States)

    Vanni, Daniele; Galzio, Renato; Kazakova, Anna; Pantalone, Andrea; Grillea, Giovanni; Bartolo, Marcello; Salini, Vincenzo; Magliani, Vincenzo

    2016-03-01

    Currently, there is no general consensus about the management of osteoporotic vertebral fractures (OVF). In the past, conservative treatment for at least one month was deemed appropriate for the majority of vertebral fractures. When pain persisted after conservative treatment, it was necessary to consider surgical interventions including: vertebroplasty for vertebral fractures with less than 30% loss of height of the affected vertebral body and kyphoplasty for vertebral fractures with greater than 30% loss of height. Currently, this type of treatment is not feasible. Herein we review the characteristics and methods of operation of three of the most common percutaneous vertebral augmentation systems (PVAS) for the treatment of OVF: Vertebral Body Stenting(®) (VBS), OsseoFix(®) and Spine Jack(®). VBS is a titanium device accompanied by a hydraulic (as opposed to mechanical) working system which allows a partial and not immediate possibility to control the opening of the device. On the other hand, OsseoFix(®) and Spine Jack(®) are accompanied by a mechanical working system which allows a progressive and controlled reduction of the vertebral fracture. Another important aspect to consider is the vertebral body height recovery. OsseoFix(®) has an indirect mechanism of action: the compaction of the trabecular bone causes an increase in the vertebral body height. Unlike the Vertebral Body Stenting(®) and Spine Jack(®), the OsseoFix(®) has no direct lift mechanism. Therefore, for these characteristics and for the force that this device is able to provide. In our opinion, Spine Jack(®) is the only device also suitable for the treatment OVF, traumatic fracture (recent, old or inveterate) and primary or secondary bone tumors.

  14. Percutaneous antegrade transarterial treatment of iatrogenic radial arteriovenous fistula.

    Science.gov (United States)

    Summaria, Francesco; Romagnoli, Enrico; Preziosi, Paolo

    2012-01-01

    Site of access vascular complications is infrequent after transradial interventions. We report the case of a 66-year-old man referred to our hospital because of right forearm swelling, oedema and pain with functional forearm disability, 1 year after a transradial primary percutaneous coronary intervention (PCI). The diagnostic and procedural issues are discussed. This is the first description of a successful and well-tolerated radial arteriovenous fistula (AVF) treatment by means of percutaneous antegrade approach with the use of a short introducer and a biocompatible covered stent.

  15. Sedation Monitoring and Management during Percutaneous Endoscopic Lumbar Discectomy

    Science.gov (United States)

    Oksar, Menekse; Gumus, Tulin; Kanbak, Orhan

    2016-01-01

    Percutaneous endoscopic laser discectomy (PELD) is a painful intervention that requires deep sedation and analgesia. However, sedation should be light at some point because cooperation by the patient during the procedure is required for successful surgical treatment. Light sedation poses a problem for endotracheal intubation, while patients placed in the prone position during percutaneous endoscopic discectomy pose a problem for airway management. Therefore, under these conditions, sedation should be not deeper than required. Here we report the sedation management of three cases that underwent PELD, with a focus on deep and safe sedation that was monitored using bispectral index score and observer's assessment of alertness/sedation score. PMID:27298743

  16. Sedation Monitoring and Management during Percutaneous Endoscopic Lumbar Discectomy

    Directory of Open Access Journals (Sweden)

    Menekse Oksar

    2016-01-01

    Full Text Available Percutaneous endoscopic laser discectomy (PELD is a painful intervention that requires deep sedation and analgesia. However, sedation should be light at some point because cooperation by the patient during the procedure is required for successful surgical treatment. Light sedation poses a problem for endotracheal intubation, while patients placed in the prone position during percutaneous endoscopic discectomy pose a problem for airway management. Therefore, under these conditions, sedation should be not deeper than required. Here we report the sedation management of three cases that underwent PELD, with a focus on deep and safe sedation that was monitored using bispectral index score and observer’s assessment of alertness/sedation score.

  17. Percutaneous fixation of selected scaphoid fractures by dorsal approach

    OpenAIRE

    Naranje, Sameer; Kotwal, P. P.; Shamshery, P.; Gupta, Vikas; Nag, H. L.

    2009-01-01

    The aim of our study was to evaluate clinical, radiological and functional outcomes of selected cases of percutaneous fixation of scaphoid fractures via a dorsal approach. Percutaneous fixation by dorsal approach was done in 32 patients (mean age 32.2 years) involving both fresh and late scaphoid fracture presentations (mean 17 days). Fourteen cases of B1 type, ten cases of B2 and eight cases of C type (Herbert’s classification) were treated. The patients were prospectively followed up clinic...

  18. Primary Percutaneous Coronary Intervention in a Patient with Haemophilia A

    Directory of Open Access Journals (Sweden)

    S. Ashwin Reddy

    2013-01-01

    Full Text Available Haemophilia A is a rare genetic condition leading to coagulation factor VIII deficiency and thus predisposing to bleeding diathesis. Due to advances in treatment, life expectancy of haemophilia A sufferers is increasing, and the incidence and prevalence of coronary artery disease are rising. There have been many reported cases of acute myocardial infarction in such patients, who subsequently undergo elective percutaneous coronary intervention. We present the case of a 55-year-old gentleman presenting with an acute anterior full-thickness myocardial infarction who required emergency primary percutaneous coronary intervention.

  19. Fuzzy and neural control

    Science.gov (United States)

    Berenji, Hamid R.

    1992-01-01

    Fuzzy logic and neural networks provide new methods for designing control systems. Fuzzy logic controllers do not require a complete analytical model of a dynamic system and can provide knowledge-based heuristic controllers for ill-defined and complex systems. Neural networks can be used for learning control. In this chapter, we discuss hybrid methods using fuzzy logic and neural networks which can start with an approximate control knowledge base and refine it through reinforcement learning.

  20. EDITORIAL: Focus on the neural interface Focus on the neural interface

    Science.gov (United States)

    Durand, Dominique M.

    2009-10-01

    they can fail to record reliably neural signals for long periods of time. McConnell et al show that by measuring the impedance of the tissue, one can evaluate the extent of the tissue response to the presence of the electrode. Another problem with the neural interface is the mismatch of the mechanical properties between electrode and tissue. Basinger et al use finite element modeling to analyze this mismatch in retinal prostheses and guide the design of new implantable devices. Electrical stimulation has been the method of choice to activate externally the nervous system. However, Zhang et al show that a novel dual hybrid device integrating electrical and optical stimulation can provide an effective interface for simultaneous recording and stimulation. By interfacing an EMG recording system and a movement detection system, Johnson and Fuglevand develop a model capable of predicting muscle activity during movement that could be important for the development of motor prostheses. Sensory restoration is another unsolved problem in neural prostheses. By developing a novel interface between the dorsal root ganglia and electrodes arrays, Gaunt et al show that it is possible to recruit afferent fibers for sensory substitution. Finally, by interfacing directly with muscles, Jung and colleagues show that stimulation of muscles involved in locomotion following spinal cord damage in rats can provide an effective treatment modality for incomplete spinal cord injury. This series of articles clearly shows that the interface is indeed one of the keys to successful therapeutic neural devices. The next Neural Interfaces Conference will take place in Los Angeles, CA in June 2010 and one can expect to see new developments in neural engineering obtained by focusing on the neural interface.

  1. Unusual airway complication after percutaneous tracheotomy: case report and literature review.

    Science.gov (United States)

    Roxbury, Christopher; Qualliotine, Jesse; Molena, Daniela; Kim, Young

    2015-08-01

    We report a case of a 59-year-old male who experienced tracheoesophageal fistula and grade IV subglottic stenosis after percutaneous dilation tracheotomy. Although percutaneous tracheotomy is considered a safe procedure that is often performed in the intensive care unit setting, it is not without complications. While subglottic stenosis and tracheoesophageal fistula are known complications of percutaneous tracheotomy, this report discusses a patient who experienced both complications simultaneously. The purpose of this report is to discuss potential serious complications of percutaneous tracheotomy and their management, and to review the literature on percutaneous tracheotomy complications. NA © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  2. What Is Neural Plasticity?

    Science.gov (United States)

    von Bernhardi, Rommy; Bernhardi, Laura Eugenín-von; Eugenín, Jaime

    2017-01-01

    "Neural plasticity" refers to the capacity of the nervous system to modify itself, functionally and structurally, in response to experience and injury. As the various chapters in this volume show, plasticity is a key component of neural development and normal functioning of the nervous system, as well as a response to the changing environment, aging, or pathological insult. This chapter discusses how plasticity is necessary not only for neural networks to acquire new functional properties, but also for them to remain robust and stable. The article also reviews the seminal proposals developed over the years that have driven experiments and strongly influenced concepts of neural plasticity.

  3. Neural Systems Laboratory

    Data.gov (United States)

    Federal Laboratory Consortium — As part of the Electrical and Computer Engineering Department and The Institute for System Research, the Neural Systems Laboratory studies the functionality of the...

  4. A neural flow estimator

    DEFF Research Database (Denmark)

    Jørgensen, Ivan Harald Holger; Bogason, Gudmundur; Bruun, Erik

    1995-01-01

    is implemented using switched-current technique and is capable of estimating flow in the μl/s range. The neural estimator is built around a multiplierless neural network, containing 96 synaptic weights which are updated using the LMS1-algorithm. An experimental chip has been designed that operates at 5 V......This paper proposes a new way to estimate the flow in a micromechanical flow channel. A neural network is used to estimate the delay of random temperature fluctuations induced in a fluid. The design and implementation of a hardware efficient neural flow estimator is described. The system...

  5. Percutaneous angioscopy. First reports on percutaneous transluminal angioplasty and local lysis under angioscopic conditions

    Energy Technology Data Exchange (ETDEWEB)

    Beck, A.

    1987-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Madhu Sudan Agrawal

    2016-01-01

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

  7. Percutaneous autonomic neural modulation: A novel technique to treat cardiac arrhythmia

    Energy Technology Data Exchange (ETDEWEB)

    DeSimone, Christopher V.; Madhavan, Malini [Cardiovascular Diseases, Department of Medicine, Mayo Clinic, Rochester, MN (United States); Venkatachalam, Kalpathi L. [Cardiovascular Diseases, Department of Medicine, Mayo Clinic, Jacksonville, FL (United States); Knudson, Mark B. [Mayo Clinic, Rochester, MN (United States); EnteroMedics, EnteroMedics, St. Paul, MN (United States); Asirvatham, Samuel J., E-mail: asirvatham.samuel@mayo.edu [Cardiovascular Diseases, Department of Medicine, Mayo Clinic, Rochester, MN (United States); Pediatric Cardiology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN (United States)

    2013-05-15

    Ablation and anti-arrhythmic medications have shown promise but have been met with varying success and unwanted side effects such as myocardial injury, arrhythmias, and morbidity from invasive surgical intervention. The answer to improving efficacy of ablation may include modulation of the cardiac aspect of the autonomic nervous system. Our lab has developed a novel approach and device to navigate the oblique sinus and to use DC current and saline/alcohol irrigation to selectively stimulate and block the autonomic ganglia found on the epicardial side of the heart. This novel approach minimizes myocardial damage from thermal injury and provides a less invasive and targeted approach. For feasibility, proof-of-concept, and safety monitoring, we carried out canine studies to test this novel application. Our results suggest a safer and less invasive way of modulating arrhythmogenic substrate that may lead to improved treatment of AF in humans.

  8. Neural Networks: Implementations and Applications

    NARCIS (Netherlands)

    Vonk, E.; Veelenturf, L.P.J.; Jain, L.C.

    1996-01-01

    Artificial neural networks, also called neural networks, have been used successfully in many fields including engineering, science and business. This paper presents the implementation of several neural network simulators and their applications in character recognition and other engineering areas

  9. Epigenomic Landscapes of hESC-Derived Neural Rosettes: Modeling Neural Tube Formation and Diseases.

    Science.gov (United States)

    Valensisi, Cristina; Andrus, Colin; Buckberry, Sam; Doni Jayavelu, Naresh; Lund, Riikka J; Lister, Ryan; Hawkins, R David

    2017-08-08

    We currently lack a comprehensive understanding of the mechanisms underlying neural tube formation and their contributions to neural tube defects (NTDs). Developing a model to study such a complex morphogenetic process, especially one that models human-specific aspects, is critical. Three-dimensional, human embryonic stem cell (hESC)-derived neural rosettes (NRs) provide a powerful resource for in vitro modeling of human neural tube formation. Epigenomic maps reveal enhancer elements unique to NRs relative to 2D systems. A master regulatory network illustrates that key NR properties are related to their epigenomic landscapes. We found that folate-associated DNA methylation changes were enriched within NR regulatory elements near genes involved in neural tube formation and metabolism. Our comprehensive regulatory maps offer insights into the mechanisms by which folate may prevent NTDs. Lastly, our distal regulatory maps provide a better understanding of the potential role of neurological-disorder-associated SNPs. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

  10. Predicting the parameters of energy installations with laser ignition: Neural network models

    Directory of Open Access Journals (Sweden)

    Alexey A. Pastukhov

    2015-06-01

    Full Text Available This article considers the possibility of using artificial neural networks for predicting the parameters of the model energy installation with laser ignition. The main stages of creating a prognostic model based on an artificial neural network have been presented. Input data were analyzed by principal component method. The synthesized neural network was designed to predict the parameter value of the model in question. The artificial neural network was trained by a back-propagation algorithm. The efficiency of the artificial neural networks and their applicability to predicting parameter values of various rocket engine elements were demonstrated.

  11. Critical Branching Neural Networks

    Science.gov (United States)

    Kello, Christopher T.

    2013-01-01

    It is now well-established that intrinsic variations in human neural and behavioral activity tend to exhibit scaling laws in their fluctuations and distributions. The meaning of these scaling laws is an ongoing matter of debate between isolable causes versus pervasive causes. A spiking neural network model is presented that self-tunes to critical…

  12. Kunstige neurale net

    DEFF Research Database (Denmark)

    Hørning, Annette

    1994-01-01

    Artiklen beskæftiger sig med muligheden for at anvende kunstige neurale net i forbindelse med datamatisk procession af naturligt sprog, specielt automatisk talegenkendelse.......Artiklen beskæftiger sig med muligheden for at anvende kunstige neurale net i forbindelse med datamatisk procession af naturligt sprog, specielt automatisk talegenkendelse....

  13. Percutaneous transhepatic access for catheter ablation of cardiac arrhythmias.

    Science.gov (United States)

    Nguyen, Duy Thai; Gupta, Rajan; Kay, Joseph; Fagan, Thomas; Lowery, Christopher; Collins, Kathryn K; Sauer, William H

    2013-04-01

    Femoral venous access may be limited in certain patients undergoing electrophysiology (EP) study and ablation. The purpose of this study is to review a series of patients undergoing percutaneous transhepatic access to allow for ablation of cardiac arrhythmias. Six patients with a variety of cardiac arrhythmias and venous abnormalities underwent percutaneous transhepatic access. Under fluoroscopic and ultrasound guidance, a percutaneous needle was advanced into a hepatic vein and exchanged for a vascular sheath over a wire. Electrophysiology study and radiofrequency ablation was then performed. All tachycardias, including atrial tachycardia, atrial flutter, atrioventricular nodal tachycardia, and atrial fibrillation, were ablated. Procedural times ranged from 227 to 418 min. Fluoroscopy times ranged from 32 to 95 min. There were no complications. All six patients have been arrhythmia-free in follow-up (5-49 months, mean 23.1 months). Percutaneous transhepatic access is safe and feasible in patients with limited venous access who are undergoing EP study and ablation for a range of cardiac arrhythmias.

  14. Percutaneous stone removal | van der Ness | SA Journal of Radiology

    African Journals Online (AJOL)

    percutaneous nephrolithotomy (PCNL) at our academic hospital. The primary objective was to determine the percentage successful PCNL procedures performed. Methods. The study included 169 patients (116 males, 53 females; mean age 45 years, range 6 - 75 years) treated with PCNL in our Department of Radiology ...

  15. Simplified percutaneous large bore suprapubic cystostomy for acute ...

    African Journals Online (AJOL)

    Introduction and objectives: Commercial cystostomy kits/trocars are not always readily available in regions with insufficient funding. Open suprapubic cystostomy procedures are yet prevalent. This paper presents a simplified percutaneous suprapubic cystostomy technique that utilizes specially selected surgical blades in ...

  16. Laparoscopic-assisted percutaneous internal ring ligation in children

    African Journals Online (AJOL)

    Laparoscopic-assisted percutaneous internal ring ligation in children. Mostafa A. Hamad a,b. , Mohamed A. Osman a,b and Mahmoud Abdelhamed a,b. Aim To evaluate the feasibility and safety of laparoscopic ligation of internal ring in congenital inguinal hernia in children. Patients and methods Laparoscopic ...

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

    African Journals Online (AJOL)

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

  18. The value of percutaneous trephine biopsy in the diagnosis of ...

    African Journals Online (AJOL)

    The results obtained in 55 adult patients with sinister lesions of vertebral bodies, who were subjected to percutaneous trephine biopsy, are presented. A positive diagnosis was made on histopathological examination of specimens from 24 patients (44%). In the remaining 31 patients (56%), pathological features were seen ...

  19. Percutaneous extrapulmonary radiofrequency ablation for tumors in the hepatic dome.

    Science.gov (United States)

    Wang, Zhen-Yuan; Sun, Wen-Bing; Li, Ming-Ying; Zhang, Xiao-Xia; Ding, Xue-Mei

    2008-01-01

    This study aims to assess the feasibility of one lung ventilation and computed tomography-guided extrapulmonary percutaneous radiofrequency ablation for tumors in the hepatic dome. Eleven patients (10 men, 1 women; age range, 34-84 years) with 12 tumors in the hepatic dome were enrolled in the study after institutional review board approval and informed consent had been obtained. A 35F or 37F left-sided double-lumen endotracheal tube was intubated after general anesthesia was induced. The right lung is permitted to collapse, with selective left lungs ventilation. With CT monitoring, the RF electrode was inserted through the empty pleural space to the targeted tumor and radiofrequency ablation procedures were performed. The median operative time was 122 minutes. The median one lung ventilation time was 134 minutes. The procedures of one lung ventilation and percutaneous radiofrequency ablation were successfully performed. There was no bronchial intubation, one lung ventilation and percutaneous radiofrequency ablation related complications, excluding minor pleural effusions recovering without thoracentesis in 2 patients. Complete tumor necrosis was achieved in 10 patients (90.9%). One lung ventilation and computed tomography guided percutaneous extrapulmonary radiofrequency ablation for tumors in the hepatic dome appears to be useful and safe.

  20. Percutaneous coronary intervention in nonagenarians: pros and cons

    Institute of Scientific and Technical Information of China (English)

    Giuseppe Biondi Zoccai; Antonio Abbate; Fabrizio D'Ascenzo; Davide Presutti; Mariangela Peruzzi; Elena Cavarretta; Antonino G.M. Marullo; Marzia Lotrionte; Giacomo Frati

    2013-01-01

    Percutaneous coronary intervention is a mainstay in the management of symptomatic or high-risk coronary artery disease. The bulk of clinical evidence and experience underlying this fact relies, however, on relatively young patients. Indeed, few data of very limited quality are available which adequately define the risk-benefit and cost-benefit profile of coronary angioplasty and stenting in very old subjects, such as those of 90 years of age or older (i.e., nonagenarians). The aim of this review is to provide a concise, yet practical, synthesis of the available evidence on percutaneous coronary revascularization in the very elderly. The main arguments elaborated upon are to what extent we can extrapolate findings from studies including younger patients to nonagenarians, whether we should provide higher priority to prognosis or quality of life in such patients, and whether we can afford to allocate vast resources to care for such subjects in an era of financial constraints. Our review of 18 studies and 1082 patients suggest that percutaneous coronary intervention is feasible and associated with acceptable short- and long-term results in this population, which is nonetheless fraught with a high mortality risk irrespective of the revascularization procedure. Accordingly, the pros and cons of percutaneous coronary intervention should be carefully weighed when considering this treatment in nonagenarians.

  1. Experience of Percutaneous Trigger Finger Release under Local ...

    African Journals Online (AJOL)

    Background: Trigger finger is a common disorder of upper extremity. Majority of the patients can be treated conservatively but some resistant cases eventually need surgery. Aim: The aim of this study is to evaluate the results of percutaneous trigger finger release under local anesthesia. Subjects and Methods: This is a ...

  2. Percutaneous core needle biopsies: The yield in spinal tuberculosis ...

    African Journals Online (AJOL)

    Background. Current recommendations for spinal tuberculosis (TB) not requiring open surgery include core needle biopsy to confirm TB and determine drug sensitivity. International figures show the positive culture yield from core needle biopsies is 50 - 83%. Objectives. To (i) assess the yield of percutaneous needle ...

  3. Percutaneous core needle biopsies: The yield in spinal tuberculosis

    African Journals Online (AJOL)

    2014-01-29

    Jan 29, 2014 ... One patient had arachnoiditis. Five patients had disease involving more than 2 vertebrae. At the time of biopsy, patients were given a general anaesthetic and either positioned prone or on their right side. A Jamshidi or Harlow. Wood needle was advanced percutaneously under fluoroscopic guidance into ...

  4. Percutaneous Management of Postoperative Duodenal Stump Leakage with Foley Catheter

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Jung Suk, E-mail: oj-cumc@daum.net; Lee, Hae Giu, E-mail: hgleehfh@catholic.ac.kr; Chun, Ho Jong; Choi, Byung Gil [Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Department of Radiology (Korea, Republic of); Lee, Sang Hoon; Hahn, Seong Tai [Yeouido St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Department of Radiology (Korea, Republic of); Ohm, Joon Young [Bucheon St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Department of Radiology (Korea, Republic of)

    2013-10-15

    Purpose: This study was designed to evaluate retrospectively the safety and efficacy of the percutaneous management of duodenal stump leakage with a Foley catheter after subtotal gastrectomy. Methods: Ten consecutive patients (M:F = 9:1, median age: 64 years) were included in this retrospective study. The duodenal stump leakages were diagnosed in all the patients within a median of 10 days (range, 6-20). At first, the patients underwent percutaneous drainage on the day of or the day after confirmation of the presence of duodenal stump leakage, and then the Foley catheters were replaced at a median of 9 days (range, 6-38) after the percutaneous drainage. Results: Foley catheters were placed successfully in the duodenal lumen of all the patients under a fluoroscopic guide. No complication was observed during and after the procedures in all the patients. All of the patients started a regular diet 1 day after the Foley catheter placement. The patients were discharged at a median of 7 days (range, 5-14) after the Foley catheter placement. The catheters were removed in an outpatient clinic 10-58 days (median, 28) after the Foley catheter placement. Conclusions: Fluoroscopy-guided percutaneous Foley catheter placement may be a safe and effective treatment option for postoperative duodenal stump leakage and may allow for shorter hospital stays, earlier oral intake, and more effective control of leakage sites.

  5. Stability of percutaneously implanted markers for lung stereotactic radiotherapy

    DEFF Research Database (Denmark)

    Persson, Gitte Bjørnsen Fredberg; Josipovic, Mirjana; Von Der Recke, Peter

    2013-01-01

    The purpose of this study was to evaluate the stability of complex markers implanted into lung tumors throughout a course of stereotactic body radiotherapy (SBRT). Fifteen patients referred for lung SBRT were prospectively included. Radio-opaque markers were implanted percutaneously, guided...

  6. Effects of percutaneous needle liver biopsy on dairy cow behaviour

    DEFF Research Database (Denmark)

    Mølgaard, Lene; Damgaard, Birthe Marie; Bjerre-Harpøth, Vibeke

    2012-01-01

    behavioural changes for up to 19 h – and particularly for behaviour previously associated with pain. Even though the exact welfare impact of percutaneous needle liver biopsies in cows is not known, and the magnitude of the behavioural changes was limited, pain always has negative effects on animal welfare...

  7. Percutaneous Gastronomy and Jejunostomy: Lessons from the First Decade

    Directory of Open Access Journals (Sweden)

    John S Goff

    1992-01-01

    Full Text Available Percutaneous gastrostomies and jejunostomies have increasingly been used for long term enteral feeding in patients with functioning gastrointestinal tracts but who are unable, for a variety of reasons, to use the standard oropharyngeal route. Since these devices can be placed without the use of general anesthesia, the morbidity and mortality generally are less than for placement of a surgical gastrostomy. A permanent gastrostomy tube is easy to manage in most patients who require prolonged tube feeding. There are four basic types of percutaneous gastrostomy techniques; three employ an endoscope and one uses only radiographic or ultrasonic guidance. All gastrostomy tubes may be convened to feeding jejunostomies if the clinical situation warrants. Jejunal feeding tubes are prone to many technical problems and do not always solve the problems of gastric dysfunction and reflux that make gastrostomy tubes less desireable. Percutaneous endoscopic gastrostomics are technically simple to perform and have become the main method for access to the gastrointestinal tract in many patients. If judiciously used, the percutaneous enterostomy offers many benefits over a nasogastric tube for long term enteral feeding.

  8. Left ventricle and systemic air embolism after percutaneous lung biopsy

    Directory of Open Access Journals (Sweden)

    Juan M. Galvis

    2017-01-01

    Conclusion: Although systemic arterial air embolism remains a rare complication of percutaneous lung biopsies, recognition prevents potential mortality which can develop due to neurological and cardiac complications. Close vigilance in the intensive care unit is recommended and hyperbaric chamber when appropriate.

  9. Percutaneous transvenous angioplasty of inferior vena cava by balloon dilatation

    Energy Technology Data Exchange (ETDEWEB)

    Suh, Kyung Suk; Kim, Jae Kyu; Park, Jin Gyun; Kang, Heung Keun; Chung, Hyon De; Kim, Shin Kon; Chung, Sang Young [Chonnam National University College of Medicine, Kwangju (Korea, Republic of)

    1989-10-15

    3 patients with membranous (2 patients) and segmental (1 patient) obstruction of IVC were successfully treated by percutaneous transvenous angioplasty using balloon catheter. Improvements of clinical and radiological findings could be obtained after procedures. Relatively good patency was obtained in all cases without complications. This procedure can be applied safely to membranous or segmental obstructions of IVC and elsewhere in the venous systems.

  10. QT Dispersion: Does It Change after Percutaneous Coronary Intervention?

    Directory of Open Access Journals (Sweden)

    Mahsa Asadi Moghaddam

    2011-02-01

    Full Text Available Background: Myocardial ischemia is one of several causes of prolonged QT dispersion. The aim of this study was to evaluate the effect that percutaneous coronary intervention has on the depolarization and repolarization parameters of surface electrocardiography in patients with chronic stable angina.Methods: We assessed the effects of full revascularization in patients with chronic stable angina and single-vessel disease who underwent percutaneous coronary intervention. Twelve-lead electrocardiograms were recorded before intervention and 24 hours subsequently. We measured parameters including QRS duration, QT and corrected QT durations, and JT and corrected JT duration in both electrocardiograms and compared the values.Results: There were significant differences between the mean QRS interval (0.086 ± 0.01sec vs. 0.082 ± 0.01 second; p value = 0.01, mean corrected QT dispersion (0.080 ± 0.04 sec vs. 0.068 ± 0.04 sec; p value = 0.001, and mean corrected JT dispersion (0.074 ± 0.04 sec vs. 0.063 ± 0.04 sec; p value = 0.001 before and after percutaneous coronary intervention. No significant differences were found between the other ECG parameters.Conclusion: Our data indicate that the shortening of corrected QT dispersion and corrected JT dispersion in patients undergoing percutaneous coronary intervention is prominent.

  11. Percutaneous injuries in doctors in the School of Medicine ...

    African Journals Online (AJOL)

    Background: Despite the official precautionary measures against percutaneous injuries, incidents still occur. Consequently, it is .... incision instruments (4.2%), and other sharp instruments (12.5%).8. These researchers also .... of the respondents had an additional qualification, of which 17 (31.5%) were MMed degrees in ...

  12. Laparoscopic-assisted percutaneous internal ring ligation in children

    African Journals Online (AJOL)

    Aim To evaluate the feasibility and safety of laparoscopic ligation of internal ring in congenital inguinal hernia in children. Patients and methods Laparoscopic percutaneous ligation of internal inguinal ring has been performed on 97 children with 133 hernias. The age ranged between 6 months and 11.5 years.

  13. Simplified percutaneous large bore suprapubic cystostomy for acute ...

    African Journals Online (AJOL)

    C.O. Okorie

    simplified percutaneous suprapubic cystostomy technique that utilizes specially selected surgical blades in the place of commercial trocars. Subjects and methods: Eighty-nine male patients with acute urinary retention underwent puncturing of the visibly and palpably distended bladder with surgical blade size 20 (7 mm ...

  14. Peritoneal Insufflation Facilitates CT-Guided Percutaneous Jejunostomy Replacement.

    Science.gov (United States)

    Chiao, David; Lambert, Drew

    2017-04-01

    The purpose of this report was to examine whether peritoneal insufflation can facilitate CT-guided percutaneous jejunostomy replacement. Peritoneal insufflation allowed clear differentiation of the adherent jejunum from adjacent bowel, permitting confident direct puncture into the adherent jejunum without the need for jejunopexy anchors.

  15. Fractional flow reserve versus angiography for guiding percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Tonino, Pim A L; De Bruyne, Bernard; Pijls, Nico H J

    2009-01-01

    BACKGROUND: In patients with multivessel coronary artery disease who are undergoing percutaneous coronary intervention (PCI), coronary angiography is the standard method for guiding the placement of the stent. It is unclear whether routine measurement of fractional flow reserve (FFR; the ratio of...

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

    African Journals Online (AJOL)

    East and Central African Journal of Surgery ... In spite of a slightly increased morbidity we recommend percutaneous fmation with figure of eight casting in all patients with severely displaced (Gartland III) fractures of the umerus including compound ones as a compromise between conservative and open surgical treatment.

  17. Results of arthrospine assisted percutaneous technique for lumbar discectomy

    OpenAIRE

    Mohinder Kaushal

    2016-01-01

    Background: Avaialable minimal invasive arthro/endoscopic techniques are not compatible with 30 degree arthroscope which orthopedic surgeons uses in knee and shoulder arthroscopy. Minimally invasive ?Arthrospine assisted percutaneous technique for lumbar discectomy? is an attempt to allow standard familiar microsurgical discectomy and decompression to be performed using 30? arthroscope used in knee and shoulder arthroscopy with conventional micro discectomy instruments. Materials and Methods:...

  18. Percutaneous renal surgery: new model for learning and training

    Directory of Open Access Journals (Sweden)

    Earp Pedro P. de Sá

    2003-01-01

    Full Text Available INTRODUCTION: Aiming at promoting and facilitating learning and training in percutaneous renal surgery, we have created an easy to assemble, reproducible and cheap laboratory model. The model was built using pig kidney, foam layer, plastic catheter, linen or cotton holding sutures, and wide scotch tape. SURGICAL TECHNIQUE: The kidney with catheterized ureter is fixed and involved in a foam layer. It stays hidden, and is visible only through radioscopy. This model is positioned and fixed to a radiological table in such a way that it simulates the patient’s lumbar region. After that, contrast medium is injected through the ureter, and the urinary system is examined through radioscopy. All percutaneous maneuvers can be accomplished, from the puncture, tract dilation, insertion of Amplatz sheath, and introduction of nephroscope, allowing lithotripsy and endopielotomy, as well as other types of percutaneous surgeries. COMMENTS: The great advantage of this model is its easy construction, by using very cheap and widely available material. Foam can be several times washed and reused. After treatment, the model can be immediately open, and a critical analysis can be made, being then possible to verify if the place of renal puncture was well chosen, if dilation was correctly accomplished, and if the collecting system has been preserved. Therefore, this model can represent a great advance for the learning and training in percutaneous surgery.

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

    African Journals Online (AJOL)

    2012-12-29

    Dec 29, 2012 ... Percutaneous lung biopsy had been described in the nineteenth century by Leyden, but image- guided needle chest biopsy only gained ... of a pulmonary lesion during a comprehensive medical review. She had a chest X‑ray ... laboratory for processing by the pathologist who was also present during the ...

  20. Reperfusion delay in patients treated with primary percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Schoos, Mikkel M; Sejersten, Maria; Hvelplund, Anders

    2012-01-01

    -hospital organization with tele-transmitted electrocardiograms, field triage and direct transfer to a 24/7 primary percutaneous coronary intervention (PPCI) center. METHODS AND RESULTS: This was a single center cohort study with long-term follow-up in 472 patients. The PPCI center registry was linked by person...

  1. Percutaneous transhepatic self-expanding metal stents for palliation ...

    African Journals Online (AJOL)

    Cancers of the pancreas, gallbladder and bile ducts are the commonest causes of malignant biliary obstruction. .... markers on the delivery catheter allow fluoroscopic control of stent release after positioning across the .... percutaneous biliary transhepatic self-expanding metal stent insertion was technically successful in all ...

  2. Indications for percutaneous endoscopic gastrostomy in complex tuberculosis patients

    NARCIS (Netherlands)

    Warmelink, G.; Poels, B. J. J.; van Altena, R.; Peters, F. T. M.

    OBJECTIVES: Percutaneous end oscopic gastrostomy (PEG) is a widely used method for providing long-term administration of tube feeding. Different indications in relation to diseases, impairments and nutritional factors for PEG placement have been mentioned in guidelines. Treatment with PEG has not

  3. Beyond Prone Position in Percutaneous Nephrolithotomy: A Comprehensive Review

    NARCIS (Netherlands)

    de La Rosette, Jean J. M. C. H.; Tsakiris, Peter; Ferrandino, Michael N.; Elsakka, Ahmed M.; Rioja, Jorge; Preminger, Glenn M.

    2008-01-01

    Context: Percutaneous nephrolithotomy (PNL) is traditionally performed with the patient in the prone position. Objective: To assess the efficacy and safety of the prone and supine positions, particularly in obese patients and in those with staghorn calculi. Evidence acquisition: A Medline search was

  4. Preoperative percutaneous transhepatic drainage: use or abuse. A clinical review

    NARCIS (Netherlands)

    Gouma, D. J.; Moody, F. G.

    1984-01-01

    The benefit of preoperative percutaneous transhepatic biliary drainage in patients with obstructive jaundice was reviewed in the literature from 1974 to July 1984. The role of preoperative drainage cannot be definitively assessed. Significant reduction of morbidity and mortality has been reported in

  5. System and method for determining stability of a neural system

    Science.gov (United States)

    Curtis, Steven A. (Inventor)

    2011-01-01

    Disclosed are methods, systems, and computer-readable media for determining stability of a neural system. The method includes tracking a function world line of an N element neural system within at least one behavioral space, determining whether the tracking function world line is approaching a psychological stability surface, and implementing a quantitative solution that corrects instability if the tracked function world line is approaching the psychological stability surface.

  6. Universal approximation in p-mean by neural networks

    NARCIS (Netherlands)

    Burton, R.M; Dehling, H.G

    A feedforward neural net with d input neurons and with a single hidden layer of n neurons is given by [GRAPHICS] where a(j), theta(j), w(ji) is an element of R. In this paper we study the approximation of arbitrary functions f: R-d --> R by a neural net in an L-p(mu) norm for some finite measure mu

  7. Optical neural net for classifying imaging spectrometer data

    Science.gov (United States)

    Barnard, Etienne; Casasent, David P.

    1989-01-01

    The problem of determining the composition of an unknown input mixture from its measured spectrum, given the spectra of a number of elements, is studied. The Hopfield minimization procedure was used to express the determination of the compositions as a problem suitable for solution by neural nets. A mathematical description of the problem was developed and used as a basis for a neural network solution and an optical implementation.

  8. Posterior keyhole corpectomy with percutaneous pedicle screw stabilization in the surgical management of lumbar burst fractures.

    Science.gov (United States)

    Maciejczak, Andrzej; Barnas, Piotr; Dudziak, Piotr; Jagiełło-Bajer, Barbara; Litwora, Bogdan; Sumara, Mateusz

    2007-04-01

    vertebral body or removal of the retropulsed bone fragment via two keyhole skin incisions on both sides of the spinous process (each skin incision measures 2 to 3 cm long). Exposure of the retropulsed fragment (the posterior upper part of the vertebral body) is achieved by medial or complete facetectomy along with complete or medial resection of the pedicle. This has to be performed bilaterally. Percutaneous stabilization requires four additional stab skin incisions. We observed no surgery-related complications (neurological, hardware, dural tears, or deep or superficial wound infections); there was perfect decompression and clearance of the spinal canal (confirmed by computed tomographic and magnetic resonance imaging scanning); and there was solid stability at the affected segments (confirmed by dynamic x-rays). Healed fusion was noted in all patients but one. The latter patient had no clinical symptoms of spinal instability. Kyphotic deformity was corrected and reversed into lordosis in three patients. Loss of deformity correction was noted in all patients; however, all patients retained lordotic alignment of the affected segment. The advantages of this method include sparing the posterior elements (lamina, spinous process, supraspinous and interspinous ligaments, and paravertebral muscles), safety of the decompression provided by the use of a surgical microscope, and perfect illumination of the operating field. The drawbacks of the method include limitation to certain types of burst fractures, the method is surgically demanding, and the method requires development of a special retractor system to eliminate the cumbersome alternate insertion and the reinsertions of the typical microdiscectomy retractor set.

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

    Directory of Open Access Journals (Sweden)

    Kanthila Mahesha

    2017-01-01

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

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

    Science.gov (United States)

    Mahesha, Kanthila

    2017-01-01

    Background: Lumbar disc herniation is a major cause of back pain and sciatica. The surgical management of lumbar disc prolapse has evolved from exploratory laminectomy to percutaneous endoscopic discectomy. Percutaneous endoscopic discectomy is the least invasive procedure for lumbar disc prolapse. The aim of this study was to analyze the clinical outcome, quality of life, neurologic function, and complications. Materials and Methods: One hundred patients with lumbar disc prolapse who were treated with percutaneous endoscopic discectomy from May 2012 to January 2014 were included in this retrospective study. Clinical followup was done at 1 month, 3 months, 6 months, 1 year, and at yearly interval thereafter. The outcome was assessed using modified Macnab's criteria, visual analog scale, and Oswestry Disability Index. Results: The mean followup period was 2 years (range 18 months - 3 years). Transforaminal approach was used in 84 patients, interlaminar approach in seven patients, and combined approach in nine patients. An excellent outcome was noted in ninety patients, good outcome in six patients, fair result in two patients, and poor result in two patients. Minor complications were seen in three patients, and two patients had recurrent disc prolapse. Mean hospital stay was 1.6 days. Conclusions: Percutaneous endoscopic lumbar discectomy is a safe and effective procedure in lumbar disc prolapse. It has the advantage that it can be performed on a day care basis under local anesthesia with shorter length of hospitalization and early return to work thus improving the quality of life earlier. The low complication rate makes it the future of disc surgery. Transforaminal approach alone is sufficient in majority of cases, although 16% of cases required either percutaneous interlaminar approach or combined approach. The procedure definitely has a learning curve, but it is acceptable with adequate preparations. PMID:28216749

  11. New ex-vivo organ model for percutaneous renal surgery

    Directory of Open Access Journals (Sweden)

    Florian Imkamp

    2011-06-01

    Full Text Available OBJECTIVES: Percutaneous Renal Surgery (PRS is a demanding procedure and success is mostly hampered by the lacking of training facilities. Thus, the purpose of the study was to evaluate a significantly improved pre-existing porcine kidney-training model for percutaneous renal access and PRS. MATERIALS AND METHODS: A biologic training model using porcine kidneys coated by a full-thickness porcine skin flap was prepared. The ureter was dissected, stones were placed into the collecting system using an 18F amplatz sheath, and a catheter was placed in the ureter for further irrigation with saline or contrast medium. For initial training with an easy access, a standard guide-wire was inserted in the ureter through the renal parenchyma. The kidney was punctured with radiographic or ultrasound guidance. Minimally invasive percutaneous nephrolithotomy (MIP was then tested using the model under radiographic or ultrasound guidance. The model was then evaluated in MIP training courses, which are regularly held at The Hannover Medical School. RESULTS: All trainees were urologists with experience in endourologic surgery but lacked practice in PRS. In conclusion, all 36 participants attained access to the collecting system using models with readily placed guide-wires. Subsequently, PRS was successful in all cases. Percutaneous puncture under ultrasound guidance and following intrarenal surgery was successful in 30 (83.3% cases. Therefore, all participants rated the model useful for simulating percutaneous renal surgery. CONCLUSIONS: This new porcine kidney model is easy to build and is made cost effective by using readily available material. Moreover, it provides realistic and reproducible training model for PRS. The "organ" model mimics the retroperitoneum by having a full-thickness skin flap with a layer of subcutaneous fatty tissue.

  12. Percutaneous cholecystostomy at the community hospital: value evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Min; Lee, Mi Suk; Lee, Jin Hee; Ym, Seong Hee; Yoon, Young Gun [Namwon Medical Center, Namwon (Korea, Republic of); Sohn, Myung Hee; Kim, Chong Soo; Han, Young Min; Choi, Ki Chul [Chonbuk National Univ., Chonju (Korea, Republic of)

    1997-10-01

    To assess the role of percutaneous cholecystostomy as a therapeutic maneuver in patients critically ill with acute cholecystitis in community hospitals. Eighteen patients, 11 with suspected acute calculous cholecystits and seven with acute acalulous cholecystitis underwent emergency percutaneous cholecystostomy. All demonstrated a variety of high risk factors for cholecystectomy:liver cirrhosis(n=3D2), diabetes mellitus(n=3D3), cardiac disease(n=3D3), underlying malignancy(n=3D2), pulmonary dysfunction(n=3D1), septic cholangitis(n=3D5), and old age(n=3D2). All percutaneous cholecystostomies were performed with ultrasound guidance and preferably using the transhepatic route. All procedures but one were successful, and most cholecystostomies were performed within 5-20 minutes. Technical problems were as follows: guide-wire buckling during catheter insertion(n=3D2) and procedure failure(n=3D1). The only major problem was a case of localized bile peritonitis due to procedural failure, but a few minor complications were encountered:catheter dislodgment(n=3D3), and significant abdominal pain during the procedure(2). After successful cholecystostomy, a dramatic improvement in clinical condition was observed in 16 of 17 patients(94%) within 48 hours. Ten of 16 patients who responded to percutaneous cholecystostomy underwent elective cholecystectomy after the improvement of clinical symptoms, and the remaining six patients improved without other gallbladder interventions. Percutaneous cholecystostomy is not only an effective procedure for acute cholecystitis, but also has a definite role in the management of these high-risk patients in community hospitals.=20.

  13. Target vessel revascularization following percutaneous coronary intervention. A 10-year report from the Danish Percutaneous Transluminal Coronary Angioplasty Registry

    DEFF Research Database (Denmark)

    Jensen, Lisette Okkels; Thayssen, Per; Kassis, Eli

    2005-01-01

    OBJECTIVE: To present the rate of target vessel revascularization (TVR) in a consecutive and unselected national population over 10 years. DESIGN: From 1989 to 1998 all percutaneous coronary interventions (PCIs) performed in Denmark were recorded in the Danish PTCA Registry. RESULTS: From 1989...

  14. Dynamics of neural cryptography.

    Science.gov (United States)

    Ruttor, Andreas; Kinzel, Wolfgang; Kanter, Ido

    2007-05-01

    Synchronization of neural networks has been used for public channel protocols in cryptography. In the case of tree parity machines the dynamics of both bidirectional synchronization and unidirectional learning is driven by attractive and repulsive stochastic forces. Thus it can be described well by a random walk model for the overlap between participating neural networks. For that purpose transition probabilities and scaling laws for the step sizes are derived analytically. Both these calculations as well as numerical simulations show that bidirectional interaction leads to full synchronization on average. In contrast, successful learning is only possible by means of fluctuations. Consequently, synchronization is much faster than learning, which is essential for the security of the neural key-exchange protocol. However, this qualitative difference between bidirectional and unidirectional interaction vanishes if tree parity machines with more than three hidden units are used, so that those neural networks are not suitable for neural cryptography. In addition, the effective number of keys which can be generated by the neural key-exchange protocol is calculated using the entropy of the weight distribution. As this quantity increases exponentially with the system size, brute-force attacks on neural cryptography can easily be made unfeasible.

  15. ANT Advanced Neural Tool

    Energy Technology Data Exchange (ETDEWEB)

    Labrador, I.; Carrasco, R.; Martinez, L.

    1996-07-01

    This paper describes a practical introduction to the use of Artificial Neural Networks. Artificial Neural Nets are often used as an alternative to the traditional symbolic manipulation and first order logic used in Artificial Intelligence, due the high degree of difficulty to solve problems that can not be handled by programmers using algorithmic strategies. As a particular case of Neural Net a Multilayer Perception developed by programming in C language on OS9 real time operating system is presented. A detailed description about the program structure and practical use are included. Finally, several application examples that have been treated with the tool are presented, and some suggestions about hardware implementations. (Author) 15 refs.

  16. Percutaneous Dilational Tracheotomy in Solid-Organ Transplant Recipients.

    Science.gov (United States)

    Ozdemirkan, Aycan; Ersoy, Zeynep; Zeyneloglu, Pinar; Gedik, Ender; Pirat, Arash; Haberal, Mehmet

    2015-11-01

    Solid-organ transplant recipients may require percutaneous dilational tracheotomy because of prolonged mechanical ventilation or airway issues, but data regarding its safety and effectiveness in solid-organ transplant recipients are scarce. Here, we evaluated the safety, effectiveness, and benefits in terms of lung mechanics, complications, and patient comfort of percutaneous dilational tracheotomy in solid-organ transplant recipients. Medical records from 31 solid-organ transplant recipients (median age of 41.0 years [interquartile range, 18.0-53.0 y]) who underwent percutaneous dilational tracheotomy at our hospital between January 2010 and March 2015 were analyzed, including primary diagnosis, comorbidities, duration of orotracheal intubation and mechanical ventilation, length of intensive care unit and hospital stays, the time interval between transplant to percutaneous dilational tracheotomy, Acute Physiology and Chronic Health Evaluation II score, tracheotomy-related complications, and pulmonary compliance and ratio of partial pressure of arterial oxygen to fraction of inspired oxygen. The median Acute Physiology and Chronic Health Evaluation II score on admission was 24.0 (interquartile range, 18.0-29.0). The median interval from transplant to percutaneous dilational tracheotomy was 105.5 days (interquartile range, 13.0-2165.0 d). The only major complication noted was left-sided pneumothorax in 1 patient. There were no significant differences in ratio of partial pressure of arterial oxygen to fraction of inspired oxygen before and after procedure (170.0 [interquartile range, 102.2-302.0] vs 210.0 [interquartile range, 178.5-345.5]; P = .052). However, pulmonary compliance results preprocedure and postprocedure were significantly different (0.020 L/cm H2O [interquartile range, 0.015-0.030 L/cm H2O] vs 0.030 L/cm H2O [interquartile range, 0.020-0.041 L/cm H2O); P = .001]). Need for sedation significantly decreased after tracheotomy (from 17 patients [54.8%] to

  17. Percutaneous Endovascular Treatment for Hepatic Artery Stenosis after Liver Transplantation: The Role of Percutaneous Endovascular Treatment.

    Science.gov (United States)

    Vidjak, Vinko; Novačić, Karlo; Matijević, Filip; Kavur, Lovro; Slavica, Marko; Mrzljak, Anna; Filipec-Kanižaj, Tajana; Leder, Nikola Ivan; Škegro, Dinko

    2015-01-01

    To retrospectively analyze the outcomes of interventional radiology treatment of patients with hepatic artery stenosis (HAS) after liver transplantation at our Institution. Hepatic artery stenosis was diagnosed and treated by endovascular technique in 8 (2.8%) patients, who underwent liver transplantation between July 2007 and July 2011. Patients entered the follow-up period, during which we analyzed hepatic artery patency with Doppler ultrasound at 1, 3, 6, and 12 months after percutaneous endovascular treatment (PTA), and every six months thereafter. During the 12-month follow-up period, 6 out of 8 patients (75%) were asymptomatic with patent hepatic artery, which was confirmed by multislice computed tomography (MSCT) angiography, or color Doppler (CD) ultrasound. One patient had a fatal outcome of unknown cause, and one patient underwent orthotopic liver retransplantation (re-OLT) procedure due to graft failure. Our results suggest that HAS angioplasty and stenting are minimally invasive and safe endovascular procedures that represent a good alternative to open surgery, with good 12-month follow-up patency results comparable to surgery.

  18. Percutaneous Endovascular Treatment for Hepatic Artery Stenosis after Liver Transplantation: The Role of Percutaneous Endovascular Treatment

    Science.gov (United States)

    Vidjak, Vinko; Novačić, Karlo; Matijević, Filip; Kavur, Lovro; Slavica, Marko; Mrzljak, Anna; Filipec-Kanižaj, Tajana; Leder, Nikola Ivan; Škegro, Dinko

    2015-01-01

    Summary Background To retrospectively analyze the outcomes of interventional radiology treatment of patients with hepatic artery stenosis (HAS) after liver transplantation at our Institution. Material/Methods Hepatic artery stenosis was diagnosed and treated by endovascular technique in 8 (2.8%) patients, who underwent liver transplantation between July 2007 and July 2011. Patients entered the follow-up period, during which we analyzed hepatic artery patency with Doppler ultrasound at 1, 3, 6, and 12 months after percutaneous endovascular treatment (PTA), and every six months thereafter. Results During the 12-month follow-up period, 6 out of 8 patients (75%) were asymptomatic with patent hepatic artery, which was confirmed by multislice computed tomography (MSCT) angiography, or color Doppler (CD) ultrasound. One patient had a fatal outcome of unknown cause, and one patient underwent orthotopic liver retransplantation (re-OLT) procedure due to graft failure. Conclusions Our results suggest that HAS angioplasty and stenting are minimally invasive and safe endovascular procedures that represent a good alternative to open surgery, with good 12-month follow-up patency results comparable to surgery. PMID:26150902

  19. Percutaneous Dorsal Instrumentation of Vertebral Burst Fractures: Value of Additional Percutaneous Intravertebral Reposition—Cadaver Study

    Directory of Open Access Journals (Sweden)

    Antonio Krüger

    2015-01-01

    Full Text Available Purpose. The treatment of vertebral burst fractures is still controversial. The aim of the study is to evaluate the purpose of additional percutaneous intravertebral reduction when combined with dorsal instrumentation. Methods. In this biomechanical cadaver study twenty-eight spine segments (T11-L3 were used (male donors, mean age 64.9 ± 6.5 years. Burst fractures of L1 were generated using a standardised protocol. After fracture all spines were allocated to four similar groups and randomised according to surgical techniques (posterior instrumentation; posterior instrumentation + intravertebral reduction device + cement augmentation; posterior instrumentation + intravertebral reduction device without cement; and intravertebral reduction device + cement augmentation. After treatment, 100000 cycles (100–600 N, 3 Hz were applied using a servohydraulic loading frame. Results. Overall anatomical restoration was better in all groups where the intravertebral reduction device was used (p0.05. All techniques decreased narrowing of the spinal canal. After loading, clearance could be maintained in all groups fitted with the intravertebral reduction device. Narrowing increased in the group treated with dorsal instrumentation. Conclusions. For height and anatomical restoration, the combination of an intravertebral reduction device with dorsal instrumentation showed significantly better results than sole dorsal instrumentation.

  20. Flow Pattern Identification of Horizontal Two-Phase Refrigerant Flow Using Neural Networks

    Science.gov (United States)

    2015-12-31

    making classification difficult. Consequently, Table 5 shows neural net - work classification results for nine flow patterns. The number of runs...AFRL-RQ-WP-TP-2016-0079 FLOW PATTERN IDENTIFICATION OF HORIZONTAL TWO-PHASE REFRIGERANT FLOW USING NEURAL NETWORKS (POSTPRINT) Abdeel J... NEURAL NETWORKS (POSTPRINT) 5a. CONTRACT NUMBER In-house 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 62203F 6. AUTHOR(S) Abdeel J. Roman and

  1. Hidden neural networks

    DEFF Research Database (Denmark)

    Krogh, Anders Stærmose; Riis, Søren Kamaric

    1999-01-01

    A general framework for hybrids of hidden Markov models (HMMs) and neural networks (NNs) called hidden neural networks (HNNs) is described. The article begins by reviewing standard HMMs and estimation by conditional maximum likelihood, which is used by the HNN. In the HNN, the usual HMM probability...... parameters are replaced by the outputs of state-specific neural networks. As opposed to many other hybrids, the HNN is normalized globally and therefore has a valid probabilistic interpretation. All parameters in the HNN are estimated simultaneously according to the discriminative conditional maximum...... likelihood criterion. The HNN can be viewed as an undirected probabilistic independence network (a graphical model), where the neural networks provide a compact representation of the clique functions. An evaluation of the HNN on the task of recognizing broad phoneme classes in the TIMIT database shows clear...

  2. [Neural codes for perception].

    Science.gov (United States)

    Romo, R; Salinas, E; Hernández, A; Zainos, A; Lemus, L; de Lafuente, V; Luna, R

    This article describes experiments designed to show the neural codes associated with the perception and processing of tactile information. The results of these experiments have shown the neural activity correlated with tactile perception. The neurones of the primary somatosensory cortex (S1) represent the physical attributes of tactile perception. We found that these representations correlated with tactile perception. By means of intracortical microstimulation we demonstrated the causal relationship between S1 activity and tactile perception. In the motor areas of the frontal lobe is to be found the connection between sensorial and motor representation whilst decisions are being taken. S1 generates neural representations of the somatosensory stimuli which seen to be sufficient for tactile perception. These neural representations are subsequently processed by central areas to S1 and seem useful in perception, memory and decision making.

  3. Neural Oscillators Programming Simplified

    Directory of Open Access Journals (Sweden)

    Patrick McDowell

    2012-01-01

    Full Text Available The neurological mechanism used for generating rhythmic patterns for functions such as swallowing, walking, and chewing has been modeled computationally by the neural oscillator. It has been widely studied by biologists to model various aspects of organisms and by computer scientists and robotics engineers as a method for controlling and coordinating the gaits of walking robots. Although there has been significant study in this area, it is difficult to find basic guidelines for programming neural oscillators. In this paper, the authors approach neural oscillators from a programmer’s point of view, providing background and examples for developing neural oscillators to generate rhythmic patterns that can be used in biological modeling and robotics applications.

  4. Neural cryptography with feedback.

    Science.gov (United States)

    Ruttor, Andreas; Kinzel, Wolfgang; Shacham, Lanir; Kanter, Ido

    2004-04-01

    Neural cryptography is based on a competition between attractive and repulsive stochastic forces. A feedback mechanism is added to neural cryptography which increases the repulsive forces. Using numerical simulations and an analytic approach, the probability of a successful attack is calculated for different model parameters. Scaling laws are derived which show that feedback improves the security of the system. In addition, a network with feedback generates a pseudorandom bit sequence which can be used to encrypt and decrypt a secret message.

  5. Neural cryptography with feedback

    Science.gov (United States)

    Ruttor, Andreas; Kinzel, Wolfgang; Shacham, Lanir; Kanter, Ido

    2004-04-01

    Neural cryptography is based on a competition between attractive and repulsive stochastic forces. A feedback mechanism is added to neural cryptography which increases the repulsive forces. Using numerical simulations and an analytic approach, the probability of a successful attack is calculated for different model parameters. Scaling laws are derived which show that feedback improves the security of the system. In addition, a network with feedback generates a pseudorandom bit sequence which can be used to encrypt and decrypt a secret message.

  6. Neural network applications

    Science.gov (United States)

    Padgett, Mary L.; Desai, Utpal; Roppel, T.A.; White, Charles R.

    1993-01-01

    A design procedure is suggested for neural networks which accommodates the inclusion of such knowledge-based systems techniques as fuzzy logic and pairwise comparisons. The use of these procedures in the design of applications combines qualitative and quantitative factors with empirical data to yield a model with justifiable design and parameter selection procedures. The procedure is especially relevant to areas of back-propagation neural network design which are highly responsive to the use of precisely recorded expert knowledge.

  7. Building Neural Net Software

    OpenAIRE

    Neto, João Pedro; Costa, José Félix

    1999-01-01

    In a recent paper [Neto et al. 97] we showed that programming languages can be translated on recurrent (analog, rational weighted) neural nets. The goal was not efficiency but simplicity. Indeed we used a number-theoretic approach to machine programming, where (integer) numbers were coded in a unary fashion, introducing a exponential slow down in the computations, with respect to a two-symbol tape Turing machine. Implementation of programming languages in neural nets turns to be not only theo...

  8. NEMEFO: NEural MEteorological FOrecast

    Energy Technology Data Exchange (ETDEWEB)

    Pasero, E.; Moniaci, W.; Meindl, T.; Montuori, A. [Polytechnic of Turin (Italy). Dept. of Electronics

    2004-07-01

    Artificial Neural Systems are a well-known technique used to classify and recognize objects. Introducing the time dimension they can be used to forecast numerical series. NEMEFO is a ''nowcasting'' tool, which uses both statistical and neural systems to forecast meteorological data in a restricted area close to a meteorological weather station in a short time range (3 hours). Ice, fog, rain are typical events which can be anticipated by NEMEFO. (orig.)

  9. Ultrasound-Guided Percutaneous Electrolysis and Eccentric Exercises for Subacromial Pain Syndrome: A Randomized Clinical Trial

    OpenAIRE

    José L. Arias-Buría; Sebastián Truyols-Domínguez; Raquel Valero-Alcaide; Jaime Salom-Moreno; María A. Atín-Arratibel; César Fernández-de-las-Peñas

    2015-01-01

    Objective. To compare effects of ultrasound- (US-) guided percutaneous electrolysis combined with an eccentric exercise program of the rotator cuff muscles in subacromial pain syndrome. Methods. Thirty-six patients were randomized and assigned into US-guided percutaneous electrolysis (n = 17) group or exercise (n = 19) group. Patients were asked to perform an eccentric exercise program of the rotator cuff muscles twice every day for 4 weeks. Participants assigned to US-guided percutaneous ele...

  10. Current status of imaging-guided percutaneous ablation of breast cancer.

    Science.gov (United States)

    Fornage, Bruno D; Hwang, Rosa F

    2014-08-01

    The purpose of this article is to briefly describe the various techniques used for percutaneous ablation of breast cancer, their preliminary results, and their limitations. The techniques include thermotherapy (radiofrequency ablation, laser irradiation, microwave irradiation, and insonation with high-intensity focused ultrasound waves), cryotherapy, and irreversible electroporation. The techniques used for percutaneous ablation of breast cancer raise many questions and issues that must be addressed before percutaneous ablation can be adopted for the treatment of early breast cancer.

  11. A neural network model for texture discrimination.

    Science.gov (United States)

    Xing, J; Gerstein, G L

    1993-01-01

    A model of texture discrimination in visual cortex was built using a feedforward network with lateral interactions among relatively realistic spiking neural elements. The elements have various membrane currents, equilibrium potentials and time constants, with action potentials and synapses. The model is derived from the modified programs of MacGregor (1987). Gabor-like filters are applied to overlapping regions in the original image; the neural network with lateral excitatory and inhibitory interactions then compares and adjusts the Gabor amplitudes in order to produce the actual texture discrimination. Finally, a combination layer selects and groups various representations in the output of the network to form the final transformed image material. We show that both texture segmentation and detection of texture boundaries can be represented in the firing activity of such a network for a wide variety of synthetic to natural images. Performance details depend most strongly on the global balance of strengths of the excitatory and inhibitory lateral interconnections. The spatial distribution of lateral connective strengths has relatively little effect. Detailed temporal firing activities of single elements in the lateral connected network were examined under various stimulus conditions. Results show (as in area 17 of cortex) that a single element's response to image features local to its receptive field can be altered by changes in the global context.

  12. Cellular computational platform and neurally inspired elements thereof

    Energy Technology Data Exchange (ETDEWEB)

    Okandan, Murat

    2016-11-22

    A cellular computational platform is disclosed that includes a multiplicity of functionally identical, repeating computational hardware units that are interconnected electrically and optically. Each computational hardware unit includes a reprogrammable local memory and has interconnections to other such units that have reconfigurable weights. Each computational hardware unit is configured to transmit signals into the network for broadcast in a protocol-less manner to other such units in the network, and to respond to protocol-less broadcast messages that it receives from the network. Each computational hardware unit is further configured to reprogram the local memory in response to incoming electrical and/or optical signals.

  13. Numerical simulation with finite element and artificial neural network ...

    Indian Academy of Sciences (India)

    Haggag F M 1993 In-situ measurements of mechanical properties using novel automated ball indentation system. American Society for Testing and Materials, Philadelphia 27–44. Haggag F M, Nanstad R K 1989 Estimation fracture toughness using tension or ball indentation tests and a modified critical strain model.

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

    Directory of Open Access Journals (Sweden)

    Robert Marcovich

    2003-06-01

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

  15. Percutaneous vertebroplasty and spinal cord compression: a case report

    Directory of Open Access Journals (Sweden)

    Ilaria Morghen

    2009-03-01

    Full Text Available

    This report describes a 60-year-old woman with intensive back pain due to metastatic vertebral body collapse, who underwent  percutaneous vertebroplasty. Subsequently, the patient developed metastatic  lesion extrusion into the  spinal canal because of pressure of the cement, with compression of the left anterolateral spinal cord. During percutaneous vertebroplasty procedure in patient with malignant tumors, the complication rate increases owing to the risk of leakage of cement resulting from the vertebral body destruction, but as also seen in our case, for the extrusion of the neoplastic tissue  and increase of the pressure in the vertebral body due to the introduction of the cement.

  16. Percutaneous antegrade ureteric stent removal using a rigid alligator forceps.

    LENUS (Irish Health Repository)

    Given, M F

    2008-12-01

    To evaluate the safety and efficacy of percutaneous antegrade ureteric stent removal using a rigid alligator forceps. Twenty patients were included in our study. Indications for ureteric stent insertion included stone disease (n = 7), malignancy (n = 8) and transplant anastomotic strictures (n = 5). Stent retrieval was carried out for proximal stent placement\\/migration in seven patients and encrustation in the remaining 13. Twenty-two stents were successfully retrieved in 20 patients. There was one technical failure (5%). There were no major complications. We had four minor complications, which included nephrostomy site pain (n = 2), periprocedural sepsis (n = 1) and a small urinoma (n = 1). All patients settled with conservative management. Percutaneous radiologically guided antegrade ureteric stent removal with an alligator forceps is safe and effective, particularly when initial surgical removal has failed.

  17. Hypoplastic left heart syndrome - a review of supportive percutaneous treatment.

    Science.gov (United States)

    Moszura, Tomasz; Góreczny, Sebastian; Dryżek, Paweł

    2014-01-01

    Due to the complex anatomical and haemodynamic consequences of hypoplastic left heart syndrome (HLHS), patients with the condition require multistage surgical and supportive interventional treatment. Percutaneous interventions may be required between each stage of surgical palliation, sometimes simultaneously with surgery as hybrid interventions, or after completion of multistage treatment. Recent advances in the field of interventional cardiology, including new devices and techniques, have significantly contributed to improving results of multistage HLHS palliation. Knowledge of the potential interventional options as well as the limitation of percutaneous interventions will enable the creation of safe and effective treatment protocols in this highly challenging group of patients. In this comprehensive review we discuss the types, goals, and potential complications of transcatheter interventions in patients with HLHS.

  18. Closure of carotid artery puncture site with a percutaneous device.

    Science.gov (United States)

    Massière, Bernardo; von Ristow, Arno; Cury, José Mussa; Gress, Marcus; Vescovi, Alberto; Pedron, Cleoni; Medina, Antônio Luiz; Masques, Marcos Areas; Silveira, Paulo Roberto; Jeha, Salim

    2009-03-01

    The surgical treatment of traumatic neck injuries in patients with hostile anatomy is associated with higher risk of complications, due to the technical challenge and associated clinical conditions. The use of a percutaneous closure device for removal of a 7.5 Fr sheath, nonintentionally implanted into the carotid artery, is reported. The right common carotid sheath was removed after introducing a 0.035-inch guidewire; the Angioseal 8 Fr device was then introduced over the wire, successfully sealing the puncture site. Duplex scan control showed patency of the carotids, sealing of the puncture, and adequate flow in the jugular vein and carotid arteries. This maneuver allowed the safe placement of a percutaneous arterial device (Angioseal) to close the puncture site.

  19. Percutaneous caval filters for the prevention of pulmonary embolism

    Energy Technology Data Exchange (ETDEWEB)

    Guenther, R.W.; Vorwerk, D.

    1988-07-01

    The Kimray-Greenfield filter is the most commonly used of all filters. Percutaneous insertion technique has made this filter more attractive also for interventional radiology. Its drawbacks are, in particular, the large calibre of the insertion instruments and its low effectivity in case of eccentric placing. Good results have been obtained to date with the specially developed cava filters that can be introduced percutaneously. Clinical and experimental studies have shown that some filters are particularly effective, such as the 'basket filter'; at the same time, these have also a higher thrombogenicity. However, independent of the choice of the cava filter, it seems that the operatively inserted filters are increasingly a thing of the past.

  20. Percutaneous left atrial appendage closure for stroke prevention

    DEFF Research Database (Denmark)

    De Backer, Ole; Loupis, Anastasia M; Ihlemann, Nikolaj

    2014-01-01

    INTRODUCTION: In atrial fibrillation (AF) patients with an increased stroke risk, oral anticoagulation (OAC) is the standard treatment for stroke prevention. However, this therapy carries a high risk of major bleeding. Percutaneous closure of the left atrial appendage (LAA) is suggested...... as an alternative option for stroke prevention in AF patients with contraindication(s) for OAC treatment. MATERIAL AND METHODS: A total of 42 patients underwent percutaneous LAA closure. In this report, we describe our experience with this procedure. RESULTS: The patients treated were AF patients with a high stroke...... risk (CHADS-VASc 4.5±1.4) and contra-indication(s) for OAC and/or a high bleeding risk (HAS-BLED 3.7±0.9). A history of intracerebral bleeding was the most common reason for LAA closure. Successful implantation was obtained in 41 of 42 patients. One major peri-procedural complication occurred; a major...

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

    Directory of Open Access Journals (Sweden)

    Lokman Ižrkilata

    2013-10-01

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

  2. The role of ultrasound in percutaneous dilatational tracheostomy.

    Science.gov (United States)

    Rudas, Máté

    2012-11-01

    Background: The use of ultrasound to evaluate cervical anatomy and to guide tracheal puncture in real-time has been advocated to improve safety and efficacy of percutaneous dilatational tracheostomy (PDT) in intensive care. Objective: To review the potential role, attributed theoretical benefits and supporting literature for ultrasound during PDT. Results: A significant number of mostly observational studies and case series support this modality. Real-time guidance enables clear visualisation of anatomical landmarks and results in a consistently high success and low complication rate, with appropriate positioning of the tracheal puncture. Recognition of unconventional vascular anatomy enables selection of an appropriate alternative puncture site or an elective open surgical approach. Conclusion: Current literature supports that using ultrasound for percutaneous tracheostomy is quick, safe, reliable and offers a plausible advantage over the traditional landmark guided procedure, especially in select patient groups, such as those who are morbidly obese or have difficult to palpate cervical anatomy.

  3. Ontology Mapping Neural Network: An Approach to Learning and Inferring Correspondences among Ontologies

    Science.gov (United States)

    Peng, Yefei

    2010-01-01

    An ontology mapping neural network (OMNN) is proposed in order to learn and infer correspondences among ontologies. It extends the Identical Elements Neural Network (IENN)'s ability to represent and map complex relationships. The learning dynamics of simultaneous (interlaced) training of similar tasks interact at the shared connections of the…

  4. Percutaneous jejunostomy through the liver parenchyma for palliation of afferent loop syndrome.

    Science.gov (United States)

    Kwon, Jae Hyun; Han, Yoon Hee

    2015-01-01

    In the treatment of afferent loop syndrome, jejunostomy or Roux-en-Y gastrojejunostomy have tended to represent the preferred procedures. In patients who are not good candidates for surgery, palliative treatment-i.e., percutaneous transhepatic biliary drainage or percutaneous direct transperitoneal jejunostomy techniques-have been applied. Transhepatic biliary drainage confers a risk of ascending cholangitis. Direct percutaneous transperitoneal drainage may be impractical when overlying bowel loops prevent access to deeply located afferent loops. In the present case, percutaneous jejunostomy through the liver parenchyma was performed successfully for palliation of afferent loop syndrome.

  5. Percutaneous ultrasonic tenotomy for chronic elbow tendinosis: a prospective study.

    Science.gov (United States)

    Barnes, Darryl E; Beckley, James M; Smith, Jay

    2015-01-01

    Elbow tendinopathy is the most common cause of elbow pain affecting active populations. Surgical excision is reserved for patients with refractory symptoms. Percutaneous ultrasonic tenotomy performed under local anesthesia also removes degenerated tissue and therefore provides an alternative treatment option to surgical excision. This investigation prospectively documented the safety and 1-year efficacy of ultrasonic percutaneous tenotomy performed by a single operator. Nineteen patients, aged 38 to 67 years, in whom >6 months of conservative management for medial (7) or lateral (12) elbow tendinopathy had failed were prospectively studied. All patients were treated with percutaneous ultrasonic tenotomy of the elbow by a single operator. Visual analog scale (VAS) for pain, the 11-item version of the Disabilities of the Arm, Shoulder, and Hand (Quick DASH) index, and the Mayo Elbow Performance Score (MEPS) were assessed by an independent observer before treatment and at 6 weeks, 3 months, 6 months, and 12 months after treatment. No procedural complications occurred. Total treatment time was <15 minutes, and ultrasonic energy time averaged 38.6 ± 8.8 seconds per procedure. Average VAS scores were significantly improved from 6.4 to 2.6 at 6 weeks and were 0.7 at 12 months (P < .0001). Similar improvement occurred with the Quick DASH (pretreatment, 44.1; 12 months, 8.6, P < .0001) and MEPS (pretreatment, 59.1; 12 months, 83.4; P < .0001). Percutaneous ultrasonic tenotomy performed under local anesthesia appears to be a safe and effective treatment option for chronic, refractory lateral or medial elbow tendinopathy up to 1 year after the procedure. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  6. Sheath hemorrhage after percutaneous ventricular assist device implantation.

    Science.gov (United States)

    Siddiqi, Saadi; Ganga, Harsha V; Dhesi, Pavittarpaul; Azemi, Talhat; Chamakura, Sanjayant; Kiernan, Francis J; Hammond, Jonathan A; Sadiq, Immad R

    2014-04-01

    Technical advances in temporary ventricular assist devices (VADs) continue to progress, allowing for percutaneous implantation during times of hemodynamic instability. However, device delivery systems, i.e., sheaths, lag in their ability to sustain the mechanical demands of these VADs for extended periods. We propose both a novel technique and the implementation of an emergency preparedness plan to be enacted specifically during those times when delivery systems fail thereby leading to potentially catastrophic bleeding complications.

  7. Percutaneous transluminal angioplasty of infrarenal arteries in intermittent claudication

    DEFF Research Database (Denmark)

    Henriksen, L O; Jørgensen, B; Holstein, P E

    1988-01-01

    Percutaneous transluminal angioplasty was performed on 55 iliac and 31 femoropopliteal arteries in 71 patients with intermittent claudication (23 women, 48 men). The two-year patency rate was 80% after iliac and 41% after femoropopliteal angioplasty. In 17 femoropopliteal cases with lesions greater...... in intermittent claudication is indicated for all cases of occlusion or stenosis of the iliac artery and for occlusion or stenosis shorter than 5 cm of the superficial femoral or the popliteal artery....

  8. Percutaneous endoscopic gastrostomy tube replacement: A simple procedure?

    OpenAIRE

    Lohsiriwat, Varut

    2013-01-01

    Replacement of gastrostomy tube in patients undergoing percutaneous endoscopic gastrostomy (PEG) is generally considered as a safe and simple procedure. However, it could be associated with serious complications, such as gastrocutaneous tract disruption and intraperitoneal tube placement, which may lead to chemical peritonitis and even death. When PEG tube needs a replacement (e.g., occlusion or breakage of the tube), clinicians must realize that the gastrocutaneous tract of PEG is more friab...

  9. Percutaneous ablation and retrieval of a right atrial myxoma.

    Science.gov (United States)

    Konecny, Tomas; Reeder, Guy; Noseworthy, Peter A; Konecny, Dana; Carney, J Aidan; Asirvatham, Samuel J

    2014-11-01

    We report the first case of percutaneous myxoma ablation and retrieval from the right atrium. This novel procedure may reduce the need for repeat surgical excisions in patients with Carney Complex and other recurrent myxoma syndromes. Copyright © 2014 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  10. Predictors of outcomes of percutaneous vertebroplasty for osteoporotic vertebral fractures.

    Science.gov (United States)

    Alvarez, Luis; Pérez-Higueras, Antonio; Granizo, Juan J; de Miguel, Ignacio; Quiñones, Diana; Rossi, Roberto E

    2005-01-01

    Retrospective review of all percutaneous vertebroplasties performed in the authors' institution from November 1994 to June 2002. OBJECTIVE.: To determine the factors affecting the outcome of percutaneous vertebroplasty for the treatment of persistent painful osteoporotic fractures. Percutaneous vertebroplasty is an efficient procedure to treat pain due to osteoporotic vertebral fracture. However, the patient population that is most likely to benefit from this procedure is uncertain, and the inclusion and exclusion criteria for an ideal candidate have varied widely in the literature. A retrospective review of 278 percutaneous vertebroplasty procedures for osteoporotic fractures at 423 levels was performed. Sociodemographic, clinical, radiologic, and procedural data were analyzed as parameters for prognosis significance by univariate and multivariate analysis with logistic regression to estimate the strength of influence of each variable. The presence of two or less symptomatic vertebrae (P < 0.03), the American Society of Anesthesiologists status I (P < 0.001), the presence of signal changes on magnetic resonance imaging (P < 0001), and the collapse of the vertebral body less than 70% (P < 0.001) were assessed as parameters for prognostic significance. Multivariate analysis also showed a significant correlation between the American Society of Anesthesiologists score and height loss of the vertebral body and the final outcome. The presence of signal changes on magnetic resonance imaging showed the highest odds ratio adjusted. Appropriate patient selection is essential for achieving clinical success. Better results can be expected in patients with an American Society of Anesthesiologists score of I and when the level managed is confirmed by magnetic resonance imaging and the vertebral body height loss is less than 70%.

  11. [Percutaneous dilatational tracheotomy or tracheostomy? Two case reports].

    Science.gov (United States)

    Bast, F; Buchal, A; Schrom, T

    2015-03-01

    In terms of numbers, percutaneous dilatational tracheotomy (PDT) is the most important tracheotomy technique since it is applied in surgical and nonsurgical disciplines. Where correctly indicated, PDT is a fast, economical and easily reversible procedure. Incorrect indication sometimes necessitates conversion of a PDT into a conventional surgical tracheostomy. In these cases scarring, wound infections and ambiguous anatomical structures can represent a surgical challenge. Where a long-term tracheotomy requirement is predicted, a surgical tracheostomy should be performed.

  12. CT-Guided Percutaneous Biopsy of Intrathoracic Lesions

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-03-15

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

  13. Percutaneous selective radiofrequency nerve ablation for glabellar frown lines.

    Science.gov (United States)

    Kim, Jun Hyung; Jeong, Jin Wook; Son, Daegu; Han, Kihwan; Lee, So Young; Choi, Tae Hyun; Chang, David W

    2011-09-01

    The dynamic muscles of the glabellar region can be overactive, giving patients a "scowling" look and making them appear angry, worried, or stressed. The authors describe percutaneous selective nerve ablation, a minimally-invasive procedure for treatment of glabellar frown lines, and report results from a series of patients treated with the technique. From November 2007 to December 2009, 27 patients (22 women and five men) underwent percutaneous selective nerve ablation to improve glabellar frown lines. Initially, the surface pathway of the nerve to the corrugator supercilii and procerus was checked with a peripheral nerve stimulator. For percutaneous localization, a 22-gauge monopolar electrode was introduced into the lateral brow and cheek skin without incision. Short electrical stimulation (0.3-0.5 mA) was delivered to identify the proper lesion sites. Synchronous contraction of corrugator supercilii was elicited and radiofrequency nerve ablation performed (85°C, 70 seconds). In all patients, the frontal branch of the facial nerve and angular nerve were treated bilaterally. The improvement was evaluated with the Wrinkle Assessment Scale. Mean patient age was 54.5 years, and mean follow-up time was 18 months (range, 12-26 months). One patient had superficial second-degree burns to the brow skin, which healed with conservative treatment. Two patients had temporary paresthesia that completely resolved in a few weeks without sequelae. The Wrinkle Assessment Scale indicated a statistically significant improvement in the glabellar frown lines (preoperative vs postoperative mean, 3.7 vs 1.8; P safety and efficacy of percutaneous selective nerve ablation.

  14. Tumor extension along percutaneous transhepatic biliary drainage tracts

    Energy Technology Data Exchange (ETDEWEB)

    Tersigni, R.; Bochicchio, O.; Cavallini, M.; Bufalini, G.; Alessandroni, L.; Arena, L.; Armeni, O.; Miraglia, F.; Stipa, S.; Rossi, P.

    1986-11-01

    Percutaneous Transhepatic Biliary Catheterization is commonly employed in the diagnosis and management of obstructive jaundice associated with malignant lesions. Tumor manipulation as an effort to obtain a histological diagnosis or to establish short or long-term internal-external biliary drainage is liable to disseminate the malignancy along the catheter tract. Two cases of malignant seeding of the catheter tract after biliary drainage have been observed.

  15. Percutaneous ultrasonic lithotripsy of symptomatic renal calculi in children

    Energy Technology Data Exchange (ETDEWEB)

    Papanicolaou, N.; Pfister, R.C.; Yoder, I.C.; Young, H.H. II; Herrin, J.T.

    1986-01-01

    Percutaneous ultrasonic lithotripsy of upper urinary tract lithiasis is a well-established procedure in adults. We successfully applied this technique to completely remove symptomatic renal calculi in two children with idiopathic hypercalciuria. The procedure was well tolerated and no complications occurred. Both patients were discharged within 4 days of the lithotripsy. This method is an alternative to surgery for the removal of large or impacted calculi from the upper urinary tracts of pediatric patients. (orig.).

  16. Nefopam Reduces Dysesthesia after Percutaneous Endoscopic Lumbar Discectomy

    OpenAIRE

    Ok, Young Min; Cheon, Ji Hyun; Choi, Eun Ji; Chang, Eun Jung; Lee, Ho Myung; Kim, Kyung Hoon

    2016-01-01

    Background Neuropathic pain, including paresthesia/dysesthesia in the lower extremities, always develops and remains for at least one month, to variable degrees, after percutaneous endoscopic lumbar discectomy (PELD). The recently discovered dual analgesic mechanisms of action, similar to those of antidepressants and anticonvulsants, enable nefopam (NFP) to treat neuropathic pain. This study was performed to determine whether NFP might reduce the neuropathic pain component of postoperative pa...

  17. PERCUTANEOUS DISCECTOMY: A CURRENT TREATMENT FOR LUMBAR DISC HERNIATION

    OpenAIRE

    Pablo Gerardo Lima-Ramírez; David Benavides-Rodríguez; Juan Yahir Viera-Ordóñez; José Augusto Ruíz-Gurría; Iván del Castillo-Vergara; Braulio Hernández Carbajal; Diego Fernando León-López

    2016-01-01

    ABSTRACT Objective: Describe the functional outcomes of patients with contained lumbar disc herniation (L4-L5, L5-S1) treated with manual percutaneous nucleotomy (MPN) and demonstrate that it remains a technique with good results. Methods: A prospective, longitudinal study with 110 patients contained with lumbar disc herniation (LDH) treated with (MPN). The evaluation was pre-surgical and 4, 30, 180 and 365 days after the surgery. We used Numeric Pain Scale (NPS), Oswestry Disability Index ...

  18. Feasibility of percutaneous contrast ultrasound-guided cholecystography in dogs.

    Science.gov (United States)

    Ji, Seoyeoun; Jung, Sunyoung; Kim, Boeun; Jung, Joohyun; Yoon, Junghee; Choi, Mincheol

    2015-01-01

    Differentiating hepatocellular disease versus biliary obstruction can be challenging in dogs presented for icterus. The purpose of this prospective study was to determine the feasibility of percutaneous contrast ultrasound-guided cholecystography in dogs. Ten normal dogs weighing 7.6-13.0 kg (median 9.8 kg) were recruited. All dogs were considered normal based on complete blood count, serum chemistry profile, ultrasound examination, and percutaneous radiographic cholecystography. Percutaneous contrast ultrasound-guided cholecystography was performed using 0.5 ml of commercially available contrast agent and two conventional ultrasound machines for simultaneous scanning at two different locations. Two observers independently evaluated the time to initial detection of contrast in the proximal duodenum and duration of contrast enhancement via visual monitoring. Dynamic contrast enhancement was calculated using time-intensity curves. Mean (± SD) and median (range) of time to initial detection were 8.60 s (± 3.35) and 8.0 s (2.0-11.0), respectively, and mean and median duration were 50.45 s (± 23.24) and 53.0 s (20.0 - 70.0), respectively. Mean, median, and range of peak intensity were 114.1 mean pixel value (MPV) (SD ± 30.7), 109.2 MPV, and 79.7-166.7, respectively, and mean, median, and range of time to peak intensity were 26.1 s (SD ± 7.1 s), 24.0 s, and 19.0-41.0 s, respectively. Findings indicated that percutaneous contrast ultrasound-guided cholecystography is a feasible technique for detecting and quantifying patency of the bile duct in normal dogs. Future studies are needed to assess the diagnostic utility of this technique for dogs with biliary obstruction. © 2014 American College of Veterinary Radiology.

  19. Comparative Study between Standard and Totally Tubeless Percutaneous Nephrolithotomy

    OpenAIRE

    Yun, Sung Il; Lee, Yoon Hyung; Kim, Jae Soo; Cho, Sung Ryong; Kim, Bum Soo; Kwon, Joon Beom

    2012-01-01

    Purpose Several recent studies have reported the benefits of tubeless percutaneous nephrolithotomy (PNL). Postoperatively, tubeless PNL patients have an indwelling ureteral stent placed, which is often associated with stent-related morbidity. We have performed totally tubeless (tubeless and stentless) PNL in which no nephrostomy tube or ureteral stent is placed postoperatively. We evaluated the safety, effectiveness, and feasibility of totally tubeless PNL. Materials and Methods From March 20...

  20. Percutaneous gastrostomy tube placement in patients with ventriculoperitoneal shunts

    Energy Technology Data Exchange (ETDEWEB)

    Sane, S.S.; Towbin, A.; Bergey, E.A.; Kaye, R.D.; Fitz, C.R.; Albright, L.; Towbin, R.B. [Department of Radiology, Children`s Hospital of Pittsburgh, 3705 Fifth Avenue, Pittsburgh, PA 15213 (United States)

    1998-07-01

    Objective. The purpose of this study is to determine the risk of CNS and/or peritoneal infection in children with ventriculoperitoneal shunts in whom a percutaneous gastrostomy tube is placed. Materials and methods. We placed 205 gastrostomy or gastrojejunostomy tubes from January of 1991 to December 1996. Twenty-three patients (10 boys, 13 girls) had ventriculoperitoneal shunts at the time of placement. All shunts were placed at least 1 month prior to placement of the gastrostomy tube. The patients ranged in age from 8 months to 16 years with a mean age of 6 years, 9 months. Patient weight ranged from 2 kg to 60 kg. All 23 children required long-term nutritional support due to severe neurologic impairment. No prophylactic antibiotics were given prior to the procedure. Of the patients, 21/23 had a 14-F Sacks-Vine gastrostomy tube with a fixed terminal retention device inserted, using percutaneous fluoroscopic antegrade technique. Two of the 23 patients had a Ross 14-F Flexi-flo gastrostomy tube which required a retrograde technique due to a small caliber esophagus in these children. Results. All 23 children had technically successful placements of percutaneous gastrostomy (7) or gastrojejunostomy (16) tubes. Of the children, 21/23 (91 %) had no complications from the procedure. Two of 23 (9 %) patients demonstrated signs of peritonitis after placement of their gastrostomy tubes and subsequently had shunt infections. In both, children CSF culture grew gram-positive cocci. The antegrade technique was used in both children who developed peritonitis. Conclusion. Our study indicates children with ventriculoperitoneal shunts who undergo percutaneous gastrostomy are at greater risk for infection and subsequent shunt malfunction. Therefore, we recommend prophylactic antibiotic therapy to cover for skin and oral flora. (orig.) With 1 fig., 7 refs.

  1. Percutaneous transluminal alcohol septal myocardial ablation after aortic valve replacement

    Science.gov (United States)

    Sitges, M.; Kapadia, S.; Rubin, D. N.; Thomas, J. D.; Tuzcu, M. E.; Lever, H. M.

    2001-01-01

    When left ventricular outflow tract obstruction develops after aortic valve replacement, few treatment choices have been available until now. We present a patient with prior aortic valve replacement who developed left ventricle outflow tract obstruction that was successfully treated with a percutaneous transcoronary myocardial septal alcohol ablation. This technique is a useful tool for the treatment of obstructive hypertrophic cardiomyopathy, especially in those patients with prior heart surgery. Copyright 2001 Wiley-Liss, Inc.

  2. Posterior Ischemic Optic Neuropathy Following Percutaneous Nephrolithotomy

    Directory of Open Access Journals (Sweden)

    Mohammad Pakravan

    2008-12-01

    Full Text Available

    PURPOSE: To report a case of posterior ischemic optic neuropathy (PION following percutaneous nephrolithotomy (PCNL. CASE REPORT: A 57-year-old man with history of diabetes mellitus, hyperlipidemia and mild anemia underwent PCNL for treatment of nephrolithiasis. He noticed painless visual loss in both eyes immediately after the procedure. Visual acuity was light perception, however ophthalmologic examinations were unremarkable and the optic discs were pink with no swelling. Visual fields were severely affected, but neuro-imaging was normal. Within three months, visual acuity and visual fields improved dramatically but the optic discs became slightly pale. CONCLUSION: This is the first report of PION following PCNL. PION is a rare cause of severe visual loss following surgery. Severe blood loss, hypotension, anemia and body position during surgery are the most important risk factors. Ophthalmologists, urologists and anesthesiologists should be aware of this condition and this rare possibility should be considered prior to surgery.

  1. Ultrasound-guided percutaneous core needle biopsy of splenic lesions

    Energy Technology Data Exchange (ETDEWEB)

    Park, SangIk; Shin, Yong Moon; Won, Hyung Jin; Kim, Pyo Nyun; Lee, Moon Gyu [Dept. of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of)

    2017-05-15

    To evaluate the safety and efficacy of ultrasound-guided percutaneous core needle biopsy of splenic lesions. This retrospective study included 30 patients who underwent percutaneous core needle biopsy of their splenic lesions using 18- or 20-gauge needles between January 2001 and July 2016 in a single tertiary care center. The characteristics of the splenic lesions were determined by reviewing the ultrasound and computed tomography examinations. Acquisition rate and diagnostic accuracy were calculated, using pathologic results of the splenectomy specimen, clinical course and/or imaging follow-up as a reference standard. Post-procedure complications were identified from electronic medical records, laboratory findings and computed tomography images. Seventy-three specimens were obtained from the 30 patients and splenectomy was performed in 2 patients. Twenty-nine of the 30 patients had focal splenic lesions, while the remaining patient had homogeneous splenomegaly. Acquisition rate and diagnostic accuracy were 80.0% (24/30) and 76.7% (23/30), respectively. Perisplenic hemorrhage without hemodynamic instability developed in one patient. Ultrasound-guided percutaneous core needle biopsy of splenic lesions is a safe method for achieving a histopathologic diagnosis and can be considered as an alternative to splenectomy in patients with a high risk of splenectomy-related complications.

  2. Osteoid osteoma: fluoroscopic guided percutaneous excision technique - our experience.

    Science.gov (United States)

    Marić, Dušan; Djan, Igor; Petković, Lazar; Vidosavljević, Marko; Sopta, Jelena; Marić, Dušica; Madić, Dejan

    2011-01-01

    Osteoid osteoma is a small benign bone lesion. It generally affects children and young adults. Traditional treatment of osteoid osteoma includes excision either by wide resection, or by the removal of the nidus using curettes and burrs after opening the overlying cortex. Newly developed techniques involve percutaneous ablation of the tumor by computed tomography-guided core-drill excision and destruction of the nidus by thermocoagulation. Fluoroscopic guided percutaneous extirpation and drilling resection procedures have been performed at the Institute for Health Care of Children and Youth, Pediatric Surgery Clinic in Novi Sad, Serbia. Some modifications in the methods were made and implemented, which resulted in an excellent cost-benefit ratio, shorter period of hospitalization, and faster recovery. The aim of this paper is to present the experience gained in the treatment of osteoid osteomas in the last 5 years at the Pediatric Surgery Clinic in Novi Sad and to describe the modifications to the percutaneous biopsy technique of osteoid osteoma that have been implemented.

  3. Radiologic Percutaneous Gastrostomy in Nondistended Stomach: A Modified Approach

    Energy Technology Data Exchange (ETDEWEB)

    Petrocelli, Francesco, E-mail: francesco.petrocelli@hsanmartino.it; Salsano, Giancarlo, E-mail: giancarlo.salsano@yahoo.it; Bovio, Giulio, E-mail: giulio.bovio@hsanmartino.it; Camerano, Francesco, E-mail: francesco.camerano@gmail.com; Utili, Alice, E-mail: aliceutili@gmail.com; Ferro, Carlo, E-mail: carlo.ferro@hsanmartino.it [IRCCS San Martino University Hospital, Department of Radiology and Interventional Radiology (Italy)

    2016-07-15

    IntroductionGastrostomy tube placement for patients requiring long-term nutritional support may be performed using different techniques including endoscopic, surgical, and percutaneous radiologically guided methods. Radiologically inserted gastrostomy (RIG), typically performed when percutaneous endoscopic gastrostomy is not possible, requires proper gastric distension that is achieved by insufflating air through a nasogastric tube. We describe a simple technique to prevent air escape from the stomach during gastrostomy tube placement. To the best of our knowledge, this technique has not yet been described in the literature.Materials and MethodsFour patients with unsuccessful percutaneous endoscopic gastrostomy were referred for fluoroscopic-guided gastrostomy. One patient had a pyriform sinus tumor and three had an ischemic stroke causing dysphagia. Gastric distention was not achieved in the patients due to air escaping into the bowel during the standard RIG procedure. A modified approach using a balloon catheter inflated in the pylorus to avoid air passing into the duodenum permitted successful RIG.ResultsThe modified RIG procedure was successfully carried out in all cases without complications.DiscussionInadequate air distension of the stomach is an unusual event that causes a failure of gastrostomy tube placement and an increased risk of both major and minor complications. The use of a balloon catheter inflated in the first part of the duodenum prevents the air passage into the bowel allowing the correct positioning of the gastrostomy.

  4. Percutaneous extraction of transvenous permanent pacemaker/defibrillator leads.

    Science.gov (United States)

    Paraskevaidis, Stylianos; Konstantinou, Dimitrios; Vassilikos, Vassilios; Theofilogiannakos, Efstratios; Mantziari, Lilian; Megarisiotou, Athanasia; Galitsianos, Ioannis; Karvounis, Charalambos

    2014-01-01

    Widespread use of cardiovascular implantable electronic devices has inevitably increased the need for lead revision/replacement. We report our experience in percutaneous extraction of transvenous permanent pacemaker/defibrillator leads. Thirty-six patients admitted to our centre from September 2005 through October 2012 for percutaneous lead extraction were included. Lead removal was attempted using Spectranetics traction-type system (Spectranetics Corp., Colorado, CO, USA) and VascoExtor countertraction-type system (Vascomed GmbH, Weil am Rhein, Germany). Lead extraction was attempted in 59 leads from 36 patients (27 men), mean ± SD age 61 ± 5 years, with permanent pacemaker (n = 25), defibrillator (n = 8), or cardiac resynchronisation therapy (n = 3) with a mean ± SD implant duration of 50 ± 23 months. The indications for lead removal included pocket infection (n = 23), endocarditis (n = 2), and ventricular (n = 10) and atrial lead dysfunction (n = 1). Traction device was used for 33 leads and countertraction device for 26 leads. Mean ± SD fluoroscopy time was 4 ± 2 minutes/lead for leads implanted lead for leads implanted >48 months (n = 21), P = 0.03. Complete procedural success rate was 91.7% and clinical procedural success rate was 100%, while lead procedural success rate was 95%. In conclusion, percutaneous extraction of transvenous permanent pacemaker/defibrillator leads using dedicated removal tools is both feasible and safe.

  5. Percutaneous Retrieval of Permanent Inferior Vena Cava Filters

    Energy Technology Data Exchange (ETDEWEB)

    Tamrazi, Anobel, E-mail: atamraz1@jhmi.edu; Wadhwa, Vibhor, E-mail: vwadhwa1@jhmi.edu; Holly, Brian, E-mail: bholly3@jhmi.edu [Johns Hopkins University School of Medicine, Division of Vascular & Interventional Radiology (United States); Bhagat, Nikhil, E-mail: nikhibhagat@gmail.com [Kaiser Permanente, Division of Vascular & Interventional Radiology (United States); Marx, Jonathan K., E-mail: jmarx9@jhmi.edu [Johns Hopkins University School of Medicine, Division of Vascular & Interventional Radiology (United States); Streiff, Michael, E-mail: mstreif@jhmi.edu [Johns Hopkins University School of Medicine, Department of Hematology (United States); Lessne, Mark L., E-mail: mlessne@gmail.com [Johns Hopkins University School of Medicine, Division of Vascular & Interventional Radiology (United States)

    2016-04-15

    PurposeTo evaluate the feasibility, risks, and techniques of percutaneous removal of permanent TrapEase and Simon Nitinol IVC filters.Materials and MethodsBetween August 2011 and August 2015, 12 patients (5 women, 7 men; age range, 26–75 years) underwent an attempt at percutaneous removal of permanent TrapEase (10) and Simon Nitinol (2) IVC filters due to a history of IVC filter complications or need for lifelong anticoagulation due to the filter. Medical records were reviewed for filter dwell time, presence of iliocaval deep venous thrombosis, procedural technique, and complications.ResultsFilter dwell times ranged from 7 days to 15 years (mean 5.1 years). Successful removal of permanent IVC filters was possible in 11 of 12 patients (91.6 %). In 1 patient, a chronically thrombosed IVC filter could not be removed despite laser sheath assistance, but was successfully recanalized with the PowerWire RF guidewire. In the failed retrieval attempt, a stent was placed through the chronically thrombosed IVC filter with restoration of in-line flow. One major complication of large venous groin hematoma was encountered.ConclusionsIn carefully selected patients, percutaneous removal of permanent IVC filters can be performed safely despite prolonged filter dwell times. Extraction of chronically embedded permanent IVC filters may be facilitated by jugular and femoral approaches, often with laser sheath assistance. Chronic filter thrombosis and caval scarring may increase the risk of retrieval failure.

  6. At the interface: convergence of neural regeneration and neural prostheses for restoration of function.

    Science.gov (United States)

    Grill, W M; McDonald, J W; Peckham, P H; Heetderks, W; Kocsis, J; Weinrich, M

    2001-01-01

    The rapid pace of recent advances in development and application of electrical stimulation of the nervous system and in neural regeneration has created opportunities to combine these two approaches to restoration of function. This paper relates the discussion on this topic from a workshop at the International Functional Electrical Stimulation Society. The goals of this workshop were to discuss the current state of interaction between the fields of neural regeneration and neural prostheses and to identify potential areas of future research that would have the greatest impact on achieving the common goal of restoring function after neurological damage. Identified areas include enhancement of axonal regeneration with applied electric fields, development of hybrid neural interfaces combining synthetic silicon and biologically derived elements, and investigation of the role of patterned neural activity in regulating various neuronal processes and neurorehabilitation. Increased communication and cooperation between the two communities and recognition by each field that the other has something to contribute to their efforts are needed to take advantage of these opportunities. In addition, creative grants combining the two approaches and more flexible funding mechanisms to support the convergence of their perspectives are necessary to achieve common objectives.

  7. Does previous open renal surgery or percutaneous nephrolithotomy affect the outcomes and complications of percutaneous nephrolithotomy.

    Science.gov (United States)

    Ozgor, Faruk; Kucuktopcu, Onur; Sarılar, Omer; Toptas, Mehmet; Simsek, Abdulmuttalip; Gurbuz, Zafer Gokhan; Akbulut, Mehmet Fatih; Muslumanoglu, Ahmet Yaser; Binbay, Murat

    2015-11-01

    In this study, we aim to evaluate the effectiveness and safety of PNL in patients with a history of open renal surgery or PNL by comparing with primary patients and to compare impact of previous open renal surgery and PNL on the success and complications of subsequent PNL. Charts of patients, who underwent PNL at our institute, were analyzed retrospectively. Patients were divided into three groups according to history of renal stone surgery. Patients without history of renal surgery were enrolled into Group 1. Other patients with previous PNL and previous open surgery were categorized as Group 2 and Group 3. Preoperative characteristic, perioperative data, stone-free status, and complication rates were compared between the groups. Stone-free status was accepted as completing clearance of stone and residual fragment smaller than 4 mm. Eventually, 2070 patients were enrolled into the study. Open renal surgery and PNL had been done in 410 (Group 2) and 131 (Group 3) patients, retrospectively. The mean operation time was longer (71.3 ± 33.5 min) in Group 2 and the mean fluoroscopy time was longer (8.6 ± 5.0) in Group 3 but there was no statistically significant difference between the groups. Highest stone clearance was achieved in primary PNL patients (81.62%) compared to the other groups (77.10% in Group 2 and 75.61% in Group 3). Stone-free rate was not significantly different between Group 2 and Group 3. Fever, pulmonary complications, and blood transfusion requirement were not statically different between groups but angioembolization was significantly higher in Group 2. Percutaneous nephrolithotomy is a safe and effective treatment modality for patients with renal stones regardless history of previous PNL or open renal surgery. However, history of open renal surgery but not PNL significantly reduced PNL success.

  8. Bioinorganic Life and Neural Activity: Toward a Chemistry of Consciousness?

    Science.gov (United States)

    Chang, Christopher J

    2017-03-21

    Identifying what elements are required for neural activity as potential path toward consciousness, which represents life with the state or quality of awareness, is a "Holy Grail" of chemistry. As life itself arises from coordinated interactions between elements across the periodic table, the majority of which are metals, new approaches for analysis, binding, and control of these primary chemical entities can help enrich our understanding of inorganic chemistry in living systems in a context that is both universal and personal.

  9. Percutaneous vertebroplasty for treatment of thoracolumbar spine bursting fracture.

    Science.gov (United States)

    Chen, Jyi-Feng; Lee, Shih-Tseng

    2004-12-01

    Percutaneous vertebroplasty can be very beneficial for patients with vertebral osteoporotic compression fractures. To the best of our knowledge, however, there has been no mention in any literature regarding the use of percutaneous vertebroplasty for the treatment of spinal burst fracture. A preliminary study was conducted on 6 patients with traumatic burst fractures of vertebrae treated with percutaneous vertebroplasty starting in June 2000. Fractures involving the anterior and middle columns of the vertebrae and the canal were mildly compressed by the retropulsed bone fragment. However, there was no obvious neurologic deficit in these patients. They initially underwent conservative treatment and thoracolumbar spinal orthosis (TLSO) brace for at least 3 months, but the intractable pain caused patients to be bedridden for prolonged periods of time and limited daily activity. As a result, the patients underwent percutaneous vertebroplasty with polymethylmethacrylate (PMMA) for treatment of spinal burst fractures. Six male patients (mean age: 38.2) who suffered from burst fractures of vertebrae with disabling back pain refractory to analgesic therapy and TLSO brace were treated in this study. The duration of conservation treatment period was 3.5 months to 8 months (mean: 5.2 months). There was no motility. However, 4 vertebrae (66.7%), on radiographs revealed evidence of PMMA leakage through the endplate fracture site into either the disc space or the paravertebral space, without any evident clinical symptoms. No intracanal leakage was seen, and no patient needed a secondary surgical intervention. Pain decreased from 84.3 +/- 5.4 mm at baseline to 34.7 +/- 4.4 mm at the third postoperative day, 30.2 +/- 5.8 at 3 months and 24 +/- 3.5 mm at 12 months. The reduction in pain from baseline to the 3-day and 3 month mark was statistically significant (p < 0.05). The mobility was at least 2 levels of improvement (mean improvement 2.7 points) at 12-months postoperative. In

  10. Conducting Polymers for Neural Prosthetic and Neural Interface Applications

    Science.gov (United States)

    2015-01-01

    Neural interfacing devices are an artificial mechanism for restoring or supplementing the function of the nervous system lost as a result of injury or disease. Conducting polymers (CPs) are gaining significant attention due to their capacity to meet the performance criteria of a number of neuronal therapies including recording and stimulating neural activity, the regeneration of neural tissue and the delivery of bioactive molecules for mediating device-tissue interactions. CPs form a flexible platform technology that enables the development of tailored materials for a range of neuronal diagnostic and treatment therapies. In this review the application of CPs for neural prostheses and other neural interfacing devices are discussed, with a specific focus on neural recording, neural stimulation, neural regeneration, and therapeutic drug delivery. PMID:26414302

  11. Implications of zinc on fetal neural tube defects | Vats | Internet ...

    African Journals Online (AJOL)

    More investigations on zinc status in mothers during antenatal period, especially in the prenatal development and antenatal zinc status including normal babies and NTD babies are required at population level. Keywords: Neural Tube Defect; Trace Element; Zinc Internet Journal of Medical Update 2012 July;7(2):19-24 ...

  12. Hyperbolic Hopfield neural networks.

    Science.gov (United States)

    Kobayashi, M

    2013-02-01

    In recent years, several neural networks using Clifford algebra have been studied. Clifford algebra is also called geometric algebra. Complex-valued Hopfield neural networks (CHNNs) are the most popular neural networks using Clifford algebra. The aim of this brief is to construct hyperbolic HNNs (HHNNs) as an analog of CHNNs. Hyperbolic algebra is a Clifford algebra based on Lorentzian geometry. In this brief, a hyperbolic neuron is defined in a manner analogous to a phasor neuron, which is a typical complex-valued neuron model. HHNNs share common concepts with CHNNs, such as the angle and energy. However, HHNNs and CHNNs are different in several aspects. The states of hyperbolic neurons do not form a circle, and, therefore, the start and end states are not identical. In the quantized version, unlike complex-valued neurons, hyperbolic neurons have an infinite number of states.

  13. Neural Semantic Encoders.

    Science.gov (United States)

    Munkhdalai, Tsendsuren; Yu, Hong

    2017-04-01

    We present a memory augmented neural network for natural language understanding: Neural Semantic Encoders. NSE is equipped with a novel memory update rule and has a variable sized encoding memory that evolves over time and maintains the understanding of input sequences through read, compose and write operations. NSE can also access multiple and shared memories. In this paper, we demonstrated the effectiveness and the flexibility of NSE on five different natural language tasks: natural language inference, question answering, sentence classification, document sentiment analysis and machine translation where NSE achieved state-of-the-art performance when evaluated on publically available benchmarks. For example, our shared-memory model showed an encouraging result on neural machine translation, improving an attention-based baseline by approximately 1.0 BLEU.

  14. The neural crest and neural crest cells: discovery and significance ...

    Indian Academy of Sciences (India)

    In this paper I provide a brief overview of the major phases of investigation into the neural crest and the major players involved, discuss how the origin of the neural crest relates to the origin of the nervous system in vertebrate embryos, discuss the impact on the germ-layer theory of the discovery of the neural crest and of ...

  15. Artificial intelligence: Neural network model as the multidisciplinary team member in clinical decision support to avoid medical mistakes

    Directory of Open Access Journals (Sweden)

    Igor Vyacheslavovich Buzaev

    2016-09-01

    Full Text Available Objective: The continuous uninterrupted feedback system is the essential part of any well-organized system. We propose aLYNX concept that is a possibility to use an artificial intelligence algorithm or a neural network model in decision-making system so as to avoid possible mistakes and to remind the doctors to review tactics once more in selected cases. Method: aLYNX system includes: registry with significant factors, decisions and results; machine learning process based on this registry data; the use of the machine learning results as the adviser. We show a possibility to build a computer adviser with a neural network model for making a choice between coronary aortic bypass surgery (CABG and percutaneous coronary intervention (PCI in order to achieve a higher 5-year survival rate in patients with angina based on the experience of 5107 patients. Results: The neural network was trained by 4679 patients who achieved 5-year survival. Among them, 2390 patients underwent PCI and 2289 CABG. After training, the correlation coefficient (r of the network was 0.74 for training, 0.67 for validation, 0.71 for test and 0.73 for total. Simulation of the neural network function has been performed after training in the two groups of patients with known 5-year outcome. The disagreement rate was significantly higher in the dead patient group than that in the survivor group between neural network model and heart team [16.8% (787/4679 vs. 20.3% (87/428, P = 0.065]. Conclusion: The study shows the possibility to build a computer adviser with a neural network model for making a choice between CABG and PCI in order to achieve a higher 5-year survival rate in patients with angina. Keywords: Coronary artery bypass grafting, Percutaneous coronary intervention, Artificial intelligence, Decision making

  16. Introduction to Artificial Neural Networks

    DEFF Research Database (Denmark)

    Larsen, Jan

    1999-01-01

    The note addresses introduction to signal analysis and classification based on artificial feed-forward neural networks.......The note addresses introduction to signal analysis and classification based on artificial feed-forward neural networks....

  17. Deconvolution using a neural network

    Energy Technology Data Exchange (ETDEWEB)

    Lehman, S.K.

    1990-11-15

    Viewing one dimensional deconvolution as a matrix inversion problem, we compare a neural network backpropagation matrix inverse with LMS, and pseudo-inverse. This is a largely an exercise in understanding how our neural network code works. 1 ref.

  18. Neural-Net Processing of Characteristic Patterns From Electronic Holograms of Vibrating Blades

    Science.gov (United States)

    Decker, Arthur J.

    1999-01-01

    Finite-element-model-trained artificial neural networks can be used to process efficiently the characteristic patterns or mode shapes from electronic holograms of vibrating blades. The models used for routine design may not yet be sufficiently accurate for this application. This document discusses the creation of characteristic patterns; compares model generated and experimental characteristic patterns; and discusses the neural networks that transform the characteristic patterns into strain or damage information. The current potential to adapt electronic holography to spin rigs, wind tunnels and engines provides an incentive to have accurate finite element models lor training neural networks.

  19. Patient-rated health status predicts prognosis following percutaneous coronary intervention with drug-eluting stenting

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; Versteeg, Henneke; Denollet, Johan

    2011-01-01

    In patients treated with percutaneous coronary intervention (PCI) with the paclitaxel-eluting stent, we examined whether patient-rated health status predicts adverse clinical events.......In patients treated with percutaneous coronary intervention (PCI) with the paclitaxel-eluting stent, we examined whether patient-rated health status predicts adverse clinical events....

  20. Plaque Composition by Intravascular Ultrasound and Distal Embolization After Percutaneous Coronary Intervention

    NARCIS (Netherlands)

    Claessen, Bimmer E.; Maehara, Akiko; Fahy, Martin; Xu, Ke; Stone, Gregg W.; Mintz, Gary S.

    2012-01-01

    Distal embolization after percutaneous coronary intervention occurs in 15% to 70% of patients, depending on the sensitivity of the diagnostic modality used, and is associated with a poor prognosis after elective and primary percutaneous coronary intervention. It has been hypothesized that imaging of

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2002-03-01

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

  2. Clinical and Angiographic Factors Associated With Asymptomatic Restenosis After Percutaneous Coronary Intervention

    OpenAIRE

    Ruygrok, Peter; Webster, Mark; Valk, Vincent; Es, Gerrit Anne; Ormiston, John; Morel, Marie-Angèle; Serruys, Patrick

    2001-01-01

    textabstractBACKGROUND: Angiographic restenosis after percutaneous coronary interventional procedures is more common than recurrent angina. Clinical and angiographic factors associated with asymptomatic versus symptomatic restenosis after percutaneous coronary intervention were compared. METHODS AND RESULTS: All patients with angiographic restenosis from the BENESTENT I, BENESTENT II pilot, BENESTENT II, MUSIC, WEST 1, DUET, FINESS 2, FLARE, SOPHOS, and ROSE studies were analyzed. Multivariat...

  3. Isolated spontaneous dissection of the superior mesenteric artery: percutaneous stent placement in two patients

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jeong Ho; Roh, Byung Suk; Lee, Young Hwan; Choi, See Sung; So, Byung Jun [Wonkwang University School of Medicine, Iksan (Korea, Republic of)

    2004-06-15

    Isolated spontaneous dissection of the superior mesenteric artery (SMA) is a rare cause of acute mesenteric ischemia. Two patients were successfully treated by percutaneous stent placement within the main trunk of the SMA. Emphasis is placed on the feasibility of nonsurgical management with percutaneous stent placement of isolated spontaneous dissection of the SMA.

  4. Accuracy of CT-guided percutaneous core needle biopsy for assessment of pediatric musculoskeletal lesions

    Energy Technology Data Exchange (ETDEWEB)

    Hryhorczuk, Anastasia L. [University of Michigan, Department of Radiology, C. S. Mott Children' s Hospital, Ann Arbor, MI (United States); Harvard University School of Medicine, Department of Radiology, Boston Children' s Hospital, Boston, MA (United States); Strouse, Peter J. [University of Michigan, Department of Radiology, C. S. Mott Children' s Hospital, Ann Arbor, MI (United States); Biermann, J.S. [University of Michigan, Department of Orthopaedic Surgery, Ann Arbor, MI (United States)

    2011-07-15

    CT-guided percutaneous core needle biopsy has been shown in adults to be an effective diagnostic tool for a large number of musculoskeletal malignancies. To characterize our experience with CT-guided percutaneous core needle biopsy of pediatric bone lesions and determine its utility in diagnosing pediatric osseous lesions, in a population where such lesions are commonly benign. From 2000 to 2009, 61 children underwent 63 CT-guided percutaneous biopsies. Radiological, pathological and clinical records were reviewed. Fourteen biopsies (22%) were performed on malignant lesions, while 49 biopsies (78%) were performed on benign lesions. Forty-nine of the 63 biopsies (78%) were adequate; these children underwent no further tissue sampling. Fourteen of the 63 biopsies (22%) were inadequate or non-conclusive. Of these patients, 12 underwent open biopsy. Retrospective analysis of percutaneous biopsies in these patients demonstrates that 9/12 provided clinically relevant information, and 4/12 patients received final diagnoses that confirmed initial core biopsy findings. No malignancies were diagnosed as benign on percutaneous biopsy. Overall, percutaneous core needle biopsy provided accurate diagnostic information in 84% (53/63) of biopsies. Our results demonstrate that CT-guided percutaneous biopsy is safe and beneficial in children. This study supports the use of CT-guided percutaneous core needle biopsy for primary diagnosis of pediatric bone lesions. (orig.)

  5. Vissage percutané rétrograde du scaphoïde | Mhammdi | Pan ...

    African Journals Online (AJOL)

    In addition to the benefit of open surgical treatment of the scaphoid, a reduced downtime and a rapid return to work, percutaneous screw technique also reduces ... patient, receiving surgical treatment for a non-displaced fracture ( type 4 of the Schernberg classification) He received a retrograde percutaneous screw fixation.

  6. Comparing percutaneous coronary intervention and thrombolysis in patients with return of spontaneous circulation after cardiac arrest.

    Science.gov (United States)

    Li, Ying-Qing; Sun, Shu-Jie; Liu, Na; Hu, Chun-Lin; Wei, Hong-Yan; Li, Hui; Liao, Xiao-Xing; Li, Xin

    2013-04-01

    To evaluate the effects of percutaneous coronary intervention and thrombolysis after restoration of spontaneous circulation in cardiac arrest patients with ST-elevation myocardial infarction using meta-analysis. We performed a meta-analysis of clinical studies indexed in the PUBMED, MEDLINE and EMBASE databases and published between January 1995 and October 2012. In addition, we compared the hospital discharge and neurological recovery rates between the patients who received percutaneous coronary intervention and those who received thrombolysis. Twenty-four studies evaluating the effects of percutaneous coronary intervention or thrombolysis after restoration of spontaneous circulation in cardiac arrest patients with ST-elevation myocardial infarction were included. Seventeen of the 24 studies were used in this meta-analysis. All studies were used to compare percutaneous coronary intervention and thrombolysis. The meta-analysis showed that the rate of hospital discharge improved with both percutaneous coronary intervention (pcirculation did not have decreased hospital discharge (p = 0.543) or neurological recovery rates (p = 0.165) compared with those who received percutaneous coronary intervention. In cardiac arrest patients with ST-elevation myocardial infarction who achieved restoration of spontaneous circulation, both percutaneous coronary intervention and thrombolysis improved the hospital discharge rate. Furthermore, there were no significant differences in the hospital discharge and neurological recovery rates between the percutaneous coronary intervention-treated group and the thrombolysis-treated group.

  7. Percutaneous Chevron Osteotomy in Treating Hallux Valgus: Hong Kong Experience and Mid-Term Results

    Directory of Open Access Journals (Sweden)

    Ka-Lee Karry Lam

    2015-06-01

    Conclusion: The mid-term results are encouraging, indicating that this is an effective method in the treatment of mild to moderate hallux valgus with advantages of percutaneous technique. Further study with longer-term results and larger sample size is needed in order to compare with other percutaneous or open techniques.

  8. Percutaneous treatment of bile duct stones in patients treated unsuccessfully with endoscopic retrograde procedures

    NARCIS (Netherlands)

    van der Velden, JJ; Berger, MY; Bonjer, HJ; Brakel, K; Lameris, JS

    Background: The preferred treatment for stones in the bile duct is endoscopic sphincterotomy followed by stone extraction. When this fails, percutaneous treatment is an alternative to surgery. The purpose of this study was to evaluate the success and complication rate of percutaneous treatment.

  9. Upset Prediction in Friction Welding Using Radial Basis Function Neural Network

    Directory of Open Access Journals (Sweden)

    Wei Liu

    2013-01-01

    Full Text Available This paper addresses the upset prediction problem of friction welded joints. Based on finite element simulations of inertia friction welding (IFW, a radial basis function (RBF neural network was developed initially to predict the final upset for a number of welding parameters. The predicted joint upset by the RBF neural network was compared to validated finite element simulations, producing an error of less than 8.16% which is reasonable. Furthermore, the effects of initial rotational speed and axial pressure on the upset were investigated in relation to energy conversion with the RBF neural network. The developed RBF neural network was also applied to linear friction welding (LFW and continuous drive friction welding (CDFW. The correlation coefficients of RBF prediction for LFW and CDFW were 0.963 and 0.998, respectively, which further suggest that an RBF neural network is an effective method for upset prediction of friction welded joints.

  10. Supine Versus Prone Position During Percutaneous Nephrolithotomy: A Report from the Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Global Study

    DEFF Research Database (Denmark)

    G. Vadivia, José; M. Scarpa, Roberto; Duvdevani, Mordechai

    2011-01-01

    To determine differences in patients' characteristics, operative time and procedures, and perioperative outcomes between prone and supine positioning in percutaneous nephrolithotomy (PCNL) using the Clinical Research Office of the Endourological Society (CROES) PCNL Global Study database....

  11. Implementing Signature Neural Networks with Spiking Neurons.

    Science.gov (United States)

    Carrillo-Medina, José Luis; Latorre, Roberto

    2016-01-01

    Spiking Neural Networks constitute the most promising approach to develop realistic Artificial Neural Networks (ANNs). Unlike traditional firing rate-based paradigms, information coding in spiking models is based on the precise timing of individual spikes. It has been demonstrated that spiking ANNs can be successfully and efficiently applied to multiple realistic problems solvable with traditional strategies (e.g., data classification or pattern recognition). In recent years, major breakthroughs in neuroscience research have discovered new relevant computational principles in different living neural systems. Could ANNs benefit from some of these recent findings providing novel elements of inspiration? This is an intriguing question for the research community and the development of spiking ANNs including novel bio-inspired information coding and processing strategies is gaining attention. From this perspective, in this work, we adapt the core concepts of the recently proposed Signature Neural Network paradigm-i.e., neural signatures to identify each unit in the network, local information contextualization during the processing, and multicoding strategies for information propagation regarding the origin and the content of the data-to be employed in a spiking neural network. To the best of our knowledge, none of these mechanisms have been used yet in the context of ANNs of spiking neurons. This paper provides a proof-of-concept for their applicability in such networks. Computer simulations show that a simple network model like the discussed here exhibits complex self-organizing properties. The combination of multiple simultaneous encoding schemes allows the network to generate coexisting spatio-temporal patterns of activity encoding information in different spatio-temporal spaces. As a function of the network and/or intra-unit parameters shaping the corresponding encoding modality, different forms of competition among the evoked patterns can emerge even in the absence

  12. Implementing Signature Neural Networks with Spiking Neurons

    Science.gov (United States)

    Carrillo-Medina, José Luis; Latorre, Roberto

    2016-01-01

    Spiking Neural Networks constitute the most promising approach to develop realistic Artificial Neural Networks (ANNs). Unlike traditional firing rate-based paradigms, information coding in spiking models is based on the precise timing of individual spikes. It has been demonstrated that spiking ANNs can be successfully and efficiently applied to multiple realistic problems solvable with traditional strategies (e.g., data classification or pattern recognition). In recent years, major breakthroughs in neuroscience research have discovered new relevant computational principles in different living neural systems. Could ANNs benefit from some of these recent findings providing novel elements of inspiration? This is an intriguing question for the research community and the development of spiking ANNs including novel bio-inspired information coding and processing strategies is gaining attention. From this perspective, in this work, we adapt the core concepts of the recently proposed Signature Neural Network paradigm—i.e., neural signatures to identify each unit in the network, local information contextualization during the processing, and multicoding strategies for information propagation regarding the origin and the content of the data—to be employed in a spiking neural network. To the best of our knowledge, none of these mechanisms have been used yet in the context of ANNs of spiking neurons. This paper provides a proof-of-concept for their applicability in such networks. Computer simulations show that a simple network model like the discussed here exhibits complex self-organizing properties. The combination of multiple simultaneous encoding schemes allows the network to generate coexisting spatio-temporal patterns of activity encoding information in different spatio-temporal spaces. As a function of the network and/or intra-unit parameters shaping the corresponding encoding modality, different forms of competition among the evoked patterns can emerge even in the

  13. Percutaneous nephrolithotomy among patients with renal anomalies: patient characteristics and outcomes; a subgroup analysis of the clinical research office of the endourological society global percutaneous nephrolithotomy study

    DEFF Research Database (Denmark)

    Osther, Palle Jörn; Razvi, Hassan; Liatsikos, Evangelos

    2011-01-01

    This study compared the characteristics and outcomes of percutaneous nephrolithotomy (PCNL) in patients with and without renal malformations using the Clinical Research Office of the Endourological Society (CROES) PCNL Global Study database.......This study compared the characteristics and outcomes of percutaneous nephrolithotomy (PCNL) in patients with and without renal malformations using the Clinical Research Office of the Endourological Society (CROES) PCNL Global Study database....

  14. Neural Network Ensembles

    DEFF Research Database (Denmark)

    Hansen, Lars Kai; Salamon, Peter

    1990-01-01

    We propose several means for improving the performance an training of neural networks for classification. We use crossvalidation as a tool for optimizing network parameters and architecture. We show further that the remaining generalization error can be reduced by invoking ensembles of similar...... networks....

  15. Neural systems for control

    National Research Council Canada - National Science Library

    Omidvar, Omid; Elliott, David L

    1997-01-01

    ... is reprinted with permission from A. Barto, "Reinforcement Learning," Handbook of Brain Theory and Neural Networks, M.A. Arbib, ed.. The MIT Press, Cambridge, MA, pp. 804-809, 1995. Chapter 4, Figures 4-5 and 7-9 and Tables 2-5, are reprinted with permission, from S. Cho, "Map Formation in Proprioceptive Cortex," International Jour...

  16. Neural Tube Defects

    Science.gov (United States)

    ... pregnancies each year in the United States. A baby’s neural tube normally develops into the brain and spinal cord. ... fluid in the brain. This is called hydrocephalus. Babies with this condition are treated with surgery to insert a tube (called a shunt) into the brain. The shunt ...

  17. Acceptability and outcomes of percutaneous endoscopic gastrostomy (PEG) tube placement and patient quality of life.

    Science.gov (United States)

    Hossein, Somi Mohammad; Leili, Maghbouli; Hossein, Antikchi Mohammad

    2011-01-01

    Since its description in 1980, percutaneous endoscopic gastrostomy has been a widely used method for insertion of a gastrostomy tube in patients who are unable to swallow or maintain adequate nutrition. This study aimed to assess the perspectives of patients/caregivers in our society regarding the acceptability of percutaneous endoscopic gastrostomy tube placement and to evaluate the outcomes. One hundred consecutive adults referred to our unit to be considered for primary percutaneous endoscopic gastrostomy feeding at Imam Reza Hospital of Tabriz University of Medical Sciences were evaluated prospectively from October 2007 to June 2009. The nutritional status of patients, complications and quality of life were assessed after percutaneous endoscopic gastrostomy insertion for six months. The data were analyzed using SPSS software. Indications for percutaneous endoscopic gastrostomy were neurologic in 66 patients and recurrent pulmonary aspiration in 14 intensive care unit adult patients. Minor complications included percutaneous endoscopic gastrostomy site infection in 8 patients and tube blockage in 5 patients. Oral feeding was resumed in 27% of the patients and the tube was removed subsequently after 3-6 months; 42 patients died due to primary diseases (in 1-6 months). The Quality of Life Index scores pre-percutaneous endoscopic gastrostomy placement and 6 months after percutaneous endoscopic gastrostomy averaged 19.25±11.85 and 30.08±27.74, respectively. A similarly significant difference was also found between mean Quality of Life Index scores pre- and post-percutaneous endoscopic gastrostomy placement (p<0.005). Percutaneous endoscopic gastrostomy is a minimally invasive gastrostomy method with low morbidity and mortality rates, and is easy to follow-up and to replace when blockage occurs.

  18. [Percutaneous fasciotomies to improve fat grafting into the breast].

    Science.gov (United States)

    Ho Quoc, C; Michel, G; Dlimi, C; Gourari, A; Meruta, A; Delay, E

    2014-04-01

    Breast reconstruction or for breast deformities is a difficult challenge to get excellent results. Lipomodeling technique can improve thoracic malformations and breast deformities. Percutaneous fasciotomies can be an excellent tool for recipient site improvement. The aim of this study is to discuss interest of percutaneous needle fasciotomies with fat grafting into breast surgery. We have realized a retrospective study with fat transfer into the breast surgery. Recipient site prepared fasciotomies during fat grafting surgical procedure. Fat was harvested and centrifugated. Fat was injected into breast reconstructions or thoracic malformations. We did notice: population (age, BMI, uni/bilateral breasts), surgical procedure (mean sessions number, mean fat transfer). Aesthetic aspects of breasts were rated by both surgeon and patient: skin improvement, volume and shape of breast. Each complication was noticed: tissue wounds, scar evolution, hematoma, infection. We started a retrospective study between 2006 and 2011. One thousand patients were treated with fasciotomies and fat grafting during the same procedure. Main indications were breast reconstruction with latissimus dorsi flap, breast implant reconstruction, breast cancer conservative surgeries, tuberous breast and Poland syndrom. Sessions number expected was between 1 and 3. No complication has been noticed, except 1 tissular wound that needed a medical treatment to solve the problem. Fasciotomie is an indispensable complement tool for fat grafting. It is a safe and reliable technique. It improves aesthetic outcomes of breast surgery. Main indications of fasciotomies with fat grafting are breast reconstruction with radiation, breast cancer conservative surgery, and tuberous breast. Percutaneous fasciotomies provide excellent aesthetic result with no scar. They improve the shape of the breast with long-standing result. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  19. The vacuum cleaner effect in minimally invasive percutaneous nephrolitholapaxy.

    Science.gov (United States)

    Nicklas, André P; Schilling, David; Bader, Markus J; Herrmann, Thomas R W; Nagele, Udo

    2015-11-01

    Percutaneous stone removal increasingly plays an important role among the different approaches of interventional stone therapy, particularly since the development of miniaturized instruments is resulting in lower morbidity for the patients. One major drawback of smaller instruments is the increased difficulty of stone retrieval after disintegration due to the reduced tract diameter. This results in longer operation time and the need of additional tools such as disposable retrieval baskets. One of the key factors in the development of minimally invasive percutaneous nephrolitholapaxy (MIP) was the design of an Amplatz sheath which provides a built-in vacuum cleaner effect for stone retrieval. A series of flow analyses with the gauges and shapes of the most commonly used nephroscopes and sheaths in percutaneous nephrolitholapaxy was performed by computational fluid dynamics. Flow velocity and direction in front of the nephroscope were computed and visualized by the software. In our study, the vacuum cleaner effect developed exclusively when a round-shaped nephroscope was used (Nagele Miniature Nephroscope System, Karl Storz GmbH & Co. KG) and depended on the relation between nephroscope diameter and inner sheath diameter. The strongest effect was observed with a 12 F nephroscope and an inner sheath diameter of 15 F. It did not develop when an oval- or crescent-shaped nephroscope was used. In front of the distal end of the round-shaped nephroscope, a slipstream develops, induced by the excursive change of width of the fluid flow on the outlet of the flushing canal. This allows the adhesion of a stone fragment in the eddy while the fluid flow is circulating around the stone. This study illustrates and explains the vacuum cleaner effect which has been detected in the development of the Nagele Miniature Nephroscope System used in MIP. It combines the reduced morbidity of smaller kidney puncture diameters with the benefit of quick and complete stone removal.

  20. Percutaneous trigger thumb release in children: neither effective nor safe.

    Science.gov (United States)

    Masquijo, Julio J; Ferreyra, Andres; Lanfranchi, Lucas; Torres-Gomez, Armando; Allende, Victoria

    2014-01-01

    Although percutaneous trigger thumb release has been extensively used in adults, the technique is not widespread in children. The purpose of this study was to evaluate the efficacy and safety of percutaneous trigger thumb release in the pediatric age group. Twenty consecutive thumbs of 15 patients scheduled for surgical release of the A1 pulley were included in this cohort. Each patient received first the percutaneous release (PR) followed by an open release (OR) and served as self-controls. Thumb extension was assessed immediately before PR, after PR, and finally after OR, using a goniometer. Extent of the A1 pulley release, iatrogenic injury to the digital nerve and vessels, and flexor tendon laceration was assessed after PR. The distance between the PR and the digital nerve was measured in millimeters. Comparison between thumb extension after PR and OR was made using a paired t test. Preoperative range of motion averaged -45.2 ± 21.7 degrees loss of extension (range, -80 to -10 degrees), decreased to -4 ± 8 degrees loss of extension (range, -25 to 0 degrees) after PR, and to 0 degrees after OR. Clinically, release was complete in 14 cases (70%) and partial in 6 cases (30%). Once the thumb was approached, we confirmed that A1 pulley was completely cut in 4 cases (20%), to >75% in 2 cases (10%), and between 50% and 75% in the remaining 14 cases (70%). There were no neurovascular iatrogenic injuries. Mean distance between the needle and the digital nerve was 2.45 ± 0.9 mm (range, 1 to 4 mm). Lacerations to the flexor tendons were observed in 80% of the cases. We do not recommend PR in the pediatric thumb given the risk of neurovascular iatrogenic injury or incomplete A1 pulley release. Level II therapeutic study-prospective comparative study.

  1. Fluoroscopically guided percutaneous jejunostomy: outcomes in 25 consecutive patients

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Z.Q. [Department of Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province (China); Shin, J.H. [Departments of Radiology and Research Institute of Radiology, Asan Medical Centre, University of Ulsan College of Medicine, Poongnap-2dong, Songpa-gu, Seoul (Korea, Republic of)], E-mail: jhshin@amc.seoul.kr; Song, H.-Y.; Kwon, J.H.; Kim, J.-W.; Kim, K.R.; Kim, J.-H. [Departments of Radiology and Research Institute of Radiology, Asan Medical Centre, University of Ulsan College of Medicine, Poongnap-2dong, Songpa-gu, Seoul (Korea, Republic of)

    2007-11-15

    Aim: To assess the feasibility and safety of fluoroscopically guided percutaneous jejunostomy. Material and methods: Between May 1999 and August 2006 percutaneous jejunostomy was attempted in 25 patients. A 5 F vascular catheter (n = 20) or a 7.5 F multifunctional coil catheter (n = 5) was used to insufflate the jejunum. The distended jejunum was punctured using a 17 G needle (n = 19) or a 21 G Chiba needle (n = 6) with the inserted catheter as a target. A 12 or 14 F loop feeding tube was inserted after serial dilations. The technical success, complications, 30-day mortality, and in-dwelling period of the feeding tube placement were evaluated. Results: The technical success rate was 92% (23/25). Technical failures (n = 2) resulted from the inability to insufflate the jejunum secondary to failure to pass the catheter through a malignant stricture at the oesophagojejunostomy site and thus subsequent puncture of the undistended jejunum failed, or failure to introduce the Neff catheter into the jejunum. Pericatheter leakage with pneumoperitoneum was a complication in three patients (12%) and was treated conservatively. The 30-day mortality was 13% (3/23); however, there was no evidence that these deaths were attributed to the procedure. Except for four patients who were lost to follow-up and two failed cases, 15 of the 19 jejunostomy catheters were removed because of patient death (n = 12) or completion of treatment (n = 3), with a mean and median in-dwelling period of 231 and 87 days, respectively. Conclusions: Fluoroscopically guided percutaneous jejunostomy is a feasible procedure with a high technical success and a low complication rate. In addition to a 17 G needle, a 21 G needle can safely be used to puncture the jejunum.

  2. Closed Reduction and Percutaneous Fixation of Calcaneal Fractures in Children.

    Science.gov (United States)

    Feng, Yongzeng; Yu, Yang; Shui, Xiaolong; Ying, Xiaozhou; Cai, Leyi; Hong, Jianjun

    2016-07-01

    Open reduction and internal fixation has been widely used to treat displaced intra-articular calcaneus fractures in children. However, the complications of surgical trauma and the wound created through the extended lateral approach cannot be ignored. This study analyzed the outcomes of displaced intra-articular calcaneal fractures in children treated with closed reduction and percutaneous fixation. Medical records of pediatric patients who had displaced intra-articular calcaneus fractures and underwent closed reduction and percutaneous fixation at the study institution between January 2008 and January 2013 were reviewed. Preoperative radiographs and computed tomography scans were used to evaluate and classify the fractures. Clinical outcomes and radiographic findings were assessed at postoperative follow-up. The study included 14 displaced intra-articular calcaneal fractures in 11 patients (7 boys and 4 girls). Mean patient age was 11.18 years (range, 6-16 years), and average follow-up time was 42.8 months postoperatively (range, 12-72 months). There were 6 tongue-type fractures and 8 joint depression-type fractures, based on the Essex-Lopresti classification, and there were 11 type II and 3 type III fractures, based on the Sanders classification. Average Böhler angle was 8.00° (range, -5° to 18°) preoperatively and 30.79° (range, 26° to 40°) postoperatively (P<.001). Average subjective American Orthopaedic Foot and Ankle Society hindfoot score was 65.7 (range, 52-68). No patients had wound breakdown or infection. In the treatment of displaced intra-articular calcaneal fractures in pediatric patients, closed reduction and percutaneous fixation achieved good outcomes, with few complications. [Orthopedics. 2016; 39(4):e744-e748.]. Copyright 2016, SLACK Incorporated.

  3. Percutaneous Ultrasound-guided Radiofrequency Ablation of Intrahepatic Cholangiocarcinoma

    Directory of Open Access Journals (Sweden)

    Yi-You Chiou

    2005-07-01

    Full Text Available This study evaluated the clinical applications, treatment effects, and complications of percutaneous ultrasound (US-guided radiofrequency ablation (RFA of intrahepatic cholangiocarcinoma. Ten patients (6 men and 4 women with histologically proven cholangiocarcinoma underwent US-guided percutaneous RFA. Tumor diameters ranged from 1.9 to 6.8 cm. There were 12 sessions of RFA for 10 solitary cholangiocarcinomas. Eight patients were treated at a single session and two patients had two treatment sessions. The efficacy of RFA was evaluated using contrast-enhanced dynamic computed tomography 1 month after treatment and then every 3 months. Complete necrosis was defined as lack of contrast enhancement of the treated region. There was complete necrosis in eight tumors. In two patients with large tumors (4.7 and 6.8 cm in diameter, enhancement of residual tissue was observed after RFA treatment, indicating residual tumor. Complete necrosis was seen in all five tumors (100% with diameters of 3.0 cm or less, two of three tumors (67% with diameters of 3.1-5.0 cm, and one of two tumors (50% with diameters of more than 5.0 cm. A large biloma was found in one patient after treatment. No serious complications occurred in the other nine patients. In conclusion, percutaneous RFA is effective and successful in the treatment of intrahepatic cholangiocarcinoma of 3 cm or less and satisfactory for tumors of 3-5 cm. The rate of serious complications after RFA is low. Further follow-up is necessary to determine long-term efficacy.

  4. Vertebral split fractures: Technical feasibility of percutaneous vertebroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Huwart, Laurent, E-mail: huwart.laurent@wanadoo.fr [Department of Radiology, Hôpital Archet 2, Centre Hospitalo-Universitaire de Nice, Nice (France); Foti, Pauline, E-mail: pfoti@hotmail.fr [Department of Biostatistics, Hôpital Archet 2, Centre Hospitalo-Universitaire de Nice, Nice (France); Andreani, Olivier, E-mail: andreani.olivier@gmail.com [Department of Radiology, Hôpital Archet 2, Centre Hospitalo-Universitaire de Nice, Nice (France); Hauger, Olivier, E-mail: olivier.hauger@chubordeaux.fr [Department of Radiology, Hôpital Pellegrin, Centre Hospitalo-Universitaire de Bordeaux, Bordeaux (France); Cervantes, Elodie, E-mail: elodie.cervantes@live.fr [Department of Radiology, Hôpital Archet 2, Centre Hospitalo-Universitaire de Nice, Nice (France); Brunner, Philippe, E-mail: pbrunner@chpg.mc [Department of Radiology, Hôpital Princesse Grasse de Monaco (Monaco); Boileau, Pascal, E-mail: boileau.p@chu-nice.fr [Department of Orthopedic Surgery, Hôpital Archet 2, Centre Hospitalo-Universitaire de Nice, Nice (France); Amoretti, Nicolas, E-mail: amorettinicolas@yahoo.fr [Department of Radiology, Hôpital Archet 2, Centre Hospitalo-Universitaire de Nice, Nice (France)

    2014-01-15

    Objective: The treatment of vertebral split fractures remains controversial, consisting of either corset or internal fixation. The aim of this study was to evaluate the technical feasibility of CT- and fluoroscopy-guided percutaneous vertebroplasty in the treatment of vertebral split fractures. Materials and methods: Institutional review board approval and informed consent were obtained for this study. Sixty-two consecutive adult patients who had post-traumatic vertebral split fractures (A2 according to the AO classification) without neurological symptoms were prospectively treated by percutaneous vertebroplasty. All these procedures were performed by an interventional radiologist under computed tomography (CT) and fluoroscopy guidance by using only local anaesthesia. Postoperative outcome was assessed using the visual analogue scale (VAS) and Oswestry disability index (ODI) scores. Results: Vertebroplasty was performed on thoracic and lumbar vertebrae, creating a cement bridge between the displaced fragment and the rest of the vertebral body. Seven discal cement leakages (11%) were observed, without occurrence of adjacent vertebral compression fractures. The mean VAS measurements ± standard deviation (SD) significantly decreased from 7.9 ± 1.5 preoperatively to 3.3 ± 2.1 at 1 day, 2.2 ± 2.0 at 1 month, and 1.8 ± 1.4 at 6 months (P < 0.001). The mean ODI scores ± SD had also a significant improvement: 62.3 ± 17.2 preoperatively and 15.1 ± 6.0 at the 6-month follow-up (P < 0.001). Conclusion: This study suggests that type A2 vertebral fractures could be successfully treated by CT- and fluoroscopy-guided percutaneous vertebroplasty.

  5. Percutaneous tracheostomy: comparison of Ciaglia and Griggs techniques.

    Science.gov (United States)

    Añón, J M; Gómez, V; Escuela, M P; De Paz, V; Solana, L F; De La Casa, R M; Pérez, J C; Zeballos, E; Navarro, L

    2000-01-01

    Although the standard tracheostomy described in 1909 by Jackson has been extensively used in critical patients, a more simple procedure that can be performed at the bedside is needed. Since 1957 several different types of percutaneous tracheostomy technique have been described. The purpose of the present study was to compare two bedside percutaneous tracheostomy techniques: percutaneous dilatational tracheostomy (PDT) and the guidewire dilating forceps (GWDF). A prospective study in two medical/surgical intensive care units (ICUs) was carried out. Sixty-three critically ill patients who required endotracheal intubation for longer than 15 days were consecutively selected to undergo PDT (25 patients) or GWDF (38 patients) technique. Intraoperative and postoperative complications were recorded. Age (mean +/- standard error) was 63 +/- 1.1 years. The patients had been mechanically ventilated for an average of 19.8 +/- 1.2 days. The GWDF technique was significantly faster than PDT technique (P = 0.02). Fifteen complications occurred in 10 out of 63 (15%) patients. They were as follows: tracheal tear (one patient in each group; in one case this was due to false passage); transient hypotension (one patient in the PDT group and two patients in the GWDF group); atelectasis (one patient in the PDT group); and haemorrhage (one patient in the PDT group and three patients in the GWDF group). In both patients with tracheal tear, reduced arterial oxygen saturation (SaO2) with concomitant subcutaneous emphysema ensued. We found no statistical differences between complications with both techniques. The surgical time required for the GWDF technique was less than that for PDT.

  6. [Stone free rate assesment after percutaneous nephrolithotomy using nephrolitometric nomogram].

    Science.gov (United States)

    Landa-Salas, Jason Damián; Torres-Anguiano, Juan Ramón; Maldonado-Alcaraz, Efraín; Lopez-Samano, Virgilio Augusto; Serrano-Brambila, Eduardo Alonso; Moreno-Palacios, Jorge

    2017-04-19

    Percutaneous nephrolithotomy remains the standard of care for kidney stones larger than 2cm. Therefore, setting a prognosis for complete stone resolution through this method is essential. The prognostic tools available have limited prediction. To evaluate the stone-free rate in patients undergoing percutaneous nephrolithotomy with the Clinical Research Office of the Endourological Society nomogram and suggest modifications to improve the classification. We analyzed a retrospective cohort of patients undergoing percutaneous nephrolithotomy applying the nephrolithometric nomogram specified. We modified the scale dividing the patients into 3groups: i from 80 to 110 points, II from 111 to 170 points, and III more than 170 points, respectively assessing the stone-free rate (Kruskall-Wallis test was performed, p<0.05). A total of 126 patients were included. According to the nehrolithometric nomogram the stone-free rate was 12.5% for patients with fewer than 111 points and 70.9% for those with 111 points or more. In the modification proposed for groups I, IIand III the stone-free rate was 12.5%, 50% and 80% respectively (p=0.000). Evaluation using the nephrolithometric nomogram demonstrated accurate stone-free rate prediction for complex and simple stones, with a lack of discrimination for patients with intermediate scores. Our modification enabled better differentiation of the intermediate groups from the high and low stone-free rate groups. Copyright © 2017 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  7. Results of percutaneous nephrolithotomy performed in a regional state hospital

    Directory of Open Access Journals (Sweden)

    Taner Çiftçi

    2011-12-01

    Full Text Available Aim: The aim of this study was to evaluate the results of percutaneous stone surgery that performe in a regional state hospital.Materials and methods: We retrospectively analyzed 183 percutaneous nephrolithotomy (PNL performed cases that treated at our clinic between June 2010 and July 2011. After necessary laboratory and radiological investigations, we performed PNL for the patients those diagnosed as having stones needed surgery. After surgery, we investigated radiologically whether residual stone fragments remained or not. When there were residual stone fragments (bigger than 4 mm, we performed ESWL, repeated percutaneous interventions and surveillance protocols. In six patients, open surgery was needed during PNL.Results: Of the totally 183 patients underwent PNL at our clinic, 102 were male and 81 were female. The mean age was 37.6 and mean stone burden was 35.5 mm2. Stone-free rate was 75.4% and the rate of the patients who have residual stones (bigger than 4mm was 25.7%. Stone free rates were 95% and 86% for stone burden lesser and more than 2 cm2, respectively. The mean blood loss was 186ml for per operational case. Totally four patients (8.5% underwent blood tranfusion.Conclusion: As a result, because of its high stone-free rates, the shorter hospital stay, minimal surgical scar and absence of wound infection, PNL is preserving its place for the treatment of stones bigger than 2 cm2. J Clin Exp Invest 2011; 2 (4: 371-374

  8. Efficacy of percutaneous radiofrequency ablation of osteoid osteoma in children

    Energy Technology Data Exchange (ETDEWEB)

    Donkol, Ragab H. [Cairo University, Department of Radiology, Faculty of Medicine, Cairo (Egypt); Assir Central Hospital, Department of Radiology, P.O. Box 34, Abha (Saudi Arabia); Al-Nammi, Ahmed [Assir Central Hospital, Department of Radiology, P.O. Box 34, Abha (Saudi Arabia); Moghazi, Khaled [Alexandria University, Faculty of Medicine, Alexandria (Egypt)

    2008-02-15

    Percutaneous radiofrequency (RF) ablation of osteoid osteoma has high technical and clinical success rates. However, there are limited data on its use in the treatment of osteoid osteoma in children. To assess the safety and efficacy of CT-guided percutaneous RF ablation of osteoid osteoma in children and compare the outcomes with published data on its use in patients unselected for age. From January 2003 to July 2006, 23 children with osteoid osteoma were treated with CT-guided RF ablation using a straight rigid electrode. Their mean age was 11 years (range 3.5-16 years) and there were 15 boys and 8 girls. The procedures were carried out under general anaesthesia. Follow-up was performed to assess technical and clinical outcome. The mean follow-up period was 2.5 years (range 13-49 months). Technical success was achieved in 21 children (91.3%). Failure occurred in two children, in one due to failure to adequately localize the nidus within the dense sclerosis and in the other because of a short ablation time (2 min) because he developed hyperthermia. Clinical success was achieved in 18 patients within 2-5 days (primary clinical success rate 78.2%).These patients were allowed to fully weight-bear and function without limitation 1 week after the procedure. Pain recurrence was observed in two patients; one was treated successfully with a second ablation after 6 months (secondary clinical success rate 82.6%). Hyperthermia was observed in two patients during the procedure. Three other minor complications were observed: wound infection in one child and skin burn in two children. No major immediate or delayed complications were observed. Percutaneous CT-guided RF ablation is an effective and safe minimally invasive procedure for the treatment of osteoid osteoma in children. It has high technical and clinical success rates that are slightly lower than those of patients with a wider range of ages. (orig.)

  9. Impact of Case Volumes on the Outcomes of Percutaneous Nephrolithotomy

    DEFF Research Database (Denmark)

    Opondo, Dedan; Tefekli, Ahmet; Esen, Tarik

    2012-01-01

    BACKGROUND: Previous studies have demonstrated relationships between case volumes and outcomes in surgery. Little is known about the impact of case volumes on the outcomes of percutaneous nephrolithotomy (PCNL). OBJECTIVE: To investigate the influence of case volumes on the efficacy and safety...... outcomes of PCNL. DESIGN, SETTING, AND PARTICIPANTS: From November 2007 to December 2009, prospective data were collected by the Clinical Research Office of the Endourological Society from consecutive patients over a 1-yr period in 96 centers globally. Data of 3933 patients in the Global PCNL study...

  10. Lumbar percutaneous discectomy. Initial experience in 28 cases

    Energy Technology Data Exchange (ETDEWEB)

    Faubert, C. (Saarland Univ., Homburg/Saar (Germany). Neuroradiological Inst.); Caspar, W. (Saarland Univ., Homburg/Saar (Germany). Dept. of Neurosurgery)

    1991-10-01

    Since November 88, 28 patients with lumbar L5 radiculopathy refractory to conservative care and with a radiologically verified central or mediolateral disc herniation at the level of L4/L5 had had a percutaneous discectomy. A short-term follow-up analysis of at least 2 months taking the clinical and functional status as well as the professional reintegration into account revealed a 64.3% (18/28 patients) satisfactory outcome and a 32.1% (10/28 patients) failure rate. Of the latter 28.6% (8/28 patients) required further open surgery. (orig./GDG).

  11. A vacuum cleaner for the pelvicalyceal system during percutaneous nephrolithotomy.

    Science.gov (United States)

    Lezrek, Mohammed; Qarro, Abdelmounim; Bazine, Khalil; Najoui, Mohammed; Asseban, Mohammed; Benjelloun, Mohammed; Kasmaoui, El Hassan; Beddouch, Amoqran; Alami, Mohammed

    2010-06-01

    Removing small stones, fragments and debris, clots, or clusters of small stones can be bothersome and time consuming. We perform a technique to sweep out fragments from the kidney during percutaneous nephrolithotomy using suction. The nephroscope is used as a vacuum cleaner by adapting the suction tube to the nephroscope operating channel. The fragments are quickly aspirated through the nephroscope working channel under direct vision. This technique gives the best opportunities to render a patient stone-free from even the fine sand debris.

  12. [Percutaneous endoscopic gastrostomy (PEG): overview and nursing care].

    Science.gov (United States)

    Chiang, Wen-Jen; Lin, Yen-Ju; Chang, Chia-Hui; Chen, Hsiao-Yu

    2012-08-01

    The dramatic increase in the elderly population in Taiwan has made dysphagia an increasingly prevalent problem in long-term care. While tube feeding is mandatory for patients unable to take food orally, this approach increases recurrent aspiration pneumonia and malnutrition risks. Percutaneous endoscopic gastrostomy (PEG) is currently the most effective and prevalent approach to enteral nutrition. This article introduces the definition, indications, contraindications, complications, advantages and disadvantages of PEG and its clinical nursing care protocols. The author hopes that this narrative description of a nurse's experience providing appropriate nursing care to a PEG patient will help enhance reader understanding of PEG care.

  13. Percutaneous fusion of lumbar facet with bone allograft

    Directory of Open Access Journals (Sweden)

    Félix Dolorit Verdecia

    2015-03-01

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

  14. [The Extended Percutaneous Needle Fasciotomy Technique (PNF+) For Dupuytren's Contracture].

    Science.gov (United States)

    Lenze, Wolfgang Paul

    2017-02-01

    The extended percutaneous needle fasciotomy (PNF+) is a minimal invasive technique especially suitable for treating severe Dupuytren's contractures and recurrences. The familiar needle fasciotomy is complemented by a spontaneous tearing of the skin and a full-thickness graft to cover the defect. Skin tears in fingers and palm are not a complication, but an integral part of the PNF+. The neurovascular bundles remain intact. This surgical procedure may be repeated as often as required. © Georg Thieme Verlag KG Stuttgart · New York.

  15. Biliary peritonitis due to gall bladder perforation after percutaneous nephrolithotomy

    Directory of Open Access Journals (Sweden)

    Nikhil Ranjan

    2015-01-01

    Full Text Available A 19-year-old male patient underwent right percutaneous nephrolithotomy (PNL for right renal 1.5 × 1.5 cm lower pole stone. The procedure was completed uneventfully with complete stone clearance. The patient developed peritonitis and shock 48 h after the procedure. Exploratory laparotomy revealed a large amount of bile in the abdomen along with three small perforations in the gall bladder (GB and one perforation in the caudate lobe of the liver. Retrograde cholecystectomy was performed but the patient did not recover and expired post-operatively. This case exemplifies the high mortality of GB perforation after PNL and the lack of early clinical signs.

  16. Primary percutaneous coronary intervention in a patient with dextrocardia.

    Science.gov (United States)

    Khan, Naveed-Ullah; Farman, Muhammad Tariq; Ashraf, Tariq

    2012-08-01

    The case of a 40-year-old male with dextrocardia who presented with ST Elevated Myocardial Infarction (STEMI) is reported. Coronary angiogram was performed after due manipulation and then successful primary percutaneous coronary intervention (PCI) of Left anterior descending (LAD) coronary artery was done. His 9 months follow up primary PCI in a patient with angiogram revealed patent stent in proximal LAD. There are very few published case reports of this rare congenital anomaly addressing technical details of successful primary PCI with dextrocardia.

  17. Artificial Neural Networks for Nonlinear Dynamic Response Simulation in Mechanical Systems

    DEFF Research Database (Denmark)

    Christiansen, Niels Hørbye; Høgsberg, Jan Becker; Winther, Ole

    2011-01-01

    It is shown how artificial neural networks can be trained to predict dynamic response of a simple nonlinear structure. Data generated using a nonlinear finite element model of a simplified wind turbine is used to train a one layer artificial neural network. When trained properly the network is ab...... to perform accurate response prediction much faster than the corresponding finite element model. Initial result indicate a reduction in cpu time by two orders of magnitude.......It is shown how artificial neural networks can be trained to predict dynamic response of a simple nonlinear structure. Data generated using a nonlinear finite element model of a simplified wind turbine is used to train a one layer artificial neural network. When trained properly the network is able...

  18. Computational Assessment of Neural Probe and Brain Tissue Interface under Transient Motion

    Directory of Open Access Journals (Sweden)

    Michael Polanco

    2016-06-01

    Full Text Available The functional longevity of a neural probe is dependent upon its ability to minimize injury risk during the insertion and recording period in vivo, which could be related to motion-related strain between the probe and surrounding tissue. A series of finite element analyses was conducted to study the extent of the strain induced within the brain in an area around a neural probe. This study focuses on the transient behavior of neural probe and brain tissue interface with a viscoelastic model. Different stages of the interface from initial insertion of neural probe to full bonding of the probe by astro-glial sheath formation are simulated utilizing analytical tools to investigate the effects of relative motion between the neural probe and the brain while friction coefficients and kinematic frequencies are varied. The analyses can provide an in-depth look at the quantitative benefits behind using soft materials for neural probes.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-05-15

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

  20. Bioprinting for Neural Tissue Engineering.

    Science.gov (United States)

    Knowlton, Stephanie; Anand, Shivesh; Shah, Twisha; Tasoglu, Savas

    2018-01-01

    Bioprinting is a method by which a cell-encapsulating bioink is patterned to create complex tissue architectures. Given the potential impact of this technology on neural research, we review the current state-of-the-art approaches for bioprinting neural tissues. While 2D neural cultures are ubiquitous for studying neural cells, 3D cultures can more accurately replicate the microenvironment of neural tissues. By bioprinting neuronal constructs, one can precisely control the microenvironment by specifically formulating the bioink for neural tissues, and by spatially patterning cell types and scaffold properties in three dimensions. We review a range of bioprinted neural tissue models and discuss how they can be used to observe how neurons behave, understand disease processes, develop new therapies and, ultimately, design replacement tissues. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Comparison of totally tubeless percutaneous nephrolithotomy and standard percutaneous nephrolithotomy for kidney stones: a randomized, clinical trial

    Directory of Open Access Journals (Sweden)

    N. Moosanejad

    2016-01-01

    Full Text Available This study aimed to compare the totally tubeless percutaneous nephrolithotomy and standard percutaneous nephrolithotomy techniques regarding their rates of success and complications in patients with kidney stones. Patients were randomly assigned to two groups. Forty-four patients (24 men; mean age: 50.40±2.02 years received totally tubeless percutaneous nephrolithotomy (PCNL; no nephrostomy catheter or ureteral catheter after PCNL and 40 patients (18 men; mean age: 49.95±13.38 years underwent standard PCNL (a nephrostomy catheter and ureteral catheter were used after PCNL. All surgeries were performed by one surgeon. Postoperative changes in hemoglobin, the blood transfusion rate, changes in creatinine levels, operation time, analgesic need, hospitalization time, and complication rate were compared between the groups. No significant differences were observed in age, gender, stone size, and surgery side between the groups (P<0.05. The operation time was significantly lower in the totally tubeless PCNL group than in the standard PCNL group (P=0.005. Pethidine requirements were significantly higher in the standard PCNL group than the totally tubeless PCNL group (P=0.007. Hospitalization time was significantly higher in the standard PCNL group than in the totally tubeless PCNL group (P<0.0001. The complication rate was 15% in the standard PCNL group and 9.1% in the totally tubeless PCNL group (P=0.73. The totally tubeless PCNL technique is safe and effective, even for patients with staghorn stones. This technique is associated with decreased pain, analgesic needs, and operative and hospitalization time. We believe that a normal peristaltic ureter is the best drainage tube.

  2. Nephron-sparing percutaneous ablation of a 5 cm renal cell carcinoma by superselective embolization and percutaneous RF-ablation

    Energy Technology Data Exchange (ETDEWEB)

    Tacke, J.; Mahnken, A.; Buecker, A.; Guenther, R.W. [Technische Hochschule Aachen (Germany). Klinik fuer Radiologische Diagnostik; Rohde, D. [Technische Hochschule Aachen (Germany). Abt. Urologie

    2001-11-01

    Purpose: To report on the nephron-sparing, percutaneous ablation of a large renal cell carcinoma by combined superselective embolization and percutaneous radiofrequency ablation. Materials and Methods: A 5 cm renal cell carcinoma of a 43-year-old drug abusing male with serologically proven HIV, hepatitis B and C infection, who refused surgery, was superselectively embolized using microspheres (size: 500 - 700 {mu}m) and a platinum coil under local anesthesia. Percutaneous radiofrequency ablation using a 7F LeVeen probe (size of expanded probe tip: 40 mm) and a 200 Watt generator was performed one day after transcatheter embolization under general anesthesia. Results: The combined treatment resulted in complete destruction of the tumor without relevant damage of the surrounding healthy renal tissue. The patient was discharged 24 hours after RF ablation. No complications like urinary leaks or fistulas were observed and follow up CT one day and 4 weeks after the radiofrequency intervention revealed no signs of residual tumor growth. Conclusion: The combined transcatheter embolization and percutaneous radiofrequency ablation of renal cell carcinoma has proved technically feasible, effective, and safe in this patient. It may be offered as an alternative treatment to partial or radical nephrectomy under certain circumstances. Abbreviations: RF = radiofrequency ablation; CT = computed tomography; HIV = human immunodeficiency virus. (orig.) [German] Ziel: Bericht ueber eine nierenschonende, perkutane Ablation eines 5 cm grossen Nierenzellkarzinoms durch kombinierte Transkatheterembolisation und perkutane Radiofrequenzablation. Material und Methoden: Ein 5 cm grosses Nierenzellkarzinom eines 43 Jahre alten Drogenabhaengigen mit serologisch nachgewiesener HIV, Hepatitis B- und C-Infektion, der eine operative Therapie ablehnte, wurde superselektiv durch Embosphaeren (Partikelgroesse: 500 - 700 {mu}m) und einer Platinspirale unter Lokalanaesthesie embolisiert. Am Folgetag

  3. Analysis of fractal electrodes for efficient neural stimulation.

    Science.gov (United States)

    Golestanirad, Laleh; Elahi, Behzad; Molina, Alberto; Mosig, Juan R; Pollo, Claudio; Chen, Robert; Graham, Simon J

    2013-01-01

    Planar electrodes are increasingly used in therapeutic neural stimulation techniques such as functional electrical stimulation, epidural spinal cord stimulation (ESCS), and cortical stimulation. Recently, optimized electrode geometries have been shown to increase the efficiency of neural stimulation by increasing the variation of current density on the electrode surface. In the present work, a new family of modified fractal electrode geometries is developed to enhance the efficiency of neural stimulation. It is shown that a promising approach in increasing the neural activation function is to increase the "edginess" of the electrode surface, a concept that is explained and quantified by fractal mathematics. Rigorous finite element simulations were performed to compute electric potential produced by proposed modified fractal geometries. The activation of 256 model axons positioned around the electrodes was then quantified, showing that modified fractal geometries required a 22% less input power while maintaining the same level of neural activation. Preliminary in vivo experiments investigating muscle evoked potentials due to median nerve stimulation showed encouraging results, supporting the feasibility of increasing neural stimulation efficiency using modified fractal geometries.

  4. Neuronify: An Educational Simulator for Neural Circuits.

    Science.gov (United States)

    Dragly, Svenn-Arne; Hobbi Mobarhan, Milad; Våvang Solbrå, Andreas; Tennøe, Simen; Hafreager, Anders; Malthe-Sørenssen, Anders; Fyhn, Marianne; Hafting, Torkel; Einevoll, Gaute T

    2017-01-01

    Educational software (apps) can improve science education by providing an interactive way of learning about complicated topics that are hard to explain with text and static illustrations. However, few educational apps are available for simulation of neural networks. Here, we describe an educational app, Neuronify, allowing the user to easily create and explore neural networks in a plug-and-play simulation environment. The user can pick network elements with adjustable parameters from a menu, i.e., synaptically connected neurons modelled as integrate-and-fire neurons and various stimulators (current sources, spike generators, visual, and touch) and recording devices (voltmeter, spike detector, and loudspeaker). We aim to provide a low entry point to simulation-based neuroscience by allowing students with no programming experience to create and simulate neural networks. To facilitate the use of Neuronify in teaching, a set of premade common network motifs is provided, performing functions such as input summation, gain control by inhibition, and detection of direction of stimulus movement. Neuronify is developed in C++ and QML using the cross-platform application framework Qt and runs on smart phones (Android, iOS) and tablet computers as well personal computers (Windows, Mac, Linux).

  5. Programmable synaptic chip for electronic neural networks

    Science.gov (United States)

    Moopenn, A.; Langenbacher, H.; Thakoor, A. P.; Khanna, S. K.

    1988-01-01

    A binary synaptic matrix chip has been developed for electronic neural networks. The matrix chip contains a programmable 32X32 array of 'long channel' NMOSFET binary connection elements implemented in a 3-micron bulk CMOS process. Since the neurons are kept off-chip, the synaptic chip serves as a 'cascadable' building block for a multi-chip synaptic network as large as 512X512 in size. As an alternative to the programmable NMOSFET (long channel) connection elements, tailored thin film resistors are deposited, in series with FET switches, on some CMOS test chips, to obtain the weak synaptic connections. Although deposition and patterning of the resistors require additional processing steps, they promise substantial savings in silicon area. The performance of synaptic chip in a 32-neuron breadboard system in an associative memory test application is discussed.

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

    Directory of Open Access Journals (Sweden)

    Tsai-Sheng Fu

    2013-08-01

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

  7. Percutaneous Renal Biopsy : A Report of 200 Caces

    Directory of Open Access Journals (Sweden)

    M. Bahadori

    1966-01-01

    Full Text Available In the diffuse medical diseases of kidney, percutaneous renal biopsy is a valuable, safe and hazardless procedure. With the aid of this nearly new technique renal pathology, the natural history of renal diseases and the response of renal diseases to therapy, as well as the prognosis of renal disorders can be evaluated."nWe have analysed 210 percutaneous biopsies in Tehran. Complications were observed in 13% of cases, there is no mortality and no patient required drastic therapeutic intervention. Anuria, peri-renal colic and peri-renal hematoma were the only serious complications, which were seen in 4 patients, and were. readily controled with simple measures We obtained renal tissue in 95% cases of our patients and in 9 I% of them the tissue was adequate for c'ear diagnosis."nLike other authors, we believe that the procedure, when properly performed, can give a far more valuable informations about the patients without any realy dangerous risk.

  8. Percutaneous treatment of bone tumors by radiofrequency thermal ablation

    Energy Technology Data Exchange (ETDEWEB)

    Ruiz Santiago, Fernando, E-mail: ferusan@ono.com [Department of Radiology, Hospital of Traumatology (Ciudad Sanitaria Virgen de las Nieves), Carretera de Jaen SN, 18013 Granada (Spain); Mar Castellano Garcia, Maria del; Guzman Alvarez, Luis [Department of Radiology, Hospital of Traumatology (Ciudad Sanitaria Virgen de las Nieves), Carretera de Jaen SN, 18013 Granada (Spain); Martinez Montes, Jose Luis [Department of Traumatology, Hospital of Traumatology (Ciudad Sanitaria Virgen de las Nieves), Carretera de Jaen SN, 18013 Granada (Spain); Ruiz Garcia, Manuel; Tristan Fernandez, Juan MIguel [Department of Radiology, Hospital of Traumatology (Ciudad Sanitaria Virgen de las Nieves), Carretera de Jaen SN, 18013 Granada (Spain)

    2011-01-15

    We present our experience of the treatment of bone tumors with radiofrequency thermal ablation (RFTA). Over the past 4 years, we have treated 26 cases (22 benign and 4 malignant) using CT-guided RFTA. RFTA was the sole treatment in 19 cases and was combined with percutaneous cementation during the same session in the remaining seven cases. Our approach to the tumors was simplified, using a single point of entrance for both RFTA and percutaneous osteoplasty. In the benign cases, clinical success was defined as resolution of pain within 1 month of the procedure and no recurrence during the follow-up period. It was achieved in 19 out of the 21 patients in which curative treatment was attempted. The two non-resolved cases were a patient with osteoid osteoma who developed a symptomatic bone infarct after a symptom-free period of 2 months and another with femoral diaphysis osteoblastoma who suffered a pathological fracture after 8 months without symptoms. The procedure was considered clinically successful in the five cases (4 malign and 1 benign) in which palliative treatment was attempted, because there was a mean ({+-}SD) reduction in visual analogue scale (VAS) pain score from 9.0 {+-} 0.4 before the procedure to <4 during the follow-up period.

  9. Percutaneous Adductor Release in Nonambulant Children with Cerebral Palsy

    Directory of Open Access Journals (Sweden)

    Ramji Lal Sahu

    2014-03-01

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

  10. Fluoroscopically guided percutaneous gastrostomy: tube function and malfunction.

    Science.gov (United States)

    McLoughlin, R F; Gibney, R G

    1994-01-01

    We describe our experience with fluoroscopically guided percutaneous gastrostomy, assessing in particular the functional performance of inserted tubes. We also examine the ability of radiological investigations to detect intraperitoneal gastrostomy leakage after the procedure. A functioning gastrostomy tube was established and maintained for as long as was required in 34 (89.5%) of 38 patients referred during a 21-month period. This necessitated further gastrostomy tube placements in 13 patients. On average, inserted gastrostomy tubes functioned for 10.75 weeks and during the review period a total of 34 malfunctioning tubes required replacement or removal. This was most commonly due to tube dislodgement, blockage, or intraperitoneal leakage. We found increasing pneumoperitoneum on sequential postprocedure erect chest films a reliable sign in the diagnosis of the latter complication. In conclusion, while we have been disappointed with aspects of individual tube function, our satisfactory overall functional success rate indicates that percutaneous gastrostomy is an effective method for establishing and maintaining enteral feeding. We also propose a protocol for the management of suspected intraperitoneal leakage based on the findings on postprocedure erect chest films.

  11. Aconite poisoning following the percutaneous absorption of Aconitum alkaloids.

    Science.gov (United States)

    Chan, Thomas Y K

    2012-11-30

    In vitro experiment using the modified Franz-type diffusion cell has demonstrated that the human skin is permeable to aconitine and mesaconitine. To characterise the risk of systemic toxicity following the topical applications of aconite tincture and raw aconite roots, relevant reports of percutaneous absorption of Aconitum alkaloids and aconite poisoning are reviewed. Published reports indicate that aconite tincture and raw aconite roots can be absorbed through the skin into systemic circulation to cause fatal and non-fatal aconite poisoning. Both aconite tincture and raw aconite roots contain very high concentrations of Aconitum alkaloids, which allow penetration of the stratum corneum along the diffusion gradient. The risk of systemic toxicity is even higher if Aconitum alkaloids are held in occlusive contact with the skin and the epidermis (stratum corneum) is already damaged. The public should be warned of the danger in using these topical aconite preparations and the risk of systemic toxicity following percutaneous absorption of Aconitum alkaloids. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  12. [Surgical and nutritional evaluation of children with percutaneous endoscopic gastrostomy].

    Science.gov (United States)

    Limousin, I Tuduri; Velilla, A Gracia; Caro, J González; Azcárate, J Morcillo; Asensio, J C De Agustín

    2009-07-01

    Percutaneous endoscopic gastrostomy (PEG) has suppoused an improvement in the nutritional management of patients with deglution difficulty. Surgical and nutritional aspects have been evaluated in our patients with PEG. A descriptive retrospective study with individual analysis of surgical, nutritional and satisfaction items has been developed. 83 PEG (1994-08) have been implanted in neurological patients (63.8%) followed by cystic fibrosis; Mean age 7 years (4 months-25 years). Two patients have a ventriculo-peritoneal shunt (VPS) and 3 a peritoneal dialysis catheter (PDC). 12% had a mild complication and 3 patients a severe one, with 2 reinterventions performed. 40 patients have the dispositive, 25 were removed after a mean follow-up of 2,5 years and 17 patients dies. Nutrition was done with initial, continuation or specials formulas. Weight evaluation was satisfactory in 96% of patients and biochemical indicators were normalized in 97% of them. Satisfaction is very high among the majority of parents. PEG is a technique that allows nutritional recuperation with few surgical complications. VPS and PDC are not contraindications for the percutaneous gastrostomy. PEG improves children and relatives life quality.

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

    Directory of Open Access Journals (Sweden)

    Guo Dongyuan

    2014-12-01

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

  14. Brain Abscess after Percutaneous Therapy for Trigeminal Neuralgia

    Directory of Open Access Journals (Sweden)

    Michele Acqui

    2015-01-01

    Full Text Available We report a case of brain abscess following the percutaneous treatment for trigeminal neuralgia. This procedure envisages the access with a needle into the middle cranial fossa through the oral cavity. Thus, in this case, the bacterial infection can be more likely ascribed to the possible contamination of the needle inside the oral cavity rather than to other frequent and more controllable causes of infection like an imperfect sterilization of surgical instruments or an inadequate antiseptic preparation of both operator’s hands and patient’s skin. The subsequent brain abscess was treated with antibiotic therapy (Vancomycin 2 gr a day and Meropenem 8 g a day for 22 days before the surgical procedure and 30 days after, until complete normalization of laboratory parameters, clinical parameters, and neurological symptoms and surgical drainage, although the culture of the abscess capsule and the purulent material resulted sterile. In conclusion, the percutaneous therapy for trigeminal neuralgia can be objectively related to risks, even if performed by expert hands. Therefore, it is important that the patient should be advised regarding risks/benefits and/or septic complications of such procedures, even if they occur very seldom. An association of surgery and antibiotic therapy results as effective treatment for this pathologic condition.

  15. PERCUTANEOUS BIPLANAR EXTERNAL FIXATOR METHOD FOR TREATMENT OF CALCONEAL FRACTURES

    Directory of Open Access Journals (Sweden)

    Jagadeesh Kumar

    2015-07-01

    Full Text Available Calcaneal fracture, the most common tarsal bone fracture, occurs predominantly in manual labors and subsequently has got considerable socioeconomic implications. Treatment modality which can offer early weight bearing and early return to work is therefore needed for those patient s. We have used a biplanar percutaneous external fixator for treating calcaneal fractures per operative visualization of the fractures. We have treated 20 calcaneal fractures in 18 patients, 12 intra articular and five extra articular, with our percutaneou s external fixator system with under image intensifier and achieving the fracture reduction. Functional outcome was measured using the American Orthopaedic Foot and ankle society Hind foot score. All fractures united with a mean of 55 days. Partial weight bearing was possible in a mean of 1.8 days and full bearing was possible in a mean of 11.6 days. All the patients were returned to their original work within six weeks. Minor infectious complications occurred in 17.6 percent of cases. The average AOFAS sco re at six months follow up was 83.8. We conclude that our percutaneous external fixator technique for fracture calcaneum is an effective alternative to the currently available – surgical and conservative treatment modalities especially in lower socio econo mic labor population who need to return to their job as early as possible. Level of Evidence – IV Case series

  16. Percutaneous Salivary Gland Ablation using Ethanol in a Rat Model

    Directory of Open Access Journals (Sweden)

    Emma Burch

    2017-12-01

    Full Text Available Objectives: Sialorrhea is a common health and psychosocial problem for children with neuromuscular dysfunction secondary to a variety of disorders such as cerebral palsy. Current accepted treatments include the injection of botulinum toxin into the submandibular glands for temporary symptom relief. The purpose of this study is to demonstrate the feasibility of percutaneous ethanol injection for longer lasting salivary gland ablation in an animal model. Material and Methods: Twenty rats were used in this study. In each rat, 98% ethanol was injected into the right submandibular gland under ultrasound guidance. No intervention was performed on the left gland, which served as the control. Ten rats were sacrificed and glands evaluated at three weeks, with the remaining 10 rats sacrificed and evaluated at three months. Unpaired, 1-tailed T-tests were used to analyse the data. Results: Ethanol injections induced a significant and sustained reduction in salivary gland size. Treated glands were 41% smaller by mass than untreated controls in the 10 rats sacrificed at three weeks (P < 0.001. Treated glands were 43% smaller by mass than untreated controls in the 10 rats sacrificed at three months (P < 0.001. Qualitative histologic analysis demonstrated extensive parenchymal damage, inflammation, and fibrosis at both three week and three month time points. Conclusions: Using a rat model, we demonstrated dramatic and sustained submandibular gland damage after percutaneous injection of ethanol.

  17. Percutaneous vertebroplasty in osteoporosis, myeloma and Langerhans' cell histiocytosis.

    LENUS (Irish Health Repository)

    Kevane, B

    2012-01-09

    This review aims to assess the effectiveness of percutaneous vertebroplasty as a treatment for the severe refractory pain associated with vertebral fracture, in a group of patients with fractures secondary to either osteoporotic or neoplastic disease. A retrospective review of 20 patients treated with percutaneous vertebroplasty in Cork University Hospital up until March 2007 was carried out and a questionnaire was prepared and distributed. Prior to vertebroplasty, patients had been symptomatic with severe pain for a mean of 20.9 weeks. Of those thirteen whom replied to a postal questionnaire, 12 (92.3%) reported pain relief and this improvement occurred within 7 days in 9 (81.8%). This was associated with decreased analgesic requirements, as determined on chart review. Prior to the procedure only 5 (38.4%) were independently mobile and this figure rose to 10 (76.9%) afterwards, occurring within one week in the majority. Subjective outcomes were better in the group of patients with neoplasm-induced fractures.

  18. Percutaneous osteosynthesis in the pelvis in cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Deschamps, Frederic; Baere, Thierry de; Tselikas, Lambros [Gustave Roussy, Interventional Radiology Department, Villejuif (France); Univeristy Paris-Sud, Le Kremlin Bicetre (France); Hakime, Antoine; Pearson, Ernesto; Farouil, Geoffroy; Teriitehau, Christophe [Gustave Roussy, Interventional Radiology Department, Villejuif (France)

    2016-06-15

    Screw fixation (osteosynthesis) can be performed percutaneously by interventional radiologists. We report our experience in cancer patients. We retrospectively reviewed all cases of percutaneous osteosynthesis (PO) of the pelvic ring and proximal femur performed in our hospital. PO were performed for fracture palliation or for osteolytic metastases consolidation. Screws were inserted under CT- or cone-beam CT- guidance and general anaesthesia. Patients were followed-up with pelvic-CT and medical consultation at 1 month, then every 3 months. For fractures, the goal was pain palliation and for osteolytic metastases, pathologic fracture prevention. Between February 2010 and August 2014, 64 cancer patients were treated with PO. Twenty-one patients had PO alone for 33 painful fractures (13 bone-insufficiency, 20 pathologic fractures). The pain was significantly improved at 1 month (VAS score = 20/100 vs. 80/100). In addition, 43 cancer patients were preventively consolidated using PO plus cementoplasty for 45 impending pathologic fractures (10 iliac crests, 35 proximal femurs). For the iliac crests, no fracture occurred (median-FU = 75 days). For the proximal femurs, 2 pathological fractures occurred (fracture rate = 5.7 %, median-FU = 205 days). PO is a new tool in the therapeutic arsenal of interventional radiologists for bone pain management. (orig.)

  19. Percutaneous nephrostomy and antegrade ureteral stenting: technique - indications - complications

    Energy Technology Data Exchange (ETDEWEB)

    Hausegger, Klaus A. [Klagenfurt General Hospital, Department of Radiology, Klagenfurt (Austria); Portugaller, Horst R. [University Hospital of Graz, Department of Radiology, Graz (Austria)

    2006-09-15

    In this review the technique, indication for and complications of percutaneous nephrostomy (PCN) and antegrade ureter stent insertion are described. In the majority of the cases PCN is performed to relieve urinary obstruction, which can be of benign or malignant nature. Another indication for PCN is for treatment of urinary fistulas. PCN can be performed under ultrasound and/or fluoroscopic guidance, with a success rate of more than 90%. The complication rate is approximately 10% for major and minor complications together and 4-5% for major complications only. Percutaneous antegrade double-J stent insertion usually is performed if retrograde ureter stenting has not been successful. However, especially in malignant obstructions, the success rate for antegrade stenting is higher than for retrograde transvesical double-J stent insertion. In the case of severe infection and bleeding after PCN JJ-stent insertion may be contraindicated so long as there is no sufficient concomitant drainage via a PCN. Lower urinary tract dysfunction should be excluded before stent placement. The complication rate is 2-4%. Consequent stent surveillance with regular stent exchange is mandatory. (orig.)

  20. Treatment of Chronic Plantar Fasciitis With Percutaneous Latticed Plantar Fasciotomy.

    Science.gov (United States)

    Yanbin, Xu; Haikun, Chu; Xiaofeng, Ji; Wanshan, Yang; Shuangping, Liu

    2015-01-01

    Plantar fasciitis, the most common cause of pain in the inferior heel, accounts for 11% to 15% of all foot symptoms requiring professional care among adults. The present study reports the results of a minimally invasive surgical treatment of chronic plantar fasciitis. All patients with plantar fasciitis who had undergone percutaneous latticed plantar fasciotomy at 3 clinical sites from March 2008 to March 2009 were included in the present study. The follow-up evaluations for this treatment were conducted using the Mayo clinical scoring system. We investigated 17 patients with recalcitrant chronic plantar fasciitis who had undergone this treatment within a follow-up period of ≥13 months. All procedures were performed in the clinic with the patient under local anesthesia. No wound infections or blood vessel or nerve damage occurred. At a mean follow-up period of 16.0 ± 2.29 (range 13 to 21) months, significant improvement was seen in the preoperative mean Mayo score (from 12.06 ± 2.54 to 89.76 ± 4.28, p plantar fasciitis with percutaneous latticed plantar fasciotomy could be a promising treatment option for patients with recalcitrant chronic plantar fasciitis. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  1. Percutaneous interventions for treating ischemic complications of aortic dissection

    Energy Technology Data Exchange (ETDEWEB)

    Chavan, Ajay; Luthe, Lars [Klinikum Oldenburg, Department of Diagnostic and Interventional Radiology, Oldenburg (Germany); Rosenthal, Herbert; Pfingsten, Stefanie; Galanski, Michael [Hannover Medical School, Department of Radiology, Hannover (Germany); Kutschka, Ingo; Haverich, Axel [Hannover Medical School, Department of Cardio-thoracic Surgery, Hannover (Germany); Easo, Jerry; Dapunt, Otto [Klinikum Oldenburg, Department of Cardio-thoracic Surgery, Oldenburg (Germany); Piepenbrock, Siegfried [Hannover Medical School, Department of Anaesthesia, Hannover (Germany)

    2009-02-15

    The aim of this study was to evaluate the role of percutaneous interventions in treating ischemia complicating aortic dissection. Forty-five patients with ischemia complicating aortic dissection were treated by balloon fenestration, true lumen stenting, angioplasty, or thrombolysis. Clinical and laboratory examinations were performed before and after intervention, and at the end of follow-up (median 37 months). Eighteen dissections were acute, 9 sub-acute, and 18 chronic. Mesenterohepatic ischemia resolved in 16 of 18 patients; lactate and SGOT values fell from 2.89 to 1.23 mmol/L (p=0.006) and from 165.9 to 59.7 U/L (p=0.034), respectively. In patients with renal ischemia, creatinine levels fell from 360.1 to 196.3 {mu}mol/L (p=0.007) accompanied by a significant reduction in blood pressure. Limb-threatening ischemia resolved in three of four patients; in 21 claudicants, the mean walking distance improved from 272 to 1,283 m (p=0.001). Spinal ischemia resolved completely or partially in six of eight patients. Adjunctive surgical measures were necessary in six patients. Overall 30-day mortality in the 45 patients was 6.7%; all three deaths were in patients with acute dissections (mortality in this subgroup 16.7%). Ischemia complicating aortic dissection can be effectively treated by percutaneous interventions resulting in good early and mid-term outcomes. (orig.)

  2. Thoracoscopic ASD closure is a reliable supplement for percutaneous treatment.

    Science.gov (United States)

    Casselman, F P; Dom, H; De Bruyne, B; Vermeulen, Y; Vanermen, H

    2005-06-01

    To determine the feasibility and effectiveness of endoscopic atrial septal defect (ASD) closure when percutaneous ASD closure is impossible or has failed. Between March 1997 and February 2003, 74 patients (63% female, mean (SD) age 44 (16) years) underwent an endoscopic ASD closure. Median preoperative New York Heart Association functional class was I. Clinical and echocardiographic follow up was obtained for all patients (mean (SD) 38 (19) months). Patients were assessed for scar aesthetics, procedure related pain, functional recovery, and overall patient satisfaction. ASD closure was successful in all patients (two primum ASD, 68 secundum ASD, four sinus venosus type). Patch repair was performed in 42%. Mean aortic cross clamp and cardiopulmonary bypass times were 54 (24) minutes and 98 (35) minutes, respectively. There were no in-hospital deaths and no conversions to sternotomy. Complications included one iliac vein stenting, one femoral arterioplasty, two revisions for suspected bleeding, and seven cases of atrial fibrillation. Two patients required late reoperation: one for atrial thrombus and another for tricuspid regurgitation. Echocardiographic control confirmed complete ASD closure in 71 patients and a small residual shunt in three patients. Ninety three per cent of the patients were highly satisfied with very low procedure related pain and 97% felt they had an aesthetically pleasing scar. Endoscopic ASD closure can be safely done with a high degree of patient satisfaction. It is now the authors' exclusive surgical approach whenever percutaneous treatment is not indicated or has failed.

  3. Percutaneous laser ablation of unresectable primary and metastatic adrenocortical carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Pacella, Claudio M. [Regina Apostolorum Hospital, Department of Diagnostic Imaging and Interventional Radiology, Via San Francesco 50, Albano Laziale, Rome 00041 (Italy)], E-mail: claudiomaurizio.pacella@fastwebnet.it; Stasi, Roberto; Bizzarri, Giancarlo; Pacella, Sara; Graziano, Filomena Maria; Guglielmi, Rinaldo; Papini, Enrico [Regina Apostolorum Hospital, Department of Diagnostic Imaging and Interventional Radiology, Via San Francesco 50, Albano Laziale, Rome 00041 (Italy)

    2008-04-15

    Purpose: To evaluate the feasibility, safety, and clinical benefits of percutaneous laser ablation (PLA) in patients with unresectable primary and metastatic adrenocortical carcinoma (ACC). Patients and methods: Four patients with hepatic metastases from ACC and a Cushing's syndrome underwent ultrasound-guided PLA. In one case the procedure was performed also on the primary tumor. Results: After three sessions of PLA, the primary tumor of 15 cm was ablated by 75%. After 1-4 (median 1) sessions of PLA, five liver metastases ranging from 2 to 5 cm were completely ablated, while the sixth tumor of 12 cm was ablated by 75%. There were no major complications. Treatment resulted in an improvement of performance status and a reduction of the daily dosage of mitotane in all patients. The three patients with liver metastases presented a marked decrease of 24-h urine cortisol levels, an improved control of hypertension and a mean weight loss of 2.8 kg. After a median follow-up after PLA of 27.0 months (range, 9-48 months), two patients have died of tumor progression, while two other patients remain alive and free of disease. Conclusions: Percutaneous laser ablation is a feasible, safe and well tolerated procedure for the palliative treatment of unresectable primary and metastatic ACC. Further study is required to evaluate the impact of PLA on survival.

  4. Which percutaneous tracheostomy method is better? A systematic review.

    Science.gov (United States)

    Sanabria, Alvaro

    2014-11-01

    The aim of this study was to assess the different methods of percutaneous tracheostomy in terms of successful performance of the tracheostomy as well as safety. Tracheostomy is the most common procedure performed on the airway for patients in ICUs. Lately, several methods of percutaneous tracheostomy (multiple dilator, progressive dilator, forceps dilation, screw-like dilation, balloon dilation, and translaryngeal) have been described, with theoretical advantages, but there is no consensus about which is better. A systematic review with critical appraisal of the literature was done. Literature in multiple databases was searched. Randomized controlled trials comparing different tracheostomy methods were selected. Clinical and methodological characteristics were assessed. A meta-analysis using fixed effect models was planned for statistically homogeneous outcomes. Fourteen randomized controlled trials were included, most of them with small sample sizes and with comparisons of multiple methods. Blue Rhino methods were less difficult for surgeons (risk difference of 14.7% [95% CI 8-21.5]) and had more minor bleeding events (risk difference of -6.3% [95% CI -13.58 to 0.8]). There were no differences in major bleeding events. Statistically, heterogeneity and lack of data impede comparison with other outcomes. The Blue Rhino method is less difficult and has more minor bleeding events, but physicians also have more experience with this technique. However, trials are underpowered to define the best method. Copyright © 2014 by Daedalus Enterprises.

  5. Metrics and clinical relevance of percutaneous penetration and lateral spreading.

    Science.gov (United States)

    Vieille-Petit, Aline; Blickenstaff, Nicholas; Coman, Garrett; Maibach, Howard

    2015-01-01

    Percutaneous penetration of urea in vivo in man has been documented. If urea can penetrate the skin, it may also move laterally. Lateral spreading of topical substances leads to unpredictable penetration dynamics and increased skin surface area exposure. The ability of urea, a low molecular-weight hydrophilic model, to penetrate the stratum corneum (SC) and spread outside the application site was investigated in vitro using tape stripping with spectroscopy. The parameters investigated were the following: time between urea application and tape stripping, formulations containing urea and use of a petrolatum-covered ring barrier around the marked application area. The percentage of urea was determined in and around the application site. The spreading of topically applied urea to neighboring areas occurred and was time but not formulation dependent. A significant difference between protocols with and without the petrolatum ring was observed. These results suggest the clinical importance of lateral spreading, occurring predominately on the skin surface. SC thickness varies between anatomical sites, predisposing areas such as the face and scalp margins to increased percutaneous penetration of topical products. The use of a protective petrolatum ring can inhibit lateral spreading of hair dye in individuals allergic to hair dye, limit systemic absorption and increase accuracy when assessing penetration dynamics. © 2014 S. Karger AG, Basel.

  6. Effectiveness of percutaneous closure of patent foramen ovale for hypoxemia.

    Science.gov (United States)

    Fenster, Brett E; Nguyen, Bryant H; Buckner, J Kern; Freeman, Andrew M; Carroll, John D

    2013-10-15

    The aim of this study was to evaluate the ability of percutaneous patent foramen ovale (PFO) closure to improve systemic hypoxemia. Although PFO-mediated right-to-left shunt (RTLS) is associated with hypoxemia, the ability of percutaneous closure to ameliorate hypoxemia is unknown. Between 2004 and 2009, 97 patients who underwent PFO closure for systemic hypoxemia and dyspnea that was disproportionate to underlying lung disease were included for evaluation. All patients exhibited PFO-mediated RTLS as determined by agitated saline echocardiography. Procedural success was defined as implantation of a device without major complications and mild or no residual shunt at 6 months. Clinical success was defined as a composite of an improvement in New York Heart Association (NYHA) functional class, reduction of dyspnea symptoms, or decreased oxygen requirement. Procedural success was achieved in 96 of 97 (99%), and clinical success was achieved in 68 of 97 (70%). The presence of any moderate or severe interatrial shunt by agitated saline study (odds ratio [OR] = 4.7; p gender (OR = 0.30; p <0.017) decreased the likelihood of success. In conclusion, based on the largest single-center experience of patients referred for PFO closure for systemic hypoxemia, PFO closure was a mechanically effective procedure with an associated improvement in echocardiographic evidence of RTLS, NYHA functional class, and oxygen requirement. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. Angioscopic assessment of various percutaneous treatments for arteriosclerosis obliterance

    Science.gov (United States)

    Kusaba, Hiroyasu; Watanabe, Kazuo; Shiraishi, Shohzo; Sato, Takashi; Koga, Nobuhiko

    1993-06-01

    We have evaluated the angioscopic findings before and after various percutaneous techniques to treat 39 lesions in 32 cases of arteriosclerosis obliterans (ASO). We applied a laser (CL50: SLT, Japan), percutaneous transluminal angioplasty (PTA), and atherectomy -- either singly or in combination, with angioscopic luminal observation (angioscope: PF14L & PF18L Olympus, Japan) recorded before and after the treatments. In the case of a complete obstruction, we employed PTA as the first choice. We used a laser prior to PTA when the PTA guide-wire failed to penetrate the lumen. For eccentric and calcified lesions atherectomy was applied. A sufficient enlargement was obtained initially in 37 of the 39 lesions. The angioscopic observations after treatment revealed carbonization (3/5) and attachment of small thrombi (3/5) after using the laser, intimal rupture (3/8), dissection (2/8), flap formation (2/8), and attachment of small thrombi (4/8) after PTA, and attachment of small thrombi (9/19), flap formation (6/19), and dissection (2/19) after atherectomy. We established the efficacy of angioscopic assessment demonstrating beneficial clinical results. The angioscopic findings suggest that attachment of small thrombi may be responsible for a poor prognosis. Additional angioscopic observations with angiography are recommended for improved understanding of the luminal changes.

  8. Computational neural learning formalisms for manipulator inverse kinematics

    Science.gov (United States)

    Gulati, Sandeep; Barhen, Jacob; Iyengar, S. Sitharama

    1989-01-01

    An efficient, adaptive neural learning paradigm for addressing the inverse kinematics of redundant manipulators is presented. The proposed methodology exploits the infinite local stability of terminal attractors - a new class of mathematical constructs which provide unique information processing capabilities to artificial neural systems. For robotic applications, synaptic elements of such networks can rapidly acquire the kinematic invariances embedded within the presented samples. Subsequently, joint-space configurations, required to follow arbitrary end-effector trajectories, can readily be computed. In a significant departure from prior neuromorphic learning algorithms, this methodology provides mechanisms for incorporating an in-training skew to handle kinematics and environmental constraints.

  9. Trace Elements and Residual Elements in Superalloys,

    Science.gov (United States)

    Trace elements , *Superalloys, Impurities, Nickel alloys, Refining, Refractory materials, Gases, Residuals, Porosity, Nonmetals, Metals, Metalloids, Segregation(Metallurgy), Auger electron spectroscopy, Fracture(Mechanics), Symposia

  10. Percutaneous Management of Ureteral Injuries that are Diagnosed Late After Cesarean Section

    Energy Technology Data Exchange (ETDEWEB)

    Ustunsoz, Bahri; Ugurel, Sahin; Duru, Namik Kemal; Ozgok, Yasar; Ustunsoz, Ayfer [GATA Medical Faculty, Ankara (Turkmenistan)

    2008-08-15

    We wanted to present the results of percutaneous management of ureteral injuries that were diagnosed late after cesarean sections (CS). Twenty-two cases with 24 ureteral injuries that were diagnosed late after CS underwent percutaneous nephrostomy (PN), antegrade double J (DJ) catheter placement and balloon dilatation or a combination of these. The time for making the diagnosis was 21 +- 50.1 days. The injury site was the distal ureter in all cases (the left ureter: 13, the right ureter: 7 and bilateral: 2). Fifteen complete ureteral obstructions were detected in 13 cases. Ureteral leakage due to partial (n = 4) or complete (n = 3) rupture was noted in seven cases. Two cases had ureterovaginal fistula. All the cases were initially confirmed with antegrade pyelography and afterwards they underwent percutaneous nephrostomy. Balloon dilatation was needed in three cases. Antegrade DJ stents were placed in 10 cases, including the three cases with balloon dilatation. Repetititon of percutaneous nephrostomy with balloon dilatation and DJ stent placement was needed in one case with complete obstruction. All the cases were followed-up with US in their first week and then monthly thereafter for up to two years. Eighteen ureters (75%) were managed by percutaneous procedures alone. A total of six ureter injuries had to undergo surgery (25%). Percutaneous management is a good alternative for the treatment of post-CS ureteral injuries that are diagnosed late after CS. Percutaneous management is at least preparatory for a quarter of the cases where surgery is unavoidable

  11. Percutaneous cholecystostomy is an effective definitive treatment option for acute acalculous cholecystitis.

    Science.gov (United States)

    Kirkegård, J; Horn, T; Christensen, S D; Larsen, L P; Knudsen, A R; Mortensen, F V

    2015-12-01

    Acute acalculous cholecystitis can be treated with percutaneous cholecystostomy in critically ill patients unfit for surgery. However, the evidence on the outcome is sparse. We conducted a retrospective analysis of acute acalculous cholecystitis patients treated with percutaneous cholecystostomy during a 10-year study period. An observational study of 56 consecutive patients treated with percutaneous cholecystostomy for acute acalculous cholecystitis was conducted in the period from 1 June 2002 to 31 May 2012. All data were obtained by review of medical records. A total of 56 consecutive patients were treated with percutaneous cholecystostomy for acute acalculous cholecystitis. Six patients (10.7%) died within 30 days after the procedure. Percutaneous cholecystostomy could serve as a definitive treatment option in 45 patients (80.4%), whereas 1 patient (1.8%) required cholecystectomy due to recurrence of cholecystitis. Four patients (7.1%) were treated with percutaneous cholecystostomy as a bridging procedure to subsequent elective laparoscopic cholecystectomy within a median of 8.8 months (range: 7.7-33.4 months). There was no significant difference in the risk of cholecystitis recurrence between patients with (6/37) and without (2/3) contrast passage to the duodenum on cholangiography (p = 0.096). Percutaneous cholecystostomy is successful as a definitive treatment option in the majority of patients with acute acalculous cholecystitis. It is associated with a low rate of mortality and subsequent cholecystectomy. © The Finnish Surgical Society 2015.

  12. Early Percutaneous Cholecystostomy in Severe Acute Cholecystitis Reduces the Complication Rate and Duration of Hospital Stay

    Science.gov (United States)

    Chou, Chung-Kai; Lee, Kuei-Chuan; Chan, Che-Chang; Perng, Chin-Lin; Chen, Chun-Ku; Fang, Wen-Liang; Lin, Han-Chieh

    2015-01-01

    Abstract The optimal timing of percutaneous cholecystostomy for severe acute cholecystitis is unclear. The aim of this study was to investigate the timing of percutaneous cholecystostomy and its relationship to clinical outcomes in patients with inoperable acute severe cholecystitis. From 2008 to 2010, 209 consecutive patients who were admitted to our hospital due to acute cholecystitis and were treated by percutaneous cholecystostomy were retrospectively reviewed. The time periods from symptom onset to when percutaneous cholecystostomy was performed and when patients were discharged were recorded. In the 209 patients, the median time period between symptom onset and percutaneous cholecystostomy was 23 hours (range, 3–95 hours). The early intervention group (≤24 hours, n = 109) had a significantly lower procedure-related bleeding rate (0.0% vs 5.0%, P = 0.018) and shorter hospital stay (15.8 ± 12.9 vs 21.0 ± 17.5 days) as compared with the late intervention group (>24 hours, n = 100). Delayed percutaneous cholecystostomy was a significant independent factor for a longer hospital stay (odds ratio 3.03, P = 0.001). In inoperable patients with acute severe cholecystitis, early percutaneous cholecystostomy reduced hospital stay and procedure-related bleeding without increasing the mortality rate. PMID:26166097

  13. Neural network technologies

    Science.gov (United States)

    Villarreal, James A.

    1991-01-01

    A whole new arena of computer technologies is now beginning to form. Still in its infancy, neural network technology is a biologically inspired methodology which draws on nature's own cognitive processes. The Software Technology Branch has provided a software tool, Neural Execution and Training System (NETS), to industry, government, and academia to facilitate and expedite the use of this technology. NETS is written in the C programming language and can be executed on a variety of machines. Once a network has been debugged, NETS can produce a C source code which implements the network. This code can then be incorporated into other software systems. Described here are various software projects currently under development with NETS and the anticipated future enhancements to NETS and the technology.

  14. Analysis of neural data

    CERN Document Server

    Kass, Robert E; Brown, Emery N

    2014-01-01

    Continual improvements in data collection and processing have had a huge impact on brain research, producing data sets that are often large and complicated. By emphasizing a few fundamental principles, and a handful of ubiquitous techniques, Analysis of Neural Data provides a unified treatment of analytical methods that have become essential for contemporary researchers. Throughout the book ideas are illustrated with more than 100 examples drawn from the literature, ranging from electrophysiology, to neuroimaging, to behavior. By demonstrating the commonality among various statistical approaches the authors provide the crucial tools for gaining knowledge from diverse types of data. Aimed at experimentalists with only high-school level mathematics, as well as computationally-oriented neuroscientists who have limited familiarity with statistics, Analysis of Neural Data serves as both a self-contained introduction and a reference work.

  15. Neural networks for triggering

    Energy Technology Data Exchange (ETDEWEB)

    Denby, B. (Fermi National Accelerator Lab., Batavia, IL (USA)); Campbell, M. (Michigan Univ., Ann Arbor, MI (USA)); Bedeschi, F. (Istituto Nazionale di Fisica Nucleare, Pisa (Italy)); Chriss, N.; Bowers, C. (Chicago Univ., IL (USA)); Nesti, F. (Scuola Normale Superiore, Pisa (Italy))

    1990-01-01

    Two types of neural network beauty trigger architectures, based on identification of electrons in jets and recognition of secondary vertices, have been simulated in the environment of the Fermilab CDF experiment. The efficiencies for B's and rejection of background obtained are encouraging. If hardware tests are successful, the electron identification architecture will be tested in the 1991 run of CDF. 10 refs., 5 figs., 1 tab.

  16. Artificial neural network modelling

    CERN Document Server

    Samarasinghe, Sandhya

    2016-01-01

    This book covers theoretical aspects as well as recent innovative applications of Artificial Neural networks (ANNs) in natural, environmental, biological, social, industrial and automated systems. It presents recent results of ANNs in modelling small, large and complex systems under three categories, namely, 1) Networks, Structure Optimisation, Robustness and Stochasticity 2) Advances in Modelling Biological and Environmental Systems and 3) Advances in Modelling Social and Economic Systems. The book aims at serving undergraduates, postgraduates and researchers in ANN computational modelling. .

  17. Neurally-mediated sincope.

    Science.gov (United States)

    Can, I; Cytron, J; Jhanjee, R; Nguyen, J; Benditt, D G

    2009-08-01

    Syncope is a syndrome characterized by a relatively sudden, temporary and self-terminating loss of consciousness; the causes may vary, but they have in common a temporary inadequacy of cerebral nutrient flow, usually due to a fall in systemic arterial pressure. However, while syncope is a common problem, it is only one explanation for episodic transient loss of consciousness (TLOC). Consequently, diagnostic evaluation should start with a broad consideration of real or seemingly real TLOC. Among those patients in whom TLOC is deemed to be due to ''true syncope'', the focus may then reasonably turn to assessing the various possible causes; in this regard, the neurally-mediated syncope syndromes are among the most frequently encountered. There are three common variations: vasovagal syncope (often termed the ''common'' faint), carotid sinus syndrome, and the so-called ''situational faints''. Defining whether the cause is due to a neurally-mediated reflex relies heavily on careful history taking and selected testing (e.g., tilt-test, carotid massage). These steps are important. Despite the fact that neurally-mediated faints are usually relatively benign from a mortality perspective, they are nevertheless only infrequently an isolated event; neurally-mediated syncope tends to recur, and physical injury resulting from falls or accidents, diminished quality-of-life, and possible restriction from employment or avocation are real concerns. Consequently, defining the specific form and developing an effective treatment strategy are crucial. In every case the goal should be to determine the cause of syncope with sufficient confidence to provide patients and family members with a reliable assessment of prognosis, recurrence risk, and treatment options.

  18. The Neural Noisy Channel

    OpenAIRE

    Yu, Lei; Blunsom, Phil; Dyer, Chris; Grefenstette, Edward; Kocisky, Tomas

    2016-01-01

    We formulate sequence to sequence transduction as a noisy channel decoding problem and use recurrent neural networks to parameterise the source and channel models. Unlike direct models which can suffer from explaining-away effects during training, noisy channel models must produce outputs that explain their inputs, and their component models can be trained with not only paired training samples but also unpaired samples from the marginal output distribution. Using a latent variable to control ...

  19. Neural induced embryoid bodies present high levels of metals detected by x-ray microfluorescence

    Energy Technology Data Exchange (ETDEWEB)

    Stelling, Mariana P.; Cardoso, Simone C.; Paulsen, Bruna S.; Rehen, Stevens K. [Instituto de Ciencias Biomedicas, Universidade Federal do Rio de Janeiro, Av. Carlos Chagas, 373 (Brazil); Instituto de Fisica, Universidade Federal do Rio de Janeiro, Av. Athos da Silveira Ramos, 14, 21941 Rio de Janeiro (Brazil); Instituto de Ciencias Biomedicas, Universidade Federal do Rio de Janeiro, Av. Carlos Chagas, 373 (Brazil)

    2012-05-17

    Molecular mechanisms driving neural differentiation in human embryonic stem cells are not completely elucidated, specially, the role of atomic elements within this process. In this work, we described the distribution of trace elements in those stem cells growing as embryoid bodies by using synchrotron radiation X-ray microfluorescence (SR-XRF). Naive and neural induced embryoid bodies derived from embryonic stem cells were irradiated with a spatial resolution of 20 {mu}m to make elemental maps and qualitative chemical analyses. We consistently detected metallic elements content raise on neural induced embryoid bodies, mimicking characteristic brain development. The use of SR-XRF reveals that human embryoid bodies exhibit self-organization at the atomic level, which is enhanced during neurogenesis triggered in vitro.

  20. Post biopsy Liver Hemorrhage Successfully Controlled by Ultrasound-guided Percutaneous Microwave Ablation

    Directory of Open Access Journals (Sweden)

    Ophelia Ka Heng Wai

    2016-01-01

    Full Text Available Percutaneous microwave coagulation therapy has been one of the major new developments in tumor ablation. Microwave ablation has also been used intraoperatively to achieve hemostasis at surgical margins in laparotomy. However, the use of microwave ablation for coagulation and hemostasis through percutaneous approach has not been described in the literature. Here, we report a case of hepatic amyloidosis with massive post biopsy liver hemorrhage, which could not be by transarterial embolization, and subsequently controlled by ultrasound-guided percutaneous microwave ablation. To the best of our knowledge, this is the first reported case of this technology application in human.

  1. Standards of practice: quality assurance guidelines for percutaneous treatments of intervertebral discs.

    Science.gov (United States)

    Kelekis, Alexis D; Filippiadis, Dimitris K; Martin, Jean-Baptiste; Brountzos, Elias

    2010-10-01

    Percutaneous treatments are used in the therapy of small- to medium-sized hernias of intervertebral discs to reduce the intradiscal pressure in the nucleus and theoretically create space for the herniated fragment to implode inward, thus reducing pain and improving mobility and quality of life. These techniques involve the percutaneous removal of the nucleus pulposus by using a variety of chemical, thermal, or mechanical techniques and consist of removal of all or part of nucleus pulposus to induce more rapid healing of the abnormal lumbar disc. These guidelines are written to be used in quality improvement programs for assessing fluoroscopy- and/or computed tomography-guided percutaneous intervertebral disc ablative techniques.

  2. Neural Based Orthogonal Data Fitting The EXIN Neural Networks

    CERN Document Server

    Cirrincione, Giansalvo

    2008-01-01

    Written by three leaders in the field of neural based algorithms, Neural Based Orthogonal Data Fitting proposes several neural networks, all endowed with a complete theory which not only explains their behavior, but also compares them with the existing neural and traditional algorithms. The algorithms are studied from different points of view, including: as a differential geometry problem, as a dynamic problem, as a stochastic problem, and as a numerical problem. All algorithms have also been analyzed on real time problems (large dimensional data matrices) and have shown accurate solutions. Wh

  3. Factors Influencing the Duration of Fluoroscopy in Percutaneous Nephrolithotomy

    Directory of Open Access Journals (Sweden)

    Alper Gok

    2013-10-01

    Full Text Available Aim: Percutaneous nephrolithotomy (PCNL is established in urology practice with routine use of fluoroscopic guidance. Aim of this study is investigating factors which influence duration of fluoroscopy in percutaneous nephrolithotomy. Material and Method: Factors influencing duration of fluoroscopy were evaluated on 199 patients who were underwent percutaneous nephrolithotomy in Türkiye Yüksek Ižhtisas Hospital between January 2008 and May 2011. An intravenous pyelogram(IVP and non-contrasted Computerized Tomography(CT were studied for all patients and size and Hounsfield Unit(HU of all stones were evaluated. Stone load was recorded as the value obtained by multiplying diameter of largest axis and the axis vertical to the former one, which are measured with ruler. Current study evaluated effects of surgical experience, number of insertions into kidney, history of previous operation in same kidney, radio-density or Hounsfield Unit of the stone as calculated in Computerized Tomography and preoperatively calculated stone load on duration of fluoroscopy. Results: It was observed that higher experience has statistically significant effect on the duration of fluoroscopy (p = 0.006. A statistically significant difference was observed between preoperatively calculated stone load categories and duration of fluoroscopy (p<0.001. When effect of one previous renal surgery on the duration of fluoroscopy was considered, there was no statistically significant relation (p = 0.393. There was a statistically significant relationship between preoperatively calculated Hounsfield Unit values and the duration of fluoroscopy (p< 0.001. A statistically significant relationship was found between single insertion or multiple insertions and the duration of fluoroscopy (p<0.001. Discussion: In conclusion, it was observed in current study that size of the stone, radio-density or Hounsfield Unit of the stone, experience and number of insertions were related with the

  4. Neural Correlates of Stimulus Reportability

    OpenAIRE

    Hulme, Oliver J.; Friston, Karl F.; Zeki, Semir

    2009-01-01

    Most experiments on the “neural correlates of consciousness” employ stimulus reportability as an operational definition of what is consciously perceived. The interpretation of such experiments therefore depends critically on understanding the neural basis of stimulus reportability. Using a high volume of fMRI data, we investigated the neural correlates of stimulus reportability using a partial report object detection paradigm. Subjects were presented with a random array of circularly arranged...

  5. Symbolic processing in neural networks

    OpenAIRE

    Neto, João Pedro; Hava T Siegelmann; Costa,J.Félix

    2003-01-01

    In this paper we show that programming languages can be translated into recurrent (analog, rational weighted) neural nets. Implementation of programming languages in neural nets turns to be not only theoretical exciting, but has also some practical implications in the recent efforts to merge symbolic and sub symbolic computation. To be of some use, it should be carried in a context of bounded resources. Herein, we show how to use resource bounds to speed up computations over neural nets, thro...

  6. A neural network system for prediction of RNA polymerase II promoters

    Energy Technology Data Exchange (ETDEWEB)

    Matis, S.; Shah, M.; Mural, R.; Uberbacher, E.

    1994-12-31

    One of the most difficult problems in the analysis of eucaryotic genes is the detection of RNA polymerase II promoter regions. Although promoter regions vary in the primary DNA sequence, a basic group of core promoter elements has been suggested in the literature. Many human promoter sequences contain a TATAA sequence element at approximately 30 bases upstream of the cap site (transcription start site). Other elements are the GC box which binds SPA and upregulates transcription, the CAAT box, and the ATG initiator codon. To characterize promoters, we constructed frequency matrices for each element using experimentally mapped human promoter regions. Additionally, we constructed histograms for the distances separating the various elements. We then used a neural network to combine these informational elements. The output of the neural network is then processed using a set of expert rules which depend on GRAIL`s ability to find exons in anonymous DNA. This improves the selectivity of promoter detection and reduces the false positive rate.

  7. Flow version of statistical neurodynamics for oscillator neural networks

    Science.gov (United States)

    Uchiyama, Satoki

    2012-04-01

    We consider a neural network of Stuart-Landau oscillators as an associative memory. This oscillator network with N elements is a system of an N-dimensional differential equation, works as an attractor neural network, and is expected to have no Lyapunov functions. Therefore, the technique of equilibrium statistical physics is not applicable to the study of this system in the thermodynamic limit. However, the simplicity of this system allows us to extend statistical neurodynamics [S. Amari, K. Maginu, Neural Netw. 1 (1988) 63-73], which was originally developed to analyse the discrete time evolution of the Hopfield model, into the version for continuous time evolution. We have developed and attempted to apply this method in the analysis of the phase transition of our model network.

  8. Ultra Long Construct Minimally Invasive Spinal Stabilization Using Percutaneous Pedicle Screws in the Treatment of Symptomatic Multicentric Spinal Metastasis.

    Science.gov (United States)

    Lee, Chee Kean; Chan, Chris Yin Wei; Kwan, Mun Keong

    2015-12-01

    Managing multiple level spinal metastases is challenging. We report the case of a 58-year-old female with advanced lung cancer who presented with multiple pathological fractures of the thoracic spine (T5, T6, T7, and T8 vertebrae). She was treated with palliative radiotherapy. Her resting pain improved, but the instability pain persisted. One month later, she had a trivial fall leading to a pathological fracture of the L2 vertebra with cauda equine syndrome. The patient was treated surgically with minimally invasive decompression of the L2 and with percutaneous instrumented stabilization using an ultra-long construct from T3 to L5 (15 spinal levels), spanning the previously radiated zone and the decompression site. Postoperatively, she had significant improvements in pain and neurology. There were no surgical complications. Ultra long construct minimally invasive spinal stabilization is the ideal approach for symptomatic multicentric spinal metastasis with poor prognostic scores. Using this technique, the goals of spinal stabilization and direct neural decompression can be achieved with minimal morbidity.

  9. [Artificial neural networks in Neurosciences].

    Science.gov (United States)

    Porras Chavarino, Carmen; Salinas Martínez de Lecea, José María

    2011-11-01

    This article shows that artificial neural networks are used for confirming the relationships between physiological and cognitive changes. Specifically, we explore the influence of a decrease of neurotransmitters on the behaviour of old people in recognition tasks. This artificial neural network recognizes learned patterns. When we change the threshold of activation in some units, the artificial neural network simulates the experimental results of old people in recognition tasks. However, the main contributions of this paper are the design of an artificial neural network and its operation inspired by the nervous system and the way the inputs are coded and the process of orthogonalization of patterns.

  10. Neural Correlates of Face Detection

    National Research Council Canada - National Science Library

    Xu, Xiaokun; Biederman, Irving

    2014-01-01

    Although face detection likely played an essential adaptive role in our evolutionary past and in contemporary social interactions, there have been few rigorous studies investigating its neural correlates...

  11. Percutaneous Radiofrequency Ablation with Artificial Ascites for Hepatocellular Carcinoma in the Hepatic Dome: Initial Experience

    National Research Council Canada - National Science Library

    Rhim, Hyunchul; Lim, Hyo K; Kim, Young-sun; Choi, Dongil

    2008-01-01

    ...) in the hepatic dome. MATERIALS AND METHODS. Sonographically guided percutaneous radiofrequency ablation with artificial ascites was performed in 25 patients with 34 HCCs using an internally cooled electrode radiofrequency system...

  12. Percutane endoscopische gastrostomie bij psychomotorisch geretardeerde kinderen; minder klachten en weinig belastend

    NARCIS (Netherlands)

    Hulsbergen, M. H.; Bosman, D. K.; Mathus-Vliegen, E. M.; Aronson, D. C.; Derkx, H. H.; Taminiau, J. A.

    2000-01-01

    OBJECTIVE: To evaluate the effects of percutaneous endoscopic gastrostomy (PEG) in children with psychomotor retardation. DESIGN: Prospective. METHOD: Data on symptoms, pros and cons and complications were collected by means of questionnaires from the parents of children with psychomotor retardation

  13. Systematic review of ventricular peritoneal shunt and percutaneous endoscopic gastrostomy : a safe combination

    NARCIS (Netherlands)

    Oterdoom, Leendert H.; Oterdoom, D. L. Marinus; Ket, Johannes C. F.; van Dijk, J. Marc C.; Scholten, Pieter

    2017-01-01

    OBJECTIVE Various international and national gastrointestinal guidelines take different positions on whether ventriculoperitoneal shunt (VPS) insertion is a contraindication to percutaneous endoscopic gastrostomy (PEG). The objective of this meta - analysis was to try to answer the question of

  14. Systematic review of ventricular peritoneal shunt and percutaneous endoscopic gastrostomy : A safe combination

    NARCIS (Netherlands)

    Oterdoom, Leendert H; Oterdoom, D. L. Marinus; Ket, Johannes C F; van Dijk, J. Marc C.; Scholten, Pieter

    2017-01-01

    OBJECTIVE Various international and national gastrointestinal guidelines take different positions on whether ventriculoperitoneal shunt (VPS) insertion is a contraindication to percutaneous endoscopic gastrostomy (PEG). The objective of this meta-analysis was to try to answer the question of whether

  15. Percutaneous endoscopic gastrostomy. Clinical care of PEG tubes in older adults

    National Research Council Canada - National Science Library

    Roche, Vivyenne

    2003-01-01

    Percutaneous endoscopic gastrostomy (PEG) tube feeding is recommended by the American Gastroenterological Association as the preferred device to provide long-term enteral nutrition when oral intake is inadequate...

  16. Percutaneous tibial nerve stimulation as neuromodulative treatment of chronic pelvic pain.

    NARCIS (Netherlands)

    Balken, M.R. van; Vandoninck, V.; Messelink, B.J.; Vergunst, H.; Heesakkers, J.P.F.A.; Debruyne, F.M.J.; Bemelmans, B.L.H.

    2003-01-01

    PURPOSE: Neuromodulative therapies have been used with moderate success in patients with chronic pelvic pain. Intermittent Percutaneous Tibial Nerve Stimulation (PTNS) is a new, minimally invasive treatment option, which has shown to significantly decrease accompanying pain complaints in patients

  17. Innovative use of self-expanded polytetrafluoroethylene endoprosthesis for percutaneous endovascular interventions.

    Science.gov (United States)

    Maluenda, Gabriel; Waksman, Ron; Bernardo, Nelson L

    2013-03-01

    VIABAHN® endoprosthesis (Gore & Associates, Flagstaff, AZ), a nitinol self-expanding polytetrafluoroethylene (PTFE) lined stent, has demonstrated utility for percutaneous treatment of chronic occlusive disease involving the superficial femoral artery. In a case series communication we aimed to describe the feasibility of a PTFE-lined stent for percutaneous treatment of conditions other than chronic occlusive disease. We report the successful use of PTFE-endoprosthesis to percutaneously treat several vascular conditions, including arterio-venous fistula closure, reconstruction of a distal limb of an aorto-femoral endoprosthesis aneurysm, femoral artery perforation repair, and an exclusion of large saphenous vein graft aorto-coronary bypass aneurysm. This case series illustrates the feasibility of the "off-label" use of self-expanded PTFE endoprosthesis to percutaneously treat several conditions, which would otherwise require "open" surgical reconstructions. Copyright © 2011 Wiley Periodicals, Inc.

  18. Short- and long-term functional effects of percutaneous transluminal angioplasty in hemodialysis vascular access

    NARCIS (Netherlands)

    J. van der Linden (Joke); J.H. Smits (Johannes); J.H. Assink (Jan Hendrik); D.W. Wolterbeek (Derk); J.J. Zijlstra (Jan); G.H.T. de Jong (Gijs); M.A. van den Dorpel (Marinus); P.J. Blankestijn (Peter)

    2002-01-01

    textabstractThe efficacy of percutaneous transluminal angioplasty (PTA) is usually expressed as the angiographic result. Access flow (Qa) measurements offer a means to quantify the functional effects. This study was performed to evaluate the short-term functional and

  19. Analysis and comparison of changing in thyroid hormones after percutaneous and surgical tracheotomy.

    Science.gov (United States)

    Esen, Erkan; Karaman, Murat; Deveci, Ildem; Tatlıpınar, Arzu; Tuncel, Arzu; Sheidaei, Shahrouz; Esen, Senem

    2012-12-01

    To evaluate the effect of the surgical and percutaneous tracheotomy on the thyroid hormones and their comparisons. Between January and May 2010, the surgical and percutaneous tracheotomy had been performed on 40 patients with respiration problems. The thyroid hormone levels were measured just before, after one and three hour of the operation and than these measurements were compared statistically. The effect of the surgical and percutaneous tracheotomy on serum thyroglobulin (TG), free thyroxine (fT4), free triiodothyronine (fT3) and thyroid stimulating hormone (TSH) levels was found statistically significant. The surgeons should not forget the possible increase of the serum thyroid hormone levels after the surgical and percutaneous tracheotomy because of the systemic effects of thyroid hormones. The patients, especially who have cardiac rhythm problems, should be monitored for a while after these processes because the increase of serum thyroid hormones may cause undesired cardiovascular effects. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  20. Percutaneous tracheostomy with the guide wire dilating forceps technique: presentation of 171 consecutive patients.

    NARCIS (Netherlands)

    Fikkers, B.G.; Heerbeek, N. van; Krabbe, P.F.M.; Marres, H.A.M.; Hoogen, F.J.A. van den

    2002-01-01

    BACKGROUND: Evaluation of percutaneous tracheostomy (PT) with the guide wire dilating forceps (GWDF) technique. METHODS: Prospective study of perioperative complications, retrospective analysis of early and late complications in an ICU in a teaching university hospital. RESULTS: The success rate of